Driving and confidently maneuvering from point A to point B takes focus and coordination, so having a panic attack while driving can threaten one’s mental and physical safety. Panic attacks are challenging in any circumstance and the added vulnerability of operating a motor vehicle can be terrifying. Fortunately, panic attack treatments can reduce symptoms, no matter the setting.
Signs & 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.
Panic attacks have a beginning and end, which separates them from other forms of anxiety that can linger and last.1 Whether the person is driving in a car, flying in a plane, or walking down the street, the potential symptoms of panic attacks are the same. To be classified as a panic attack, a person only needs to have four or more symptoms at a time.1
Signs and symptoms of a panic attack while driving include:1
- 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
- Fear of death or dying
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.2,3 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.
Are Panic Attacks While Driving Common?
Some panic attacks are expected and predictable, while others can seemingly come from nowhere. Because of this, panic attacks while driving are common, especially for people who feel a heightened sense of stress, fear, or anxiety when driving.
Each year, around two or three percent of adults and adolescents experience panic attacks.1 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.
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:1
- 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: High anxiety can stem from environmental issues or biological concerns. In either case, high anxiety paired with driving can trigger a panic attack.
- 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
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 – Fifth Edition (DSM-5).1
6 Tips for Coping With Panic Attacks While Driving
Preventing all panic attacks while driving could be impossible. Anyone hoping to reduce the risks from attacks should consider exploring healthy ways to cope, including identifying the panic, pulling over safely, and reminding yourself that panic equals discomfort, not danger.
Six tips to cope with panic attacks while driving are:4
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 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. 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.”
6. 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.
Can Panic Attacks While Driving Be Treated?
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.5,6
Medication
A prescriber may offer several types of medication to limit the frequency and intensity of panic attacks.6
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.
Therapy
With therapy, cognitive behavioral therapy (CBT) styles and interventions are going to be the most effective. 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:5
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.5,6 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.
For Further Reading
Many groups and organizations are working to learn more about panic attacks and their treatment. For those interested, the Anxiety and Depression Association of America offers a support group locator tool on their site, making finding a supportive meeting as easy as a few clicks.
Here are additional resources:
