Calling yourself "claustrophobic" may seem like an easy way to describe how you're feeling when you're in an uncomfortably busy bar or on a crowded train, but it might not be the best term to casually throw around. We all feel jam-packed or congested from time to time, but claustrophobia can be a very serious phobia that can rise to the level of a mental disorder, explains Franklin Schneier, MD, co-director of the Anxiety Disorders Clinic and special lecturer in psychiatry at Columbia University Medical Centre. So it's important to know the difference between a mild phobia and one that interferes with your everyday life.
Technically, claustrophobia is an excessive fear of closed spaces, Dr. Schneier says. It's a "situational phobia," so people with claustrophobia experience a variety of super fearful and anxious feelings when they're in closed spaces, he says. Most people with claustrophobia feel fine until they're triggered, and some people just experience more frequent triggers because they're exposed to them regularly (because they have to commute in traffic or ride an elevator everyday). "Typical thoughts are the fear that they will be trapped, that they will not be able to breathe, or that their anxiety will reach a level of panic that will cause them to lose control in some way," Dr. Schneier says. Usually, these thoughts manifest with physical symptoms, like having trouble breathing, feeling your heart pounding, getting hot or cold, or just sensing general nervousness. Maybe you've felt like this before, but does that mean that you have claustrophobia?
The chance that someone will have claustrophobia at one point in their life is only 4%, and Dr. Schneier says people usually experience it for long periods of time, and then they get over it. It's much more common for people to have mild claustrophobic fears that never reach the level of a disorder, and up to 22% of women and 8% of men will experience those, he says. "As is true for most phobias, the rate in women is generally double or more the rate in men," he says. In order for someone to be diagnosed with claustrophobia, they have to have excessive and marked fears or anxieties about being in closed spaces that persist for at least six months, and lead to avoidance of those places or activities, Dr. Schneier says. If you feel like that's you, and your symptoms interfere with your life, you should seek treatment from a therapist or psychiatrist who specialises in phobias.
So why do some people get hit with claustrophobic symptoms in the first place? It's complicated. Claustrophobia can be an "exaggerated form of a natural instinct" to avoid dangerous situations where you'd get trapped and lose air supply, Dr. Schneier says. "Somehow, in people with claustrophobia, the fear of this extreme situation has become generalised to situations that are not, in fact, dangerous," he says.
Claustrophobia does run in families, and it can be genetic or just a trait you pick up from your family members. In some cases, you can develop claustrophobia after a particularly traumatic event, like getting stuck in an elevator for a long period of time — but often, there's no precipitating event, Dr. Schneier says. Doctors don't totally have a medical explanation why people are claustrophobic, but they may have anxiety-prone brain circuits that make them more sensitive to small stressors, Dr. Schneier says. "But, a brain-based cause of claustrophobia specifically has not been identified," he says.
Luckily, claustrophobia is definitely treatable through cognitive behavioural therapy, Dr. Schneier says. Therapists usually work with you to figure out your (possibly unrealistic or unhelpful) beliefs about closed spaces, and then they help you find more useful ways of thinking that will help you cope the next time you're in one of those feared situations. "Sometimes, this may include relaxation exercises as another coping tool," Dr. Schneier says. Once you have the cognitive tools, the goal is to gradually enter the situations that you're afraid of.
If you think you might be claustrophobic, you shouldn't discount your symptoms. That said, nonchalantly assigning yourself with a phobia can belittle the fact that some people struggle to go about their daily lives because their phobias are so severe. But, if it's interfering with your life, even slightly — like you can't stand going to the movies or standing in a crowd because it makes you so anxious — you may want to consider getting help.