Managing Claustrophobia During Medical Procedures

If you experience symptoms of claustrophobia, you may feel afraid or anxious to undergo some important medical tests, such as a computerized tomography (CT) scan, bone scan, positron emission tomography (PET) scan, or a magnetic resonance imaging (MRI) scan.

While forgoing some activities due to your claustrophobia may be of no consequence, avoiding medical tests can be quite a different case. Delaying imaging can cause a health concern to go undiagnosed and for necessary treatment to be delayed.

What you are feeling is very real and in need of acknowledgement, but it should not prevent you from getting the medical care you need. There are many claustrophobia treatment options that can help mitigate your symptoms to make this process and other life experiences a bit easier.

What Is Claustrophobia?

The "Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) classifies claustrophobia as a type of anxiety disorder known as a specific phobia.

Diagnostic criteria for a specific phobia are as follows:

• An individual may experience intense fear of tight or crowded places that can come up in real time, or when thinking about an upcoming or hypothetical situation.
• When an individual is thinking about or is in an enclosed or tight space, it brings up anxiety symptoms (panic, sweating, racing heart, hot flashes, difficulty breathing, feeling dizzy, and shaking) immediately or almost immediately.
• An individual will avoid enclosed or tight spaces at all costs.
• An individual may have a phobic response that lasts at least six months.
• The phobia interferes with the individual's quality of life.
• An individual may have cognitions that include a fear of being suffocated, feeling unable to escape, and feeling restricted.
• An individual may have a reaction that is out of proportion, given the situation.

Claustrophobia Is Different for Everyone

Like other phobias, claustrophobia can range in terms of symptom intensity. Each individual will have unique triggers and responses depending on a variety of factors.

Identifying your specific triggers can help you find appropriate resources and support. Claustrophobia may be triggered by a variety of situations including:

• Riding in an elevator
• Being in a small room filled with lots of people
• Traveling via airplane or boat
• Going through a revolving door
• Hiking through caves
• Driving in a small car
• Riding the subway

Why Medical Procedures Trigger Claustrophobia

MRIs, CT scans, PET scans, and bone scans all require certain parts of your body to be enclosed or semi-enclosed in the specific machine so it can capture clear images of the area of interest. For some individuals with claustrophobia, this can incite high levels of fear, anxiety, and panic.

But those are not the only factors at play. According to research, the loudness and duration of time in the machine, as well as feelings of suffocation and fear of being injured, are the top reasons MRIs are dreaded by those with claustrophobia.

Studies indicate that CT scans and PET scans may feel triggering for those with claustrophobia as well.

Effects of CT, MRI, and Bone Scan Claustrophobia

CT scans and PET scans can trigger symptoms of claustrophobia prior to the scan, with symptoms continuing once the scan is complete even if the patient has experienced this type of procedure before.

Patients may experience anxiety during the screening process which may result in them moving more during the actual medical test.

This can impact the image quality of the scan and may lead to the patient having to do the procedure again, or having to stay in the machine for longer periods of time, thus increasing their anxiety even more.

Managing Claustrophobia

Claustrophobia related to bone scans, MRIs, CT, and other imaging procedures may be treated with psychotherapy and/or medication. It's important to take your time finding the best treatment for your unique needs so your symptoms can be managed.

This will obviously help you in a situation like one of these medical tests, but more importantly, it will help improve your overall quality of life with claustrophobia.

Medication

Medications may be prescribed to help you manage symptoms associated with claustrophobia. Often times, medications are prescribed alongside psychotherapy treatment.

Medications that may be used to treat symptoms of claustrophobia include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Benzodiazepines
• Beta-blockers

Psychotherapy

There are many psychotherapy treatment options available for claustrophobia. A mental health professional may help you better understand why your claustrophobia developed and how to manage your symptoms. They may also offer you appropriate resources and referrals.

Some treatment options and exercises include:

• Cognitive behavioral therapy (CBT)
• Exposure therapy, imaginal exposure therapy, virtual reality exposure therapy, and systematic desensitization
• Hypnotherapy
• Eye movement desensitization and reprocessing (EMDR)
• Visualization exercises
• Relaxation exercises
• Meditation
• Emotional freedom technique
• Group therapy for specific phobias

Talk to Your Doctor

Even though it may feel nerve-wracking to speak with your doctor about your symptoms of claustrophobia, keep in mind that they are there to help you and provide you with the best treatment possible.

These may include:

• Pre-treating you with anti-anxiety medication prior to the procedure
• Offering more open communication prior to the procedure
• Offering you relaxation tips

It is also worth asking about alternative types of imaging procedures, which may be acceptable for some conditions.

Be sure to discuss the risks and benefits of possible alternatives with your physician so you can make an informed decision regarding your medical care.

Preparing Yourself for the Procedure

Preparing yourself ahead of time and the day of your procedure may help reduce your level of fear. Some things you should ask about include:

The Imaging Machines

Some facilities offer open MRIs, which have no sides. Others have open upright MRIs, which eliminate the closed chamber and allow the patient to sit or stand.

When that is not possible, ask about entering the machine feet first. (This may be permitted depending on what part of the body is being scanned.)

To See the Equipment in Advance

For many people, just seeing the machine and understanding how it operates can help reduce anticipatory anxiety. You may even be permitted to lie on the table or watch a technician turn on the equipment.

Distractions

Facilities may provide music, earplugs, and special headphones to help reduce the machine's sound and create a more peaceful environment. Some facilities may set up a relaxing beach scene or another pleasant environment within the testing room as well.

Receiving Updates

Because certain procedures may take awhile, it can be helpful to know when you have reached certain milestones. Typically technicians will check in every few minutes after each scan is taken, but you may also request to know when you have hit the halfway point.

Takeaway

It is totally normal to feel nervous about an upcoming medical procedure, especially one that involves holding still in a tight machine while scans are taken. Many people have fears of being trapped, smothered, or suffocated, but if your anxiety is strong enough that it is preventing you from seeking appropriate medical care, it's critical that you speak with your physician or a mental health professional.

Keep in mind that health care providers understand claustrophobia and are there to support you so you can get the best care possible.