All About Claustrophobia: Definition, Health Effects, and How to Cope With It

Imagine hopping onto a crowded subway, shimmying into a tiny nook in your attic, or getting strapped into a seat on a plane for hours at at time — while most people feel perfectly fine in confined spaces, for Americans grappling with claustrophobia, being in these kinds of scenarios (or even the mere thought of them) can elicit intense fear.

Odds are you’ve seen claustrophobia portrayed in movies and TV shows before — a character panics, and gets sweaty and short of breath as they try to escape a tight space. In a nutshell, claustrophobia — one of thousands of phobias that exist — is defined as the fear of enclosed spaces, according to Krystal M. Lewis, PhD, a clinical psychologist at the National Institute of Mental Health (NIMH) section on Development and Affective Neuroscience in Bethesda, Maryland.

“It’s an extreme and most times irrational fear of small, confined spaces which prevents individuals from going to certain places, being in specific situations, and can significantly impact an individual’s life experiences,” Dr. Lewis explains. “There is often a fear of not being able to escape, fear of not getting enough air, and in general just feeling confined.”

Claustrophobia affects 12.5 percent of Americans, estimates from StatPearls suggest. Here’s everything you need to know about this phobia, how it’s diagnosed, and how it’s treated.

Claustrophobia is a “persistent and irrational fear” of enclosed spaces or of being confined, according to the American Psychological Association (APA). Elevators, closets, and tunnels or being on an airplane or in the backseat of a car are all examples of situations that may trigger claustrophobia, per APA.

People with claustrophobia often try to avoid situations in which they may encounter confinement or enclosure, and if they do land in these situations, it brings them intense anxiety or distress, APA states.

Some use the term claustrophobia colloquially to describe anyone who feels nervous in enclosed spaces, but it’s important to note that claustrophobia is a clinical diagnosis that can seriously interfere with an individual’s ability to function, according to Matthew Sacco, PhD, a sports performance psychologist at the Cleveland Clinic in Ohio, where he treats psychophysiological conditions.

“It’s a type of anxiety disorder in the category of anxiety disorders called specific phobias,” Dr. Sacco says.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies phobias primarily under four categories, according to Martin Antony, PhD, a clinical psychologist at Toronto Metropolitan University, who has written numerous books about phobias. They include:

• Fears related to animals, such as spiders, dogs, or tigers
• Fears related to the natural environment, such as heights, earthquakes, thunderstorms, or the dark
• Fears related to blood, injuries and medical issues, such as getting your blood drawn, broken bones, or giving birth
• Fears related to specific situations, such as being in confined or enclosed spaces like airplanes or elevators. Claustrophobia falls under this category.

A serious fear of confined spaces can trigger similar symptoms to an anxiety or panic attack, Dr. Antony says. Potential symptoms of claustrophobia, according to the Cleveland Clinic, include:

• Shaking or sweating
• Chest tightness or rapid heartbeat
• Rapid breathing or difficulty breathing
• Flushing (red, hot face) or chills
• Choking feeling
• Upset stomach
• Feeling faint, dizzy, or lightheaded
• Dry mouth
• Feeling disoriented or confused
• Tingling or numbness
• Ringing in your ears
• In children, crying, tantrums, clinging, or freezing

You may encounter emotional symptoms beyond the physical, too. Per Cleveland Clinic, they can include:

• Fear of losing control, fainting, or dying
• Feelings of overwhelming anxiety or dread
• Feeling an intense urge to leave the situation.
• Knowing that the fear isn’t rational, but you can’t deal with it

Someone with claustrophobia may start feeling anxious or experiencing symptoms simply by thinking about small or confined spaces, with the thought disrupting whatever you were previously doing or focused on, Sacco says.

That’s because your nervous system is kicking into “fight, flight, or freeze” mode, he explains. “This is what can be so challenging for people to understand about this type of fear — a person cannot simply ‘relax’ and move on. The body has to return to equilibrium, which can take some time after the perception of danger has passed.”

Certain situations can trigger claustrophobia, the Cleveland Clinic notes. They include:

• Elevators
• Airplanes
• Tunnels
• Trains
• Caves
• Small cars
• Cellars
• MRI imaging machines
• Small rooms with no windows or with windows that cannot be opened
• Thoughts about being in a confined space

Some people may be more predisposed to anxiety and, in turn, to claustrophobia, Lewis says. “Specific negative life events such as trauma, bullying, child abuse and similar early life experiences may lead to claustrophobia in youth or adulthood,” he explains.

Research suggests there may be a genetic contribution, too, Sacco says. Research published in the journal Translational Psychiatry shows that defects in a single gene (GPM6A gene) may be tied to increased risk of claustrophobia.

This means that a child with one or both parents with claustrophobia may be more susceptible to having it, too. “This is likely due to the fact that if a child is raised around a parent who has claustrophobia, he or she vicariously experiences the parent’s anxiety, thus feeling anxious themselves,” Sacco says.

In addition, Antony says, “one-time traumatic events” that happen in childhood or adolescence, like being trapped in an elevator, can trigger anxiety or apprehension later in life.

Getting diagnosed with claustrophobia will typically begin by seeing your primary care provider or a mental health professional. They may ask you questions or give you a questionnaire you’ll need to complete to assess your specific symptoms and how much they interfere with your life, according to Cleveland Clinic.

However, to be diagnosed with a phobia like claustrophobia, you’d need to meet the DSM-5 criteria, which includes the following, according to Antony:

• Marked Anxiety or Fear The person has significant, intense fear triggered by a specific object or situation.
• Immediate Anxiety Response The trigger nearly always elicits immediate anxiety or fear.
• Disproportionate Anxiety Response The fear reaction must be out of proportion to the actual danger posed by the trigger.
• Avoidance or Extreme Distress The individual goes out of their way to avoid the object or situation, or endures it with extreme distress.
• Life-Limiting The phobia significantly impacts the individual’s school, work, or personal life.
• Six Months Duration In children and adults, the duration of symptoms must last for at least six months.
• Not Caused by Another Disorder Many anxiety disorders have similar symptoms. A doctor or therapist would first have to rule out similar conditions such as agoraphobia, obsessive-compulsive disorder (OCD), and separation anxiety disorder before diagnosing a specific phobia.

The duration of claustrophobia varies from person to person. Left untreated, phobias like claustrophobia can be lifelong, according to Mayo Clinic. But with the right treatment, it’s possible to permanently overcome it.

There are a range of treatment options available to people diagnosed with claustrophobia, according to Brenda K. Wiederhold, PhD, a clinical psychologist and co-founder and chief behavioral health officer of the Virtual Reality Medical Center in La Jolla, California, which uses virtual reality as a therapeutic strategy to help manage certain phobias. Dr. Wiederhold completed the first virtual reality study — to treat aerophobia (fear of flying) — published in 2002, and has since worked with patients through virtual reality to help manage their phobias.

The two main treatment options for claustrophobia are cognitive behavioral therapy (CBT) and exposure therapy, according to Cleveland Clinic. A combination of CBT and exposure therapy is the gold standard for treating phobias, including claustrophobia, Antony notes. Medication and lifestyle strategies, such as relaxation techniques, may also be used in some cases.

Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy (aka “talk therapy”) in which a mental health professional, such as a therapist, helps patients learn to identify unhelpful or distorted thinking and behavioral patterns and replace them with more constructive ones.

During CBT sessions, your therapist can help you learn to manage your phobia by discussing your symptoms, help you understand why your symptoms happen, learn helpful coping strategies to keep your mind and body calm, and reevaluate and change your thinking patterns around your phobia.

“These involve strategies that help people to identify and challenge some of their beliefs they have — for example, to look for evidence that they won’t suffocate on an elevator and help you consider changing the way you think, feel, and behave,” Antony says.

Exposure Therapy

During exposure therapy, also known as desensitization therapy, patients work with a mental health professional to gradually expose themselves to their fears in safe and controlled settings to learn to better manage them, according to Cleveland Clinic. It can be done in a variety of settings and ways, says Weiderhold, such as:

• Virtual reality settings, like in Wiederhold’s practice, which gradually helps expose people with phobias to virtual simulations of their fears
• Visualization exercises, such as looking at pictures of feared objects of situations
• Short bouts of real-life exposures to feared objects or situations

You’ll also likely start with small exposures and gradually increase the difficulty of these exposures over time, per Cleveland Clinic. For example, if you’re fearful of sitting in a confined space like an airplane, your therapist may work with you over time to get comfortable with simply getting to the airport, then later sitting in the lounge near your gate, and eventually sitting on the plane itself, Wiederhold explains.

Medication

In some instances when anxiety is severe, individuals with phobias may be prescribed medication, according to Cleveland Clinic. This may happen ahead of situations such as taking a flight or undergoing an MRI scan, for example. Benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) are the most common options, according to Lewis.

Lifestyle Strategies

While CBT and exposure therapy with a mental health professional are often the most crucial part of treatment, you can supplement these therapies with certain lifestyle strategies. Some of the most effective strategies are those that can help you relax, such as mindfulness, meditation, and journaling to alleviate stress, Lewis says.

Deep breathing exercises (such as breathing in slowly and deeply through your nose, holding for three seconds, and then breathing out slowly through your mouth) and progressive muscle relaxation (repeatedly tensing and relaxing certain muscles throughout your body) can also be helpful, per Cleveland Clinic.

Phobias like claustrophobia may lead to certain complications, according to Mayo Clinic, including:

• Social isolation, especially if an individual avoids places and things that trigger their phobia
• Mood disorders, such as depression
• Other anxiety disorders
• Misuse of drugs or alcohol
• Increased risk of suicide

Wiederhold, Lewis, and Sacco agree the most common misconception about claustrophobia is that it isn’t a legitimate fear. In some cases, friends, family members, or coworkers may — sometimes inadvertently — downplay what someone with claustrophobia is going through, making the experience more difficult to live with, Wiederhold says.

Some constructive ways to help a loved one cope include:

Be Considerate and Validate Their Experience

If your loved one has claustrophobia, never tell them to “just get over it,” or that, “it’s not a big deal.”

“People often minimize the level of fear and distress that claustrophobia can cause. They think the person is exaggerating and getting too upset,” Sacco says. Instead, acknowledge how your loved one is feeling, remind yourself of what they are genuinely going through, and consider the techniques they’ve practiced to help them navigate the experience.

Be Patient

Maybe your loved one won’t board a plane or go underground to catch the subway. They could have a years-long aversion to enclosed spaces, and their “fight, flight, and fear” response is taking over, says Sacco.

Try not to force your loved ones into these scenarios and do what you can to accommodate their needs as they work through therapy. There is no overnight remedy to conquering claustrophobia, so understand that their battle may be for the long haul when you’re doing activities.

Offer Support

Go with your loved one to their first therapy appointment, especially if it will increase the odds of them attending and returning to their sessions. Exposure therapy or CBT can be daunting, so helping them take the first few steps is key, Lewis says. Encourage them as they work toward conquering their fear — while certain situations may seem benign to you, it often requires a lot of bravery for your loved one with claustrophobia to face them.

About 12.5 percent of the U.S. population has claustrophobia, and the majority are female, according to StatPearls. Phobias can happen at any age, but they most often start in childhood or adolescence. On average, people with claustrophobia tend to fear three objects or situations, per Cleveland Clinic.

Other conditions with symptoms that can resemble those of phobias like claustrophobia, according to the DSM-5, include:

• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Separation anxiety disorder
• Social phobia
• Panic disorder with agoraphobia
• Agoraphobia without history of panic disorder