Claustrophobia (Fear of Enclosed Spaces)

What is claustrophobia?

Claustrophobia is an intense fear of confined or enclosed spaces.

Many fears seems reasonable. We all try to avoid things that make us feel uncomfortable. The difference between a fear and a phobia is that a phobia is an intense and irrational fear toward one or more things or situations. Also, with phobias, the level of your fear doesn’t match the actual danger presented by the feared object or situation.

Phobias become a health issue when the fear interferes with your ability to carry out daily activities. Phobias can limit your ability to work efficiently, put a strain on your relationships and reduce your self-esteem.

What situations can trigger claustrophobia?

Common triggers include:

• Tunnels.
• Elevators.
• Trains.
• Airplanes.
• Small cars.
• Caves.
• MRI imaging machine.
• Cellars.
• Small rooms without windows or with windows that can’t be opened.
• Thoughts about being in a confined space.

What does claustrophobia feel like?

If you have claustrophobia, you feel anxious about being in an enclosed or tight-fitting space. You may have trouble concentrating and functioning. You may be overwhelmed with thoughts about being in a confined space. Your thoughts may keep you up at night.

How common is claustrophobia?

About 12.5% of the population has claustrophobia. The average person with a specific phobia, such as claustrophobia, fears three objects or situations. About 75% of people with a specific phobia fear more than one object or situation.

Who gets claustrophobia?

Claustrophobia is more common in females than males. Although anyone, at any age, can develop a specific phobia, most develop in childhood and adolescence.

What are the symptoms of claustrophobia?

Symptoms of claustrophobia are similar to symptoms of anxiety and a panic attack. You may experience:

Physical symptoms

• Sweating or shaking.
• Tightness in chest or rapid heartbeat.
• Trouble breathing or breathing fast.
• Chills or flushing (red, hot face).
• Choking feeling.
• Upset stomach or feeling “butterflies” in your stomach.
• Dizziness, feeling faint or lightheaded.
• Dry mouth.
• Feeling confused or disoriented.
• Numbness or tingling.
• Ringing in your ears.
• Crying, tantrums, freezing or clinging (symptoms of a specific phobia in children).

Emotional symptoms

• Fear of losing control.
• Fear of fainting.
• Feelings of dread.
• Feeling overwhelming anxiety.
• Feeling an intense need to leave the situation.
• Understanding that the fear isn’t rational, but you can’t overcome it.
• Fear of dying.

What causes claustrophobia?

What causes claustrophobia isn’t fully understood. Researchers believe causes might include:

• A traumatic event as a child: Some adults with claustrophobia report one or more events where they were trapped or confined to a tight space as a child.
• A triggering event after childhood: You may have had a triggering event such as you got stuck in an elevator or experienced severe turbulence on an airplane.
• Childhood exposure to a parent’s claustrophobia: You may develop claustrophobia if you felt the anxieties of one of your parent’s reaction to confined spaces.

Technically, scientists believe neurochemicals overstimulate an area of your brain — your amygdala — in the presence of fear. There’s also thought that a single genetic mutation can increase your risk of claustrophobia if you have that gene defect.

How is claustrophobia diagnosed?

If you have claustrophobia, you have a fear of enclosed spaces and you know it’s a problem because you take great caution in avoiding situations in which you might encounter confined spaces.

Your healthcare provider will want to confirm that your fear is indeed a phobia versus a normal fear and that it’s not the result of a medical condition or psychiatric disorder. Phobias significantly interfere with your ability to live a normal life. Your provider may give you a questionnaire to fill out or ask you directly how your claustrophobia has affected your daily life, how intense your fear feels and how often you feel it, how it affects your interactions with your friends and family and how you cope. Your provider may also ask you other questions about yourself, including recent life changes, stressors, and any medications or supplements that you take.

Your provider may make the diagnosis of claustrophobia if you have all of the following:

• Your fear of enclosed spaces is intense and has been present for six months or longer.
• Your fear or anxiety is about a specific situation or object — in this case, enclosed spaces such as an elevator or small car.
• Your fear and anxiety almost always happen as soon as you encounter your specific fear or think about the feared situation.
• You avoid your feared situation or endure it with intense fear or anxiety.
• Your fear is out of proportion to the actual danger.
• Your fear is causing you significant distress or significantly hampers your ability to function.

How is claustrophobia treated?

Exposure therapy and cognitive behavioral therapy are the two main treatments for claustrophobia.

Exposure therapy (also called desensitization therapy)

In this type of psychotherapy, you are gradually exposed to your feared situation. With gradual, repeated exposure, the goal is that you will feel comfortable in your specific feared situation.

Exposure therapy may involve:

• Facing your feared phobia directly, in real-time.
• Recalling and describing your feared experience.
• Looking at pictures or using virtual reality to get close to the real feared experience yet be in a safe environment.

Exposure therapy can be paced in several ways. Therapy also includes relaxation and breathing exercises. Your psychologist will develop a unique plan for you, based on the severity of your symptoms.

Cognitive behavioral therapy (CBT)

This type of psychotherapy (talk therapy) focuses on managing your phobia by changing the way you think, feel and behave.

During CBT, you’ll:

• Discuss your symptoms and describe how you feel.
• Explore your phobia more deeply to gain an understanding of how to respond.
• Learn how to recognize, reevaluate and change your thinking.
• Use problem-solving skills to learn how to cope.
• Face your phobia instead of avoiding it.
• Learn how to keep your mind and body calm.

Are medications used to treat claustrophobia?

In addition to therapy and coping strategies, medications are sometimes prescribed for a short period of time to treat anxiety caused by claustrophobia. For example, your provider might prescribe medications to treat anxiety when you’re flying. The two main medication classes most often prescribed are:

• Benzodiazepines, such as the antianxiety drugs alprazolam (Xanax®), clonazepam (Klonopin®) and diazepam (Valium®).
• Selective serotonin reuptake inhibitors, such as paroxetine (Paxil®) or escitalopram (Lexapro®).

What can I do to better cope with claustrophobia?

In addition to seeing your primary healthcare provider or psychologist, you can try any of the following that make you feel comfortable:

• Talk to someone you trust: Having someone listen to your claustrophobic fears can be helpful to you.
• Learn strategies to relax: Try deep breathing exercises (breathe in slowly and deeply through your nose, hold for three seconds, breathe out slowly through your mouth), meditation, mindfulness, progressive muscle relaxation (tensing and relaxing muscle groups) and other methods to relax. Visualize and focus your attention on something that makes you calm.
• Join a support group: Support groups can be helpful in knowing you are not alone and for sharing tips and advice.
• Check if an organization provides a course for overcoming your fear: For example, if you’re afraid of flying, check if an airline or your local airport offers a class on fear of flying.
• Take care of yourself: Eat a well-balanced diet, follow good sleep habits and exercise for 30 minutes at least five days a week. Healthy lifestyle choices can decrease your anxiety.

What can I expect if I have a diagnosis of claustrophobia?

Without treatment, a phobia can last a lifetime and can isolate you from people and social activities.

Fortunately, phobias are very treatable. Psychotherapy — exposure therapy in particular — helps as many as 90% of people committed to practicing the techniques they learn. You may notice improvements within weeks to a few months.

Having claustrophobia, what can I do to better prepare myself for an MRI imaging test?

Tell your healthcare provider you have claustrophobia at your first medical appointment. They may prescribe a medication to take shortly before your test to help calm your nerves. Depending on the area of your body being examined, there may be other options during an MRI scan. Ask if an open MRI machine is available and could be an option for your exam.

Know that a calming light breeze will blow on your face, a headset is available to block out noise or to listen to music during your scan, and you’ll have a panic button if you feel uncomfortable and wish to be removed from the machine at any time. Also, your technician will talk to you throughout the scan. Other tips to keep yourself calm include:

• Take a few deep, slow breaths before entering the machine.
• Keep your eyes closed from the time you lie down on the table and picture yourself in a place that is calming and peaceful to you (e.g., lying on a beach or under the stars on a blanket in an open field).

How do I know at what point I need to see my doctor for my claustrophobia?

It may be time to see your healthcare provider if your intense fear of enclosed spaces:

• Interferes with your daily activities, including functioning at work or school.
• Keeps you away from activities or special events with family and friends.
• Consumes your thoughts most of the time.
• Keeps you up at night.

A note from Cleveland Clinic

It may be comforting to know that many people have phobias. Your healthcare provider is ready to help you. The good news is that claustrophobia is a treatable condition. With treatment and your commitment to practice the techniques you learn in therapy, you can learn to cope with your triggers, manage your fear of confined spaces and enjoy your life.