Do you panic in crowded elevators or feel anxious in rooms without windows? These feelings can arise with claustrophobia.

People with claustrophobia fear being in confined spaces. When this phobia is triggered, it can feel like the walls are closing in as the mental and physical symptoms of anxiety arise.

These feelings might lead you to avoid closed spaces like public restrooms, car washes, or airplanes.

Claustrophobia is a specific phobia, like arachnophobia (a fear of spiders) and a fear of flying.

Specific phobias are among the most common anxiety disorders in the United States, affecting 8.7% of the population. An estimated 12.5% of the population has claustrophobia.

Like other specific phobias, claustrophobia is more common in females than males.

The symptoms of claustrophobia vary between people. Some might experience moderate anxiety, while others become overwhelmed with fear and may have panic attacks.

People with claustrophobia can feel anxiety or panic when they encounter crowded or tight spaces, such as an elevator.

According to the Diagnostic and Statistical Manual of Mental Disorders (DMS-5), to be diagnosed with a specific phobia, symptoms must arise most times when you encounter the trigger, get in the way of your daily life, and last for 6 months or more.

Claustrophobia can have the following psychological or emotional symptoms:

  • intense anxiety or fear
  • fear of losing control
  • feeling an overwhelming need to leave the situation or room
  • knowing the fear is unreasonable but not being able to control it

Claustrophobia can also trigger physical symptoms of anxiety, including:

  • breathing problems
  • sweating
  • trembling
  • heart palpitations
  • dry mouth
  • chest pain
  • fainting
  • dizziness

Behavioral symptoms may include:

  • avoidance: avoiding elevators, crowds or being in heavy traffic
  • checking: checking for, or standing near, exits in a room

Triggers of claustrophobia may include:

  • elevators
  • public restrooms
  • MRI machines
  • tunnels
  • airplanes
  • crowded places
  • rooms with no windows
  • subways
  • revolving doors
  • cars with central locking

In many cases, people can trace their phobia back to a negative experience that involved being in an enclosed space, such as being stuck in a small place or having a traumatic event happen in an enclosed space.

Research from 2021 suggests that the same brain regions that are disrupted in social anxiety disorder are also involved in claustrophobia. One theory is that the frontal regions of the brain are unable to downregulate from hyperactivation, leading to increased fear.

Based on brain imaging, researchers believe that phobias are linked to the following brain regions:

  • amygdala, the ”fear center” of the brain
  • globus pallidus, involved in movement
  • left insula, involved in social life and empathy

During an assessment, a client will be asked how the fear impacts their daily life and relationships.

The clinician may use a questionnaire, such as the Spielberger psychology questionnaire. This set of questions consists of 20 items that measure external anxiety.

For children, there are three common scales used to evaluate symptoms of anxiety and fear. These include:

  • Fear Survey Schedule for Children: Revised
  • Revised Children’s Manifest Scale
  • State-Trait Anxiety Inventory for Children

The clinician may also screen the client for other disorders. A person with one phobia is 83% more likely to have other phobias. Research also shows that adolescents with more than one phobia tend to have earlier onset.

The first line of treatment for claustrophobia is cognitive behavioral therapy (CBT), where you work through negative or distorted beliefs and learn how to confront and change any beliefs that lead to feelings of fear.

Exposure therapy is another type of treatment where you get exposed to the physical sensation of anxiety in a controlled environment.

Exposure therapy can be paced in a variety of ways. These include:

  • Graded exposure: Together, the client and therapist construct a “fear hierarchy,” ranking triggers according to difficulty. They begin with mild or moderately difficult exposures and gradually work up to more difficult ones.
  • Flooding: In flooding exposure, the client is “flooded” with their phobic trigger until the anxiety diminishes. In this treatment, there is no gradual build up and no option of avoidance. The aim of flooding is for the person to realize that their trigger isn’t as dangerous as they’d believed, and that the discomfort is in their mind. Of course, this treatment isn’t for everyone, and the client must be fully aware of what is going to happen.
  • Systematic desensitization: Exposure treatment is combined with relaxation exercises so that the trigger feels more manageable. The aim is for the client to associate the feared situation with relaxation.

A newer form of treatment for phobias involves the use of virtual reality. For instance, a specific game for claustrophobia offers both elevator and MRI machine scenarios.

In some cases, a clinician might prescribe medication. These can include:

Benzodiazepines are the most commonly prescribed medication for people with specific phobias who are unable to avoid their triggers daily. However, they can be addictive and must be used with caution.

It’s important to come up with a plan for when you are exposed to your triggers. For instance, if you are afraid of getting on an airplane, but have no other choice, try the following tips:

  • Visualize a place that makes you feel calm. If looking at trees or the ocean makes you feel relaxed, consider carrying a photo that you can look at when you’re feeling anxious.
  • If possible (if you’re in an airplane seat, for example), close your eyes, put in headphones, and play relaxing music or soothing nature sounds.
  • Breathe deeply while counting to three with each breath.
  • Talk to yourself in a soothing way, as you’d talk to a loved one who is going through this. Tell yourself it’s going to be OK and that you’ll get through this.
  • If possible, call or text a trusted loved one who can talk you through the experience.
  • Stay in the moment by focusing on your senses. What do you see, feel, hear, and smell?

In the long-term, consider engaging in daily activities that will reduce your body’s stress response. These may include:

Phobias, including claustrophobia, are treatable. If you think you have claustrophobia, reach out to a trusted healthcare professional to discuss treatment options.

If you’re looking for a therapist or mental health support, the American Psychological Association (APA) offers tips. You can also check out Psych Central’s Find Help resources.