Mar 4, 2019

How To Overcome Fear Of Driving

Overcome fear of driving by:

Learning the symptoms of fear of driving
Restructuring your thoughts
Using imaginal exposure and rehearsal
Learning to manage anxiety and panic attacks

If you have been dealing with the fear of driving, I'm very sorry. It can be very uncomfortable and people often feel ashamed and embarrassed.

The fear of driving (driving phobia) is an intense irrational fear of driving an automobile or even just sitting in one.

The fear of driving is irrational because of the assumption that every driving occurrence will lead to catastrophic disaster or that you will lose control and deliberately drive off the road.

It is, however, reasonable to assume that traffic accidents can occur and therefor it is helpful for us to drive carefully and defensively.

It is also reasonable to assume that you are capable of controlling the vehicle.

But fear and phobias by nature are not reasonable or rational so that the fear of driving can cause crippling anxiety and panic.

Unlike other phobias, the fear of driving is particularly troublesome since it's very difficult to avoid it.

If you don't live in a big city with adequate public transportation, you will need to drive or be driven to your daily obligations such as work, school, and doctors appointments.

Fear of driving is categorized by the Diagnostic and Statistical Manual of Mental Disorders (DMS-5) as a specific phobia that causes emotional, physical, and behavioral symptoms.

Fear of Driving Symptoms

Emotional

Specific Fear of driving or being a passenger in an automobile
Driving always causes immediate fear or anxiety
The thought of driving causes anxiety
The fear is way out of proportion to the actual danger posed by driving
Panic attacks

Physical

Pounding heart
Sweating
Trembling
Shortness of breath
Feeling of choking
Chest pain
Nausea
Feeling dizzy
faintness
Numbness or tingling
Chills or hot flashes

Behavioral

Fleeing or running away
Freezing or being immobilized
Avoidance

Causes For Fear of Driving

Learned From Past Experiences

Also known as “Classical Conditioning,” most driving phobias develop after a person has a negative experience or a panic attack while driving.

Prior accidents causing PTSD, driving through severe weather, losing control of the car, witnessing or hearing reports of fatal car crashes, and getting lost while driving all have the potential to cause anxiety and trigger symptoms of a panic attack.

We begin to associate anxiety and panic with driving, panic attacks recur while driving, and the fear is then established.

Avoidance

Avoidance is the major way that you feed the fear and develop a phobia like fear of driving.

Escaping and avoiding only temporarily reduces the fear and anxiety.

Avoidance also confirms and maintains the belief that driving is dangerous. You might not have a panic attack by avoiding driving but you have also reinforced that that driving is dangerous.

Avoidance Becomes A Vicious Cycle

The more you avoid driving, the more fearful driving becomes. The more fearful driving becomes, the worse your anxiety and panic attacks become. The worse your panic attacks become, the more you avoid driving.

Performance Anxiety

Thinking that you are a bad driver, getting in everyone's way, and just plain annoying people with your driving can cause increased anxiety.

You may also feel that your driving skills are being judged and tested by everyone on the road.

Control

As with most anxiety disorders, the fear of driving is rooted in control.

Fear of losing control accidentally, fear of losing control of your will and deliberately driving off the road, or fear that others will lose control are some of the specific fear that some have while driving.

Fear of losing control while driving causes people to become over-controlled and grip the steering wheel tighter or to drive slower.

Unfortunately, this reinforces the irrational belief that there is danger. This will increase the level of anxiety and further fuel a panic attack.

Having a panic attack while driving further causes you to feel out of control. The sympathetic nervous system (Fight or Flight) is fast, automatic, and is activated mostly without our conscious control. This is why you feel out of control and fear losing control during a panic attack.

Your natural response is to attempt to gain more control or maintain control when panicking. If you are driving when a panic attack happens you will grip the steering wheel tighter.

Treatment

If you believe you could have a Specific Phobia, such as the fear of driving, it will be helpful and important to seek consultation with a mental health professional to first verify the diagnosis and then receive appropriate treatment.

The most effective treatment for phobias is a form of Cognitive Behavioral Therapy called Exposure Therapy.

Treatment sometimes consists of a combination of medication and psychotherapy. Medication helps take the edge off the physical symptoms of anxiety and psychotherapy helps to challenge irrational thinking and beliefs that lead to the anxiety and avoidance.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving.

You learn different ways of responding to the feared object or situation and to your feelings of anxiety. CBT helps challenge and change unhelpful beliefs that cause anxiety by restructuring your automatic thinking.

CBT sessions also provide education on the symptoms of phobias and how to manage the emotional and physical symptoms of anxiety such as how to stop a panic attack.

Cognitive Restructuring

Cognitive restructuring is used to identify and dispute unhelpful, automatic, and irrational thinking so that you can create highly effective thoughts with the power to alter your emotions and behavior.

An example of an irrational thought is “What if I panic, lose control, and deliberately drive off the road?"

We develop beliefs about ourselves, other people, and the world. These beliefs influence how we think.

If you believe that the world is basically a dangerous place, then your thoughts will follow. If you believe that you are defective and not a capable person, then your thoughts will reflect those beliefs.

It is not the feared object or situation that causes the anxiety, it’s your thinking and beliefs that cause the fear and anxiety.

Exposure Therapy

Exposure therapy, also known as prolonged exposure, is a form of CBT.

As with most anxiety disorders, in order to learn how to overcome the symptoms of anxiety and to know that you can cope with anxiety and master the symptoms, you need to have the experience of successfully managing the symptoms.

This often means exposing yourself to the thoughts, images, and to the object or situation that triggers the fear, and then applying the coping strategies until the thoughts, images, and feared object no longer produce the same level of fear.

Exposure therapy gradually exposes people to the feared object. This helps to systematically desensitize you from the feared object.

First imagining it (Imaginal exposure). You will get relaxed, close your eyes, and imagine yourself just sitting in the car. You will identify all of your thoughts and beliefs about what would happen if you were near it.

Second, you will learn to manage the symptoms of anxiety you experience while doing the imaginal exposure. Then you can make a fear hierarchy and gradually expose yourself to this list.

1. A picture of a car or someone driving on the highway.

2. Then a video of someone driving.

3. Then near a parked car.

4. Then sitting in a parked car.

5. You will continue to gradually work your way up to starting the engine, then a very short drive, and finally extended the drive further as your anxiety diminishes on short drives.

By repeatedly using imaginal rehearsal, and then exposing yourself to this hierarchy while at the same time learning to decrease your symptoms of anxiety and develop more balanced beliefs, you will become more desensitized to driving and no longer fear it.

Medication

Please consult with your primary care physician or a psychiatrist regarding the use of any medication.

Medication can help reduce the symptoms of anxiety that occur with specific phobias. Commonly prescribed medications include benzodiazepines and beta-blockers.

Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use. However, the long term use of benzodiazepines is associated with the risk of developing tolerance, dependence, and possible other adverse effects.

Commonly prescribed benzodiazepines are:

Alprazolam (Xanax)

Lorazepam (Ativan)

Diazepam (Valium)

Clonazepam (Klonopin)

Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety.

Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to anxiety.

Commonly prescribed Beta Blockers:

Propranolol (Inderal)

Atenolol (Tenormin)

Acebutolol (Sectral)

Bisoprolol (Zebeta)

Metoprolol (Lopressor, Toprol-XL)

Nadolol (Corgard)

Nebivolol (Bystolic)

Managing Anxiety

Feeling confident in your ability to manage the symptoms of anxiety will help with your fear of embarrassment and fear of panic attacks in public places.

Learn to manage panic attacks while driving

Turn on Your Parasympathetic Nervous System

The parasympathetic nervous system is also called the “Rest and Digest” system. It produces a calm and relaxed feeling by:

Decreasing the heart rate

Dilating the blood vessels

Increasing salivation

Stimulating tear production

Stimulating the digestive system

Increasing a feeling of calm

Improves sexual arousal

The parasympathetic nervous system is activated by stimulating something called the vagus nerve. This nerve is very long and it runs from the hypothalamus in the brain to the chest, diaphragm, and intestines.

The vagus nerve can therefore be stimulated through diaphragmatic breathing, humming, and singing.

You can also turn on your parasympathetic nervous system with progressive muscle relaxation and by exposing yourself to cold temperatures.

Diaphragmatic Breathing Exercise

Inhale through your nose slowly by expanding from your belly first then fill your upper lungs for a count of 5
Hold your breath for a count of 2.
Exhale slowly and forcefully through pursed lips for a count of 10.
Repeat this 5 to 10 times or do it for at least 1 minute.

Progressive Muscle Relaxation

From a seated position begin by tensing your legs and buttocks for a count of 5, then relax.
Tense your abdomen for a count of 5, then relax for a count of 5.
Tense your arms for a count of 5, then relax for a count of 5.
Shrug your shoulders to your ears and tense for a count of 5, then relax for a count of 5.
Press your tongue to the roof of your mount for a count of 5, then relax for a count of 5.

Tips: Let all of the tension release and flow out or your muscles. Exhale as you release the tension and relax. You should feel the muscles become loose and limp.

Focus on the difference between the tension and relaxation as this is the most important part of the exercise.

Exposure to Cold

Research indicates that your sympathetic (fight or flight) system slows down and your parasympathetic system increases when your body adjusts to cold temperatures (Makinen et. al. 2008).

It appears that any kind of cold exposure works such as drinking cold water, running hands under cold water, and splashing cold water on your face.

Take care of your physical health