Panic Attacks While Driving: Signs, Causes, & How to Stay Calm

Anxiety About Driving Is Normal

Driving anxiety isn’t always triggered by being involved in a car accident or the potential of having one. There’s a variety of reasons why someone may experience anxiety while driving. Feeling panicky and intimidated behind the wheel is normal and more common than you think. Nevertheless, there are ways to cope and keep your driving nervousness under control.¹

Each year, around two or three percent of adults and adolescents experience panic attacks.² Since people can have attacks in numerous settings and environments, there is not much information about where these attacks happen and what the person is doing prior.

Symptoms of a Panic Attack While Driving

Panic attacks are marked by a sudden and powerful surge of fear, worry, anxiety, and discomfort. They begin rapidly and can completely overwhelm a person’s thoughts, feelings, and behaviors. Each person’s experience with panic attacks is different, and just because certain symptoms presented during one attack does not guarantee they will always return.

Symptoms of a panic attack while driving include:²

• Heart palpitations, pounding in chest, and rapid heart rate
• Sweating
• Shakiness and trembling
• Feeling short of breath or struggling to breathe
• Sensations of choking
• Discomfort or pain in the chest
• Nausea or discomfort in the stomach
• Dizziness, lightheadedness, feeling faint, or feeling unsteady
• Experiencing chills or hot flashes
• Numbness or tingling sensation (paresthesias)
• Feeling disconnected from self or the world around
• Fear of going “crazy” or being out of control
• Feeling like they’re dying

To be classified as a panic attack, a person only needs to have four or more symptoms at a time.² Panic attacks have a beginning and end, which separates them from other forms of anxiety that can linger and last.²

At times, these symptoms can be so sudden and severe people will confuse a panic attack for a heart attack. In fact, it can be hard to tell the two apart in the moment and you should never hesitate to seek medical assistance in these situations.

How Long Does a Panic Attack Last?

Panic attacks typically last between five and 20 minutes, but some could continue for an hour or longer.^3,4 There is no way to predict how long or intense the next attack will be. That said, very long attacks are not normal. If you’re experiencing panic attacks that last longer than an hour, consult with your mental health treatment team.

What Causes Panic Attacks While Driving?

The cause of panic attacks while driving could be a clear and obvious connection between driving and stress or a deep unconscious issue. In other cases, there might be no connection between stress and driving at all. Ultimately, nearly any stimuli could trigger a panic attack, or the panic attack could come for no apparent reason at all.

The most common causes of panic attacks while driving are:²

• High stress: If a person is getting behind the wheel with high stress from their day, they could encounter a higher risk of panic attacks while driving
• High anxiety after a car accident: Whether it’s a major automobile crash or not, a person can still feel a great deal of stress afterwards. Many studies have particularly focused on this topic often linked car accidents as the primary reason for the onset of driving-induced panic and anxiety.⁵
• Panic disorder: A person with panic disorder will have panic attacks. Some will be expected and predictable, but others might not be, which means a panic attack when driving is possible.
• Specific phobia: People can have a phobia related to driving, getting into an accident, or other driving-related issues like going over bridges, through tunnels, and onto major highways
• Vision problems: Problems seeing, seeing well at night, or processing the many stimuli while driving could induce a state of panic
• Pain from sitting in the car: It’s not uncommon for people to experience car sickness, restlessness, and body aches, especially if they’ve been sitting in the car for too long. Just the thought of having to endure the pain again can make you averse getting back in the car to or avoid driving all together.

How Are Panic Attacks Diagnosed?

Only an educated and experienced mental health professional can properly and accurately diagnose a panic attack. A person who has panic attacks could receive a panic disorder diagnosis.

Diagnosing professionals can include a host of practitioners including:

• Psychiatrists
• Psychologists
• Therapists, including professional counselors and social workers
• Primary care physicians and physician assistants
• Nurses and nurse practitioners

Any of these professionals will consult with the official diagnostic criteria set forth by the American Psychiatric Association (APA) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).²

How to Stop Panic Attacks While Driving

Preventing all panic attacks while driving could be impossible. Anyone hoping to reduce the risks from attacks, or help someone else manage their attacks, should consider exploring healthy ways to cope, including identifying the panic, pulling over safely, and reminding yourself that panic equals discomfort, not danger.

Here are nine tips for coping with a panic attack while driving:⁶

1. Identify the Panic

Periods of high anxiety and panic attacks may seem similar, but they are actually very different. Because they are different, they need to be addressed by unique techniques and interventions. Spending time and energy treating a panic attack like it’s a period of high anxiety could be problematic.

2. Pull Over Quickly & Safely

No one should attempt to continue driving while in the middle of a panic attack. The condition can impair one’s coordination and reaction time, which could make driving too challenging. At the first sensation of an attack, assess your environment to find a convenient and safe location to pull over.

Note: If you can’t safely pull over right away, continue driving cautiously until an opportunity presents itself.

3. Remember That Panic Equals Discomfort, Not Danger

The fear triggered by a panic attack can be intense as it works to convince a person that they are dying, losing their mind, or having a serious medical event. In reality, panic attacks, even while driving, rarely create actual danger. On the other hand, acting like a panic attack is dangerous and could cause people to drive erratically and endanger themselves or others.

4. Focus On Coping Skills

Focus on your breath, stay grounded in the present, and practice other relaxation skills. They may not offer immediate symptom resolution, but they can help manage symptoms effectively. People who feel unsure of what to do and how to cope should spend more time during periods of calm to research and practice coping skills to use next time.

5. Find Safe Ways to Distract Yourself

Distraction is an effective technique that can help to shift your focus away from anxious emotions. However, when driving, it’s important to be cautious about what you use to divert your attention. Consider listening to music, or a podcast or audiobook. You can also start singing or mentally/verbally recite empowering mantras. The point is to redirect your attention safely and healthily (not texting and driving). Use your best judgment and find practical but secure options.

6. Check In With Your Thoughts

During a panic attack, a person’s thoughts are swirling and racing in all sorts of negative and unhelpful ways. To counteract this, anyone having an attack should use self-talk and thought  patterns that focus on understanding, acceptance, and kindness, rather than judgment and frustration.

Saying things like “Stop it,” “Relax,” or “Why do you always do this?” are not going to help the situation. Those kinds of statements only allow panic to grow.

Consider replacing it with:

• “You can do this.”
• “It’s going to be alright.”
• “Stay patient.”

7. If You Can, Keep Driving Safely

Stopping on the side of the road/highway or getting off an exit to park somewhere not only can be dangerous but may also work against you. Instead, stay on track and opt to keep driving safely and cautiously. Otherwise, ceasing to drive might make it harder and cause you to become even more hesitant to get back behind the wheel.

8. Don’t Reach for Drugs

People reach for all sorts of negative coping skills during and after panic attacks, but they are never advisable. Alcohol and other drugs may temporarily improve symptoms in the short-term before creating worse situations in the long-term.

9. Practice Driving in Safe Settings for Longer Stretches

One way to stave off panic and anxiety is exposure. This means gradually exposing yourself to that which causes you anxiety. Start by practicing driving in familiar and safe areas for longer stretches. You may feel apprehensive in the beginning but the more you practice the easier it will get. If you think this might be too overwhelming, consider enrolling the help of a supportive friend to be your companion and act as a copilot which can make your driving experience less daunting and more secure.

Treatment for Panic Attacks While Driving

No matter where or when the panic attack takes place, it can be treated. Medication, therapy, and self-help skills can go a long way to limit the unwanted impact of panic attacks.^7,8

Therapy

Cognitive behavioral therapy (CBT) styles and interventions are the standard treatments for panic attacks. CBT is a highly-effective and well-tested style of therapy applied to many mental health conditions, like anxiety and panic attacks.

The best CBT-based treatments for panic attacks include:⁷

• Standard CBT for panic disorder
• Exposure therapy
• Acceptance and commitment therapy

Medication

A prescriber may offer several types of medication to limit the frequency and intensity of panic attacks.⁸

Here are types of medications used to treat panic attacks:

• Selective serotonin reuptake inhibitors (SSRIs): Medications that interact with the brain to increase levels of available serotonin. Options include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): Drugs that interact with serotonin as well as norepinephrine. Venlafaxine (Effexor XR) is approved for panic attacks.
• Benzodiazepines: A class of medications that sedate the central nervous system. Options like alprazolam (Xanax) and clonazepam (Klonopin) are only for short-term use due to risks of addiction and dependence.

How Long Will Treatment Take?

Depending on the treatment and level of symptoms, a person with panic attacks could begin feeling positive results in less than an hour from benzodiazepines, a few weeks from SSRIs or SNRIs, and a few months with therapy.^7,8
The timeline varies greatly based on a person’s needs and symptoms.

Final Thoughts

Without treatment, someone can expect panic attacks to continue. Rather than wait and stress over the next panic attack, make the decision to find a team of mental health professionals to face the challenge of panic attacks head on. Remember, you’re not alone.