Specialist Dr. Yaprak Arslan Psychiatrist & Psychotherapist

Claustrophobia is one of the specific phobias commonly encountered in mental health but often not sufficiently understood. It is known in everyday life as ‘fear of enclosed spaces,’ but its symptoms are not limited to fear of riding in an elevator.

What is Claustrophobia?
Claustrophobia is a subtype of specific phobia according to the DSM-5. The individual experiences a marked and persistent fear of being in a closed, confined, or escape-impaired environment. This fear is disproportionate to the actual level of threat and often interferes with the person's ability to function in daily life.

Examples of triggering situations may include:

• Elevators
• Airplanes
• Tunnels
• MRI or CT scan machines
• Small rooms without windows
• Public transport

Symptoms

The symptoms experienced by individuals with claustrophobia are both physical and cognitive/emotional:

Physical symptoms:

• Palpitations
• Sweating
• Shortness of breath
• Chest tightness
• Dizziness
• Nausea
• Feeling faint

Cognitive symptoms:

• Fear of losing control
• Thoughts such as ‘I'm going to suffocate’ or ‘I won't be able to get out’
• Desire to escape and intense restlessness

These symptoms can sometimes progress to a panic attack. For this reason, claustrophobia can also occur alongside panic disorder.

Avoidance Behaviour and Its Effects on Quality of Life

Claustrophobia is often reinforced by avoidance behaviour. The person tries to stay away from situations that cause fear. Although this avoidance provides short-term relief, it causes the fear to become more entrenched in the long term.

For example:

• A person who needs an MRI scan may postpone or cancel the procedure.
• They may avoid using public transport.
• They may withdraw from environments such as job interviews or social events that take place in enclosed spaces.
• As a result, health, social life, and occupational functioning may all be negatively affected.

Causes and Risk Factors

Several factors may contribute to the development of claustrophobia:

1. Traumatic Experiences

• Experiences such as being trapped in a closed space, being locked in a room as punishment, or being stuck in an elevator during childhood may be contributing factors.

2. Learned Behaviour

• If a parent or caregiver has similar fears, these reactions may be learned and internalised during childhood.

3. Cognitive Factors

• Distortions in threat perception can lead individuals to overinterpret threats. Automatic thoughts such as ‘I'm going to suffocate’ or ‘I can't escape’ fuel fear.

4. Neurobiological Factors

• Some studies show differences in the response levels of brain structures such as the amygdala to threat perception.

5. Genetic Predisposition

The presence of anxiety disorders or specific phobias in the family may increase the risk.

• Diagnostic Criteria (Specific Phobia According to DSM-5)
• A diagnosis of claustrophobia must meet the criteria for specific phobia:
• Persistent and excessive fear of a specific object or situation
• Avoidance behaviour or intense distress when exposed to the object or situation
• This fear must persist for at least 6 months
• Impairment in daily functioning
• The fear cannot be better explained by another psychiatric condition

Treatment Methods

Claustrophobia is a treatable condition. The main approaches are as follows:

1. Cognitive Behavioural Therapy (CBT):

• Phobic thought patterns are identified and restructured.
• The exposure method is used to systematically approach feared situations.
• The client confronts fear-inducing environments in a controlled manner.

2. Relaxation and Breathing Techniques:

• Body awareness and regulation techniques are taught to cope with panic symptoms.

3. EMDR:

• Traumatic experiences that lead to claustrophobia can be processed using methods such as EMDR.

4. Medication:

• Antidepressants or anti-anxiety medications may be added to treatment for individuals with severe anxiety disorders.
• A combination of medication and psychotherapy is recommended for a permanent solution.

When Should You Seek Support?

• Professional help is recommended if the following situations are observed:
• There is a significant decline in daily functioning
• Mandatory situations such as MRIs or flights are constantly being postponed
• The fear is combined with other anxieties and becomes generalised
• If panic attacks develop
• Claustrophobia can reduce a person's quality of life, but significant improvement can be achieved
• with appropriate therapy. The treatment process not only reduces symptoms but also helps to
• increase the person's self-confidence.