What is Claustrophobia? What Causes Claustrophobia?

Claustrophobia is an anxiety disorder; the sufferer has an irrational fear of having no escape or being closed-in. It frequently results in panic attack and can be triggered by certain stimuli or situations, such as being in a crowded elevator, a room without windows, or sitting in an airplane. Some people may even experience claustrophobia when wearing tight-necked clothing.

The word claustrophobia originates from Latin claustrum which means "a shut in place" and Greek phobos, which means "fear". Research has shown that approximately 6% of people suffer the disorder worldwide, but the majority are not receiving treatment for it.

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 Medilexicon's medical dictionary claustrophobia is:

"A morbid fear of being in a confined place."

What are the 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.

A claustrophobic may suffer symptoms similar to anxiety that are triggered by being in a small space. The phobia of the small space is based on the fear of running out of oxygen along with the fear of restriction. When in an small confined space, someone with claustrophobia may start to show the following symptoms:

• Sweating
• Accelerated heart rate
• Increased blood pressure
• Hyperventilation, or 'over-breathing'
• Shaking
• Sweating
• Panic attacks
• Light-headedness
• Nausea
• Fainting
• Fear of actual harm or illness

It is not essentially 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 a claustrophobic's anxiety are:

• elevators/lifts
• basements/cellars
• small rooms
• airplanes
• locked rooms
• cars
• trains
• crowded areas

As claustrophobia is also defined by the phobia of being restricted, being confined to one area can also trigger the anxiety (e.g. having to wait in line at a checkout/cash register). There have also been studies to support the theory that MRI machines can cause claustrophobia, due to the prolonged length of time spent in a confined space with restricted movement.

As the above situations can cause a claustrophobic to suffer anxiety and panic attacks, a claustrophobic will try their best to avoid them. The following are examples of how a claustrophobic may behave:

• 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 troubled.
• In a crowded party, even if the venue is a large and spacious room, they will position themselves near the door.
• Avoid driving during peak times, when traffic is likely to be congested
• Avoid travelling as a passenger in a car during peak traffic times
• 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 deal 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 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 Amygdala - the amygdala is a tiny part of the brain that is used to control how the body processes fear. During a study, Fumi Hayano discovered that people who suffered panic disorders had a smaller amygdale 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.

How is Claustrophobia Diagnosed?

Claustrophobia would be diagnosed as a result of seeing a psychologist. The patient may be seeing the psychologist because they suffer the symptoms of claustrophobia, or they could be originally seeing them about another anxiety problem or phobia.

The psychologist would ask for a description of the symptoms and what triggers them. Using their knowledge and resources, the psychologist would then determine the type and severity of the patient's phobia.

There are methods put in place to help decide if the patient is suffering claustrophobia and to what extent. These methods are:

• Claustrophobia questionnaire - Originally developed in 1993 and modified in 2001 this has been a helpful way of identifying the symptoms of claustrophobia.
• Claustrophobia Scale - Developed in 1979, this method is made up of 20 questions that when answered can help establish the levels of anxiety when diagnosing the claustrophobia.

How is Claustrophobia Treated?

After diagnosis has been made, the psychologist would try one or a few of the following methods to help the claustrophobic deal with their fear:

• CBT (Cognitive Behavioral Therapy) - This is a well recognized treatment method for many other types of anxiety disorder. The goal of CBT is to retrain the claustrophobic's brain to no longer feel threatened by the places they fear. An approach taken may be slowly exposing the patient to small spaces and helping them deal with their fear and anxiety (in vivo exposure). This is the most common way claustrophobia is treated.
• Drug Therapy - This type of therapy can help manage the anxiety symptoms, however it does not deal with the problem itself. This along with the undesired side effects makes this method far from first choice for treating claustrophobia.
• Relaxation Exercises - Taking deep breaths, meditating and doing muscle relaxing exercises are effective at dealing with negative thoughts and anxiety.
• Alternative/Natural medicine - There are some natural products and homeopathic medicines that some patients say help them manage panic and anxiety.