Meaning
Claustrophobia is a type of specific phobia. Specific phobias are classified as anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A specific phobia is an intense and irrational fear of a specific object or situation that is out of proportion to the actual danger posed. The fear and avoidance causes significant distress or impairment.
For someone with claustrophobia, this means experiencing intense and irrational fear in a confined or crowded situation that is, otherwise, safe.
If you have claustrophobia, know that you are not alone. Approximately 7.4% of people will experience a specific phobia such as claustrophobia in their lifetime.
Anyone of any age can develop claustrophobia, but there are some factors that will heighten your risk. Specific phobias, including claustrophobia, are more common in women. A 1987 study of 40 people with claustrophobia identified 20 years as the average age of onset, but more research is required to confirm that.
Symptoms
Claustrophobia symptoms overlap with other anxiety disorder symptoms. However, the key is that claustrophobia symptoms are triggered by exposure to a crowded, enclosed, or confined situation.
Locked room Magnetic resonance imaging (MRI) Crowded elevator Windowless room Car wash Road tunnel Public bathroom Revolving doors Airplanes
Claustrophobia symptoms include:
Difficulty breathingTremblingSweatingTachycardiaDry mouthChest painExcessive and overwhelming fear and anxietyFear of losing controlIntense desire to escape
People with claustrophobia typically understand that their response is irrational, but feel unable to control their reaction. They may begin to avoid situations that they believe trigger their claustrophobia, which might mean refusing to drive, fly in an airplane, use a public restroom, ride in an elevator, or countless other triggers.
Over time, this avoidance, in addition to the physical and emotional symptoms, can have a significant impairment of daily life.
Causes
Scientists are unsure of the exact causes of claustrophobia, which likely differ from person to person. There are, however, a few theories on the causes of specific phobias, and claustrophobia in particular.
Childhood Trauma
Mental health professionals believe that environmental factors, such as childhood trauma, can contribute to the development of claustrophobia. This could include experiences like being trapped in a confined space, bullying, or abuse.
Near Space Perception
Claustrophobia may also be caused by perceptual differences in near space, which you might think of as your “personal space” or “personal bubble.” A 2011 study found that people with larger near spaces reported higher rates of claustrophobia. This is likely related to the defensive function of near space.
Genetics
There also may be a genetic cause behind claustrophobia. A 2013 study found that a mutation of the GPM6A gene is more frequent in individuals with claustrophobia.
Diagnosis
Claustrophobia can be diagnosed by a primary care healthcare provider or through a referral to a mental health professional such as a psychiatrist.
To diagnose claustrophobia, your healthcare provider will ask you questions about your symptoms and your history. These questions can help identify or rule out related disorders such as social anxiety disorder, post-traumatic stress disorder, or panic disorder.
There are no physical or laboratory tests for claustrophobia, but your healthcare provider might administer standardized evaluations and questionnaires. These could include the Claustrophobia Scale, or the Claustrophobia Questionnaire (CLQ).
To be diagnosed with claustrophobia, your healthcare provider must find that you meet the DSM-5 standards for specific phobia.
Treatment
It is important to seek treatment for claustrophobia in order to get back to living your life to its fullest. Treatment methods might include psychotherapy, medication, exposure therapy, virtual reality, and alternative therapies.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a central treatment of claustrophobia and other specific phobias and anxiety disorders. In CBT, you are taught to become aware of your thoughts and reactions, and positively change your behaviors.
A 2001 randomized controlled trial found that five sessions of CBT was effective at clinically improving claustrophobia symptoms, and that benefits were maintained at the one year mark. A 2008 case study found that CBT helped a claustrophobic patient with cancer better cope with claustrophobic situations such as MRI and radiography.
Medication
In addition to CBT, medication is a treatment option for claustrophobia. Your healthcare provider might recommend anxiety medications, such as benzodiazepines or selective serotonin reuptake inhibitors (SSRIs), such as Paxil (paroxetine) or Lexapro (escitalopram).
Exposure Therapy
Exposure therapy is a common treatment for specific phobias like claustrophobia. In exposure therapy, you are exposed to the triggering stimulus, which for those with claustrophobia would be a confined, enclosed situation.
Through gradually confronting the frightening stimulus with therapeutic support instead of avoiding it, you learn coping mechanisms. Through exposure, the brain may actually rewire fear pathways. A 2007 study found that exposure therapy normalized the over-activation in the amygdala among participants with specific phobias.
A randomized controlled trial found that not only was exposure therapy effective at clinically improving claustrophobia, but it was comparable to CBT (80% exposure therapy group clinical improvement compared to 79% CBT group).
Virtual Reality
Virtual reality (VR) is another way to engage in exposure therapy for claustrophobia. VR involves using a computer-generated environment to simulate a claustrophobia situation. One example is the “Claustrophobia Game,” developed and studied in 2018, which has both MRI and elevator scenarios.
Research does support the use of virtual reality in treating claustrophobia, although more research is needed. A 2000 study of four participants with claustrophobia found that after eight VR exposure sessions, all participants had reduced fear, reduced avoidance, and improved self-efficacy in claustrophobia situations.
Hypnosis
Hypnosis may be an effective alternative treatment for claustrophobia although it has not been widely studied.
Among people with claustrophobia, hypnosis has largely been studied in relation to MRIs. MRI (Magnetic Resonance Imaging) is performed in a long, enclosed tube that induces claustrophobia in many people. Avoiding MRI use can have negative health consequences.
A 1990 study found that medical hypnosis enabled 10 patients with claustrophobia to complete an MRI procedure. A 1999 case study also found that hypnosis enabled a patient to complete an MRI procedure without claustrophobia.
A Word From Verywell
If you only experience symptoms when exposed to a claustrophobic situation, like a crowded elevator or closet, then you might think the easiest solution is to avoid those triggers. Unfortunately, avoidance can have a profound negative impact on your life, and prolonged avoidance can actually worsen symptoms.
By avoiding claustrophobic situations, you might quit driving or riding public transport, or refuse to fly. You might also find it distressing or refuse to undergo important medical procedures like MRIs. Avoiding these situations can limit your life and impact your health.
Know that many people experience a phobia during their lifetime. Treatment is available for claustrophobia. If your symptoms are impacting your daily life, talk to your healthcare provider about options.
