What is Claustrophobia (Fear of Small Spaces)?
A phobia is an intense fear that can seriously interfere with a person’s daily life. This could be seen in their avoidance of the object or situation that they fear. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes several types of anxiety disorders such as separation anxiety, social anxiety, panic disorder, generalized anxiety disorder, selective mutism, and specific phobias. Specific phobias are intense fears related to certain activities, people, objects, or situations.
Claustrophobia, for example, is a type of specific phobia where people fear enclosed spaces, like engine rooms, tiny or locked rooms, basements, tunnels, elevators, MRI machines, subway trains, and crowded places. Generally, people with specific phobias avoid the object or situation that they fear. The fear could lead to feelings of danger, disgust, or physical symptoms. It can be distressing, but most people find ways to manage by avoiding small or enclosed places. People might react similarly to all triggers related to their fear. For example, the fear of being trapped, such as in a long line or in a dentist’s chair, is also considered a sign of claustrophobia.
People who are claustrophobic are not necessarily afraid of enclosed spaces themselves, but more of what could happen within these spaces. It’s similar to agoraphobia, or the fear of having a panic attack in public. Claustrophobia can be seen in the same light – as a fear of being trapped. Most enclosed spaces come with some degree of feeling trapped and restricted. This can make people, and animals too, feel vulnerable when confined. For example, animals can easily develop distress when put in a confined environment.
Claustrophobic people are also often afraid of suffocating. This intense fear is common among them and is seen as a serious threat. Many claustrophobic individuals feel that they can’t breathe when they’re in tight spaces, bringing a sensation of shorts of breath.
What Causes Claustrophobia (Fear of Small Spaces)?
Social anxiety disorder is a mental health condition defined by the DSM-V, a manual for mental health disorders, that involves a powerful fear of social situations and scrutiny. Similarly, people with claustrophobia feel a significant fear and anxiety being in closed spaces. It is believed that for individuals with social anxiety disorder, certain areas in the front of the brain are unable to control a part of the brain called the amygdala, which tends to be overactive. This imbalance is also present in those suffering from claustrophobia.
Studies have looked at the brain’s reaction to fear-producing situations in people with specific fears. They found that areas such as the globus pallidus, amygdala, and left insula became more active when faced with fear.
There are two fear-related processes linked to deep-seated pathological fear: fear sensitization and failure of fear habituation. Fear sensitization is when the amygdala becomes more responsive to fear. On the other hand, fear habituation is about becoming less emotionally responsive after experiencing repeated stimuli, but in this process, the amygdala becomes less habituated or less used to stimuli.
Recently, researchers have discovered a potential genetic link to claustrophobia. A defect in the GPM6A gene, which can be found in the amygdala and throughout the central nervous system, could mean a higher risk of developing claustrophobia. This gene produces a specific neuronal protein that deals with stress, and is found on a particular chromosome connected with panic disorder.
Risk Factors and Frequency for Claustrophobia (Fear of Small Spaces)
Claustrophobia, or the fear of enclosed spaces, affects a noticeable portion of the population. At some point in their life, between 7.7% and 12.5% of people will experience it. Women tend to experience specific phobias, like claustrophobia, more often.
- By the age of 16, approximately 1 in 10 people will have experienced an anxiety disorder.
- In medical settings, claustrophobia can be particularly noticeable. Studies have shown that between 1% and 15% of people undergoing MRI scans experience claustrophobia, with an average rate of 2.3%.
- Because of their claustrophobia, some people need to be sedated for their MRI scan or might not be able to have the scan at all.
Signs and Symptoms of Claustrophobia (Fear of Small Spaces)
Patients suffering from specific phobias, like claustrophobia, commonly experience both physical and emotional symptoms. Healthcare professionals use these symptoms, along with specialized screening tools, to diagnose the condition.
For claustrophobia, physical symptoms can range from trouble breathing, trembling, and sweating, to rapid heartbeat, dry mouth, and chest pain. In terms of emotional symptoms, individuals may undergo intense anxiety or fear, feel like they’re losing control, have a strong desire to escape the situation, and finally, they might recognize their fear as illogical but struggle to overcome it.
These individuals often fear being in small, confined spaces, which can induce a sense of inadequate oxygen or feeling restricted. The thought of or actual confinement may trigger fear of insufficient breathing, depleting oxygen, and being limited or trapped. If anxiety levels get too high, further symptoms may develop:
- Sweating and chills
- Increased heart rate and high blood pressure
- Dizziness and lightheadedness
- Dry mouth
- Hyperventilation
- Hot flashes
- Nausea
- Headache
- Numbness
- A choking sensation
- Chest tightness or pain and difficulty in breathing
- An urge to urinate
- Confusion
However, it’s important to bear in mind that not every person with claustrophobia will exhibit all these symptoms, as the condition varies from person to person.
Testing for Claustrophobia (Fear of Small Spaces)
When trying to evaluate if someone has claustrophobia, a significant fear, doctors will typically start by conducting an interview to learn more about a patient’s experience with fear. They will want to find out whether the fear is related to a specific phobia, a normal level of fear, a general medical condition, or a broader anxiety disorder.
The doctor will ask questions about how the fear affects the person’s development, daily life, and family dynamics. This information helps them distinguish between anxiety and phobias. For instance, in the case of children, the doctor might ask how the child’s parents respond to their fear, whether the child or parent can remember what triggers the anxiety, and if there are disruptions in the child’s daily routines that occur more than three times a day.
There are also questionnaires that can help evaluate whether someone has claustrophobia. One test, called the Spielberger psychology questionnaire, has 20 items that measure the person’s level of anxiety, with scores ranging from 20 to 80.
Furthermore, there are three different scales commonly used when trying to assess symptoms of anxiety and fear in younger age groups: The Revised Children’s Manifest Scale, the Fear Survey Schedule for Children-Revised, and the State-Trait Anxiety Inventory for Children. These tools help professionals understand and measure the level of fear or anxiety a child might be experiencing.
Treatment Options for Claustrophobia (Fear of Small Spaces)
The primary way to manage claustrophobia, or fear of enclosed spaces, is through cognitive behavioral therapy. This approach allows people to discuss and understand their distorted fears and negative thoughts.
One specific method used in therapy is called interoceptive exposure. In this process, the patient is introduced to the physical feelings of anxiety, but within a controlled situation. This technique may be more effective for individuals mainly afraid of internal outcomes related to anxiety. However, it might be less effective for those worried about external factors.
Virtual reality (VR) technology is also becoming a popular tool for managing claustrophobia. Using a stimulating computer-generated environment can be helpful, particularly for simulating scenarios that trigger claustrophobia, like being in an elevator or undergoing an MRI scan. Despite various treatments for fear disorders, only around 40% of patients experience long-term benefits, and complete recovery is not always accomplished.
Medication can also be used to treat claustrophobia. The choices include benzodiazepines, selective serotonin reuptake inhibitors, and other medicines that are still being researched. Benzodiazepines are often used for patients who must confront their phobia occasionally. Medicines like escitalopram, paroxetine, and hydrocortisone have been studied for their effectiveness. In particular, hydrocortisone, a type of steroid hormone, may boost the effectiveness of cognitive-behavioral therapy when taken orally at certain doses.
What else can Claustrophobia (Fear of Small Spaces) be?
A survey of 9,282 American adults found that having a specific phobia may be related to the occurrence of other mental health conditions. These conditions include post-traumatic stress disorder (PTSD), social phobia, bipolar disorder, generalized anxiety disorder, alcohol addiction, separation anxiety disorder, and major depressive disorder.
PTSD is a disorder that could be present alongside a specific phobia. The main characteristic of PTSD is that it usually happens after a person experiences a traumatic event. However, it’s worth noting that a specific phobia doesn’t always occur as a result of a traumatic event. This means that someone can have a phobia without having experienced a related traumatic incident.
What to expect with Claustrophobia (Fear of Small Spaces)
People who suffer from claustrophobia usually have a persistent anxiety disorder, which can lead to other mental health issues. Research has indicated that teenagers who have more phobias tend to experience these fears earlier on. This same research found that individuals who experience specific fears related to certain situations or blood-injection-injury are most likely to show signs of encumbrance and seriousness.
Furthermore, those experiencing natural environment phobias appear to have more social difficulties and high symptoms of depression and anxiety, compared to those who are just fearful of animals.
Possible Complications When Diagnosed with Claustrophobia (Fear of Small Spaces)
Once a person is diagnosed with a specific phobia, there’s a high chance, about 83%, that they might have other specific phobias as well. However, having claustrophobia alone typically doesn’t lead to thoughts of self-injuries or suicide. Though in rare instances, when combined with other mental health conditions like depression or anxiety, claustrophobia may lead to suicidal thoughts.
For people needing MRI scans for diagnosis or treatment, claustrophobia can be a significant hurdle, as their fear may prevent them from undergoing the procedure, even with extra assistance. Similarly, claustrophobia can negatively impact a person’s social life. Fear of enclosed spaces like elevators, changing rooms, or subways could trigger a panic attack, resulting in a sudden dip in their mental well-being.
Preventing Claustrophobia (Fear of Small Spaces)
It’s important for people to be educated about the symptoms and signs of claustrophobia – a fear of enclosed spaces. By understanding what claustrophobia is and where their anxiety is coming from, they can seek the appropriate help and manage their fears better.
Additionally, teaching individuals how to manage their own stress or anxiety when they start to feel a claustrophobic attack can be useful. Staying away from triggers as much as possible can also help maintain a balanced life. Finally, people should be made aware of the different treatment options so they can make an informed decision about what might work best for them.