One of the most consistently stressful things for sufferers of Depersonalization / Derealization to do is drive. 

Sufferers regularly report that the simple act of driving your car from one place to another can cause intense anxiety, resulting in increased depersonalization and derealization. Feelings of dissociation while driving can be terrifying - not just because of the experience itself, but the worry that you may cause an accident and hurt yourself or somebody else.

Why does this happen? Of all the different activities, why is driving with Depersonalization particularly difficult?

And do you really need to worry that you'll cause an accident?

Let's break this down to 7 easy steps!

1. Fear of Loss of Control

The fear of losing control of yourself, your body and mind is one of the most common symptoms with Depersonalization / Derealization or any other anxiety spectrum condition. The anxiety is so stressful that you fear you might lose consciousness, fall asleep, lose control of your limbs etc.

Or you might have disturbing thoughts about consciously hurting yourself and others, which can seem all the more dangerous when you’re behind the wheel of a speeding car.

But you don’t need to worry. It’s been well established in anxiety treatment that these thoughts have no bearing whatsoever on the likelihood of acting on them. They’re just unwanted thoughts caused by anxiety.

They don’t mean anything or carry any importance. You’re not going to lose control over your mind and body and you’re certainly not going to deliberately hurt yourself or anybody else.

2. There's a Lot Happening Visually

When you’re driving - especially in the daytime - there’s a lot to take in visually. You’re constantly monitoring the movement of traffic around you, your own speed / mirrors, traffic lights, pedestrians, cyclists etc etc.

When you have an anxiety-based disorder like Depersonalization / Derealization, your brain's visual center is more active than usual.

Because the anxiety is triggering the fight-or-flight response in your amygdala, your pupils stay dilated and you’re taking in more visual information than is normal (this is why people with DPDR often have trouble spending time in brightly-lit places like supermarkets etc).

It can seem frightening, but just remember that it’s a perfectly natural physical response and it will stop as you recover.

And more importantly, you can still do everything you normally would perfectly safely - even driving!

3. You're Outside Your Comfort Zone

When you develop a anxiety-spectrum condition like DPDR, it’s very common to want to hole up in your house, stay in bed, keep the curtains closed etc. So being outside in traffic conditions can feel quite overwhelming and frightening in comparison.

This can increase feelings of anxiety. And since DPDR is anxiety-based condition, this can then increase feelings of dissociation while driving

While staying home can help you to feel a bit calmer, it’s actually counterproductive because it makes you associate calmness with staying inside. When you do go outside and drive, even though it can feel stressful, you will eventually get home safely.

In your mind you have registered that in spite of the fear, you went out and completed the task successfully. This is a hugely important building block in recovery from anxiety / DPDR and the more often you do it, the faster you will remove the anxious associations from that task.

4. Travelling to a Different Place

When you’re driving, much of the anxiety can be worsened if you happen to be going to a place that’s new and unfamiliar. The fear of going to a different / strange place can often cause a lot of fear with sufferers of anxiety / DPDR.

I suffered from this acutely when I had DPDR, and in particular one the greatest fears I had was going abroad.

Again, this can seem overwhelming but it’s driven completely by anxiety and can be stopped by pushing through it and repeating the action until it loses its temporary association with anxiety.

5. Reality Testing

This is a well-known psychological fact that I kept coming back to during my time with DPDR and it’s particularly relevant here.

People suffering from Depersonalization often worry that the condition will somehow get so bad that they’ll start to hallucinate, or develop into a psychotic break that could lead to a car crash whilst driving.

The good news is that this never happens with Depersonalization. It’s scientifically documented that with Depersonalization, what’s known as your ‘Reality Testing’ (your ability to distinguish between real, external events and internal fantasy) remains intact.

That is to say that regardless of how anxious you feel, you won’t start to hallucinate or experience psychosis. And also, DPDR will not develop into anything worse than itself.

6. There's 'No Escape'

Driving with Depersonalization can cause a feeling of claustrophobia, especially when stuck in traffic. You can’t get out of the car, you can’t move forwards or backwards.

You're stuck in this small space and there is 'no escape'. But of course this isn't a rational fear; you’re perfectly safe in the car and in fact, it's quite a secure, protected space.

The only reason you experience fear and anxiety is because your mind is overreacting to a normal, everyday activity. You need to actively overwrite these thought habits, which brings us to:

7. Distract Yourself

If you’re a qualified driver, then driving itself should be a fairly straightforward process. You shouldn’t even need to think about what you need to do!

When you’re in the midst of an anxiety-spectrum condition like Depersonalization however, your awareness can be heightened and you can feel overwhelmed by the seeming amount of work you need to do in the car (mirrors, brakes, signals etc).

This attentiveness doesn’t make your driving any safer or more dangerous, it just means you’re not as relaxed as you should be.

And one of the most effective ways to relax is to stay distracted. The minute you sit into the car, put on the radio. Put on your favourite album and sing along to it - loud! Put on a podcast that you enjoy.

The goal is to keep your mind occupied while you're on the road, re-associating the car with fun and enjoyment.

The driving itself will come to you naturally as the anxiety / DPDR thoughts fade away.