Maybe you take the long way to avoid the highway. You wait until traffic is lighter. Or you ask someone else to drive because certain trips make you anxious. You may still get to where you need to go, but driving starts to take more planning and energy than it used to.
Driving anxiety can affect drivers and passengers. It may start after a car accident or near miss, or build gradually without one clear cause. The anxiety can affect your body, your thoughts, and the choices you make around travel. Avoiding difficult driving situations may feel helpful at first, but over time, it can keep the fear going. Occupational therapy can help you understand these patterns and gradually work toward the driving or passenger situations that matter in your daily life.
Understanding driving anxiety
Driving anxiety is fear, worry, or panic related to driving or travelling in a vehicle. It may happen only in certain situations, such as on highways, in heavy traffic, at busy intersections, or on unfamiliar roads. For some people, the anxiety can begin before almost any trip.
Not everyone with driving anxiety stops driving. You may keep driving while feeling tense, watching closely for danger, or thinking about what could go wrong. You may also start planning around the anxiety by choosing certain routes, travelling only at quieter times, or relying on someone else to drive.
These kinds of avoidance and safety behaviours can make the situation feel easier in the moment, but they may also keep the anxiety going over time.
Signs and symptoms of driving anxiety
Driving anxiety can affect how you feel physically, what you think about, and how you respond before or during a trip. The experience is different for everyone, and you may notice only some of these signs.
You may experience:
- A racing heart or sweaty palms
- Shortness of breath or chest tightness
- Tense shoulders, arms, or hands
- A tight grip on the steering wheel
- Dizziness or feeling light-headed
- Difficulty concentrating
- Panic or fear of losing control
- Worry about making a mistake or being in a collision
- A strong urge to leave or avoid the situation
The anxiety can also start before you get into the car. You may think through the route again and again, picture what could go wrong, or spend a lot of time deciding whether you should make the trip.
Your travel habits may begin to change too. You might stick to familiar roads, avoid highways, drive only when traffic is light, or ask someone else to take the wheel. As a passenger, you may tense up, close your eyes, or feel uneasy because someone else is in control of the vehicle.
When these patterns become part of your routine, driving anxiety can start to affect work, appointments, errands, social plans, and other activities that matter to you.
Why driving anxiety can develop
For some people, driving anxiety starts after a car accident, near miss, or another frightening experience on the road. Afterwards, everyday moments such as seeing brake lights ahead, having another vehicle follow closely, or approaching a busy intersection may bring back a strong sense of danger.
This can happen because your brain learns from experiences that feel threatening. After a frightening event, it may begin to connect certain sights, sounds, or body sensations with danger. Later, those same cues can trigger anxiety even when there is no immediate danger.
A collision is not always the reason. Driving anxiety may build over time around worries about traffic, making a mistake, losing control, or feeling unable to leave the situation once a trip has started. Fear can be learned in different ways, and there is not always one event that explains why it began.
Passengers can experience driving anxiety too, especially when not being in control of the vehicle adds to their worry. Whatever the starting point, the way you respond to the fear can play an important role in whether it continues.
How avoidance can keep driving anxiety going
When a driving situation feels threatening, your body’s fight-or-flight response can switch on. Your attention shifts toward possible danger, your heart rate may increase, and your muscles may tense. This response is useful when danger is real, but anxiety can also trigger it in situations your brain has learned to associate with fear. These learned associations can happen quickly, before you have time to decide whether there is an immediate danger.
Avoidance can then become part of the cycle. It may lower anxiety in the moment, but it also gives you fewer opportunities to have experiences that could change what you expect will happen.
Avoidance can keep the threat expectation in place
If highway driving makes you anxious, you might take another route. Once you decide to avoid the highway, the anxiety may drop, making it more likely that you will make the same choice the next time.
The problem is that you never get new information about the highway itself. You do not get the chance to find out whether the drive is more manageable than you expected or whether the anxiety changes once you are in the situation. Research on anxiety treatment describes this new learning through experience as an important part of changing fear. Repeated, gradual exposure can help you learn new information by facing situations you fear.
Fear can spread to other driving situations
Driving anxiety may begin with one specific situation, but the fear does not always stay there. Once your brain has linked a certain driving experience with danger, other situations that feel similar may begin to trigger the same response.
For example, anxiety about one difficult highway merge may later show up when merging onto other highways. Heavy traffic, faster speeds, or unfamiliar roads may also start to feel threatening because they share features your brain has come to associate with danger.
If you keep avoiding these situations, you have fewer chances to learn that they may be different from the situation you originally feared. Over time, this can allow the anxiety to affect more routes and types of driving.
Safety behaviours can start to feel necessary
Safety behaviours are things you rely on because they make an anxious driving situation feel easier or more controlled. They are different from safe-driving habits, such as wearing a seat belt, following traffic laws, or adjusting your driving for road and weather conditions.
You might repeatedly ask a passenger for reassurance, feel unable to drive unless someone is beside you, or grip the steering wheel tightly because it makes you feel more in control. As a passenger, you might close your eyes whenever traffic becomes busy.
If the drive goes well, you may start to believe that it was because of the safety behaviour rather than because the situation itself was manageable. Over time, the behaviour can begin to feel necessary, which can keep the fear in place. Escape and reassurance are anxiety-reducing behaviours that can become reinforced when they lower distress.
How occupational therapy can help with driving anxiety
Occupational therapy focuses on helping you take part in the activities you need and want to do in everyday life. When driving anxiety gets in the way, an occupational therapist can look at which situations have become difficult, what happens when you feel anxious, and what you want to be able to do.
Driving is often connected to something bigger. It may be how you get to work, attend appointments, run errands, visit family, or stay involved in your community. Occupational therapy connects treatment to those real-life goals.
Understanding your triggers and patterns
Your occupational therapist can help you look more closely at when the anxiety happens and what may be keeping it going. This may include identifying routes or driving situations you avoid, physical symptoms you notice, thoughts that come up, and safety behaviours you rely on.
For example, you may be comfortable driving around your neighbourhood, but avoid the highway because merging makes you anxious. Someone else may drive without difficulty but become very anxious as a passenger. Understanding these details helps shape a plan around what is actually affecting your life.
Using graded exposure to practice difficult situations
Graded exposure is a step-by-step approach that can be used as part of occupational therapy for driving anxiety. Instead of starting with a situation you fear most, you gradually practice situations that have become difficult or that you have been avoiding.
Depending on your starting point, a plan might include:
- Sitting in a parked car
- Taking a short trip as a passenger
- Driving on familiar neighbourhood streets
- Driving during a quieter time of day
- Completing part of a route you have been avoiding
- Gradually working toward heavier traffic or highway driving
These are examples, not a set sequence. Someone who is comfortable driving locally but avoids highways will need a different plan from someone who feels anxious whenever they are in a moving vehicle.
Gradual exposure gives your brain a chance to build new experiences with the situations that have become linked with fear. Instead of avoidance ending the experience, you have opportunities to learn that the situation may be different from what your anxiety predicts.
Occupational therapy for driving anxiety can include the use of exposure and fear ladders to plan these steps around the situations that are most relevant to you.
Connecting treatment to everyday goals
Your driving goal may have less to do with a particular road and more to do with what is at the other end of the trip. You may want to commute to work without taking a much longer route, attend appointments without arranging another ride, visit family independently, or feel more comfortable travelling as a passenger.
Occupational therapy keeps those goals at the centre of care. The aim is to help driving anxiety have less influence over where you go, how you make plans, and the activities you take part in.
When driving anxiety starts affecting daily life
You do not need to wait until anxiety stops you from driving completely before seeking support. It may be time to speak with a healthcare professional when driving anxiety starts changing your routine, limiting where you go, or taking up a lot of your time and attention.
Consider seeking support if you:
- Regularly avoid driving or travelling in a vehicle
- Experience panic or strong physical symptoms before or during trips
- Miss work, appointments, or social plans because of driving anxiety
- Limit yourself to familiar roads or necessary trips
- Continue to feel anxious about driving after a car accident or near miss
- Spend a lot of time worrying about an upcoming drive
- Notice that you are avoiding more driving situations over time
An occupational therapist can help you understand what is contributing to the anxiety and build a plan around the driving or passenger situations you want to work toward.
FAQs
Why do I feel more anxious on highways than on local roads?
Highway driving can feel more difficult because it often involves higher speeds, merging, lane changes, and fewer opportunities to stop or change direction. If one of these situations already makes you uneasy, you may become more alert to possible danger and notice your anxiety more strongly.
Over time, avoiding highways can make them feel even less familiar. A gradual exposure plan can help you work toward highway driving in smaller, more manageable steps.
Why is driving alone more difficult than driving with someone?
Having another person in the car can feel reassuring, especially if you worry about becoming anxious or something going wrong. When you drive alone, that reassurance is no longer there, which may make you pay more attention to anxious thoughts or physical symptoms.
If you begin to feel that you can only drive when someone is with you, that person’s presence may also become a safety behaviour. Occupational therapy can help you gradually work toward driving situations that feel difficult on your own.
Can you have a panic attack while driving?
Panic attacks can happen while driving and may include a racing heart, shortness of breath, dizziness, shaking, or a sudden fear of losing control. Having a panic attack does not necessarily mean you have a panic disorder, but worrying about another attack can sometimes lead to avoiding driving or certain routes.
If anxiety or panic makes it difficult to concentrate on driving safely, move to a safe place to stop when you are able to do so. An occupational therapist can help you understand what triggers these reactions, identify any avoidance patterns that develop afterward, and gradually work toward driving situations that have become difficult.
How long does it take to improve driving anxiety?
There is no set timeline for driving anxiety to improve. Progress depends on factors such as which situations you fear, how much you have been avoiding them, and the goals you are working toward.
With graded exposure, progress usually happens through repeated practice rather than one large step. Your occupational therapist can help you set realistic goals and adjust the plan as you work through different driving situations.
Can driving anxiety return after it has improved?
Driving anxiety can become stronger again during periods of stress or after another difficult experience on the road. That does not mean you are back at the beginning.
The strategies you have learned can help you recognize avoidance early and start practicing situations again before the fear begins to affect more of your routine.
Is driving anxiety the same as a driving phobia?
Driving anxiety and a driving phobia are related, but they are not exactly the same. Driving anxiety is a broad term for fear or worry related to driving and can range from mild anxiety in certain situations to more intense fear. A driving phobia generally refers to a specific phobia, situational type, where the fear is persistent, feels out of proportion to the actual danger, and leads to significant distress or avoidance. Both can affect your daily life, and occupational therapy can help address how the fear is affecting your routines, independence, and ability to take part in driving or passenger activities.
Sources
- Centre for Addiction and Mental Health. Anxiety Disorders: An Information Guide.
- Canadian Psychological Association. “Psychology Works” Fact Sheet: Phobias.
- Katzman MA, Bleau P, Blier P, et al. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders.
- Canadian Association of Occupational Therapy. Exposure therapy for anxiety disorders: A beginner’s guide for occupational therapists.
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This blog originally appeared on Lifemark.ca.