Anxiety on trains: an editable ladder from one stop to a long trip
If a train with no stop for twenty minutes sounds impossible, begin with a local train that stops every few minutes. This example ladder has twelve steps, from a video to a two-hour trip alone. It is not a tested program: change the routes and times and rate each step yourself. Start with the first step that feels hard but doable, and repeat it until you have tested your prediction safely, even if some fear remains.
Trains
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 of a commuter or intercity rail journey filmed from a passenger seat.
Go to a rail station, look up your line on the departure board, and watch two trains come and go.
If early boarding is allowed, sit on a waiting train for 3 minutes with a valid ticket, then step off before it leaves.
Start here — uncomfortable but doable
Ride a local train for one stop, where the next station is only a few minutes away.
Ride a local train for three or four stops with a trusted person.
Ride the same local stretch on your own.
Take a train with a 10-to-15-minute gap between two stops, with your companion.
Take that longer gap alone, in a seat away from the doors.
Take an express that skips several stations, alone.
Take a 45-to-60-minute ride alone that includes at least 20 minutes without a stop.
Ride alone to a station in a town you do not know well, get off, and take the next train back.
Take a two-hour train trip alone, without looking up places to get off along the way.
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.
- Never use the emergency brake or try to open the doors because of anxiety, and follow your own railway's rules on emergency equipment. For its railroad trains in New York, for example, the MTA says to use the emergency brake only when the train's continued movement is a danger to riders, and that in most situations letting the train continue to the next station is the safest response.
- Never try to leave a stopped train on your own. Follow the crew, announcements and signs.
- Stand back from the platform edge and stay off the tracks at all times.
- If you feel physically unwell on board, tell a crew member. In an emergency, call 911.
A self-help tool. Not a medical device or a substitute for professional care.
Why trains can trigger panic
On a train, the way out is decided by the timetable. Once the doors close, the next chance to step off may be two minutes away or forty, and on an express the stations you know flash past without stopping. NHS inform describes agoraphobia as a fear of being in situations where escape might be difficult or help would not be available, and a long gap between stops can feel exactly like that.
Every mile can also feel like a mile further from home. The thought "if I feel bad, how will I get back?" grows with distance, and you may predict that an unexpected stop would leave you stranded, with no information and no help. The sway of the carriage and the jolt of braking can feel like dizziness when you are already on alert.
Choosing only local trains, sitting by the doors and planning where you could jump off all bring relief. They also keep the belief that you would not cope without an exit close by. A ladder lets you stretch the gap between stops a little at a time and see what actually happens.
Predictions people make about trains
Before an exposure, it helps to name what you expect to happen. Here are some predictions you might recognize:
- •“The train will break down between stations and I will be stuck for hours”
- •“I will panic on an express with no stop for half an hour”
- •“I will need to get off and the doors will not open”
- •“I will be too far from home to get back if I feel unwell”
- •“Other passengers will see me shaking or crying”
- •“The swaying will make me so dizzy that I lose control”
- •“I will badly need the toilet and will not be able to get to one”
Safety behaviors that keep the fear of trains 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:
- 1Taking only local trains that stop at every station, even when an express would save an hour
- 2Standing in the vestibule by the doors for the whole trip instead of taking a seat
- 3Memorizing every station where you could get off and call a ride home, in case you need to flee
- 4Refusing any journey longer than a set number of minutes
- 5Timing each gap between stations on your phone
- 6Sitting next to the restroom on every trip, even when you rarely need it, as a place to hide
- 7Checking again and again, right before boarding, that you could still get a refund and back out
Tips for trains
- Read the timetable once before the trip, so you know where the longer gaps are. Then put it away. Timing every gap as you ride keeps your attention on escape instead of on the ride.
- Choose off-peak trains for the first steps, when you can pick your seat. Add busier trains, where you may have to stand or sit away from the doors, as a later step.
- Know how to reach the crew before you need them. On MTA railroad trains in New York, for example, some cars have intercoms near the side doors that connect you to the train crew.
- Pack what any traveler packs: your ticket, water and a charged phone. What to leave behind over time are the extras anxiety adds, such as a list of every station where you could bail out.
- Long rides are good practice time. The NHS inform self-help guide notes that it can take up to 45 minutes for anxiety to start to fall in a long situation, so on a ride that starts hard, staying on to your planned stop gives the fear time to ease. That is about fear only: if you feel physically unwell, tell the crew.
- This example grades the gap between stops. If what you fear most is something else, such as crowds, distance from home or reaching a toilet, rate those situations and put them on your ladder instead.
- Feeling dizzy or queasy on a moving train is not always panic. The NHS describes motion sickness as feeling dizzy, or feeling or being sick, when traveling by car, boat, plane or train, and suggests looking straight ahead at a fixed point rather than reading or using a screen.
When to get professional care
Self-help ladders are helpful for manageable avoidance, but some situations call for professional evaluation and support:
- •You turn down jobs, trips or family visits because they involve a train journey.
- •The fear is spreading to buses, shops or simply being far from home. NHS inform notes that people with agoraphobia may find it hard to travel on public transport, and suggests speaking to a doctor.
- •Your fear began after a frightening incident on a train and comes with nightmares or flashbacks. A professional who works with trauma is a better place to start than this ladder.
- •You have ever fainted or lost awareness. Get a medical assessment before practicing on longer journeys.
Questions about trains
What should I do if I have a panic attack on a train?
If you recognize it as panic and you are safe, stay in your seat and let the wave run its course, even if the next stop is twenty minutes away. If you feel physically unwell or something is wrong on the train, tell the crew and follow their instructions. For the panic itself, the NHS suggests breathing slowly and deeply and reminding yourself that the attack will pass, and notes that most panic attacks last between 5 and 20 minutes, though some last longer. Rate your fear every few minutes in your head and note when it peaks and when it starts to ease. That record, written in your log afterwards, is what the practice is for.
Can I use the emergency brake if I really need to get off?
No. Needing to get off because of panic is not a reason to stop the train. For its railroad trains, the MTA says to use the emergency brake only when the train's continued movement presents a danger to riders, and otherwise not to use it, especially in a tunnel or on a viaduct. It adds that in most situations, letting the train continue to the next station is the safest response. If you feel unwell, tell the crew.
Why does an express feel so much worse than a local train?
A local train offers an exit every few minutes, even if you never use it. An express removes that, so the prediction "I will not be able to cope without a way out" suddenly feels real. That is why this ladder grades the gap between stops, from a few minutes to twenty or more, rather than the length of the whole trip.
Should I tell the conductor that I get anxious?
You can if it helps you feel less alone, but you do not have to. If you start to feel physically unwell, do tell the crew. Try not to turn it into a ritual, though: needing to check in with staff before every ride is a form of reassurance-seeking that you can drop in later steps. Talking to staff about an accessibility or medical need is different: that is not a habit to drop.
- •Phobias (NHS inform)
- •Phobias self-help guide (NHS inform)
- •Incident and emergency preparedness at the MTA (Metropolitan Transportation Authority (MTA))
- •Panic disorder (NHS)
- •Motion sickness (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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