I wish to commend you for your tireless and passionate commitment to improve our health using this platform. For the last three years, whenever my mum is in a plane or elevator, she is always anxious to get out, the situation worsens as she experiences increase in heart beat and sweating and currently the idea of getting into a plane or elevator could increase her heart rate. The Psychotherapist we visited outside Nigeria diagnosed her with Claustrophobia. Can you share information about this problem?
Thanks Anita for your question, Claustrophobia is a form of anxiety disorder in which an irrational fear of having no escape or being closed-in can lead to a panic attack. Triggers may include being inside an elevator, a small room without any windows, or even being on an airplane like the case of your mum.
People with claustrophobia will go to great lengths to avoid small spaces and situations that trigger their panic and anxiety. They may avoid places like the subway and prefer to take the stairs rather than an elevator.
How to diagnose?
A psychologist or psychiatrist will ask the patient about their symptoms. A diagnosis of claustrophobia may emerge during a consultation about another anxiety-related issue. The psychologist will ask for a description of the symptoms and what triggers them and try to establish how severe the symptoms are and rule out other types of anxiety disorder.
What are the symptoms?
Claustrophobia is an anxiety disorder. Symptoms usually appear during childhood or adolescence. Being in or thinking about being in a confined space can trigger fears of not being able to breathe properly, running out of oxygen, and distress at being restricted.
When anxiety levels reach a certain level, the person may start to experience the following:
- Sweating and chills and accelerated heart rate and high blood pressure
- Dizziness, fainting, and lightheadedness and dry mouth
- Hyperventilation, or “over breathing”
- Hot flashes and shaking or trembling and a sense of “butterflies” in the stomach
- Nausea and headache and numbness and a choking sensation
- Tightness in the chest, chest pain, and difficulty breathing and an urge to use the bathroom and confusion or disorientation and fear of harm or illness
Examples of small spaces that could trigger anxiety are:
- Elevators or changing rooms in stores.
- Tunnels, basements and trains and subway trains.
- Revolving doors and airplanes and public toilets.
- Cars, especially those with central locking.
- Crowded areas.
- Some medical facilities, such as Magnetic Resonance Imaging scanners.
- Small rooms, locked rooms, or rooms with windows that do not open
Some treatment options are:
- Cognitive behavioral therapy (CBT): The aim is to retrain the patient’s mind so that they no longer feel threatened by the places they fear. It may involve slowly exposing the patient to small spaces and helping them deal with their fear and anxiety. Having to face the situation that causes the fear may deter people from seeking treatment.
- Observing others: Seeing others interact with the source of fear may reassure the patient.
- Drug therapy: Antidepressants and relaxants can help manage symptoms, but will not solve the underlying problem.
- Relaxation and visualization exercises: Taking deep breaths, meditating and doing muscle-relaxing exercises can help deal with negative thoughts and anxiety.
- Treatment can take up to 10 weeks, with sessions twice a week. With appropriate treatment, it is possible to overcome claustrophobia.
Tips for coping with the problem are:
- Staying put if an attack happens. If driving, this may include pulling over to the side of the road and waiting till symptoms have passed.
- Reminding yourself that the frightening thoughts and feelings will pass.
- Trying to focus on something that is not threatening, for example, the time passing or other people.
- Breathing slowly and deeply, counting to three on each breath.
- Challenging the fear by reminding yourself that it is not real.
- Visualizing positive outcomes and images.
- Longer-term strategies may include working out an exercise programme.