Fighting Fear

Confronting phobias and other fears

Beyond Panic Disorder: A Way of Living

Curing panic disorder is relatively simple, although difficult. A phobic point of view can persist, however, in which all of life is constrained by fears. Further treatment can allow patients to live more fully and appreciate life as an adventure. Read More

actually, a panic attack can be potentially lethal

The few times I've experienced a full-blown panic attack, was when I was driving my car.

The first time it was on surface streets; I was lost and needed to deliver a package by a deadline, and it seemed I was going to blow it. As the attack escalated from a pounding heart and rapid, shallow breathing to a tunnelling-in of my vision and a feeling of dizzyness, I was able to pull over, stop the car and ride out the attack safely. (And I squeaked in just under the deadline.)

The second time it happened, though, I happened to be just taking a pleasure drive around San Francisco. I'd driven over the Golden Gate Bridge with no problems, earlier in the day, and so was totally blindsided by the sudden fear that engulfed me when I found myself entering the Bay Bridge, on the upper deck, going from San Francisco toward Oakland. I think there was something about the "openness" of that bridge that triggered me; I could see through it to the water hundreds of feet below. Panic began to take over my mind.

As I began to squeeze the steering wheel in a death grip, my whole body stiffening, I truly thought I was in danger of, at worst, passing out, which would allow my driverless car to just veer over, roll off the bridge and I would fall to a sudden, gruesome death. At the least, I feared having to come to a total stop in the middle of this enormously long and tall bridge, causing the people behind me to go ballistic with rage until I could ride out the attack.

What happened next was... odd.

It was as though a separate part of my brain began observing and commenting on my situation, like an uninvolved bystander located behind my left shoulder. "Wow, this must be what a total panic attack is like! Your heart is pounding, your breathing is rapid and shallow, you're muscles are rigid, your vision is tunnelling in, and now you feel dizzy, on the verge of passing out! ...Interesting!"

Then, this "detached observer" part my brain came up with an idea: "Just focus on that car license plate in front of you; pace the speed of that car and in a little while you'll be off the bridge." That license plate, just a few numbers of it, was all I could see; my vision had nearly shut down to just a pinhole.

So, obviously, I did make it off the bridge intact, and at the first opportunity I pulled over and cried for a while and gradually relaxed and got my composure back.

Since then, I've avoided driving over really large, tall bridges. Thank goodness, there are practically none of those around where I live now, so they're easily avoided.

But I noticed that after that incident, even much smaller bridges, including elevated freeway entry and exit ramps, were starting to make me experience mild panic. So, I decided that I could either give in to the panic and stop being able to drive AT ALL... OR I could fight it. So, I developed "tricks" to distract myself whenever I feel the panic attack begin, when I'm driving. ("You're in the slow lane, in the middle of the road, as far away from the edge as possible, and this is not very high up. Its almost over... Now its over, you're back on the ground." etc.) This seems to work for me. I haven't felt any "bridge panic" in, well, a decade or more. But then, I've not even come close to driving over a very large bridge in that time.

But I thought I needed to point out that if a person's panic attacks occur while driving, that they very well could turn out to be lethal, for yourself and potentially for other parties as well.


yes panic attacks can be lethal. they can happen at any given moment! ive had them at all kinds of embarrassing times =/ ive had them alone, with people, and under the influence (the scariest-my first attack and i actually stopped breathing for a little bit after slamming my head against the bathtub.) but i found this article to be beautiful because it illustrates the thoughts running through the affected's head on a daily basis. people with this effects every area of their lives. I just had a wake-up call, myself that taught me that fact and have made a promise to myself that I will no longer let this control me.

Panic attacks

I understand very well how it feels to have a panic attack while driving. You describe it very well. The feeling is of an imminent loss of control, but the reality is that no one loses control while having a panic attack! You provide two more examples of someone who felt that you almost lost control but did not. Try to take seriously the fact that we in the Phobic Clinic have dealt with this
condition over a period of 40 years without running into anyone who had an accident while having a panic attack--and yet it is part of the panic attack to think that if things got just a teeeny bit worse, the driver would have been immobilized. It is precisely the heart of treatment for someone to test out this idea over and over again until the phobic does not have to take my reassurance or anyone else's on faith. The phobic and panicky person needs to see for himself/herself. The alternative, as you demonstrate, is to avoid bridges, or driving at night, or driving to unfamiliar places and finally to stop driving altogether.

Same Information As Always

This article offers nothing new, no insight for those who have done any reading on panic. The author states:

This treatment goes under the heading of “exposure therapy,” or “cognitive-behavioral treatment.”

Exposure therapy and CBT are two totally different things. CBT is a great theory which does not work in application. (I know, many who practice CBT will cite statistics of its effectiveness.) CBT does nothing for the underlying emotion and irrational thoughts. It is one thing to write that my fear of elevators is addressed by emotional reasoning (cognitive distortion number seven in Feeling Good by David Burns) but that does nothing to address the feeling.

Exposure therapy can be effective in some circumstances. I used it to conquer a fear of public speaking. But one must understand and be willing to tolerate the torment that must be endured for it to have a chance to be effective. Yes, I know it is broken down into manageable steps, another fallacy that does not always have real-world application.

It is also important to note that exposure therapy can make a phobia worse. Those practicing it never mention that.

The article captures attitude issues well but unfortunately follows with the same old proposed solutions and offers nothing new.

Panic attacks

For any of your readers/followers who are attempting to learn more about panic attacks and how to deal with them, the following site may be of some value...
This is a site I developed to help a family member who is dealing with anxiety and panic issues, and has quite a bit of in-depth information (book length) broken up into specific aspects of the anxiety/panic attack phenomenon.

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Fredric Neuman, M.D. is the Director of the Anxiety and Phobia Center at White Plains Hospital.


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