Driving a motor vehicle is one of the most common situations that triggers panic and anxiety. Bridges and tunnels, in particular, can be challenging since they present the possibility of getting stuck with no easy or safe escape. Driving related anxiety, although not a formal DSM mental health diagnosis, can create symptoms that range from mild discomfort to extreme distress for many.
People with driving related anxiety risk effects like frequent traffic accidents or becoming homebound, so steps must be taken to decrease the condition. Fortunately, various professional treatment strategies and at-home skills can help people cope with their driving anxiety.
Signs of Driving Anxiety
Since driving related anxiety is not a specific mental health disorder classified by the American Psychiatric Association (APA), there are no set symptoms and signs of driving anxiety. Signs of driving anxiety can range from a subtle change in thinking when grabbing the keys, anxiety while driving on the freeway to a full-blown panic attack at the mere thought of getting behind the wheel.
Driving related anxiety will affect the thoughts, feelings, and behaviors of the individual in a variety of ways. In mild cases, it can pose a minor inconvenience for some, or it could create a challenge that makes leaving the home, attending doctors’ appointments, or arriving to work or school impossible.
The types of symptoms will largely depend on the severity of the anxiety.
Some signs that driving may be causing you mild anxiety include:1
- Feeling restless, keyed up, or on edge when driving, preparing to drive, or thinking about driving
- Feeling easily fatigue and tired during or after driving
- Having trouble concentrating while driving
- Being irritable and short with others
- Feeling tension, especially in the neck and back while driving
- Having troubling dreams involving driving
These symptoms tend to have only a minor impact on a person’s health and well-being. Other people may experience driving related anxiety that is so severe that it creates panic attacks that present before, during, or after driving.
Signs and symptoms of a panic attack include:1
- Heart palpitations
- Excessive sweating
- Feeling shaky
- Shortness of breath or trouble breathing
- Chest pain and tightness
- Nausea or stomach discomfort
- Feeling dizzy or lightheaded
- Having chills or feeling very hot
- Numb or tingling sensations
- Feeling disconnected from the body
- Fear of losing control or “going crazy”
- Fear of dying
These symptoms could present rapidly, or they could grow steadily over the course of many years. A person with a driving phobia could have such an intense fear of negative consequences stemming from driving that they stop driving completely. This decision could cut them off from friends, family, and other positive aspects of life as they become confined to their home.
Causes of Driving Anxiety
Driving related anxiety does not have one particular cause. Instead, numerous biological components and environment experiences can factor into the emergence of driving anxiety.
The underlying causes of driving related anxiety might include:2,3,4
- A recent accident: Perhaps the clearest cause of driving anxiety is when someone experiences a recent crash. The accident may trigger a number of anxiety reactions like post-traumatic stress disorder (PTSD), acute stress disorder, adjustment disorders, and phobias. It’s estimated that up to 30% of people experience anxiety related symptoms after being involved in a traffic accident.2
- Scary or uncomfortable driving situations: Not all problematic driving situations end in an accident. People who nearly crash, must drive in adverse conditions like snow, fog, or flooding rains, or must drive long distances in unfamiliar situations may experience new anxieties.
- Specific phobias like agoraphobia: Being fearful of open spaces, crowds, or other situations may increase the risk of driving related anxiety.
- Family history of anxiety disorders: Having a family history of anxiety disorders greatly increases a person’s chance of developing anxiety. Driving related anxiety is just one way this could be expressed.
Like other mental health conditions, the presence and severity of driving related anxiety often depends on the balance of risk and protective factors. Someone with higher risks and fewer protective factors will see emerging anxiety, while someone with many protective factors can overcome the anxiety.
Example of protective factors include:
- Healthy coping skills
- Safe environments
- Healthy and supportive family members
- Uneventful driving record
The Physical and Mental Effects of Driving Related Anxiety
Driving related anxiety triggers a negative impact on the individual’s physical and mental health and well-being. These effects will not only diminish a person’s abilities behind the wheel, but they will influence all aspects of a person’s life if left untreated.
In the short-term, anxiety makes driving more stressful and difficult. For example, a person’s natural response to driving related anxiety is to squeeze the steering wheel and become overly focused or distracted during the drive, which actually decreases performance and results in discomfort from muscle tension. These people could see their anxiety increase and their driving become more erratic.
In the long-term, a person who continues to drive while anxious could endure the cumulative experience of muscle tension, restlessness, fatigue, changes in heart rate, worry, fear, and stress.1 Furthermore, the long-term stress could make someone stay home and refuse to drive at all. This person could note problems with their finances, housing, relationships, employment, and other supports due to lack of driving.
Six Ways to Cope With Driving Related Anxiety
Driving related anxiety can be a very powerful force in a person’s life, but luckily, there are many ways for an individual to cope with driving related anxiety. By taking steps to understand your anxiety, explore strategies that help minimize symptoms, and implement behavioral interventions, you can take steps to overcome your anxiety. Here’s how:5
1. Understand your Anxiety
Understanding the root causes associated with your driving related anxiety can help you develop the appropriate coping skills to minimize symptoms. Take a moment to retrace your experiences with driving related anxiety by investigating when it began, when it worsened, and what people, places, and things are involved in the process.
Did your parents exhibit signs of driving related anxiety, or did a recent accident trigger these symptoms? Does the anxiety strike all of the time or only when you drive alone?
Perhaps the most important aspect of this is to understand if driving related anxiety is the main problem or a symptom of a larger problem. If the driving issues are linked to PTSD, obsessive-compulsive disorder (OCD), or another serious anxiety disorder, professional treatment will be needed to target these larger issues.
2. Make a Goal
During this process, you will need to be intentional with the goal you hope to achieve and how you hope to achieve it. Consider the long-term and short-term consequences of your actions.
If your goal is to achieve long-term relief of anxiety while driving, you will likely pursue a certain path. If your goal is to only escape anxiety in the short-term, another set of choices will accomplish that result. Ultimately the decision is yours, but be sure to remember that what’s best for the short-term isn’t usually best in the long-term.
3. Experiment with Relaxation
Whenever high stress and anxiety begin to spring forth in new situations, it is a wonderful time to reevaluate your relaxation techniques. Relaxation techniques are behavioral interventions that help minimize stress and anxiety.
The following are relaxation techniques that are used to reduce anxiety:
- Deep breathing
- Progressive muscle relaxation (PMR): The process of tensing then relaxing one group of muscles at a time.
- Guided imagery: Using your imagination to create calm and peaceful images, promoting relaxation.
- Mindful meditations
- Autogenic training: This type of relaxation technique replaces the worry and fear of anxiety with calm and uplifting self-talk.
4. Bring In Your Supports
You probably could confront and improve your driving related anxiety independently, but tackling a tricky issue with your friends and family is always more rewarding and more fun. If you need help with your driving anxiety, bring in your supports.
Supports can:
- Help remind you of coping skills
- Recommend new coping skills
- Keep you on track
- Drive with you to reduce tension and stress
Even the process of sharing your story of driving related anxiety can be helpful. Telling others about your stress and struggles can help the healing process and speed your recovery.
5. Start Small With Exposure
Even though you may be tempted to take bold steps to resolve your driving anxiety, stressful situations require time and patience to resolve. Avoid putting yourself in a position where you are not likely to succeed.
To reduce driving anxiety, spend time thinking about the aspects of driving that trigger anxiety. Ask yourself:
- When does the anxiety start?
- What makes the anxiety peak?
- When do the anxiety symptoms decrease?
- What does the anxiety feel like?
By identifying and targeting the facets of driving that cause mild anxiety and repeating them regularly while using relaxation skills, your body will begin to adjust to the physical and mental sensations of anxiety, and the situation won’t feel as stressful.
By exposing yourself to more and more stressful aspects of driving anxiety, you will cause a temporary increase in anxiety but a long-term decrease. Without this exposure, your symptoms cannot improve.
Be cautious, trying to move too quickly can actually increase the driving related anxiety.
6. Talk To A Therapist
For many people, driving related anxiety is a condition they can resolve on its own. Others, though, will need the guidance and knowledge of a mental health professional.
Mental health therapists will effectively assess your symptoms and prescribe a course of treatment specifically tailored to your needs.
Treatments For Driving Anxiety
With driving related anxiety, cognitive behavioral therapy, exposure therapy, and the principles of systematic desensitization are the most effective treatment options. In fact, about 80% of people with conditions related to driving anxiety find success with these therapy options.6
Approximately 80% of untreated anxiety conditions, like driving phobias, become chronic mental health issues.6
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is the first-line treatment option for individuals who have been diagnosed with anxiety. CBT works by investigating the connection between a person’s thoughts, feelings, and behaviors and offering alternatives that produce more positive and healthy outcomes.
Once distorted thoughts and unhealthy behaviors are identified, the therapist can help by teaching healthier behaviors as substitutions. With repetition, thoughts and behaviors that create relaxation will replace those that triggered anxiety.
Exposure Therapy
As the name suggests, exposure therapy requires the person to confront the stressful situation in an attempt to eventually overcome the anxious thoughts associated with the specific stressor.
In the case of driving related anxiety, the therapist will encourage the individual to experience the parts of driving that increase stress. In a process called systematic desensitization, the therapist and client will collaborate to address the stressors that are attached to anxiety related driving.4
The therapist will encourage the client to engage in exposure, experience symptoms as the anxiety increases and remain in the situation until the anxiety subsides. By starting with less stressful triggers and gradually moving on to more anxiety-provoking triggers, the individual can increase their resilience on a gradual level.
For example, a person might experience mild anxiety just from thinking about driving, moderate anxiety from sitting in the car, and severe anxiety when starting the car. Systematic desensitization would have the individual start off by thinking about anxiety and once their symptoms dissipate, they can move on to sitting in the car.
Some of these steps can be conducted using virtual reality techniques to simulate a real-life experience.2
Medication
Like other anxiety disorders, medication can be a helpful tool to decrease symptoms and increase the effects of therapy strategies for driving related anxiety. It is important to find medications that can be used while operating a motor vehicle.
Some useful medications for driving related anxiety include:6,7
- Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac)
- Serotonin – norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima)
- Other antidepressants like mirtazapine (Remeron), clomipramine (Anafranil), and imipramine (Tofranil)
Benzodiazepines such as clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan), may be a poor choice for driving anxiety due to the risk of drowsiness and slowed reactions while under the influence of these medications.6 Always use the medications as prescribed and discuss any side effects with the prescriber to stay safe.
Additional Resources for Driving Anxiety
Driving related anxiety may seem like a unique and socially isolating situation. In reality, many people across the U.S. and around the world experience some level of stress, tension, and discomfort when driving.
There are reputable groups working to address and treat all types of anxiety disorders. Some of the most helpful resources for people with anxiety include:
