Claustrophobic? Here's how to prepare for a screening.

For many people, squeezing into an imaging machine for an MRI or a CT scan is just a part of their medical treatment. But for people with claustrophobia, it can mean an incoming panic attack.

Claustrophobia is a form of an anxiety disorder, agoraphobia, characterized by an irrational fear of confined or crowded spaces because the person has an underlying subconscious fear that they are unable to escape, says Dr. V. Geeta Bansal, a neurologist with the Great Lakes Institute of Neurology and Psychiatry and an Advocate Physician Partner with Advocate Condell Medical Center. When individuals are triggered, the sympathetic nervous system responsible for our fight or flight response takes over and the person experiences a panic attack.

Claustrophobia could be related to the dysfunction and overactivity of the amygdala, which is the part of the brain that controls how we process fear, Dr. Bansal says. The amygdala is a primitive part of the brain that evolutionarily helps us to stay safe, but sometimes it can be dysregulated and there can be fear responses that don't sometimes make sense to us. For these reasons, people affected by claustrophobia will go out of their way to avoid tight spaces such as elevators, tunnels, trains or airplanes.

But what happens when someone needs to be screened?

Dr. Bansal recommends patients listen to relaxing music that can help distract their mind from the fact they are in a small space. Deep, calm breathing can also mitigate hyperventilation or an anxiety attack. And it can also be helpful to talk to the technician, family member or friend during the screening or visit the facility where you're getting screened beforehand.

"The more educated you are on the specifics of the test, the less likely you are to be surprised by something," Dr. Bansal says. "Ask the doctor to explain the details of the MRI procedure and know what to expect."

Dipin Gupta is a patient who experienced firsthand how claustrophobia can interfere with an important screening. He was supposed to have a nuclear stress test but the minute he got into the room, he could feel his claustrophobia rising. The room felt too small and too tight with too many people. He aborted the procedure.

But then someone recommended he reach out to the cardiology team at Advocate Condell Medical Center. Members of the cardiology and nuclear medicine teams shared that he could take a 360 virtual tour on the Advocate Condell website that included the nuclear cardiology suite and imaging room. On top of that, they helped him schedule an in-person tour of the department, imaging room and imager, during which he was allowed to lay down and go through a pretend imaging procedure.

"The staff was so good and they were all taking such good care of me," Gupta says. "It was feeling like home. With people with claustrophobia, you have to give people time and go slowly and the thing will get easier. At Condell, all the staff people were holding my hand and being so nice. I can tell you it was a world class experience I had there."

Dr. Bansal shares some additional tips for people affected by claustrophobia:

- Distract your mind from triggers

- Breathe slowly and deeply

- Focus on something safe

- Remind yourself that fear and anxiety will pass

- Challenge what is triggering the attack by repeating that the fear is irrational

- Treat your claustrophobia by psychotherapy, exposure therapy or cognitive behavioral therapy

- Try different relaxation and visualization techniques such as counting down from 10 or picturing a safe space