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Claustrophobia: Your Top Questions About Fear of Tight Spaces Answered

Have you ever felt nervous, irrational, or even terrified while being in a small, confined area? Claustrophobia is a phobia of tight spaces which produces anxiety-related symptoms and panic attacks. Next, Flo outlines the warning signs of claustrophobia and ways to manage the condition.

Claustrophobia describes an illogical fear of being trapped in a confined space from which you cannot escape. It’s classified as a specific phobia (or anxiety disorder), similar in nature to post-traumatic stress disorder (PTSD), generalized anxiety disorder, or social anxiety disorder.

Patients with claustrophobia often realize that their reactions are unreasonable, but such knowledge isn’t enough to rein in the incredibly intense emotions they’re experiencing.

The precise cause of claustrophobia has yet to be discovered, but it’s important to remember this condition is not an indication of personal weakness or character flaws. Naturally, claustrophobia can take a toll on overall mental health, and is likely brought on by a combination of individual and environmental factors.

The amygdala is a tiny structure inside the brain designed to control how humans process fear and generate fight-or-flight responses to certain stimuli. A smaller than usual amygdala may create abnormal reactions to negative situations. 

Conditioning also plays a key role in the development of claustrophobia. They typically occur at a young age and could include:

  • Accidentally becoming trapped in an enclosed space (e.g., a closet or box)
  • Falling into a pool and being unable to swim
  • Getting your head stuck between a set of bars 
  • Being lost/separated from your parents in a crowded, unfamiliar setting
  • Enduring certain forms of punishment like getting locked up in a tiny room
  • Having your parents leave you inside of a locked car

Experts theorize that biology may be a contributing factor in the onset of claustrophobia, in some cases. Scientific research has discovered mutations which impact a stress-regulating gene in mice, resulting in claustrophobia-like symptoms. Of course, a great deal of investigation is still needed to establish a similar link in people.

Alternatively, claustrophobia could be the product of a dormant evolutionary survival instinct. Such a trait would have helped humans to stay safe in the past, but is no longer necessary in the modern world. This potentially explains why claustrophobia presents in young children and is so easily picked up.

Growing up with a parent who has claustrophobia is also a conditioning experience. Witnessing your mother or father demonstrate a clear phobia of tight spaces leads you to view those spaces as dangerous, too. Consequently, instances of learned claustrophobia are prevalent among families with a history of this disorder.

The warning signs of claustrophobia typically arise during childhood or adolescence, with the two primary examples being a fear of restriction or suffocation. 

Each claustrophobia patient may possess different triggers, or situations and settings in which they’re susceptible to a panic attack. These usually include locked rooms, MRI or CAT scan machines, the barber’s or dentist’s chair, caves and tunnels, basements, cars, buses, and airplanes, etc. For some, merely stepping into an elevator is anxiety-inducing. And even new moms with claustrophobia may feel uncomfortable co-sleeping with their babies.

Claustrophobia patients frequently observe the following symptoms while in an enclosed area, or when they’re thinking about being in one:

  • Sweating
  • Tachycardia
  • Heart palpitations
  • Chills
  • High blood pressure
  • Nausea
  • Ringing in the ears
  • Headaches
  • Trembling
  • Hot flashes
  • Dry mouth
  • Difficulty breathing
  • Chest tightness
  • Hyperventilation
  • Dizziness
  • Fainting
  • Numbness
  • Confusion
  • A strong urge to use the bathroom
  • Ritualistic behaviors
  • Feeling sick or weak
  • Inability to remain still or calm

Your mental health provider will ask about personal symptoms and triggers, then match them to a standard set of criteria to reach a diagnosis.

Though there’s no physical test for claustrophobia, they might perform a physical exam or order lab work to exclude other medical issues known to elevate stress.

To confirm claustrophobia or another type of phobia, symptoms must meet the criteria listed below, which comprises the claustrophobia test:

  • Excessive fear caused by a certain situation
  • The patient is an adult who acknowledges its irrationality
  • Anxiety is brought on by the phobia’s cause 
  • The patient goes to great lengths to avoid the trigger
  • Evading the trigger affects daily life
  • The phobia lasts at least six months (though it’s generally longer)
  • Symptoms cannot be attributed to another mental health problem

Numerous scales and questionnaires have also been established to aid in the diagnosis of claustrophobia. They distinguish between various symptoms, measure anxiety levels, and gauge the claustrophobia patient’s desire to steer clear of unpleasant situations.

A psychiatrist or therapist might rely on several types of therapy to treat claustrophobia, including:

  • Exposure therapy

It allows the patient to progressively confront their fears in a safe environment.

  • Cognitive behavioral therapy (CBT)

It’s a form of talk therapy where negative feelings and thoughts associated with claustrophobia can be discussed, along with strategies for overcoming them.

  • Rational emotive behavior therapy (REBT)

Action-oriented therapy encourages patients to identify and dispute the negative thoughts behind the phobia and to focus on the present.

  • Virtual reality

A virtual reality device simulates a claustrophobia-triggering experience (e.g., stepping onto a crowded elevator or being inside an MRI machine). It gradually desensitizes the patient to what was once a terrifying situation.

At times, providers may opt to prescribe medications to keep severe symptoms of claustrophobia in check (e.g., antidepressants or anti-anxiety drugs). Beta-blockers and benzodiazepines are another tool for short-term treatment. To achieve the best long-term results, however, such medications might be used in conjunction with the above therapies.

Despite the willingness of many claustrophobia patients to completely avoid particular circumstances, it poses quite a practical challenge. Furthermore, it could potentially make the symptoms of claustrophobia worse over time. Below are four strategies for empowering patients to manage the stress of being physically confined:

Prevent hyperventilation by puckering your lips like you’re about to blow out a candle. Then, gently exhale through your mouth. Breathe in deeply and slowly count to three before releasing your breath again.

Divert your attention away from where you are at the moment to calm down and nip a sudden attack of claustrophobia in the bud. Consider engaging in a repetitive action like:

  • Counting out loud items you can see (e.g., food products on a supermarket shelf)
  • Concentrating on the movement of a watch or clock
  • Caressing your own hand or another part of your body gently, again and again

Coming to the realization that your phobia of tight spaces isn’t grounded in reality might serve as an effective coping mechanism. Whenever the symptoms of claustrophobia start creeping up on you, repeatedly tell yourself that these fears are irrational and everything will be just fine.

Try and visualize a cherished moment in time or a specific setting where you felt calm, safe, and happy. Allow your mind to escape to that time or place to alleviate stress during a bout of claustrophobia.

Cases of claustrophobia, or a phobia of tight spaces, range from mild to severe and usually arise when an individual perceives themselves as being trapped.

Scientists conjecture that claustrophobia is a complex blend of factors, such as amygdala dysfunction, environmental conditioning, and childhood traumas. If you’ve observed symptoms of claustrophobia, talk to your health care provider about therapy, management strategies, and medications that could help you overcome those fears.

https://www.ncbi.nlm.nih.gov/pubmed/23632458

https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders

http://www.div12.org/sites/default/files/WhatIsExposureTherapy.pdf

https://www.nhs.uk/conditions/claustrophobia/

https://www.mayoclinic.org/diseases-conditions/specific-phobias/symptoms-causes/syc-20355156

https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162

https://www.mountsinai.org/health-library/symptoms/hyperventilation

https://www.healthdirect.gov.au/claustrophobia

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