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Panic Attacks While Driving - Dawn's Story

An Illustrative Example by Dominica Applegate

Excitement filled the air as Dawn and her sister, Donna, drove to Georgia for a relaxing weekend at a cabin. Dawn's son was graduating from Fort Benning Army Airborne School and she was delighted to be able to be there to watch him graduate. Dawn was completely unaware that today she would experience her first panic attack while driving, which would become a serious challenge for her over the coming months.

Dawn, 43, is a single mother with three children. She lives in a rural town in Pennsylvania, is an office manager, is involved in several community activities, and is fairly popular in her small town. The past year has been difficult for Dawn. She went through a divorce and it was a painful and traumatic time for her. Emotionally drained and stressed to the max, Dawn went to her doctor because her hands were continually shaking and she was having difficulty sleeping at night. He told her that it is quite normal to experience mild symptoms of anxiety during a stressful season of life. He stated that if her symptoms did not improve or became worse, they could discuss the possibility of anti-anxiety medication for symptom management.

It was a gorgeous day. The sun was beaming and the sky was a beautiful blue. Conversation was rich as Dawn drove down Interstate 95 happily discussing life with her sister. Suddenly, out of the blue, Dawn began feeling extremely nervous, like something awful was about to happen. Her heart began thumping harder and harder like it was going to burst out of her chest. She noticed that it was getting more difficult to get air into her lungs and gasped for air. "How odd," she thought to herself. "I don't have asthma. What is happening to me?" Suddenly, as if someone was stabbing her in her mid-chest she felt intense, alarming pain. She gasped and quickly clutched her chest with one hand and clenched the steering wheel with the other.

Anxiety wreaks havoc in our society and though a small dose of anxiety does not normally pose a problem for individuals, abnormal or extreme anxiety is problematic for many. Panic attacks while driving are a common way for anxiety disorders to manifest themselves. According to the National Institute of Mental Health, about 40 million adults are affected by anxiety disorders per year. It is not uncommon to hear of friends or family members being diagnosed with disorders such as Panic Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, or Social Anxiety Disorder.

Dawn had already been wrestling with chronic anxiety for the past year or so. She was constantly tense and full of fear. She made attempts to combat her anxiety by utilizing deep breathing and relaxation techniques, as well as exercising, which indeed helped lessen symptoms, but for unknown reasons, while on Interstate 95 that sunny day in October, she experienced her first panic attack while driving.

A panic attack, or panic disorder, is characterized by "sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations."

Panic disorders are quite common, with about six million adults diagnosed per year. Higher levels of anxiety while driving are becoming more and more common as well. With busy traffic and aggressive drivers, one’s anxiety level can already be soaring, making the chances of having a panic attack while driving much greater.

Dawn pulled over that day and within a couple minutes the pain had subsided. Fairly certain that she was not in imminent physical danger, she went on to enjoy her vacation and returned home hoping that she would not have such a frightening experience again.

Excessive and prolonged anxiety is dangerous and affects people differently. Sometimes the anxiety and stress manifests through muscle tension around the chest, causing extreme pressure and pain. According to an article in Psychiatry Weekly, reports show that 17 to 32 percent of patients who go to an emergency room with chest pain have panic disorder.

Though Dawn thought her episode was a one-time event, two weeks later she was driving her daughter to a soccer game and while merging onto highway traffic, she began to feel the same nervous feeling that she felt on the way to Georgia. Her palms became sweaty and fear knotted her chest. "Oh no!" she thought, "Please, not again," she begged. Within moments she was gasping for air, her hands went numb, and she felt as if she had lost all control as the panic grew inside her.

Dawn recovered from her second panic episode within five minutes and resolved to see her doctor the next day for an exam. Upon hearing of her attacks and ruling out any physical conditions, her doctor told her that she had most likely suffered from a panic attack and recommended that she see a Psychologist colleague Dr. Remington.

"I can’t even get on a highway anymore and if I can avoid driving all together, I do," Dawn told Dr. Remington. "I simply don't want to have another dreadful panic attack while driving again but I also don't want to be stuck at home either. My friends are worried about me because I won't meet them out anymore and I'm afraid of driving to my family reunion in Buffalo next month. I just don't know what to do!"

Dr. Remington, a leading anxiety specialist in Dawn's hometown, diagnosed Dawn as having Panic Disorder and together they created a treatment plan to attempt to manage her anxiety and panic attacks. Dawn's fear of driving was increasing as she began thinking that driving was the trigger for her panic attacks, so she knew unless she got a handle on her anxiety, she would not be able to get in a car at all.

Dr. Remington explained to Dawn that there were various medications and therapies to help her manage panic disorder. Dawn said that she really wasn't comfortable taking anti-anxiety medications and would rather try other treatments first. After discussing all of their options, they decided to try treatments known as CBT, exposure therapy and guided visualizations to alleviate her symptoms.

Exposure therapy, guided visualization and CBT help clients confront fears by having them visualize situations they are afraid of and learn how to better handle the fearful emotions as they arise. This is done in a safe environment as to have the patient confront his or her fear using imagination before practicing exposure in real life situations. New coping skills are learned such as deep breathing and positive thought replacement. In Dawn's case, her doctor helped her confront her traumatic panic attacks while driving through guided visualizations. As she felt the unpleasant emotional and physical symptoms arise, he taught her how to identify her negative self-talk which was helping fuel her panic, and replace those statements with more positive ones.

As Dawn would sit in his office and envision herself having a panic attack while driving her car, he would calmly talk to her and encourage her to breathe deeply and relax every muscle. He used guided visualizations to help Dawn maintain to a relaxed state physically and mentally and see herself driving on and off highways in a peaceful and joyful state. Additionally, he encouraged her to utilize meditation daily to decrease anxiety levels and play soothing and uplifting music in her car as she drove.

Dr. Remington gradually taught Dawn through exposure therapy to confront her fears and through guided visualizations to relax and gain control when she felt herself becoming anxious. Dawn was proactive in her treatment plan and began driving with more confidence. She felt confident that through continued therapy, she would be able to manage her anxiety levels and overcome panic disorder completely.

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