Panic Attacks While Driving 

Note: You can also print this document in Adobe PDF format by clicking here. (It requires Adobe Reader which you can obtain for free here.)

Question: “I have panic attacks mostly whilst in a car. This has led to me being unable to drive my own car. I used to drive everywhere but am now unable to drive to the shops. I am a little better if someone is with me but cannot do this on my own as my chest gets tight, my heart races and I shake all over and that is before I get in the car?"

Answer: For the purpose of an example let’s say that the above statement was made by an individual with the name Amanda (obviously the person’s true identity will be held in confidence).  Let’s again use Cognitive Behavioral Therapy to analyze the thoughts behind the statement to locate the cognitive distortions and then substitute healthier thoughts that can make us feel better.

The key points of Amanda’s statement are:

“This (having panic attacks) has led to me being unable to drive my own car.”

“…am now unable to drive to the shops.”

“…cannot do this on my own…”         

First, I recommend that you click here and look at the list of Cognitive Distortions and then try to locate what possible distortions might be present in Amanda’s thinking before continuing to read directly below.  Hint: There is more than one distortion present.  Once you’ve done this, write them down or type them out and then come back to this spot.

Okay, welcome back (I hope you have really given this a try yourself)

If you guessed that the following four distortions are present then you’re right: 1. Disqualifying the positive 2. Jumping to conclusions: fortune telling 3. Magnification

Let’s look specifically at how each distortion is actually present in this statement and then we will look at some alternative more realistic thoughts.

1. Disqualifying the positive - All of the points put forward by Amanda are likely disqualifying the times that she has driven her car to various locations, including the shops, and did perfectly fine.

2. Jumping to conclusions: fortune telling – Amanda is concluding that because of her anxiety while in the car that she can never drive alone.  Again there are probably many times she’s done (We’ll come back to this one though).

3. Magnification –  Amanda obviously is having symptoms of anxiety before she gets in the car but she is not dying and is really just feeling anxiety.

Now to really see something beneficial some from the process, let’s try to generate an alternative, more accurate way of thinking about the situation.  Again, before reading on, try to generate some on your own. Once you’ve done this, write them down or type them out and then come back to this spot.

Okay here’s an alternative:

As pointed out, Amanda has likely driven many times alone and done just fine.  She has probably done so after feeling very anxious too.  Just because she is nervous does not mean she cannot drive. 

While she may be extremely uncomfortable driving her car she can start out by taking baby steps.  That is, by going on short drives accompanied by a friend or someone else.  Over time she can increase the distance.  She can then start the same process again, this time without anyone in the car with her.  Over time she can go a further and further.

I would encourage you to stick with the examples that I feature in newsletters, and, rather than looking for immediate payoffs, look to the future, but with a belief that you are slowly working on your thoughts and overall perceptions and that slowly over time you can change.

I have read about and known of many individuals who have had success with CBT even when they had either very difficult cases or felt there was no hope.  In many cases they may have had a persistent therapist that worked with them and stayed on top of the situation to ensure that they followed through on their “homework.” 

I hope you will give yourself plenty of this very beneficial homework, i.e. working on your own thoughts. 

I would like to end on quoting the Royal College of Psychiatrists about the breadth of problems that can be helped by CBT:

"CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue."¹

1. Royal College of Psychiatrists. Cognitive Behavioral Therapy (CBT). Retrieved November 7, 2010 from  Royal College of Psychiatrists website:

http://www.rcpsych.ac.uk/mentalhealthinfoforall/treatments/cbt.aspx