Anxiety on the subway: a step-by-step ladder for riding again
If going underground makes your heart pound, start on the platform, not on a packed train. This example ladder has twelve steps, from a short video to your full route at rush hour. It is a starting point, not a tested program: change the stops and times and rate each step yourself. Pick the first step that feels hard but doable, and repeat it until you have tested your prediction safely, even if some fear remains.
Subway
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 video filmed inside a subway car during a ride between two stations.
Walk down into a station outside rush hour and stand on the platform for 5 minutes without boarding.
Stay on the platform while three trains arrive and leave, watching the doors open and close.
Start here — uncomfortable but doable
Ride one stop outside rush hour with a trusted person, then ride back.
Ride one stop alone outside rush hour.
Ride three stops alone and stay on to the stop you planned, even if you want to get off sooner.
Ride a stretch of your usual line where two stations are farther apart, with your companion.
Ride that longer section alone.
Sit or stand in the middle of the car, away from the doors, for five stops.
Ride at the edge of rush hour, when the car is busy but you can still find some space.
Ride five stops at the height of rush hour, standing in a crowded car and holding a pole.
Ride your full everyday route at rush hour, alone, checking service status once before you leave.
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, then use the free Panic Reset. If you are driving, pull over and park where it is safe to do so: after a tunnel or bridge, never inside or on it.
- Keep taking any medication as prescribed. Talk to your prescriber before changing anything.
- Stand back from the platform edge, and never go onto the tracks for any reason.
- Never try to leave a train between stations on your own. The MTA warns that tracks may still be electrified and other vehicles may still be moving; wait for instructions from staff.
- Only pull the emergency brake if the train's continued movement is an immediate danger to people. Feeling panicky is not a reason to pull it; tell staff instead.
- If you feel physically unwell, tell a crew member or use the intercom if the car has one. In an emergency, call 911.
A self-help tool. Not a medical device or a substitute for professional care.
Why the subway can trigger panic
The subway takes away daylight and the easy way out. Once the doors close, you cannot leave until the next station, and between stations there is only a dark tunnel outside the window. The NHS lists tube trains among the common triggers of claustrophobia, and names being stuck in a tunnel between stations as the kind of experience that can set it off.
Crowds add a second layer. In a busy car you may be pressed close to strangers, far from the doors, in warm air, while the train brakes and sways. It is easy to read a racing heart or a hot face as proof that you must get out now, and the thought of others seeing you panic can make the urge stronger.
When getting off early is mainly a way to calm the fear, it keeps the fear in charge. Jumping out one stop before yours, or letting crowded trains go by, brings quick relief, but it also teaches you that you only made it because you escaped. Staying on for a stop you planned is how you find out what happens when you do not.
Predictions people make about the subway
Before an exposure, it helps to name what you expect to happen. Here are some predictions you might recognize:
- •“The train will stop in the tunnel and I'll be stuck down there for an hour”
- •“I'll panic in a packed car and won't be able to reach the doors”
- •“Everyone will stare if I push my way off in a hurry”
- •“I'll faint on the train and nobody will help me”
- •“If something goes wrong underground there will be no way out”
- •“I'll get flustered, miss my stop and end up somewhere I don't know”
Safety behaviors that keep the fear of the subway going
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:
- 1Standing right by the doors on every ride, even when the car is nearly empty
- 2Riding one or two stops, then getting off to "reset" on the platform before the next train
- 3Letting crowded trains go by until an almost empty one arrives
- 4Paying for taxis or walking long distances so you never go underground
- 5Refreshing service alerts again and again while the train is moving
- 6Traveling only if a friend meets you at the station
- 7Keeping music loud enough that you never hear the brakes or the announcements
Tips for the subway
- Board near the middle of the train on your first rides. The MTA notes that in New York the conductor is usually at the center of the train, which makes it easier to get attention if there is a problem.
- Find out once, before you ride, how to reach help. In New York stations, Help Points have a red button for emergencies and a green one for information. Knowing that is preparation; checking for it again and again on every trip is a safety behavior to drop later.
- Hold a pole or strap when the train moves. The MTA tells riders to hold on when the train is moving, so this is part of riding safely, not a habit to give up.
- Treat rush hour as its own step. Do your first rides mid-morning or early afternoon, when you can choose where to stand, and add busier trains once quieter ones feel manageable.
- When the urge to get off early hits, name the stop you are riding to and stay on until you reach it. Rate your fear at the moment of the urge and again when the doors open at your stop.
When to get professional care
Self-help ladders are helpful for manageable avoidance, but some situations call for professional evaluation and support:
- •You cannot get to work, school or appointments because the subway is the only practical way there and even the first steps feel impossible.
- •You are starting to avoid buses, stores or other busy places too, or leaving home is getting harder. NHS inform describes this wider fear of places where escape might be difficult and suggests talking to a doctor about it.
- •Your fear began after an incident on a train or in a station and comes with nightmares or flashbacks. A professional who works with trauma is the right place to start, not this ladder.
- •Panic attacks come often and out of the blue, above ground as well as below.
- •Your worry is mainly about crime or your personal safety rather than about panic. This ladder is not built for that; follow your transit system's safety advice and its staff.
Questions about the subway
What if the train stops between stations while I am on it?
Stay on the train and wait for information. The MTA tells riders not to try to leave a train on their own in an emergency, because the tracks may still be electrified and other trains may be moving, and says staff will keep riders informed in person or over the public address system. The NHS notes that most panic attacks last between 5 and 20 minutes, though some last longer, so a wave of panic can rise and settle while you wait.
Should I pull the emergency brake if I start to panic?
No. The MTA says to pull the brake only if the train's continued movement presents an immediate danger to people. Panic feels urgent, but it is not that kind of danger. If you need help, use the intercom near the end of the car if there is one. If there is not, the MTA suggests alerting the conductor in the middle of the train by waving or calling out when the doors open at the next station.
How do I cope with a packed rush-hour car?
Plant your feet, hold on, and let your eyes rest on one steady thing, such as a map or an ad. Notice that the crowd moves: people get off at every stop, and space opens and closes. Before the ride, write down what you expect, for example "I will have to get off", and afterwards what actually happened. Crowded rides are a high step, so reach them after quieter trains feel manageable.
Does this apply if my city is not New York?
The ladder works on any subway, metro or underground system. The safety details on this page come from New York's MTA, and other systems have their own rules and equipment, so check your system's safety page once and follow its staff, signs and announcements.
- •Incident and emergency preparedness at the MTA (Metropolitan Transportation Authority (MTA))
- •Riding the subway (Metropolitan Transportation Authority (MTA))
- •Claustrophobia (NHS)
- •Phobias (NHS inform)
- •Panic disorder (NHS)
A self-help tool. Not a medical device or a substitute for professional care.
Take your ladder with you
We're building a companion mobile app that keeps your ladder and practice log on your phone, so you can record each practice once you're done.
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