Claustrophobia is an anxiety disorder in which the sufferer has an irrational fear of having no escape or being closed-in. It frequently results in a panic attack and can be triggered by certain stimuli or situations, such as being in a crowded elevator, a small room without any windows, or being in an airplane. Some patients with claustrophobia find their anxiety levels rise when they wear tight-necked clothing.
Contents of this article:
What is claustrophobia?
The word claustrophobia comes from the Latin word claustrum which means "a shut in place" and Greek phobos meaning "fear".
Claustrophobia sufferers will commonly try to avoid being in enclosed spaces such as elevators.
People with claustrophobia can find the disorder hard to live with, as they will go to great lengths to avoid small spaces and situations that trigger their panic and anxiety. They will avoid certain places like the subway/underground and will prefer to take the stairs over using a lift/elevator no matter how many floors they need to ascend/descend.
According to the book "Phobias: A Handbook of Theory, Research and Treatment"4, published by Wiley, between 15% and 37% of people worldwide are affected by claustrophobia. Even though many of them have severe symptoms, a very small percentage ever receive some kind of treatment for the disorder.
The National Health Service5, UK, says that claustrophobia affects about 10% of the UK population.
Signs and symptoms of claustrophobia
A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.According to the NYU Langone Medical Center6, claustrophobia typically develops during the individual's childhood or teenage years.
Claustrophobia is an anxiety disorder. An afflicted person has symptoms of anxiety that are triggered by being in a confined space, or the thought of it. The sufferer dreads not being able to breathe properly, running out of oxygen, along with distress at being restricted.
When anxiety levels reach a certain level, the following physical signs of claustrophobia are possible:
- Accelerated heart rate
- Increased blood pressure
- Dry mouth
- Hyperventilation, or 'over-breathing'
- Hot flashes (UK: hot flushes)
- Shaking or trembling
- Butterflies in your tummy
- Panic attacks
- Fear of actual harm or illness
- Chocking sensation
- Tightness in the chest, sometimes chest pain
- An urge to go to the toilet
- Confusion and/or disorientation.
It is not necessarily the small spaces that trigger the anxiety but the fear of what can happen to the person if confined to that area, hence the fear of running out of oxygen. Examples of small spaces that could trigger anxiety are:
- shop changing rooms
- subway trains (UK: tube/underground trains)
- small rooms
- hotel rooms with windows that do not open
- revolving doors
- public toilets
- locked rooms
- cars - especially if they have central locking
- crowded areas
- automatic car-washes
- some medical devices, such as MRI (magnetic resonance imaging) scanners.
As claustrophobia is also defined by the phobia of being restricted, being confined to one area can also trigger the anxiety, for example, having to wait in line at a checkout/cash register).
As the above situations can trigger severe anxiety and panic attacks in people with claustrophobia, they will try their best to avoid them.
The Government of Victoria1 in Australia gives the following examples how people with claustrophobia may behave or react:
- As soon as they enter a room they may urgently check out where the exits are and position themselves near them. When all the doors are closed they may feel more anxious.
- In a crowded party, even if the venue is a large and spacious room, they will try to position themselves near the door.
- Avoid driving during peak times, when traffic is likely to be congested
- Avoid traveling as a passenger in a car during the rush hour
- In severe cases, some individuals with claustrophobia may panic when a door is closed
- Avoid using elevators and use the stairs, even if this means getting tired, out of breath and sweating a lot.
What causes claustrophobia?
Claustrophobia is generally the result of an experience in the person's past (usually in their childhood) that has led them to associate small spaces with the feeling of panic or being in imminent danger. Examples of these kinds of past experiences are:
- falling into a deep pool and not being able to swim
- being in a crowded area and getting separated from parents/group
- crawling into a hole and getting lost/stuck.
As the experience will have dealt some kind of trauma to the person, it will affect their ability to cope with a similar situation rationally. The mind links the small space/confined area to the feeling of being in danger and the body then reacts accordingly (or how it thinks it should).
This type of cause is known as classic conditioning and can also be a behavior inherited from parents or peers. If for example, a claustrophobic person has a child, the child may observe their parent's behavior and develop the same fears.
There are other theories behind the causes of claustrophobia, these are:
- Smaller Amygdalae - the amygdala (plural: amygdalae) is a tiny part of the brain that is used to control how the body processes fear.
In a study published in Psychiatry and Clinical Neurosciences7, Fumi Hayano and colleagues discovered that people who suffered panic disorders had smaller amygdalae than average.
This smaller size could interfere with how the body processes panic and anxiety.
- Prepared Phobia - there is also a theory that phobias develop on the genetic level rather than psychologically. The research behind this theory suggests that claustrophobia and some other phobias are dormant evolutionary survival mechanisms. A survival instinct buried within our genetic code that was once crucial to human survival but is no longer needed.
A team from Germany and the United Kingdom wrote in the journal Translational Psychiatry2 that a single gene defect probably contributes to the development of claustrophobia.
The amygdalae (red areas) were found to be smaller in people with panic disorders.
Image credit: Life Science Databases.
On the next page we look at how claustrophobia is diagnosed and the treatment options for claustrophobia.