What Triggers Claustrophobia?

Claustrophobia is the fear of confined spaces. The cause is unknown but may be linked to trauma, genetics, family influence, or environment. Common triggers include elevators, planes, tunnels, MRI machines, and other crowded or closed spaces.

Claustrophobia is a specific phobia, an anxiety disorder revolving around the fear of a specific object or situation. Specific phobias lead people to avoid certain things or to anxiously endure them in ways that negatively contribute to the person’s ability to function in some area of their life.

Claustrophobia is the fear of confined spaces. For someone with claustrophobia, confinement produces immediate distress out of proportion to either the actual danger or to relevant sociocultural context.

Claustrophobia is common. Up to five percent of the United States general population suffers from some degree of it, ranging from mild to serious disorders. Many people live with claustrophobia without having it diagnosed. They simply avoid spaces likely to provoke the reaction.

The anxiety may be linked to a previous traumatic experience, such as a distressing event in childhood. In other cases, claustrophobia is passed from parent to child (or between other family members) as the child picks up on the adult’s fear and imitates it. 

However, many cases of claustrophobia are not tied to a clear point of origin in personal experience. There may also be genetic, environmental, and unknown other factors involved.

Claustrophobia often begins in adolescence. If you or someone you know has claustrophobia, there are treatment options available.

The main sign of claustrophobia is a relationship between symptoms of anxiety and confined or crowded spaces. You may feel as if you are trapped with no way out and no control over the situation. In addition to affecting the way you think and feel emotionally, fear may produce certain physiological effects. These include:

• Nausea
• Sweating
• Rapid heartbeat
• Fast or labored breathing
• Fainting 
• Dizziness
• Tense muscles

Certain habits may also indicate claustrophobia. Your doctor may ask you whether you do any of the following:

• Look for exits when entering a room
• Stay near exit doors in crowded places
• Feel nervous if doors are shut
• Avoid airplanes, subways, elevators, or cars in heavy traffic

The original cause of claustrophobia is not known definitively but may be linked to any of the following:

• Trauma
• Genetics
• Family influence
• Environment 

As for immediate triggers, any crowded or close space may provoke claustrophobia. Common triggers include:

• Elevators
• Planes
• Tunnels
• Public toilets
• Cars with central locking
• Revolving doors
• MRI machines

In addition, claustrophobia may either affect or be affected by the size of a person’s "near space," an area defined through their perception of how close objects are to them. A recent study demonstrated a relationship between large near spaces and claustrophobic fear. People more likely to experience claustrophobia were also more likely to unconsciously define a larger area as "near"

You should see a doctor for any anxiety disorder that impedes your ability to function or significantly detracts from your quality of life. If claustrophobia leads you to avoid professional or social situations, prevents you from seeking other medical treatment, or causes disruptive anxiety or panic attacks, you may benefit from medication or therapy.

In order to diagnose claustrophobia, your doctor will likely begin by taking a full personal and family history in order to discover the extent of the problem and rule out alternative possibilities. They may then ask you to complete certain psychological evaluations. 

One of the most popular tools for diagnosing various anxiety disorders is the State-Trait Anxiety Inventory (STAI). This inventory asks subjects to self-report in answer to a number of questions. These questions are designed to measure both state anxiety, anxiety about an event or situation, and trait anxiety, anxiety that is a personal characteristic. It can be used to differentiate specific from general phobias and to differentiate anxiety from depression.

There are three main types of treatment for claustrophobia, and your doctor will work with you to find the best option for you.

Cognitive behavioral therapy (CBT)

The most common approach is to begin with cognitive behavioral therapy (CBT). CBT is talk therapy aimed at dismantling faulty patterns of thought and developing better coping mechanisms to deal with a problem (in this case, claustrophobia). CBT also addresses behavioral patterns, encouraging patients to face their fears and develop self-soothing techniques.

Medication

In some cases, a psychiatrist or primary care provider may prescribe medication. For patients who encounter situations that cause anxiety only infrequently, benzodiazepines are most commonly prescribed. Examples include diazepam (Valium) and alprazolam (Xanax).

Interoceptive exposure

A more recently available option is exposure therapy in a controlled environment. Patients have the ability to encounter their fears within a controlled space such as a virtual reality game