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Three Steps to Dealing with a Panic Attack While Driving: An Interview Anxiety Expert Chris Holly

Panic attacks can happen anywhere. But dealing with one on a highway in the middle of nowhere is especially terrifying. To find out just how to deal with this situation, we caught up with anxiety expert Chris Holly.

Here’s what he had to say.

Are panic attacks on the road common?

Panic attacks can happen anywhere and certainly driving is one of the places that it is not unusual for people to experience difficulty with anxiety or panic.  The experience of driving is full of surprises, complex decisions and misinterpretations of reality that can trigger significant and major distress.

When I have panic attacks, it feels like I’m dying. How do you know if you’re having a panic attack or if something is really wrong?

It is difficult to tell the difference, especially in the midst of a panic attack!  There are many people who show up in the emergency room via ambulance, who first think they are having a heart attack and then discover that they are suffering with a panic disorder.  Typically people who are having a panic attack feel like they are about to lose their mind or some great catastrophe is about to overcome them.

The physical symptoms include: racing heart, chest pain, tightness or restricted breathing, feeling dizzy or lightheaded, numbness or tingling in the ends of one’s fingers and toes, sweating, an intense sudden desire to use the bathroom (yes, I know that one sounds odd), and dry mouth and weakness in the legs and arms.

OK. So how do you differentiate between these classic symptoms of panic attacks or actual physical illness?

Patterns are a good sign. As in if the activity of, saying driving a car, triggers an anxiety reaction then you can assume that the source is an anxiety disorder. Also, if the physical symptoms always begin after there is a sense of impending doom, it is safe to assume that the physical symptoms are of a psychological origin. If you are concerned about having heart problems in addition to panic attacks, it is perfectly acceptable to inquire with your primary care physician about wearing a Holter monitor, which is a device about the size of a pager or an iPod Touch, that one wears continuously for a day or two, in order to detect if there are any abnormal heart rhythms and then they can be treated.

This is scary stuff. If this happens when you are driving, should you keep driving and push through it…or pull over?

Good question.  The answer is pull over so you’re not distracted. This is when pre-planning comes in handy.

In times like this, you want to practice coping skills.  Things like calming breathing exercises and meditative breathing have been found to trigger the parasympathetic ‘rest and digest’ response that is opposite of the sympathetic response, which is the “fight or flight” response of the nervous system.

Download stuff ahead of time so you’re prepared. Carry music or readings that can help the process. And don’t start driving again until you are ready.

If you had to break it down, what are the three steps that we should take to deal with a panic attack while driving?

1. Engage in a relaxation breathing.  Focus on your breath, and make an effort to breath in and out in a measured way.  When the uncomfortable thoughts spin through your mind, return your attention to the breath and continue until symptoms abate.

2. Listen to music or speech of some kind, preferably an opposite emotion evoking kind of sound, like soothing music or a comedian.  Not only will this help to refocus you, it can improve your mood as well.

3. Call a friend or family member.  Interaction with people who are sensitive and kind when you are experiencing terror can be helpful in trying to wind down the fight or flight response.

Is there anything else you would like to add before we wrap this interview up?

Yes. Do seek help if you suffer from an anxiety disorder.  There is no shame in reaching out. Millions of people suffer with this same thing. It’s ok to ask for assistance.


About Chris:

Chris Holly received his Masters in Social Work from the University of Illinois in 2001. He has worked in the mental health field for eight years. Previously, he worked with homeless veterans and the seriously and persistently mentally ill in a community mental health center. He also headed up a partial hospitalization program, seeing patients with depression, bipolar disorder and anxiety in a daytime group therapy setting. Chris sees patients 14 and older with specializations in trauma, personality disorders and depression, but enjoys assisting any and all kinds of difficulties people face.


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