Fear of highway driving: a step-by-step ladder you can edit
If the highway feels impossible, you do not have to start there. Below is an example ladder of twelve steps, from watching a video to the highway conditions you find hardest. It is a starting point, not a tested program: reorder or reword the steps and replace the fear numbers with your own. Pick the first step that feels uncomfortable but doable, and repeat it until you have tested what you fear and it feels manageable enough to repeat safely.
Highway driving
Easiest first. The suggested steps, their order, times and distances, and the fear numbers are illustrative examples, not a tested program. Rate each step yourself from 0 (no fear) to 100 (the most afraid you can imagine), change the wording to fit your life, and add your own steps.
Watch a short dashcam video of highway driving and notice what your body does.
Sit in your parked car with the engine running for a few minutes.
Ride as a passenger on the highway for two exits, sitting in the front seat.
Start here — uncomfortable but doable
Take a short drive on quiet local roads you know well.
Drive on a busy multi-lane road (not a highway) outside rush hour.
Drive one highway exit at a quiet time, with a trusted person in the passenger seat.
Drive three exits with your companion, handling the merge and the exit yourself.
Drive one highway exit alone at a quiet time.
Drive three to five exits alone at a quiet time.
Make one lane change when traffic allows it safely, then return to your usual lane.
Drive a longer stretch alone in moderate traffic, planning your route but not checking every exit on the way.
Drive the highway conditions that are hardest for you, such as heavy traffic or long gaps between exits.
Keep your ladder
Stay safe while you practice
- If you feel chest pain, pain spreading to your arm or jaw, or you faint, stop and call 911.
- Don't practice after alcohol, cannabis, or medication that makes you drowsy.
- If your fear goes above 80 and stays there, stop safely, breathe out slowly, and pick a lower step next time. Stopping is not failing.
- If a panic attack starts, get somewhere safe first (if you are driving, stop the car), then use the free Panic Reset.
- Keep taking any medication as prescribed. Talk to your prescriber before changing anything.
- Only practice if you hold a valid license, the car is roadworthy, and you are currently able to drive safely. If a medical condition, medication, fainting or blackouts, or the after-effects of a crash affect your driving, get a medical or professional assessment before using this ladder.
- Safety comes before practice. If anxiety makes it hard to drive safely (you feel faint or dizzy, your vision blurs, or you cannot keep your attention on the road), leave the road at the next safe place, such as an exit, rest area or parking lot, and stop driving. Use the shoulder only in a real emergency.
- Never watch videos, do breathing or grounding exercises, or fill in the practice log while driving. Do them before you set off or once you are safely parked.
A self-help tool. Not a medical device or a substitute for professional care.
Why highway driving triggers panic
Highways, freeways and interstates take away some of the things that make other roads feel manageable. Exits can be miles apart, you cannot simply stop, and traffic keeps moving around you at speed. Some people describe this as feeling trapped, with no easy way out, and that feeling can make anxiety build quickly.
Some people with highway anxiety also become more aware of physical sensations at higher speeds, such as a faster heartbeat, tight hands on the wheel or feeling slightly light-headed. It is easy to read these sensations as a sign that something is going wrong, even when they are a normal part of feeling anxious.
Avoidance keeps the fear going. After one frightening drive, some people start taking back roads "just for now". Each detour brings relief, but it also means you never get to learn that you can drive the highway, feel anxious, and still arrive. A ladder gives you a way to collect that evidence in steps small enough to take.
What you might be predicting
Before an exposure, our minds predict the worst possible catastrophe. Here are the predictions people often have:
- •“I'll have a panic attack and have nowhere to pull over”
- •“I'll lose control of the car”
- •“I'll faint behind the wheel”
- •“I'll freeze and cause an accident”
- •“I'll be stuck in the fast lane and unable to get out”
- •“Other drivers will notice I am panicking”
Safety behaviors to drop, one at a time
Safety behaviors give quick relief, but they convince the brain that you only survived because of the crutch. As you move up your ladder, aim to drop them gradually. Only drop what anxiety adds; anything that genuinely keeps you or others safe stays:
- 1Planning every route around highways, even when it doubles the trip
- 2Only driving the highway when someone else is in the car
- 3Refusing to change lanes even when traffic or your exit calls for it
- 4Gripping the wheel as hard as you can and holding your breath at merges
- 5Keeping a phone call running with someone "in case something happens"
- 6Driving only at dawn or late at night when the road is empty
- 7Counting down the miles to the next exit the whole way
Tips for this situation
- Choose a quiet time for the first highway steps, such as mid-morning on a weekend, and drive a route you already know.
- Before each practice, write down what you expect to happen and how sure you are. Afterwards, compare it with what actually happened. That comparison is the most useful part of the log.
- Drop one safety behavior at a time. For example, keep your companion in the car but end the phone call, then later drive without the companion.
- Only drop habits that anxiety adds. Your seat belt, a legal and safe speed, a safe following distance, mirror and blind-spot checks and normal traffic rules are part of driving well, so they always stay.
- Plan your route as you would for any trip, including where you will leave the highway. What to drop is the extra checking that anxiety adds, such as counting every exit or rehearsing escape routes the whole way.
When to get professional care
Self-help ladders are helpful for manageable avoidance, but some situations call for professional evaluation and support:
- •You have avoided highways for months and cannot manage even the first steps on your own.
- •Panic attacks happen often, including away from the car, or you are starting to avoid other places too.
- •Driving fear began after a crash or a frightening incident and comes with nightmares or flashbacks. These can call for a trauma-focused assessment and treatment from a mental health professional, so start there rather than with this ladder.
- •You have ever actually fainted, blacked out or lost awareness, while driving or elsewhere. Feeling faint or dizzy during panic is different from losing consciousness, which needs a medical assessment before you drive or practice.
Frequently asked questions
Can a panic attack make me crash the car?
Feeling out of control is a common symptom of panic, but the sensation of losing control does not by itself mean that you have actually lost control of the car. Strong symptoms can still make driving unsafe, for example if you feel faint, your vision blurs or you cannot concentrate. If that happens, leave the road at the next safe place and stop until it passes. The NHS notes that most panic attacks last between 5 and 20 minutes. Feeling faint is a common panic symptom; actually losing consciousness is not the same thing. If you have ever fainted or lost awareness, or have a condition that affects consciousness, get a medical assessment before you drive or practice.
How long should I stay on one step?
Repeat a step until you have tested your prediction a few times and the step feels manageable, then move on. You do not need to wait for your anxiety to reach zero. Guides differ on the exact rule: the NHS inform self-help guide suggests staying in the situation until your anxiety has dropped by at least half, while the inhibitory learning approach described by Craske and colleagues focuses on testing what you fear rather than on how far the fear drops. Practice regularly, and only when you can do it safely.
Does riding as a passenger really count as a step?
Yes. For some people the highway itself is the trigger, not only the driving. Being a passenger lets you get used to the speed, the merges and the long stretches between exits before you add the job of driving. If being a passenger is harder for you than driving, move this step higher on your ladder.
What should I do if I have a panic attack on the highway?
Keep your eyes and attention on the road. If the symptoms make it hard to drive safely, leave the road at the next safe place, such as an exit or rest area, and stop driving. Once you are safely parked, you can breathe out slowly or ground yourself, for example by naming five things you see, and let the wave pass. End the practice there. Drive again only once the symptoms have passed and you feel able to drive safely; if you are not sure, wait longer or ask someone to pick you up. Stopping is not failing.
Is this twelve-step ladder a tested program?
No. It is an editable example built on graded exposure: facing a feared situation in small steps, as the NHS inform phobias self-help guide describes. Evidence for virtual reality based psychological treatment of driving phobia is limited: a 2022 systematic review rated all 14 studies it found as low in methodological quality. The order of the steps, the distances and times, and the fear numbers are only examples, so rate each step yourself and change the ladder until it fits you.
- •Phobias self-help guide (NHS inform)
- •Phobias (NHS inform)
- •Panic disorder (NHS)
- •Panic Disorder: What You Need to Know (National Institute of Mental Health)
- •Maximizing exposure therapy: An inhibitory learning approach (Craske et al., 2014) (Behaviour Research and Therapy)
- •Psychological therapy using virtual reality for treatment of driving phobia: a systematic review (Elphinston et al., 2022) (Disability and Rehabilitation)
A self-help tool. Not a medical device or a substitute for professional care.
Take your ladder with you
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