Claustrophobia (Fear of Small Spaces) : Symptoms, Causes, Diagnosis and Treatment

Have you felt the sensation of being suffocated in enclosed spaces like elevators and crowded places? This feeling of fear, when it goes beyond rational is called Claustrophobia. Claustrophobia, by definition, is an intense fear of enclosed spaces.

Claustrophobia is triggered when you find yourself in places like elevators, a space with no windows, overly crowded trains.

You might have heard of this term often in your daily conversations. It is because claustrophobia is one of the most common phobias out there. Although claustrophobia is not one of the panic disorders, people often feel panicked when they find themselves in enclosed spaces.

Usually, people get rid of this phobia over time as they grow. But a few of them might require professional help/therapy to cope with the symptoms.

As mentioned above, claustrophobia can vary from person to person. For a few it can be mild nervousness or little anxiety, for others, it can be a full-blown panic attack. Symptoms of this phobia are triggered in certain situations, such as being in an enclosed space or a crowded room.

The symptoms might include:

• Shortness of breath
• Excessive Sweating
• Trembling
• Dizziness
• Nausea
• A sensation of fear or panic
• Dry mouth
• Feeling confused
• Hot flashes
• Suffocation
• Headache
• Hyperventilation
• Choking Sensation
• Urge to urinate

If you’re claustrophobic, some symptoms can go severe and mild also:

• Automatically look for exits in each space you enter
• Avoid triggering situations, such as riding in elevators, subways, elevators or airplanes or in cars during heavy traffic.
• Standing near or directly by the exits in a crowded place
• Feel scared that the doors will shut while you’re in a room.

Some situations may trigger Claustrophobia:

• Standing in closet
• Undergoing MRI or CT scan
• Standing in crowded room
• Riding in an airplane or car
• Being in a packed elevator
• Being in small room without windows
• Car washes
• Caves or crawl spaces
• Tunnels
• Public restrooms

Claustrophobia is a type of what they call ‘specific phobia’. Specific phobias are the phobias where the fear of the individual is related to an object, a particular person or an activity.

If you’re one of these specific phobias, chances are that this part of your brain - amygdala is more sensitive. Amygdala is the base of your brain and is responsible for responses to fear.

Other causes of Claustrophobia:

1. Your genes may be responsible for this. You heard it right, researchers have found that defect in a specific gene called GPM6A can cause this. That means if one of your parents are claustrophobic, chances are that you might be on too.
2. The fear of enclosed spaces can be related to a traumatic event that you might have faced in childhood. It can be: bullying, being stuck in a tight place, physical or mental abuse.
3. If you’re a person with anxiety or depression, you might respond to the enclosed places with a fear.

Do not wait for your symptoms to be persistent. Claustrophobic people can be helped easily in the earlier stages. But if not acted upon it earlier, it can be overwhelming.

During the diagnosis, your mental health expert might ask a few questions about any history of excessive fears to rule out other medical possibilities. You doctor might ask you a few questions to figure out if you meet all the criteria, like :

• That this is not related to another type of disorder. People sometimes confuse Claustrophobia with Cleithrophobia (fear of being trapped)
• Whether it is a result of any traumatic event
• The phobia is continuous and has been there for more than 6 months
• In a few cases, these symptoms can be a result of other underlying mental conditions like OCD ( Obsessive-compulsive Disorder)
• If it is a response to any environmental change

Claustrophobia is generally treated using the psychotherapy method. Apart from that, you might be in need of various therapy sessions in order to control your fears and triggers. Your doctor might also suggest a few medications to control the symptoms after the trigger.

The treatments of claustrophobia include:

1. Cognitive behavioural therapy (CBT): This therapy is used to control and alter the negative thoughts that you might get related to your fears with enclosed spaces.
2. Interoceptive exposure: This method tries to create fears of the patient in a controlled environment in order to give them a less intense experience to modify their response to the same situation.
3. Medication: In order to help you with your physical symptoms and panic situations during the trigger, your doctor might suggest a few antidepressants or anti-anxiety medications. The medication will be normally coupled with the therapy. Medication can only help you with symptoms but it’s never a solution.
4. Visualisation therapy: Visualisation therapy is usually combined with exposure therapy. The doctor advised a few methods to control the symptoms during the episodes, for example: visualising a safe place.

Many doctors or health professionals can offer much more than medication to help reduce your irrational reaction. The doctors can guide through the visualization technique and some other relaxation techniques to relax and can help you prevent a possible panic attack. Check with your doctor about new relaxing skills before your trip, as some exercises take several days.

Eye Movement Desensitization and Reprocessing (EMDR): It is a treatment modality that is somewhat effective for treating phobias associated with past trauma. This therapeutic intervention assists people in sorting out negativity thoughts and emotions that may come with past trauma. Doctors will assist an individual to focus on their inner experience of trauma while visually following an outer stimulus.

Systematic desensitization: This is another technique which involves relaxation and visualization to decrease anxiety. In this technique, individuals are instructed to use relaxation and visualization techniques while experiencing anxiety related to phobia. A person is encouraged to focus on methods of physical and mental relaxation while being exposed to a trigger, with the idea that a person can overcome their fear.

Try to travel with your friend or relative or any close family members. So that person can talk you down, help you work through a relaxation exercise, or simply keep you distracted during the trip.

The person suffering from claustrophobia can impact travel in a variety of ways. With some prior planning, however, as such, there is no reason that your claustrophobia should prevent you from seeing the world.

Managing Claustrophobic person without the guidance of a doctor can be highly intense and distressing and could lead to co-occurring substance abuse. The person may attempt to self-medicate with alcohol and drugs in attempts to alleviate physiological and emotional distress.

Co-occurring substances only lead to exacerbate the symptoms of claustrophobia. There are various side effects associated with drinking or drug abuse that could amplify physiological symptoms.

Drug and alcohol abuse alter brain chemistry by reducing the levels of neurotransmitters that cause mood disorders. Alcohol and drugs can also negatively impact physical health and cause isolation, making it harder to cope and obtain help.

Most of the time claustrophobic people try to avoid crowded places or enclosed spaces. But in order to carry out the daily activities, it is not as feasible as you might think. Sometimes they find themselves in a few unavoidable situations. We understand that it can be as scary as anything, here a few tips to help you with such situations:

• Take deep and slow breaths.
• Count to three or four slowly with each breath.
• Try to remember a good incident or experience you have had recently.
• It might be a little hard but make yourself believe that this moment will pass soon and the fear is irrational.

We know it might be harder than we are making it sound here. But with a little will power and strong mental strength, you can at least make it a little easier on yourself.

The intensity of Claustrophobia can vary from person to person; some people might feel claustrophobic in a big room with no windows. The others might feel it in a super enclosed box or inside an MRI machine.

People with claustrophobia can have an extreme fear; they can be afraid of a closed room with no windows, a group of people can suffocate them and there are times one can fear even travelling in cars or trains. Fortunately, claustrophobia is a treatable condition with a high recovery rate.