Medical Driving Evaluations

Driving With Anxiety

Posted by Joan Cramer on Sep 24, 2019 7:44:05 AM
Joan Cramer
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Driving can be a stressful experience for anybody. For those with some form of anxiety disorder or driving phobia, it can feel overwhelming. Simply thinking about getting behind the wheel can be paralyzing. Your mind fills with worries about all the “what if’s,” like “What if I get lost?” “What if I cause an accident?” “What if other drivers get angry at me?” While these thoughts can make you hesitant to get on the road, we want you to consider another “what if.” What if you succeed? You could broaden your world, be more independent, and go places and do things you’ve always dreamed of. If you’re visiting our website, you’re already taking the first step towards freedom.

What is anxiety?

Anxiety is a broad term that encompasses several fear-related disorders that collectively impact around 12.5% of Americans. Some of these disorders relate to a specific fear of driving, whereas others present with more generalized problems that may also impact one’s ability to drive.

One of the most common forms of anxiety is general anxiety disorder. People with this condition are overwhelmed by unreasonable worries about everyday events, like caring for family, going to work, or preparing meals. People may feel fear and dread to the point where they struggle to perform routine activities. They may also have physical symptoms like insomnia, digestive problems, chest pain, muscle tension, and frequent urination. It is common for them to struggle with staying focused on tasks or being easily startled.

Panic attacks are another common form of anxiety. They appear suddenly, causing you to feel terrified, detached, out of control, or to have a sense of impending doom. Physically, you may be dizzy, shaking, sweating, nauseous, and have a rapid, pounding heart rate. These symptoms usually pass in a matter of minutes, and for most people, are a one-time event. Those that experience this on a regular basis are said to have a panic disorder.

Obsessive-compulsive disorder (OCD), is an anxiety disorder in which the person feels bombarded with intrusive thoughts and is compelled to carry out certain actions in order to alleviate these thoughts. For some, this may involve repetitively washing hands, closing doors, or checking the mirror while driving. They may spend hours dealing with unwanted thoughts that they may have caused an accident, eventually getting to the point of calling hospitals and police to see if anyone has reported anything.

Some people experience repeated fear and anxiety that is related to a specific traumatic event, such as a car accident. This is known as post-traumatic stress disorder (PTSD) and may only manifest itself when triggers remind the person of the event. It may involve avoidance, flashbacks, nightmares, insomnia, difficulty concentrating, hypervigilance and outbursts of anger.

Vehophobia, or the fear of driving, may be caused by PTSD, unwarranted fears of the dangers of driving (collisions, road rage, etc), or from agoraphobia, the fear of being trapped in an unsafe environment without the means to escape. Those who suffer this form of anxiety have a persistent, irrational fear specifically of driving. It ranges from a mild but constant sense of hesitation to a debilitating feeling of terror and may get worse when driving in traffic or at high speeds.

It is important to note that in some cases, anxiety is actually a symptom of a medical condition. It can be difficult to distinguish the symptoms of a panic attack from those of a heart attack. Also, low blood sugar, which can result from improperly managed diabetes, can produce symptoms such as fear, shakiness, tingling, and sweating. If you are experiencing these symptoms and don’t know for sure that they are anxiety-related, consult a doctor as soon as possible to rule out any other serious health problems. Do not hesitate to call an ambulance, as these symptoms may be signs of a life-threatening emergency.

How can anxiety impact my ability to drive?

For those with vehophobia, their anxiety is directly connected to driving. They may be so fearful that they do not even want to get into a vehicle. Even if they do bring themselves to the point of starting down the road, intrusive thoughts about possible worst-case scenarios or memories of past traumatic events may cause them to have panic attacks, which may distract them and cause them to neglect the tasks of driving. For some, there may only be certain aspects of driving that cause anxiety, such as merging with traffic, crossing bridges, or driving in unfamiliar locations. Some people may avoid driving in any situation that would trigger their anxiety, or when they unexpectedly encounter a trigger, they may have a sudden increase in symptoms.

Other forms of anxiety may not be directly related to operating a vehicle but may distract you with physical symptoms or intrusive thoughts that make it hard to focus on driving. You may be consumed with worries about work problems or the safety of loved ones, or may feel nauseated and shaky, and not pay enough attention to the road. Some may have sensitivity to light, which makes looking at the road a painful experience. They may have insomnia, which leaves them too exhausted to safely drive. For some people, their symptoms may manifest in hyperventilation, which can make you feel dizzy and even lose consciousness while behind the wheel.

What can I do on my own to improve my ability to drive with anxiety?

Regardless of why you suffer from anxiety, there are several things you can do that may help you feel more at ease behind the wheel.

First, take things slow. You don’t need to rush straight from never driving into going 70 down a busy freeway. First, just spend time sitting in the car in your driveway until you feel comfortable. If you have your permit or license, practice simply going around your block. Once you feel good about this, try adding another block or two. It may take time, but using these little steps, many find they are able to gently work up to driving farther and under more challenging conditions.

Another thing you can do is to intentionally think about the things that make you anxious. Don’t do this to dwell on them, but to analyze them and see, “Is this fear really legitimate?” For example, many people with anxiety dwell on the worst-case scenario, let’s say of getting in a car accident when really, the odds are a thousand times better that they will have a completely uneventful drive. Spend time thinking about the ways that things could go well instead of how they could go wrong.

Many people with driving anxiety find it helpful to read articles or watch videos by other people with anxiety who share about their journey to freedom behind the wheel. Knowing that others have found the strength to press through the worry and fear can encourage you to take each next step.

A key component of getting over anxiety is adjusting your lifestyle habits. Cut out junk food and caffeine, which can aggravate anxiety symptoms. Add in a healthy exercise routine, which can burn off stress and increase hormones that help you relax. Lay off movies, video games, and social media, as these can all feed stress and fears and have been shown to make anxiety worse. Instead, choose hobbies that get you outdoors in the fresh air and sunlight. Things like walking, gardening, or playing with pets are better alternatives.

If you suffer from some form of anxiety, be sure to consult your physician or counselor about what is best in your individual situation. You may need to deal with issues from your past in order to move on in the present, and in some cases, medication may be recommended.

Am I too anxious to drive?

There are no laws prohibiting someone with anxiety from driving. While many sufferers of anxiety may feel incapable of driving, that same awareness of the dangerous side of driving may actually help them be more diligent and safe drivers than the general population. If you are concerned about your or a loved one’s ability to drive due to anxiety, the best course of action is to have them evaluated by a Certified Driver Rehab Specialist (CRDS). They will help you determine what you need to do to safely get on the road.

What does Next Street look for when assessing anxiety patients for driving?

When we evaluate you, our CRDS is often able to meet you in the comfort of your own home. All you need to do to prepare is get a good night’s sleep and eat well since the visit can take a couple of hours. We will check your vision and give you a physical and cognitive exam to make sure you are fit to drive. We will also discuss with you the fears you have concerning driving. Based on what we find in our assessment, we will prescribe a course of action and possibly recommend you to other specialists to help you overcome specific challenges.

Possible driving outcomes

Depending on the results of our evaluation, there are a few different courses of action we may recommend.

Drive on

We may feel that you are fit to start driving right away, and you may only need to use some simple coping techniques to get over specific fears.

Professional counseling

For those with more severe anxiety, you may need to spend some time with a professional therapist to work through some issues before you are ready to drive.

Restricted driving privileges

You may be safe to drive in some conditions, but we recommend you be restricted from more stressful ones, such as nighttime driving or freeway driving, at least until you demonstrate that you are ready for these situations.

Retirement from driving

Very rarely will we ever need to recommend a complete end to driving due to anxiety, but in the unlikely event that we do, we will be sure to help you come up with a transportation plan that works for you. Depending on your comfort levels, this may involve riding with loved ones, using public transportation, or taking ride services like Uber, Lyft and Metro Taxi. 


Topics: driver rehab, driving evaluations, medical driving, anxiety

Driving is Important

We Are Here to Keep You Safe Behind the Wheel

Our Driver Rehabilitation program works with patients whose change in health may affect their ability to safely drive. We have a team of Certified Driving Rehab Specialists that will work with patients on evaluating your driving abilities. We also have a team of professional instructors to help you gain or regain the skills you need to drive. We created this blog to talk about the various diagnoses we experience and how they may affect your experience behind the wheel. 

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