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How To Stop Panic Attacks While Driving

August 17, 2020

 

 

Here are some tips to help you cope with having a panic attack while driving. Use Self-Talk to help shift you away from reacting with catastrophic thoughts to more helpful thinking. Do some Deep breathing to reduce feeling dizzy or lightheaded and help you feel more in control.  Progressive Muscle Relaxation will help your heart slow down and reduce tension. Use Safe Distraction to shift your brain from the panic by pulling your attention out of your head and outside of your body. Use Time Projection to help you move your focus away from the danger and to a safe destination. Take breaks when driving long distances to help you relax and regain mental focus. Eat snacks to maintain healthy blood sugar levels to decrease physical and mental exhaustion and increase your ability to manage anxiety.

  

 

 

Panic Attacks While Driving

 

I am sorry if you are having panic attacks while driving your car. I know how scary this can be. Feeling anxious while driving is normal and panic attacks are commonly experienced when anxiety is high.

 

Driving can be risky and dangerous at times. Driving on busy highways, over bridges, at night, and in the rain can cause higher levels of stress and anxiety. What makes this worse is feeling trapped in your car with no escape. 

 

This translates to more physical tension, faster breathing, a faster pounding heart, and thoughts of losing control that cause you to feel fearful.  The fight or flight stress response kicks in and then a panic attack can quickly follow.

 

Panic Attack Statistics

Experiencing panic attacks while driving can be very scary. According the National Institute of Mental Health (NIMH) approximately 2.7% of the population or roughly 3 out of 100 people experience panic disorder each year.

 

What do people fear when driving?

The fear of losing control is a major cause and symptom of a panic attack. People who have panic attacks while driving, fear losing control of their vehicle, whether due to their own impulse control to maintain control of the vehicle or due to other drivers actions.

 

You may fear driving off the road, driving off of overpasses and bridges, and other vehicles running into you. A panic attack can also be triggered by these fearful thoughts of losing control.

 

You may have unwanted fearful thoughts of deliberately losing control and driving off the road or bridge. You may fear and worry about your own impulse control to keep yourself safe while driving.

 

After having their first panic attack while driving, many people start avoiding specific areas where the panic attack first occurred.

 

Soon bridges, tunnels, construction areas, any elevated roads, and driving next to big trucks are also avoided.

 

Panic attacks while driving can eventually lead a person to avoid driving altogether or even being a passenger in a car. 

 

Experiencing panic attacks while driving can quickly turn into a fear of driving or a driving phobia.

 

What are the symptoms of a panic attack while driving?

 

 

 

The Fear of Driving (Driving Phobia)

 

Driving phobia is an intense irrational fear of driving an automobile or even just sitting in one.

 

Driving phobia is categorized by the Diagnostic and Statistical Manual of Mental Disorders (DMS-5) as a specific phobia that causes emotional, physical, and behavioral symptoms.

 

The Fear of Driving Symptoms

 

Emotional

  • Specific Fear

  • Panic attacks

Physical

  • Pounding heart

  • Sweating

  • Trembling

  • Shortness of breath

  • Feeling of choking

  • Chest pain

  • Nausea

  • Feeling dizzy 

  • faintness

  • Numbness or tingling

  • Chills or hot flashes 

Behavioral

  • Fleeing or running away

  • Freezing or being immobilized

  • Avoidance

 

How Are Panic Attacks Diagnosed?

 

There is no diagnosis of "Panic Attacks" but there is a diagnosis of Panic Disorder. Panic attacks are usually a symptoms of other anxiety disorders.  However if panic attacks are experienced due to the anticipation and fear of experiencing a panic attack (Fear of Fear) then a diagnosis of Panic Disorder can be made.

 

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) defines Panic Disorder as recurrent and unexpected panic attacks that can be diagnosed if one or more of the following symptoms occur:

  • Pounding heart

  • Sweating

  • Trembling

  • Shortness of breath

  • Feelings of choking

  • Chest pain

  • Nausea

  • Feeling dizzy

  • Faintness

  • Feelings of unreality (Derealization) or feeling detached from your body (Depersonalization)

  • Fear of losing control or going crazy

  • Fear of dying

  • Numbness or tingling

  • Chills or hot flashes

These symptoms must also be followed by 1 month or more of worry about future panic attacks and unhelpful behavior aimed at trying to control it such as avoidance.

 

 

 

What Causes Panic Attacks While Driving?

 

Panic attacks while driving and the fear of driving can be caused by any number of things.

 

Past Experiences 

 

Prior accidents, driving through severe weather, losing control of the car, witnessing or hearing reports of fatal car crashes, and getting lost while driving all have the potential to cause anxiety and trigger symptoms of a panic attack.

 

Misinterpretation of Physical Sensations

 

Causes can also be simple such as low blood sugar and feeling tired. This can cause uncomfortable physical sensations that could be interpreted as internal danger, leading to a panic attack while driving.

 

After having the first terrifying panic attack while driving, the fear becomes having another panic attack while driving.

 

Driving is now associated with significant anxiety and panic so that driving even short distances or just getting into the car can trigger a panic attack.

 

Avoiding driving will then strengthen the fear, prolong the fear, and increase the occurrence of panic attacks.

 

Control Issues

 

As with most anxiety, panic attacks are related to control. Being in control of one's own physical safety and avoiding danger.

 

Do you hate feeling out of control or do you like it, such as when riding a roller coaster?

 

Control can be both a feeling and a behavior. Control is also a reflexive action that aids in our survival. Take for example losing control and slipping on ice. Your reflexive reaction will be to get control fast before you fall.

 

Just knowing that you will be walking on ice will motivate you to be more in control and walk carefully. It is natural for us to try and regain control when we feel out of control.

 

Panic attacks cause people to feel out of control. The sympathetic nervous system (Fight or Flight) is fast, automatic, and is activated mostly without our conscious control. This is why you feel out of control and fear losing control during a panic attack.

 

Most people attempt to gain more control or maintain control when panicking. If you are driving when a panic attack happens, you may grip the steering wheel tighter.

 

You become over-controlled in response to a panic while driving and your fear of losing control.

 

Unfortunately, this reinforces the false perception that there is danger. This can increase the level of anxiety and further fuel a panic attack.

 

So you are not really maintaining control, you are maintaining and reinforcing the panic attack. ​

 

When it comes to anxiety and panic, the more controlling you are, the more out of control you will feel. By increasing your level of control when anxious, the message that you are in danger gets to the sympathetic nervous system and then it works even harder.

 

 

 

Here Is How To Stop A Panic Attack While Driving

 

When listening to the radio and opening the windows doesn't work, these strategies below can be performed while driving so that you have the experience of overcoming a panic attack. This will improve your confidence in dealing with a panic attack while driving and will decrease the number of future panic attacks.

 

It is preferable to use these strategies while you are driving but you can also stop the car by the side of the road and perform these techniques until the panic attack subsides and then begin driving again.

 

 

1. Use Self-Talk

 

Use the self-talk technique at the first sign of anxiety or a panic attack. Label your feelings and state what is actually happening.

 

This will help shift you away from reacting with catastrophic thoughts of "OMG, OMG I'm going to lose control and die" to a more realistic response that begins to stop the anxiety.

 

Say to yourself:

"I am feeling scared. I am not in any real danger, this is only anxiety. A panic attack is not dangerous. It's only a false alarm."

 

 

2. Deep breathing

 

Deep breathing is by far is the most helpful strategy to manage and minimize the symptoms of a panic attack while driving.

 

Deep breathing gives you a sense of control over your body when feeling out of control during a panic attack, especially if you are hyperventilating or feeling dizzy.

 

Deep breathing helps correct the oxygen and carbon dioxide levels during panic attacks to reduce feeling dizzy or lightheaded.

 

Deep breathing works to activate the parasympathetic nervous system which is responsible for producing a calm and relaxed feeling.

 

Deep Breathing Exercise

  • Inhale through your nose slowly by expanding from your belly first then fill your upper lungs for a count of 5

  • Hold your breath for a count of 2

  • Exhale slowly and forcefully through pursed lips for a count of 10

  • Repeat this 5 to 10 times or do it for at least 1 minut

 

3. Progressive Muscle Relaxation

 

Progressive muscle relaxation is often used in conjunction with deep breathing to overcome the fight or flight stress response of the sympathetic nervous system by activating the parasympathetic, rest and digest, system.

 

As you tense and then release a muscle, it has to relax. Tensing each muscle group and then relaxing causes your muscles to become more relaxed than they were before tensing. As a result the heart slows down because relaxed muscles don’t need as much oxygen.

 

Breathing and blood pressure also slow down. This will also help you to decrease being over-controlled and will send the message to your sympathetic nervous system that the danger has passed.

 

Progressive Muscle Relaxation Exercise While Driving

  • While driving or sitting in a stopped vehicle, begin by tensing your right hand by griping the steering wheel for a count of 5, then relax your grip for a count of 5

  • Tense your left hand by gripping the steering wheel for a count of 5, then relax your grip for a count of 5

  • Shrug your shoulders to your ears and tense for a count of 5, then relax your shoulders for a count of 5

  • Tense your abdomen for a count of 5, then relax for a count of 5

 

Tips: Focus on the difference between the tension and relaxation as this is the most important part of the exercise.

 

 

4. Safe Distraction

 

Distraction is helpful in providing temporary relief from the mental symptoms of a panic attack.

 

It causes you to stop focusing on the physical symptoms of a panic attack and the fearful thoughts about driving that fuel to a panic attack.

 

Distraction shifts your brain from the cycle of the panic feedback loop by pulling your attention out of your head and outside of your body.

 

You stop analyzing your symptoms and you start focusing on things you see in your environment, like how many colors you see while driving or how many different state license plates you can find.

 

Music is also a great safe distraction. You use your hearing focus on the music. You can choose music that either helps calm you or music that makes you feel strong and motivated.

 

5. Time Projection

You can also project your mental focus beyond the current moment or feared situation. You can focus your thoughts further ahead, when you are at your destination and feel more comfortable.

 

When driving over a bridge, you would focus your thoughts on the other side of the bridge and what it feels like when you are on the way down and near land.

 

The symptoms of a panic attack begin to decrease because you are moving away from the danger of focusing on the uncomfortable symptoms and repeating “OMG, OMG, I’m going to die” and instead focusing on the safety of your destination.

 

6. Take breaks when driving long distances

During long drives that anxiety will take its toll on you physically. Feeling tense, looking for any danger to avoid, and being over-controlled will deplete your physical resources.

 

You may experience a dip in your blood sugar and become very fatigued. Pulling off the road at a rest stop or a gas station will give you a necessary break, help you relax, and make it possible for you to continue to your destination.

 

7. Eat snacks to maintain healthy blood sugar levels

Eating helps to ensure that your blood sugar level doesn't dip too far and cause adrenal fatigue. This will cause you to feel more nervous and anxious.

 

Anxiety and stress tap into your adrenaline and burn up your blood sugar for energy. This will cause you to feel physically exhausted and mentally foggy.

 

Try to eat healthy snacks such as a protein bar, trail mix, or something easy to open while your driving. This will replenish your blood sugar levels and increase your ability to manage anxiety and stop you from having a panic attack while driving. 

 

 

What Is The Treatment for Panic Attacks?

 

If you believe you could have Panic Disorder it will be helpful and important to seek consultation with a mental health professional to first verify the diagnosis and then receive appropriate treatment.

 

Treatment often consists of a combination of medication and psychotherapy.

 

Medication helps take the edge off the physical symptoms of anxiety and psychotherapy helps to challenge irrational thinking and beliefs that lead to the panic attacks.

 

Cognitive Behavioral Therapy (CBT)

 

Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving.

 

You learn different ways of responding to the symptoms of a panic attack. CBT helps challenge and change unhelpful beliefs that cause anxiety by restructuring your automatic thinking.

 

CBT sessions also provide education on the symptoms of panic disorder.

 

Cognitive Restructuring

 

Cognitive restructuring is used to identify and dispute unhelpful, automatic, and irrational thinking so that you can create highly effective thoughts with the power to alter your emotions and behavior.

 

An example of an irrational thought is “What if I lose control of my car. I’ll have a panic attack and crash.”

 

We develop beliefs about ourselves, other people, and the world. These beliefs influence how we think. If you believe that the world is basically a dangerous place, then your thoughts will follow.

 

If you believe that you are defective and not a capable person, then your thoughts will reflect those beliefs.

 

It is not the public place that causes the anxiety, it’s your thinking and beliefs that cause the fear and anxiety.

 

Exposure Therapy

 

Exposure therapy, also known as prolonged exposure, is a form of CBT.

 

As with most anxiety disorders, in order to learn how to overcome the symptoms of panic disorder, you need to have the experience of successfully managing the symptoms. This often means exposing yourself to the thoughts, images, and the public places that trigger the panic attacks, and then applying the coping strategies until the thoughts, images, and public places no longer produce the same level of fear. 

 

Medication

 

Please consult with your primary care physician or a psychiatrist regarding the use of any medication.

 

Medication can help reduce the symptoms of anxiety that occur in public situations that you have been avoiding such as school, work, and any other necessary public location.

 

Commonly prescribed medications include benzodiazepines and anti-depressants.

 

Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use. However, the long term use of benzodiazepines is associated with the risk of developing tolerance, dependence, and possible other adverse effects.

 

Commonly prescribed benzodiazepines are:

  • Alprazolam (Xanax)

  • Lorazepam (Ativan)

  • Diazepam (Valium)

  • Clonazepam (Klonopin)

 

Anti-depressant medications are also effective at reducing symptoms of anxiety on a daily basis. This helps dampen the physical and emotional effects of anxiety and increases a person’s capacity to cope with stressful situations.

 

Commonly prescribed anti-depressants are:

  • Citalopram (Celexa)

  • Escitalopram (Lexapro)

  • Sertraline (Zoloft)

  • Paroxetine (Paxil)

  • Fluoxetine (Prozac)

 

Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety.

 

Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to a panic attack. Beta blockers do not interfere with cognitive performance and are by far my favorite for removing the jitters before a speech.

 

Commonly prescribed Beta Blockers:

  • Propranolol (Inderal)

  • Atenolol (Tenormin)

  • Acebutolol (Sectral)

  • Bisoprolol (Zebeta)

  • Metoprolol (Lopressor, Toprol-XL)

  • Nadolol (Corgard)

  • Nebivolol (Bystolic)

 

Conclusion

Panic attacks can be very uncomfortable and frightening, especially when driving and staying in control is important.  But panic attacks are very treatable and most people stop experiencing panic attacks as they are able to prevent them and stop them.

 

Here are more ways on how to stop panic attacks

 

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Attacking Panic System

I want to help you. Please feel free to contact me confidentially by email below with any questions or if you need some advice about the content posted on The Fear Blog.

Dr Hunter's Qualifications

My name is Dr. Russell A Hunter, PsyD and I am a Licensed Clinical Psychologist recognized by the National Register of Health Service Psychologists as meeting the National Register’s stringent requirements for education and experience as a healthcare professional.

 

I specialize in the field of Clinical Psychology and I am an expert in the treatment of Panic Disorder, Anxiety Disorders,  ADHD, and Neurocognitive Disorders. I provide CBT and psychological testing at Northern Virginia Psychiatric Associates within the Prince William Medical Center.

I published a book titled, "Attacking Panic: The Power to Be Calm" and it is available on Amazon and Barnes & Noble. 

Attacking Panic: The Power To Be Calm. Copyright © 2017 Russell A. Hunter, Psy.D. All rights reserved. Attacking Panic is available in paperback and Kindle edition at Amazon and in paperback at Barnes & Noble and other online retailers.

How to Stop A Panic Attack Quickly.

Russell A. Hunter, Psy.D. Psychology Today Profile

National Register of Health Service Psychologists

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