When most think of Claustrophobia,they are either reminded of prevalent social images of a critically frightened person in an elevator (or otherwise small compartment), or simply freaking out about something seemingly ordinary to others, like the horrors of a crowded grocery store and an almost comically long lines (I confess to being a recurrent, last minute carriage ditcher, so I know how difficult it truly can be to make it to checkout). Or maybe the thought of walking into a packed mall can become so daunting it is nearly—or completely—impossible to go (and counting the blessings of online shopping). While this Anxiety Disorder can appear off-putting or even ridiculous to less sympathetic people, in actuality the ill effects of Claustrophobia are seriously life-limiting and depression-heightening—a reminder of one’s illnesses—on the daily.
Trust me: back in 1998, my parents rented a hotel room on the 17th floor of the Radison in Boston, Massachusetts, causing me to walk up the stairs whenever I wanted to leave or return. Later on, I couldn’t remain in the backseat of a two-door car for more than a couple of moments without sweating as if I’d just completed a match at the French Open; and began to take a shine to remaining in my house while working freelance jobs, venturing to my garden for my big outdoor trip of the day. It is a terrible way to function because you are so aware of what you are missing, but it does, nonetheless, largely dictate ones life—but it doesn’t have to! With appropriate types of medication and therapy, people with this behavioral health ailment can begin to overcome the underlying anxieties they’re rooted in, and eventually assist in eliminating what feels often feels deeply shameful and quite embarrassing.
What Is Claustrophobia?
Simply put, Claustrophobia is a great terror of enclosed spaces, in which the sufferer irrationally believes there is literally no exit. According to Medilexicon’s medical dictionary, Claustrophobia is classified as “a morbid fear of being in a confined place.” This includes elevators/lifts, airplanes, basements/cellars, small and crowded rooms, locked or windowless rooms, cars, and trains. Sometimes even wearing a shirt that fit snuggly around the neck (my dad could be the poster child for the last of these symptoms] can be acutely triggering). Claustrophobia is also often the result of previous trauma, and the belief that they will respond to unsound situations by panicking, certain if they had a panic attack in a forum before, they are bound for the same fate if returning to that place (in fact, they’re often 100% convinced it will). The brain, in this case, is thought to subconsciously link “danger” and “small spaces,” which is known as classic conditioning. Such behaviors are frequently observed—and then internalized—by the words and actions of a parent who is also Claustrophobic.
Aside from drafting a large portion of their lives to avoid being triggered, a common result of Claustrophobia are repeated and intense panic attacks. We must not diminish the importance of this, for true panic attacks are terrifying: these episodes may literally feel life-threatening. Panic attacks include heavy sweating that is often accompanied by shaking, an accelerated heart beat, increased blood pressure, hyperventilation, nausea, light-headedness, or actual fainting. As this illnesses is largely predicated on the fear of having a panic attack, or of not being able to leave when the feeling is seriously urgent, it must also be noted that Claustrophobes have the tendency to avoid triggering environments. Respectively, their behaviors may appear most fully and profoundly at specific times/circumstances, typically when they feel unsafe and not in direct control. To better illustrate the outcomes of the condition, a few example are that:
- Upon entering a room, they may frantically check for exit signs, and even position themselves close by. I can testify as a primary source that this grows significantly worse when all of the doors in a room are closed, even if they are not locked (but especially when they are!);
- When at a crowded party or event, even in large venues, they will again likely positions themselves near the doors;
- The overwhelming tendency to avoid traveling (regardless of whether they are driving, or sitting in the passenger seat) at high-traffic times/rush hour; and if at all possible, avoid being stuck in traffic (especially in tunnels);
- Complete avoidance of elevators/lifts (take my example of walking up and down 17 flights of stairs during my stay at the Radison!), and risk becoming quite fatigued in the process.
What’s more, there are multiple theories beyond classic conditioning that may indeed apply directly to the illness. Many psychiatrists believe strongly in the “smaller amygdala” thesis (my note: “amygdala” is the part of the brain that processes fear), which has been derived from the studies of Fumi Hayano, who first discovered that people suffering with Claustrophobia oftentimes have a smaller amygdala than average, and thus produce a higher response to fear. “Prepared phobia” is another point of concern for many medical professional, as it is their belief, through copious research, that such phobias develop on the genetic level, and are a class of dormant evolutionary survival mechanisms.
How Is Claustrophobia treated?
As with any illnesses, the level of severity can range from mild to extremely severe. The most common method intervention is Cognitive Behavioral Therapy (CBT), which is employed to re-train the claustrophobic mind to examine an issue more rationally, and to learn best practices for managing the threats of enclosed spaces. The formerly used (and sometimes still used) idea of “flooding,” where the patient is fully exposed to their fears until rendered calmer, which was not wholly effective. With a more just and tolerable CBT plan (which frequently includes “anchoring:” essentially a much shorter exposure to triggers while supervised by sensitive, astute doctors). This way, doctors and patients can work collectively at a comfortable (though still intense) pace, and keep strict track of triggers and negative emotional responses in a notebook. From there, Claustrophobes and their doctors can begin to properly target particular aspects of each patient’s conditions. In addition to therapy, the anxiety may be critical enough to warrant anti-anxiety medication, when often involves the use of beta blockers, antidepressants, and/or benzodiazepines. These medications are addictive, and cannot be discontinued all at once, thus it is imperative a psychiatrist is directly and continually involved in the care.
There are many individuals who retain claustrophobic tendencies even after engaging in support (which should be, after all, ongoing), but also recognize these thought as unrealistic and fear-based. This classic “re-framing” of harrowing situations is yet another tenet of CBT: to use positive reinforcement and thinking about a time when a similar circumstance occurred, and the person with claustrophobia transcended it. Reminding sufferers of their successes is of absolute importance. We must note our progresses, both great and small.
I just stayed at a hotel this weekend; on the 10th floor, actually. And I finally did not have to take the stairs unless I wanted to.
It can and does get better with work and commitment. I’m living proof! Perhaps you are as well.
(Care to share your success story? Or your own experiences? Feel free to add your voice to the conversation, and leave a comment!)