Medicines for Claustrophobia

What it is

Claustrophobia is the fear of enclosed or confined spaces. It is one of the more common specific phobias, and can range from mild unease to an intense fear that triggers significant anxiety or even panic attacks. People with claustrophobia may feel fearful or panicky in situations such as small rooms, lifts, tunnels, crowded places, aeroplanes, trains, MRI scanners, or any space that feels enclosed or from which escape feels difficult; some also fear being restricted or not being able to get out, rather than the space itself. When exposed to (or anticipating) the feared situation, a person may experience the symptoms of anxiety or a panic attack, such as a racing heart, sweating, trembling, shortness of breath, chest tightness, dizziness, a feeling of dread, or a fear of losing control; and they may go to considerable lengths to avoid enclosed spaces, which can affect daily life, travel, work, and medical care (for example avoiding necessary scans). Like other phobias, claustrophobia involves a fear that is out of proportion to any actual danger, and the person often recognises this but still cannot control the fear. Claustrophobia can develop for various reasons, sometimes linked to a past frightening experience, and sometimes without an obvious cause. Importantly, claustrophobia is very treatable: phobias generally respond well to psychological treatments, particularly cognitive behavioural therapy (CBT) and gradual exposure, which help people to face and reduce their fear over time. Self-help techniques and support can also help, and, in some situations, other support may be used (for example to help someone tolerate a necessary medical procedure). The key messages are that claustrophobia is a common and treatable fear of enclosed spaces, that it can cause significant anxiety and avoidance, and that talking therapies such as CBT are effective in helping people overcome it.

How it is treated

Claustrophobia is very treatable, and the main and most effective approach is psychological therapy, particularly cognitive behavioural therapy (CBT) with gradual exposure, along with self-help and support. Because phobias respond well to treatment, it is worth seeking help if claustrophobia is affecting your life or causing distress. The main treatment is talking therapy, especially CBT, which helps people understand and change the thoughts and responses that maintain the fear, and — crucially — uses gradual, graded exposure: facing the feared situation in a step-by-step way, starting with less anxiety-provoking situations and progressing gradually, which helps the person learn that the situations are not dangerous and that their anxiety reduces over time, so the fear lessens. This graded approach is very effective for specific phobias. Learning and practising anxiety-management techniques — such as controlled breathing and relaxation — helps people cope with the anxiety during exposure and in feared situations. Self-help resources and guided self-help based on these principles can also be effective, and support is available. In some cases, other measures may be used — for example, to help someone tolerate a necessary medical procedure such as an MRI scan (options such as open scanners, support, relaxation techniques, or, occasionally, medication for the procedure may be discussed), or, for some people with significant anxiety, other treatments as advised by a doctor. It is worth seeing a GP if claustrophobia is significantly affecting your life, causing marked distress, leading to avoidance that is a problem (for example avoiding necessary medical care or travel), or if you would like help to overcome it — the GP can advise and arrange access to psychological therapy. The reassuring and encouraging messages are that claustrophobia is common and very treatable, that talking therapies (particularly CBT with gradual exposure) are effective in helping people face and reduce their fear, and that self-help and support are available — so it is worth seeking help rather than living with the limitations the fear can cause.