CLAUSTROPHOBIA: What is it, Causes, Symptoms and Treatment

Surely all of us as human beings have had some experience that produces exorbitant fear. Fear paralyzes us and fills us with anguish about what may happen minutes, hours or days later, but it can also trigger a vasovagal or noradrenergic response in where our hearts shake, our blood freezes, our hairs stand on end, our pupils dilate and all we want to do is run out of a determined situation. What characterizes us as subjective beings is that not all of us fear the same things, some fear the same things more intensely. heights, others to animals, some to blood and a very considerable number have an intense fear of closed places or with little space. That is why in this Psychology-Online article we explain more about the claustrophobia, what is it, its causes, symptoms and treatment both psychological and pharmacological of this phobia.

Index

1. What is claustrophobia
2. Causes of claustrophobia
3. Difference between claustrophobia and delusional disorder
4. Claustrophobia symptoms
5. How to overcome claustrophobia: treatment

What does claustrophobia mean? Claustrophobia is a type of anxiety disorder in which a intense fear or anxiety about confined or enclosed places. For example, some of these places might be the following:

• Elevators.
• Small rooms.
• Tunnels
• Vehicles with all windows closed.
• Rooms with little or no lighting.

Being fear or fear a natural emotion and necessary for human survival, it cannot be labeled as something pathological or abnormal. It transforms into something that requires psychological intervention when this fear disables us to function properly or as we used to do before the characteristic symptoms appeared. In the following article you will find more information about what is fear in psychology.

The claustrophobia It is part of the anxiety disorders of DSM 5 (2013), in a subcategory called specific phobias. Claustrophobia is, as its name implies, a type of phobia characterized by its phobic stimulus: closed spaces.

But in order to make a diagnosis of specific phobia, the fear response must differ from the normal and transient fears that commonly occur in the population. For the diagnostic criteria to be met, the fear or anxiety must be intense and severe, although this fear can vary with the proximity of the feared situation (closed spaces) and can happen in anticipation of it or in real exposure to the situation. Therefore, a person who feels anxiety only rarely when exposed to closed spaces would not be diagnosed (for example, if one in five times they experience anxiety when being indoors or reduced).

However, the degree of fear or anxiety may vary at different times of the day. exposure to closed spaces due to various contextual factors, such as the presence or accompaniment of other people, the duration in which it is maintained within enclosed spaces and the size of the room and the number and size of possible exits (doors and Windows).

DSM 5 (2013) states that the sociocultural environment of the individual must be taken into account when diagnosing claustrophobia. For example, fear of the dark may be reasonable in contexts of ongoing violence or fear of Enclosed spaces may be reasonable for diseases involving a pathway obstruction respiratory

Above all, in order to diagnose a person with claustrophobia, the phobia must cause clinically significant discomfort or social, labor or other important areas of activity deterioration.

The risk factors or possible causes of claustrophobia presented by DSM 5 (2013) are the following:

• Environmental: such as overprotective parents, loss of parents, physical abuse, sexual abuse and harmful experiences in places similar to phobic stimuli.
• Genetic and physiological: there may be a genetic susceptibility to claustrophobia (for example, a person with a first-degree relative who has suffered the same intense and marked fear of closed places is significantly more likely to have the same phobia).
• Temperamental: negative affectivity or behavioral inhibition contribute to the appearance of this phobic disorder.

In response to the delusions of patients with schizophrenia or a delusional disorder, sometimes they avoid objects. Therefore, the same symptom can appear as in claustrophobia: avoid closed or confined places. However, the marked difference between these two pathologies is that in schizophrenia and the rest of psychotic disorders it presents with anosognosia (the ignorance of the disease or the situation referred to patients who have no perception of their functional deficits). While in claustrophobia, whoever presents it is aware of it.

According to DSM 5 (2013) the symptoms of claustrophobia are the following:

• Persistence of a coping mechanism avoidance of phobic stimulus.
• Many times their symptoms come in the form of crisis of panic complete or limited (expected or unexpected)
• Feeling short of breath
• Incrise of cardiac frecuency.
• Hyperhidrosis (excessive sweating).
• Shaking or shaking.
• Feeling of suffocation
• Pain or discomfort in the chest.
• Nausea or abdominal discomfort.
• Motor agitation
• Hyperventilation
• Feeling dizzy, unsteady, light-headed, or fainting.
• Chills or feeling hot
• Paresthesias (numbness or tingling sensation).

We understand then that the person diagnosed with claustrophobia is not afraid of the closed space itself, but rather of the possible unpleasant consequences to be in the place. For example, to remain locked up forever or suffocate due to the little amount of air in the place, the limitation of movements (moving the arms, legs or head).

When the person with claustrophobia anticipates that he will enter or enter a closed space he will experience the noradrenergic and / or vasovagal reaction: dizziness, increased heart rate, or any of the above listed. Because of these symptoms, confined spaces are generally avoided (for example, take the stairs instead of the elevator).

Claustrophobia usually complicates the life of the person who presents it in some aspects. A common example is the medical magnetic resonance test, since to perform this test the patient must be inside a closed tube-shaped device. Therefore, it is important to apply an effective treatment for claustrophobia in order to improve the quality of life of the patient.

Claustrophobia: psychological treatment

Below are two types of behavioral techniques for claustrophobia psychological intervention:

• Flood therapy or flooding: Celedonio Castanedo (2008) states that in flood therapy an imaginary or in vivo situation is created, in which the patient is exposed to situations that cause anxiety while does everything possible to prevent avoidance or escape responses from occurring, such as becoming distracted, falling asleep, or ceasing to imagine the situation, arguing tiredness, laziness, or pain in head. It is one of a kind of exposure techniques. Although certain risks have been found when the patient decides to suspend treatment due to how invasive the treatment usually is but it creates a faster result than systematic desensitization, which is somewhat more structured and with a longer process. duration.
• Systematic desensitization: According to Celedonio Castanedo it is a technique created by J. Wolpe in which his basic procedure establishes a list of situations in which key stimuli found in the analysis of the components of the anxiety response are incorporated. These stimuli are included tactically so that situations have the ability to evoke anxiety, with different degrees of intensity, then the patient is asked to imagine himself experiencing these situations. Then, according to the intensity of the anxiety experienced, the list of situations is structured in a hierarchy that begins with situations that produce the lowest levels of intensity and ends with the most anxiogenic. Systematic desensitization then consists of asking the person with claustrophobia that, being relaxed (for this they will have trained in relaxation techniques previously), imagine several scenes that each provoke a greater reaction than the previous one. The repeated presentation in imagination, while the subject is relaxed, of the phobic stimuli, produces the gradual weakening and the elimination of the anxiety responses.

Claustrophobia: drug treatment

The drugs of first choice due to their reduced side effects are the selective serotonin reuptake inhibitors (SSRIs), each of them must be prescribed and controlled by a clinical professional. The following is the most effective drug in treating specific phobias (claustrophobia):

• Escitalopram: generally classified as an antidepressant, but it does not serve as an antidepressant alone.

How does it work? Improves serotonin transmission, blocks the serotonin reuptake process, desensitizes serotonin receptors and increases serotonergic transmission.

How long does it take to take effect? The effects are not immediate, usually until the second or fourth week. If there are no effects for six to eight weeks a higher dose may be required or no effect may be achieved and then you can switch to another drug or add another drug as an adjuvant. The usual dose is 10-20 mg per day and it is increased to 20mg per day if necessary (one intake in the morning and one in the afternoon). Its routes of administration can be by tablets, capsules or oral solution. The trade names are Lexapro, Celtium, and Meridian.

Their side effects and their respective interactions with other drugs should be taken into account. For example, with tramadol, monoamine oxidase blockers, triptan, and blood thinners.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Claustrophobia: what is it, causes, symptoms and treatment, we recommend that you enter our category of Clinical psychology.

Advice

• To learn to control the anxiety that is generated in situations of claustrophobia, it is important to know how to listen to your own body, detecting when you are tense, to be able to start the relaxation techniques in which the patient will be instructed in the therapies behavioral
• Anticipation. The established tendency in the claustrophobic to make negative predictions and anticipations about what will happen when entering a closed space (not being able to move, suffocating…). For this, cognitive techniques are used aimed at maintaining uncertainty with a normal level of d
• Before entering a confined space, stop and breathe deeply.

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM 5). Editorial Panamericana.
• Castanedo Secadas, C. (2008). Six psychotherapeutic approaches. Editorial El Manual Moderno. Mexico City.