Claustrophobia

Fear of enclosed/confined spaces

Probably the most famous among the list of phobias in the world, and most used term in pop culture, its present in every 10th person walking on this rock.

Although 10% isn't less, Claustrophobia falls at number 5, in the top phobias in the world after Arachnophobia, Ophidiophobia, Astraphobia, Trypanophobia.

It's normal to fear being trapped when there's a genuine threat, but people with claustrophobia become fearful in situations where there's no obvious or realistic danger.

They'll go out of their way to avoid confined spaces, such as lifts, tunnels, tube trains and public toilets (see below for a full list). However, avoiding these places often reinforces the fear.

Some people with claustrophobia experience mild anxiety when in a confined space, while others have severe anxiety or a panic attack. The most common experience is a feeling or fear of losing control.

Triggers

Many different situations or feelings can trigger claustrophobia. Even thinking about certain situations without exposure to them could be a trigger.

Common triggers of claustrophobia include:

•lifts

•tunnels

•tube trains

•revolving doors

•public toilets

•cars with central locking

•car washes

•shop changing rooms

•hotel rooms with sealed windows

•planes

If you've felt anxious during the last six months about being in a confined space or crowded place, or if you've avoided these situations for this reason, it's likely that you're affected by claustrophobia.

MRI scan anxiety

If you have claustrophobia and you need to have an MRI scan, let the staff at the hospital know before the day of your appointment.

They may be able to give you a mild sedative, or advise you to speak to your GP for a prescription.

In some cases, you may be able to attend an open or upright MRI centre, designed for people with severe MRI anxiety. However, these clinics are often only available privately.

Symptoms

Panic attacks are common among people with claustrophobia. They can be very frightening and distressing and symptoms often occur without warning.

As well as overwhelming feelings of anxiety, a panic attack can also cause physical symptoms, such as:

•sweating

•trembling

•hot flushes or chills

•shortness of breath or difficulty breathing

•a choking sensation

•rapid heartbeat (tachycardia)

•chest pain or a feeling of tightness in the chest

•a sensation of butterflies in the stomach

•nausea

•headaches and dizziness

•feeling faint

•numbness or pins and needles

•dry mouth 

•a need to go to the toilet

•ringing in your ears

•feeling confused or disorientated

If you have severe claustrophobia, you may also experience psychological symptoms such as:

•fear of losing control

•fear of fainting

•feelings of dread

•fear of dying

How does it develop?

Claustrophobia is generally the result of an experience in the person's past (usually in their childhood) that has led them to associate small spaces with the feeling of panic or being in imminent danger. Examples of these kinds of past experiences are:

• falling into a deep pool and not being able to swim
• being in a crowded area and getting separated from parents/group
• crawling into a hole and getting lost/stuck.

As the experience will have dealt some kind of trauma to the person, it will affect their ability to cope with a similar situation rationally. The mind links the small space/confined area to the feeling of being in danger and the body then reacts accordingly (or how it thinks it should).
This type of cause is known as classic conditioning and can also be a behavior inherited from parents or peers. If for example, a claustrophobic person has a child, the child may observe their parent's behavior and develop the same fears.

There are other theories behind the causes of claustrophobia, these are:

• Smaller Amygdalae - the amygdala (plural: amygdalae) is a tiny part of the brain that is used to control how the body processes fear.
  
  In a study published in Psychiatry and Clinical Neurosciences, Fumi Hayano and colleagues discovered that people who suffered panic disorders had smaller amygdalae than average.
  
  This smaller size could interfere with how the body processes panic and anxiety.


• Prepared Phobia - there is also a theory that phobias develop on the genetic level rather than psychologically. The research behind this theory suggests that claustrophobia and some other phobias are dormant evolutionary survival mechanisms. A survival instinct buried within our genetic code that was once crucial to human survival but is no longer needed.
  
  A team from Germany and the United Kingdom wrote in the journal Translational Psychiatry that a single gene defect probably contributes to the development of claustrophobia.

After diagnosis has been made, the psychologist may recommend one or some of the following methods to help the patient deal with his or her fear:

• CBT (Cognitive Behavioral Therapy) - This is a well recognized treatment method for most anxiety disorders. The goal of CBT is to retrain the patient's mind to no longer feel threatened by the places they fear. This may involve slowly exposing the patient to small spaces and helping them deal with their fear and anxiety (in vivo exposure).
  
  Watching others as a cure for claustrophobia - researchers at the Karolinska Institute, Sweden, reported in the journal Psychological Science that phobias may be cured by watching others interact with the source of the fear.


• Drug Therapy - This type of therapy can help manage the anxiety symptoms, however, it does not deal with the problem itself. Health care professionals may use drug therapy if other interventions have not provided satisfactory results.


• Relaxation Exercises - Taking deep breaths, meditating and doing muscle-relaxing exercises are effective at dealing with negative thoughts and anxiety.


• Alternative/Natural medicine - There are some natural products and homeopathic medicines that some patients say help them manage panic and anxiety.