What to do if you have a panic attack while driving

What could cause a panic attack while driving?

Panic Disorder

Panic disorder is a type of anxiety disorder in which individuals experience regular panic attacks that occur suddenly and with no apparent trigger. This means that someone with panic disorder could experience a panic attack at any time, including while driving ^[1].

People with a diagnosis of panic disorder also commonly experience ongoing anxiety and fear of another panic attack occurring, which could actually cause the occurrence of a panic attack. For example, someone who has experienced a panic attack while driving may be afraid of this happening again, thus causing increased stress and anxiety which may lead to another panic attack ^[1][2].

Phobias

Panic attacks can also occur in the context of specific phobias. For example, someone may experience driving phobia or a phobia of bridges or tunnels, which could cause the occurrence of a panic attack while driving and facing a feared stimulus ^[3][4].

Anxiety about driving

Many people experience some level of anxiety about driving, which can increase the chance of having a panic attack. Anxious drivers might worry about going above a certain speed, driving long distances or unknown routes, driving in bad weather, or being beeped or shouted at by other drivers, all of which may increase their level of anxiety while driving and potentially cause a panic attack ^[5][6].

Previous car accident

A person might be more likely to experience a panic attack while driving if they have been involved in a car accident previously, particularly if the accident caused severe damage or harm to the vehicle or person involved. This could cause symptoms of posttraumatic stress disorder (PTSD) or a fear of being involved in another accident, which could increase the risk of a panic attack occurring ^[4][7].

Stressful situations prior to driving

As panic attacks can be brought on or worsened by high stress levels, the risk of having a panic attack while driving may be increased if the individual encounters a stressful situation prior to beginning their journey in the car. Stressors could be related to work, relationships, or personal situations ^[3][8].

Historical life stressors

Similarly, a history of trauma, abuse, severe life stressors, or other anxiety disorders can cause ongoing or chronic stress and anxiety, thus potentially increasing the likelihood of a sudden panic attack occurring at any time or in any situation ^[3][8].

What are the dangers of having a panic attack while driving?

Dangerous actions

If a panic attack occurs suddenly while an individual is driving, there is a risk that they will react in a dangerous way, such as swerving suddenly or losing focus. Driver’s experiencing panic attacks may pull over to the side of the road without checking, which could cause an accident resulting in harm to themselves or others ^[5].

Worsening anxiety

Experiencing a panic attack can be very distressing. Experiencing a panic attack while driving may be even more distressing, as there may be an increased risk of danger. This could cause a worsening in symptoms of panic disorder or other anxiety disorder. The worsening symptoms may include an increased fear of further panic attacks occurring, which can potentially have a detrimental effect on a person’s mental wellbeing ^[1][6].

Overly cautious driving

If an individual has experienced a panic attack while driving, they may become overly cautious while driving in the future. While cautious driving may feel safer, it could in some instances actually cause a greater risk to the individual and others on the road.

For example, driving significantly below the speed limit or slowing excessively before corners could increase the risk of a collision. Also, driving in this way may distract the individual, thus causing dangerous errors or judgments while driving ^[5][9].

Prevent driving in future

Similarly, the individual may feel so afraid of experiencing another panic attack while driving that they chose to stop driving altogether. This could have potentially detrimental effects on their social and professional life, while also reinforcing their fear of driving ^[6][9].

How to deal with panic attacks while driving

Pull over

If you are concerned that the symptoms of a panic attack will impair your ability to drive safely, you should pull over to the side of the road when it is safe to do so. The symptoms will typically subside within a short period of time. Then you can safely return to the road ^[3][5].

Continue driving

Alternatively, if it is not safe or appropriate to pull over, you should continue to drive, to ensure your own and others’ safety. Also, you may be able to utilize some coping strategies while driving to help you reduce your panic attack symptoms quickly.

By continuing to drive during and after a panic attack, you can confront your fears and prove to yourself that you are confident and capable of managing a panic attack while driving. Proving this to yourself could thereby reduce or prevent the reoccurrence of panic attacks while driving in the future ^[8][9].

Don’t avoid driving

By avoiding driving after experiencing a panic attack, you may reinforce the anxieties that led to the panic attack. This could potentially worsen symptoms and increase the chances of further panic attacks ^[10].

If you feel unable to immediately start driving again, try to slowly return to driving by gradually increasing the length of time and distance you spend in the car until you feel confident driving as normal ^[3][6].

Breathing exercises

During a panic attack, breathing exercises can be very helpful in reducing the physical symptoms experienced. If you have a panic attack while driving, try taking slow and deep breaths. As you breathe, count the inhale and exhale. This can reduce your heart rate and increase blood flow, make it easier to focus on driving, and help you to return to a calm state quicker ^[3][8].

Other coping techniques

You may have other useful coping strategies that you have practiced during panic attacks. You can use these strategies if a panic attack occurs while driving.

For example, try telling yourself that this will pass, that you are not in any danger, and that you are in control. This can help to reduce your fear and help panic attack symptoms subside ^[10].

Similarly, you might find it useful to put on a song you like and can sing along to. You could also try focusing on something outside of the car, such as counting how many red cars you pass. This can help to distract you from the physical and emotional sensations you are experiencing ^[3][8].

Avoiding substances

Some people use alcohol or drugs to help them cope with the distress caused by experiencing panic attacks, but this can potentially worsen mental and physical health, increase the risk of further panic attacks, and increase the risk of accidents while driving.

You may wish to also avoid drinking caffeine while driving. Caffeine can cause similar sensations to those that are experienced during a panic attack, such as increased heart rate ^[8][10].

What further treatment is available?

If you experience panic attacks while driving and this is impacting your overall wellbeing, you may wish to seek professional advice. A doctor may be able to provide you with a diagnosis and recommend or prescribe appropriate treatment.

Therapy              

Various types of therapy have been found to be useful in reducing panic attacks and driving anxiety, such as virtual reality exposure therapy (VRET), cognitive behavioral therapy (CBT), and other talk therapies. These interventions can help to increase distress tolerance, and teach coping strategies, reduce anxieties. They can also help individuals to understand underlying causes of panic attacks, which can help to reduce your symptoms ^[1][3][9].

Medication

Your doctor may decide to prescribe a medication to help reduce your panic attacks and any other symptoms you experience, depending on your diagnosis and condition. This might include an antidepressant, beta-blocker, or benzodiazepine ^[1][8]. However, you should always talk to your doctor about taking medication whilst driving so that you fully understand any risks.

Self-help

Various self-help techniques can be helpful in reducing the occurrence and severity of panic attacks. Self-help techniques can also help reduce other symptoms associated with anxiety disorders. Self-help techniques can include maintaining a healthy diet, engaging in regular exercise, keeping a consistent sleep schedule, utilizing mindfulness and relaxation techniques, and practicing breathing exercises ^[3][8].