The only thing we have to fear is....
June 18, 2018 11:26 AM Subscribe
I have a history of anxiety issues, for which I take medication. That history has included previously not-too-frequent panic attacks, usually while I'm driving. For the past couple weeks, they've not only been not-infrequent, they've become a daily occurrence when I'm driving to/from work. I have a doctor's appointment scheduled for late next week, but I need some tips in the meantime.
Relevant information:
They're not related to any specific thing (that I know of). I don't have any major crises at the moment. What triggers them is that "What if I have a panic attack?" moment, which has now morphed into the "I am probably going to have a panic attack" thought as soon as I turn the key, which ultimately culminates in light-headedness and "OMG I'm going to hyperventilate," followed by a forced struggle to breathe normally. (And if you've ever done that, you know it's impossible to breathe normally when you're yelling at yourself to breathe normally.) Lather, rinse, repeat.
From experience, I know that the more I try to focus on my breathing, the more problematic my breathing becomes. So, what other strategies can I use while I'm driving to help either stave off a panic attack or right myself if one starts?
My commute is about 25 minutes, and I've started taking back roads instead of the highway because a) I can, b) I find it to be a calmer drive, and c) there are a few crossroad stop signs that slow me down both literally and mentally. (I also pull over if it gets to be too intense, which I've only had to do a couple of times, so please no lecturing on that front.)
Ideas for different strategies? I try to focus on music or podcasts, but so far they haven't proved to be successful distractions. I am also doing a 10-minute guided meditation every morning.
I'd be especially interested in hearing from people who experience panic attacks while driving. (Feel free to MeMail if you'd rather not post publicly.) I really don't want to turn into a person who doesn't leave the house.
Relevant information:
They're not related to any specific thing (that I know of). I don't have any major crises at the moment. What triggers them is that "What if I have a panic attack?" moment, which has now morphed into the "I am probably going to have a panic attack" thought as soon as I turn the key, which ultimately culminates in light-headedness and "OMG I'm going to hyperventilate," followed by a forced struggle to breathe normally. (And if you've ever done that, you know it's impossible to breathe normally when you're yelling at yourself to breathe normally.) Lather, rinse, repeat.
From experience, I know that the more I try to focus on my breathing, the more problematic my breathing becomes. So, what other strategies can I use while I'm driving to help either stave off a panic attack or right myself if one starts?
My commute is about 25 minutes, and I've started taking back roads instead of the highway because a) I can, b) I find it to be a calmer drive, and c) there are a few crossroad stop signs that slow me down both literally and mentally. (I also pull over if it gets to be too intense, which I've only had to do a couple of times, so please no lecturing on that front.)
Ideas for different strategies? I try to focus on music or podcasts, but so far they haven't proved to be successful distractions. I am also doing a 10-minute guided meditation every morning.
I'd be especially interested in hearing from people who experience panic attacks while driving. (Feel free to MeMail if you'd rather not post publicly.) I really don't want to turn into a person who doesn't leave the house.
Do you drink any caffeinated beverages in the morning? If so, try cutting those out. (It made a big difference in my anxiety levels even though I was addicted and I hated quitting coffee. Now I drink decaf.)
What if you play a familiar album and sing along the whole way? That might be a sneaky way of regulating your breathing and distracting your brain...
posted by purple_bird at 11:47 AM on June 18, 2018
What if you play a familiar album and sing along the whole way? That might be a sneaky way of regulating your breathing and distracting your brain...
posted by purple_bird at 11:47 AM on June 18, 2018
Try to shift your thinking from "OMG, I'm going to have a panic attack" to "Yeah, I will probably will - no big deal - I can handle that - after all I've had lots of practice." And it's true - you've been driving through lots of panic attacks already and while it is uncomfortable, nothing really bad has happened yet.
Think about it. What's the worse that can happen? It might get so bad that you need to pull over for a few minutes. And it that happens? You will be a few minutes late. No big deal. More likely you will just have a very uncomfortable drive but you will still get to where you need to go. Give yourself permission to pull over if you really need to but don't do it until you are certain that you need it.
Also, if you are driving while it is happening, try focusing on driving at an exactly steady speed. In your head say "OK. I'm having another attack. All I have to do is stay focused and drive at exactly xx mph until I get there. Just keep driving. " This will help you stay focused on the road instead of on your body.
posted by metahawk at 11:49 AM on June 18, 2018 [3 favorites]
Think about it. What's the worse that can happen? It might get so bad that you need to pull over for a few minutes. And it that happens? You will be a few minutes late. No big deal. More likely you will just have a very uncomfortable drive but you will still get to where you need to go. Give yourself permission to pull over if you really need to but don't do it until you are certain that you need it.
Also, if you are driving while it is happening, try focusing on driving at an exactly steady speed. In your head say "OK. I'm having another attack. All I have to do is stay focused and drive at exactly xx mph until I get there. Just keep driving. " This will help you stay focused on the road instead of on your body.
posted by metahawk at 11:49 AM on June 18, 2018 [3 favorites]
Can you leave earlier or otherwise temporarily adjust your work schedule so that there are fewer people on the road whenever you're commuting? A good friend of mine had her everyday anxiety spike to severe levels after some life stress/trauma and once she was able to arrange with her boss to arrive at work at 6-7 and leave by 2-3, she found it a lot easier to cope, both with overall driving anxiety and with individual acute attacks.
posted by poffin boffin at 11:57 AM on June 18, 2018
posted by poffin boffin at 11:57 AM on June 18, 2018
Can your doctor call in a prescription for something for acute anxiety to get you through the week? I take Prozac for anxiety, but my psychiatrist also started me off with a small supply of ativan because I was having frequent panic attacks. Taking one in the morning and one at night was super helpful for me while we waited for the Prozac to take effect.
NB that you should of course take it first when you aren't driving to see what it does to you. I can drive no problem on 1mg of ativan, but YMMV (literally).
posted by Ragged Richard at 12:03 PM on June 18, 2018
NB that you should of course take it first when you aren't driving to see what it does to you. I can drive no problem on 1mg of ativan, but YMMV (literally).
posted by Ragged Richard at 12:03 PM on June 18, 2018
Can you switch from music and podcasts to foreign-language instruction? The sections where you repeat the new phrases and vocabulary words might help.
I'd also try a portable, warming wrap like Thermacare, for calming comfort, even if you're driving with the a/c on; the company has versions for backs and shoulders, and there are no-name drugstore brands, too. (There are also re-useable rice-filled heating pads, but they might migrate too much on the drive.)
It would mean altering your current schedule to leave home earlier, but consider taking breaks in your commute by stopping for breakfast or coffee. And if any part of your anxiety might be exacerbated by thinking panic attack = getting to work late, just commit to arriving half an hour to an hour early until you meet with your doctor. Creating a bit of a temporal cushion has helped me. Best wishes.
posted by Iris Gambol at 12:27 PM on June 18, 2018
I'd also try a portable, warming wrap like Thermacare, for calming comfort, even if you're driving with the a/c on; the company has versions for backs and shoulders, and there are no-name drugstore brands, too. (There are also re-useable rice-filled heating pads, but they might migrate too much on the drive.)
It would mean altering your current schedule to leave home earlier, but consider taking breaks in your commute by stopping for breakfast or coffee. And if any part of your anxiety might be exacerbated by thinking panic attack = getting to work late, just commit to arriving half an hour to an hour early until you meet with your doctor. Creating a bit of a temporal cushion has helped me. Best wishes.
posted by Iris Gambol at 12:27 PM on June 18, 2018
Not a long-term solution but for the immediate future, can you arrange alternate transportation until your doctor's appointment? Either public transportation, cab/rideshare, or find a buddy to carpool with?
posted by yeahlikethat at 1:18 PM on June 18, 2018
posted by yeahlikethat at 1:18 PM on June 18, 2018
Have your eyes checked. It's probably time to di that anyway, right?
I have an astigmatism that effects my depth perception, there may be an imperceptible (to you) change in your vision that makes driving extra scary.
If you take medications, have a general blood test to check for irregularities. Sometimes longterm meds cause weird deficiencies (anemia comes to mind) that can exacerbate anxiety. Sometimes the answer really is just a change in nutrition and maybe some supplements.
If everything else is fairly stable, these are my two triggers for extreme driving anxiety. I suffered tremendously from driving anxiety, but not now that I addressed these two issues.
Think outside the box a bit, if not vision or chemistry, maybe there is some other trigger. Are your tires aligned? How are your breaks? Maybe your subconscious is noticing something about your car and you should get it checked out?? If anything, spending $0 to $50/$100 to have your car assessed might give you confidence if the car comes back with high marks.
posted by jbenben at 1:44 PM on June 18, 2018
I have an astigmatism that effects my depth perception, there may be an imperceptible (to you) change in your vision that makes driving extra scary.
If you take medications, have a general blood test to check for irregularities. Sometimes longterm meds cause weird deficiencies (anemia comes to mind) that can exacerbate anxiety. Sometimes the answer really is just a change in nutrition and maybe some supplements.
If everything else is fairly stable, these are my two triggers for extreme driving anxiety. I suffered tremendously from driving anxiety, but not now that I addressed these two issues.
Think outside the box a bit, if not vision or chemistry, maybe there is some other trigger. Are your tires aligned? How are your breaks? Maybe your subconscious is noticing something about your car and you should get it checked out?? If anything, spending $0 to $50/$100 to have your car assessed might give you confidence if the car comes back with high marks.
posted by jbenben at 1:44 PM on June 18, 2018
I feel like I say this every time somebody experiences an untoward mental state associated with a car, but anxiety is both a short and long term effect of carbon monoxide exposure, so I think you should get your exhaust system checked out and buy a CO detector designed for cars.
posted by jamjam at 2:27 PM on June 18, 2018 [1 favorite]
posted by jamjam at 2:27 PM on June 18, 2018 [1 favorite]
What thefang said and also what jamjam said. If you are part of a healthcare organisation that gives you access to various classes, see if there is an anxiety class. I took a 6-week class through Kaiser and it was great. Our teacher (who used to be a therapist but quit and now teaches yoga plus this type of class) talked about how anxiety attacks are basically metal false alarms, and they need to be confronted and acknowledged and you need to go about your business as usual, even though you may be terrified, because otherwise your brain will just defeat you. I have developed lots of ways to talk to (acknowledge) my anxiety, etc. I am on meds, which cut down on the panic attacks a lot, but taking the class (ironically) increased them briefly. This stuff is really hard. MeMail me if you want more details of my own struggle. Best of luck!
posted by Bella Donna at 2:34 PM on June 18, 2018 [1 favorite]
posted by Bella Donna at 2:34 PM on June 18, 2018 [1 favorite]
Panic attacks have a large physiological component. 2 things that can help by affecting your body:
1. very cold, very wet cloth on the face (stimulates mammalian dive reflex). Bring a travel mug of ice water and a wash cloth.
2. Valsalva Maneuver (vagus nerve stimulation)- affects the process that sends the electrical heartbeat signal. It's similar to the effort of bearing down to pop, but you bear down on your diaphragm. If you do it hard enough, long enough, you could make yourself pass out, so pull over and set the brake. I have never passed out from it, but this is new to you. Some research suggests it may affect inflammation and other stuff.
posted by theora55 at 4:44 PM on June 18, 2018 [1 favorite]
1. very cold, very wet cloth on the face (stimulates mammalian dive reflex). Bring a travel mug of ice water and a wash cloth.
2. Valsalva Maneuver (vagus nerve stimulation)- affects the process that sends the electrical heartbeat signal. It's similar to the effort of bearing down to pop, but you bear down on your diaphragm. If you do it hard enough, long enough, you could make yourself pass out, so pull over and set the brake. I have never passed out from it, but this is new to you. Some research suggests it may affect inflammation and other stuff.
posted by theora55 at 4:44 PM on June 18, 2018 [1 favorite]
My psychiatrist (who is awesome) says sometimes you have to "medicate the purse, not the person". Meaning that knowing you have an anti-anxiety med like Xanax in your handbag or pocket can sometimes be enough to de-escalate an attack.
It works *so well* for me. I used to get panic attacks very frequently, and they're sooo awful while you're driving -- I'm really sorry you're dealing with that. I always keep a pill or two on me, and when I start to feel that 'Am I about to have a panic attack?" cycle start, I just tell myself "yeah, maybe i am. and if it doesn't go away in five minutes i'm taking a xanax and then there will be no panic attack" and, my friend, it's like a magic spell. Faced with actual solutions, my panic hangs it head and skulks back to where it came from. On the rare occasions it didn't, I just took the xanax, which for me is very effective in quickly stopping an active attack.
After four months of this, the frequency dropped to maaaybe one every other month. It's been really nice. I hope you can find a solution.
posted by ananci at 6:13 PM on June 18, 2018 [7 favorites]
It works *so well* for me. I used to get panic attacks very frequently, and they're sooo awful while you're driving -- I'm really sorry you're dealing with that. I always keep a pill or two on me, and when I start to feel that 'Am I about to have a panic attack?" cycle start, I just tell myself "yeah, maybe i am. and if it doesn't go away in five minutes i'm taking a xanax and then there will be no panic attack" and, my friend, it's like a magic spell. Faced with actual solutions, my panic hangs it head and skulks back to where it came from. On the rare occasions it didn't, I just took the xanax, which for me is very effective in quickly stopping an active attack.
After four months of this, the frequency dropped to maaaybe one every other month. It's been really nice. I hope you can find a solution.
posted by ananci at 6:13 PM on June 18, 2018 [7 favorites]
Sing in the car. It’s hard to panic and sing at the same time physiologically.
posted by warriorqueen at 5:02 AM on June 19, 2018 [1 favorite]
posted by warriorqueen at 5:02 AM on June 19, 2018 [1 favorite]
I used to have this problem while driving years ago. What helped for me was singing along loudly to music I knew and liked. Also, calculating percentage of trip elapsed / still to go. And finally telling myself I could pull over and stop if I needed anytime. Oh and also exhaling slowly over count of ten to control breathing.
Still wasn't great though - car journeys were an ordeal and what fixed it long term was medication then lifestyle changes. Good luck
posted by JonB at 10:06 AM on June 19, 2018
Still wasn't great though - car journeys were an ordeal and what fixed it long term was medication then lifestyle changes. Good luck
posted by JonB at 10:06 AM on June 19, 2018
Just a note that in the DBT training I've done, there have been cautions that people with any current heart problems or history of heart problems should not do any of the mammalian-dive reflex skills (including using ice on the face) unless it's cleared by their doctors first. The teacher's guide for DBT states:
Heart problems. Using cold water to induce the dive reflex can reduce heart rate very rapidly. Individuals with any heart disorder, a heart rate below their normal baseline due to medications, other medical problems, anorexia nervosa, or bulimia nervosa should only use this procedure with permission of their medical providers. In general, recommending that participants check with their medical providers before using the procedure is a good idea. Adolescents should seek parental permission as well.posted by lazuli at 4:16 PM on June 19, 2018 [1 favorite]
« Older Word to describe "X Make Up Y" word relationships | A tiny fridge or something else? Newer »
This thread is closed to new comments.
posted by thefang at 11:46 AM on June 18, 2018 [1 favorite]