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Panic Attacks While Driving
Experiencing panic attacks while driving can be very scary. According the 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.
The fear of losing control is a major 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.
They may fear driving off the road, driving off of overpasses and bridges, and other vehicles running into them while having a panic attack. A panic attack can also be triggered by these fearful thoughts of losing control.
People may have unwanted fearful thoughts of deliberately losing control and driving off the road or bridge. They fear and worry about their own impulse control to not drive off the road.
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 anywhere 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.
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
Shortness of breath
Feeling of choking
Numbness or tingling
Chills or hot flashes
Causes of Panic Attacks While Driving
Panic attacks while driving and the fear of driving can be caused by any number of things.
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.
As with most anxiety disorders, panic attacks are rooted in 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.
Helpful Techniques 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, preferably while driving so that you have the experience of overcoming a panic attack while driving. This will improve your confidence in dealing with a panic attack while driving and should decrease the amount of future panic attacks.
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
Also known as diaphragmatic breathing, 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
Repeat this 5 to 10 times or do it for at least 1 minute
Exhale slowly and forcefully through pursed lips for a count of 10
Hold your breath for a count of 2
Inhale through your nose slowly by expanding from your belly first then fill your upper lungs for a count of 5
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
Tips: Focus on the difference between the tension and relaxation as this is the most important part of the exercise.
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 that just add more 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 something else in your environment, like how many colors you see while driving or how many different state license plates you can find.
You can also project your mental focus beyond the current moment or feared situation. You can focus on further ahead when you are at your destination and feel more comfortable.
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.”
What Is The Treatment for Panic Disorder?
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 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, 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.
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:
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:
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: