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What is Claustrophobia? Symptoms, Causes, and Treatment for the Fear of Confined Spaces

Claustrophobia is something that everyone can relate to. Whether it’s a tightly packed train, a caving expedition or a fever dream of being buried alive, a fear of confined spaces is a universal human experience.Of course, not everyone experiences claustrophobia to the same degree. If you’ve ever had a rush-hour commute, you’ve likely been sardine-packed onto an underground train. Maybe you’ve been caving or simply watched adrenaline-filled documentaries about underground drama without breaking a sweat.


So while feeling claustrophobic is a part of most people’s vocabulary — often as a synonym or metaphor for feeling trapped — not everyone suffers from claustrophobia itself. As we’ll see, there’s a big difference between disliking small spaces and suffering from an anxiety disorder. So let’s go down the rabbit hole (sorry) of claustrophobia, and find out exactly when a fear of confined spaces becomes a full-blown phobia.



What is Claustrophobia?


Claustrophobia is an anxiety disorder characterized by the irrational fear of small, enclosed or confined spaces: the word claustrophobia comes from the Latin word claustrum meaning a confined space and phobia, meaning fear.


There is a rational basis for the fear of confined space: it makes us feel trapped, there could be situations underground where there is limited oxygen, and it’s generally uncomfortable to be in a confined space. The ubiquity of this feeling is demonstrated in the number of horror movies themed around claustrophobia: Oxygen, The Descent, Buried, and The Cave, to name but a few.


When Does a Fear Become a Phobia?


Despite claustrophobia being a relatable feeling, phobias are identified by intense and irrational feelings. If your heart starts racing watching a movie called Oxygen, you’re reacting rationally to a movie designed to arouse your fear. If you quit your job to avoid your morning commute, then your fear of tight spaces is more intense and the anxiety you feel is impacting your life.


Almost everyone recognises the fear of enclosed spaces, but only around 10% to 12.5% of people experience true claustrophobia.


If you’re living with claustrophobia, you may have normalized your behaviour, making it difficult to identify that a phobia is negatively impacting your life. Let’s take a look at the common symptoms of claustrophobia: recognising your condition is the first step to getting help.


Symptoms of Claustrophobia


Many people are uncomfortable with enclosed spaces. But what are the stand-out symptoms of claustrophobia? Before we look at the physical and emotional hallmarks of a phobia, it’s important to recognise that your fear is impacting your life.


Changing your behaviour to avoid situations that spark your anxiety is a major symptom of claustrophobia. Do you avoid travel because buses and aeroplanes make you uncomfortable? Do you always take the stairs because elevators make you panicky?

Alongside these changes in behaviour are the common following symptoms:


Physical symptoms

  • Flushed hot or feeling chills

  • Sweating 

  • Tightness in your chest

  • Elevated heart rate

  • Trouble breathing or hyperventilating

  • Nausea

  • Dizziness

  • Dry mouth.


Feelings that accompany claustrophobia: 

  • Confusion or disorientaton

  • Overwhelming anxiety or feelings of dread

  • An intense desire to get away

  • Fear of dying.


These feelings may be accompanied by the knowledge that your fear is irrational and your emotional reaction is disproportionate, but you are unable to control your response.


What Causes Claustrophobia?


Around one in ten people experience anxiety in confined spaces, making claustrophobia one of the most common phobias. There’s a rational basis for this fear, but a disproportionate response means you have a phobia. But why do so many people have claustrophobia?


  • Trauma or triggering experience: An early childhood experience or profoundly traumatic event can cause claustrophobia. A stuck elevator, a locked cupboard door or a panic attack on a crowded train leaves a powerful impression on the mind and a residual anxiety around enclosed spaces.


  • Learned behaviour: Claustrophobia can also be learned behaviour, caused by exposure to other peoples’ fear of confined spaces, particularly as a child. If a parent is excessively anxious around enclosed spaces, this can rub off on the child who learns to associate small spaces with an anxious reaction.


  • Genetic or evolutionary predisposition: Objectively, becoming trapped in a small space can be dangerous! Research has shown [1] that twins are likely to share a phobia, leading researchers to estimate that genetics is responsible for around 50% of phobia development. Thousands of years of evolution may have left us with an evolutionary fear of small spaces, encoded in our genes.


Claustrophobia Treatment


Like any other mental health problem, claustrophobia can be treated.


Cognitive-behavioural therapy (CBT): CBT is a popular and proven therapeutic approach for treating phobias, including claustrophobia. CBT involves systematically identifying and challenging irrational thoughts and patterns of belief about enclosed spaces. It also includes building coping strategies for anxiety, allowing you to face your fears. 


Exposure therapy: Exposure therapy requires gradual exposure to the object of your fear. For claustrophobia, this may take the form of entering stressful environments in controlled ways, such as entering a tube station outside of rush hour times and building up to the busiest hours of the day. By safely experiencing the object of your anxiety in a controlled manner, you’ll learn you have nothing to fear.


oVRcome’s Virtual Reality Exposure Therapy: Our app-based treatment program for claustrophobia is clinically proven to reduce the severity of phobia symptoms [2]. oVRcome combines the gold standard of CBT psychotherapy with graded exposure therapy in virtual reality environments. This is particularly beneficial for environmental phobias such as claustrophobia because our realistic VR simulations effectively and safely simulate these spaces.


Medication: Medication such as SSRIs (selective serotonin reuptake inhibitors) and benzodiazepines like clonazepam or diazepam can be used to manage the symptoms of claustrophobia. However, medication never treats the root cause, and only suppresses the anxiety you experience from triggering situations. While these medications can help you regain control and live a normal life, they should be used alongside treatment rather than as a replacement for it.


Wrapping Up


Discomfort in enclosed spaces is normal, but when it starts impacting your life you may need to take action: don’t let fear, anxiety and phobia stop you from living life to the full. If the thought of a crowded plane, busy subway or trip to the cellar causes irrational anxiety, or if you avoid these things altogether, then you may have claustrophobia.


Fortunately for those with claustrophobia, there’s light at the end of the tunnel. CBT and exposure therapy are proven to work, and our app-based treatment programmes are safe, effective and can be started today from the comfort of your couch. Try oVRcome’s treatment for claustrophobia today.


References


  1. Sawyers C, Ollendick T, Brotman MA, Pine DS, Leibenluft E, Carney DM, Roberson-Nay R, Hettema JM. The genetic and environmental structure of fear and anxiety in juvenile twins. Am J Med Genet B Neuropsychiatr Genet. 2019 Apr;180(3):204-212. doi: 10.1002/ajmg.b.32714. Epub 2019 Feb 1. PMID: 30708402; PMCID: PMC6414251.  2. Lacey, C., Frampton, C., & Beaglehole, B. (2022). OVRcome – Self-guided virtual reality for specific phobias: A randomised controlled trial. Australian & New Zealand Journal of Psychiatry. https://doi.org/10.1177/00048674221110779

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