What is claustrophobia?

Claustrophy is the irrational fear of closed spaces that some people experience, such as small, windowless rooms, elevators, tunnels, basements, cars, subways, or airplanes. This is what is known as a phobia or anxiety when exposed to an object or a specific situation, which is why the person who suffers from it tries to avoid it in all possible ways. It equally affects men and women and it is estimated that 6-7% of the world's population suffers from it, although very few of them are diagnosed and receive treatment. In addition, it must be taken into account that there are many types of phobias (environmental conditions, animals, blood, people, situations ...) and that the triggers are not always closed spaces and dead ends, it can also occur in open spaces where there is a crowd, such as a demonstration, a concert or a very crowded venue.

Medically, claustrophobia is a and various theories are postulated about its origin. Some studies showed that the brain structure responsible for the fear response, the so-called amygdala cerebral had a smaller size in patients with phobia, causing exaggerated reactions to fearful situations. However, many psychiatrists and psychologists affirm that claustrophobia may be due to a traumatic conditioning experience, probably in childhood, in which exposure to a closed space was associated with a situation of fear. This association is fixed in the mind of the patient. and it can reappear at any age. Triggering factors or experiences may have been being locked in a darkened room, falling into a pool without knowing how to swim, getting lost in a crowd, getting stuck in a tight spot, being left alone in a vehicle, etc.

Symptoms that a claustrophobic experiences

To say that a person suffers from claustrophobia, it is not enough for them to get a little nervous in an elevator or in a tunnel, a series of criteria are needed:

• Severe and persistent fear, excessive or irrational in the presence or anticipation of the situation of being in a closed space.
• Exposure to the phobic stimulus (being in a closed space) always provokes an immediate anxious response that can lead to a crisis of.
• The same person admits that fear is excessive or irrational.
• The person tries avoid being in closed spaces and if it is, it is with intense anxiety or discomfort.
• Symptoms must last more than six months if the patient is under 18 years of age.
• The symptoms cannot be better explained by another psychiatric disorder, such as post-traumatic stress disorder, agoraphobia with or without anxiety, or social phobia.

Faced with exposure to a closed space or the mere anticipation of such a situation, the claustrophobic patient will present fear of either being locked up or of drowning from shortness of breath. This usually leads to a state of anxiety with sweating, palpitations, chest tightness, and a feeling of choking. Many claustrophobics unbutton jackets, shirts and ties thinking that this will improve their air intake.

How is it diagnosed?

The diagnosis will be based initially on the history that the patient tells of his personal experience. In addition, there are some tools to assess the claustrophobia of a patient, such as the claustrophobia scale, which assesses the patient's anxiety levels through 20 questions, or the claustrophobia questionnaire, a 24-item test that allows differentiating the symptoms of fear of drowning or confinement. It is important psychiatric or neurological associated with symptoms of claustrophobia.

Treatment for claustrophobia

The treatment of phobias in general and claustrophobia in particular can be approached from different points.

• Pharmacologically, basic antidepressants or anxiolytics can be prescribed to the patient to keep their anxiety levels under control, as well as rescue anxiolytic medication, for example diazepam, in case of suffering an anxiety crisis triggered by a potentially claustrophobic situation. However, as with most psychiatric disorders, drug treatment is not enough.
• Behavioral therapy is usually effective, especially in patients who fear not so much being in such situations but what may happen to them if they are in them. The treatment seeks to modify the erroneous impressions and thoughts attributed to these situations, in a way that reduces anxiety and the need to avoid such situations.
• In vivo exposure consists of exposing the patient slowly and gradually to his fear of enclosed spaces, increasingly leading to situations with greater claustrophobic potential. This method, despite being slow, has been shown to be effective in about 75% of claustrophobic patients.
• Interoceptive exposure is a method that seeks to recreate the physical sensations of the patient when he is in a claustrophobic situation but in a safe and controlled environment, with the same intention as in vivo exposure but without putting the patient in the feared situation. Negative perception and fear of such situations improve in approximately 25% of patients treated with this method.

Precautionary measures

There are no specific preventive measures against claustrophobia. However, if relatives or friends of a person detect behaviors that may be compatible with said disorder, it is important that they urge the patient to contact a specialist as soon as possible.