Having a Panic Attack While You’re Driving Is Terrifying and Dangerous

The first time it happened, I was driving through the Queens-Midtown Tunnel in New York.

I doubt anyone particularly enjoys driving in crowded tunnels, but I had done it before without a problem—until that day. I was about halfway through when the tunnel seemed to narrow. It looked as if the walls were shrinking inwards, forming a deep, dark, dead end up ahead. The rational part of me, which was disintegrating by the second, informed me I was having a panic attack, and that panic attacks play tricks on people. But I was too far gone down my mental tunnel of terror.

My stomach jumped, and my vision wavered. Pinpricks were climbing up my spine. With a clammy hand, I fumbled for the car window and rolled it down. But the air, smelling of rock dust and diesel, did nothing to calm me. I couldn’t stop, and there was nowhere to pull over. I was convinced I was going to crash and die.

But I didn’t crash, swerve, faint, or do anything else my brain told me was about to happen. By the time I got home, I felt giddy and a little embarrassed. Thank god no one else was there to witness my random and unnecessary freak out. I wrote the panic attack off as a one-time incident and tried to forget about it. But the next time I drove, it was all I could think about: What if it happens again? And sure enough, it did.

The next time was on a bridge. The time after that, in traffic. Then on the highway. Soon the panic attacks were happening before I was even in the car.

For 15 years, I was a fearless driver. I was among the first of my friends to get my license. I drove in the city, on highways and drove a motorbike all over Thailand. I often used it as a meditative strategy (usually to come down from a fight with whatever boyfriend I was antagonizing at the time). I would hop in my rusty, trusty Pontiac Sunfire, and drive until I felt better. When I moved from western Canada to New York last year, I drove alone across two countries, covering almost 2,500 miles. So why, at almost 30 years old, was I suddenly getting panic attacks while driving?

I finally did what any responsible person would do in this situation—I googled it. Blogs, discussion forums and “Five ways to overcome driving anxiety” style articles were everywhere. Knowing I wasn’t the only one out there with this problem comforted me—and the “tips” seamed reasonable—but I still didn’t understand why it was happening. So I gave up on self-diagnosis and turned to the experts, who shared their theories on driving anxiety and how to overcome it.

“Driving anxiety is usually a variation of a panic disorder or agoraphobia,” says Frederic Neuman, psychiatrist and director of the Anxiety and Phobia Treatment Center in White Plains, New York. “People who have panic attacks are afraid they’re in a particular setting where they’re likely to lose control of themselves and do something embarrassing or dangerous, like driving off a bridge or into a crowd.” And as I found, this type of anxiety can pop up at any time in your life.

Simply put, agoraphobia is a fear of being trapped or unable to escape a situation. But I didn’t have that. I was fine in crowded subways and elevators. Well, unless the elevator stopped. And the alarm button didn’t work. And we were trapped in there for days, eventually forced to eat each other for survival. Okay, Neuman: 1, me: Still trapped in a tunnel.

Neuman adds that there’s an assumption that people with driving anxiety have been in a crash or experienced trauma on the road. Sometimes that’s true, but more often it stems from an underlying anxiety disorder, like agoraphobia. One percent of American adults have agoraphobia, and more than 40 million people are affected by some type of anxiety disorder.

Mary Sloan, 23, works as a quality assurance specialist in Houston. Driving never bothered her, and she usually enjoyed her drives to and from work every day. Then one random day, she had a panic attack on the highway. “My vision was blurry, I felt myself getting light-headed and I couldn’t catch my breath,” Sloan tells me. “Your brain thinks you’re actually dying, and you can’t stop thinking about it.”

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She didn’t know what caused the sudden onset of panic, but she did know she had to do something about it. Sloan spoke to a friend with driving anxiety, who recommended finding a way to calm the body during moments of panic; she recommended chewing gum or blasting cold air in the car. After all, it’s not your thoughts but rather the physiological reaction to those thoughts that make panic attacks so unbearable.

After some experimenting, Sloan came up with a few of her own panic attack preventatives. She cut out coffee (which can exacerbate some people’s anxiety), assembled a calming playlist, and practiced deep breathing. Even though Sloan says most of her drives now are panic-attack free, she still can’t help “feeling a little antsy” every morning when she walks to her car. “It’s super frustrating, especially when you want to bring friends somewhere,” she says. “You don’t know if you should warn them and run the risk of them thinking you’re crazy.”

I’ve had the same thought. How does a friend you just picked up react when you say, “By the way, I may or may not have a massive panic attack and potentially kill us all while I drive us safely to our destination today”?

Ken Goodman, a therapist in California who developed a program called The Anxiety Solution Series, says concerns about driving with others usually comes from a fear of judgment. But avoidance tends to reinforce existing anxieties around driving, and the best thing to do is start driving with someone you trust.

"Find the most supportive person, explain the situation and ask if they'll drive around with you," he says. "Before you even walk out to the car, take a few deep breaths. Accept that you have the anxiety without beating yourself up over it. Anticipatory anxiety is very common, and often time people will discover it isn't as bad when they actually do it."

Luckily, the only passenger I usually have in the car is my greyhound, who is blissfully unaware of my sweaty palms and roiling brain. But for people like Greg Weber, 52, a web developer in Montana who was responsible for driving his two young children around at the peak of his driving anxiety, a panic attack on the road was a nightmare. “It was a serious hindrance on my life. I dreaded driving, and when you have kids you don’t have a choice,” Weber says. “I sweated and hyperventilated, and I could barely keep my thoughts and body under control. The discomfort was so intense I felt like if I couldn’t stop driving right that second, I wasn’t sure what would happen.”

Weber’s battle with driving anxiety started in the ‘90s, before he could google for help. For years he suffered in silence, ashamed to be a grown man having panic attacks in the car. Ironically, Weber wasn’t even thinking about his driving anxiety when he took his first meditation class. Stress at home and work was becoming unbearable, and he’d heard meditation could help. “I meditated for five or ten minutes a day, and after a few weeks I noticed when I drove, my anxiety level was less,” he says. “I had put up with driving anxiety for a long time, and through inadvertent action it started to get better.”

After that, Weber took behavioral therapy courses, which taught mindfulness and stress management. It took 15 years, but his driving anxiety is mostly under control. Weber even teamed up with a clinical therapist in the UK to create a program called Driving Peace, which explores the roots of driving anxiety, and provides strategies for overcoming it.

After my first panic attack driving, I wanted to stay away from tunnels, bridges, highways, heavy traffic, construction zones, and the left lane. David Shanley, a Denver-based psychologist specializing in anxiety disorders, recommends doing the exact opposite of this. “I try to turn the tables on anxiety by helping people be comfortable with the stuff that’s making them uncomfortable,” he says. “Ultimately, people have to be willing to face the thing making them anxious. The more you do it, the easier it gets.”

Shanley utilizes Acceptance and Commitment Therapy (ACT), which is a combination of mindfulness and exposure therapy (a technique that requires exposing a person to their anxiety source). Trying to control every anxious thought is like trying to catch a cloud; ACT teaches patients to accept these thoughts, and just let them float by. If patients are more open to their fears, he says it’s easier to face them. “The peak intensity of a panic attack doesn’t last that long,” he says. “I help patients ground themselves in the moment by giving them breathing strategies and relaxation techniques. If they can do those and just hang in there, those intense feelings will go away.”

Goodman treats patients with cognitive behavioral therapy, a psychotherapy that challenges dysfunctional thinking and adapts distorted emotions. In simpler terms, you’re kind of talking yourself down. This therapy—which also incorporates mindfulness, meditative breathing and relaxation techniques—is meant to be practiced daily.

The behavior becomes ingrained, and when faced with a stressful situation—like a looming panic attack on the road—patients are better able to cope during crisis. For example, if I’m feeling panicky on the road, I would concentrate on all the details of the car in front of me, focusing thoughtfully on each detail for a few seconds. This is meant to keep me in the present moment, and away from any mental quicksand.

Goodman also utilizes exposure therapy by driving around with patients. It may sound counterintuitive, but he says that being receptive to uncomfortable situations and sensations actually makes them more bearable. “It’s sort of like teaching someone to drive all over again,” he said. “I teach them strategies for overcoming anxiety before we get in the car. We start with driving a little outside their comfort zone, and then expand out.”

I still haven’t been able to drive in a tunnel since that first panic attack five months ago. But I’ve been encouraged by people like Sloan and Weber who overcame their driving anxiety, and talking to mental health experts has helped me realize I’m not interested in doing this on my own. Even just admitting to myself this is a problem instead of bemoaning it has helped.

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