Statistics have it that 1 in 4 people in the UK will experience a mental health problem in any given year. This includes anxiety disorders that affect over 8 million people in the UK. For someone with anxiety disorder, even the simplest activities of day-to-day life like using the public transport can trigger intense fear that may lead to panic attack. Published by Hypnosis in London on 04 August 2016, written by Malminder Gill.

In February this year, Britain had its first national summit to help those with mental health disorders cope with their struggle in using public transport such as trains, buses, and airplanes. This gathering of policymakers, transport providers, and representatives of those with mental health disorders was actualized after observing that majority of public transport are equipped with features to help those physical disabilities but not those with mental health disorders.

How Public Transport Can Trigger Anxiety

There are several things about using the public transport that can trigger anxiety. These include fear of being in public, interactions with other people, being in an unstructured situation one doesn’t have control of, and being in confined spaces. These situations can lead someone with social anxiety and certain phobias like agoraphobia (extreme fear of enclosed places) to suffer from a panic attack. 

People with social anxiety disorder suffers from an intense fear of interaction with other people. It brings feelings of self-consciousness and feelings of being judged or evaluated, making them avoid situations that involve interaction with other people.

Social interactions with strangers and feelings of being watched while doing something are enough to cause these people to suffer from intense emotional distress. They start to sweat profusely, feel that their heartbeat’s racing, and they start to notice muscle twitching especially on their face. The anxiety felt by these people can eventually build up into a panic attack.

Managing Anxiety On Public Transport

Whether one has social anxiety disorder or is mentally healthy but feels anxious in being on a bus, train, or airplane, the following tips can help in coping with feelings of anxiety:

• Try distraction
  People with social anxiety found certain distractions helpful in alleviating anxiety in using the public transport. When used correctly in acute situations, certain distraction techniques can help alleviate anxiety. In a study conducted to find the link between distraction and anxiety reduction, it was found out that subjects who underwent distracted exposure showed greater reductions in subjective fear than those who didn’t.^[1]
• Practice deep breathing exercises
  Also known as diaphragmatic breathing, deep breathing stimulates the parasympathetic nervous system (PNS) which has a role to play on certain activities when the body is at rest. Its action is the opposite of the sympathetic nervous system which is associated with the body’s response when it’s on a fight-or-flight mode.
  
  When the PNS is stimulated, it also triggers stimulation of the vagus nerve. This nerve which runs from the base of the brain to the abdomen releases the neurotransmitter acetylcholine which helps improve focus and calmness.^[2]
  
  In one study, it shows that breathing therapy helps in alleviating anxiety of those with hyperventilation syndrome and anxiety disorders.^[3]
• Write down thoughts
  Some people with anxiety disorders find it helpful to write down their thoughts including their fears. When worries, fears, and thoughts are written down, it makes it easier for some to realize that many of them are irrational.
  
  The therapeutic benefit of journaling is shown in this study published in The Arts in Psychotherapy. The study, which involved medical students, has shown that visual journaling has helped in decreasing the anxiety and negative affect of the subjects.^[4]
• Seek help
  Hypnotherapists are professionals who use guided hypnosis to help individuals deal with certain issues like anxiety and phobias. My approach in hypnotherapy is highly personalized; it’s different from one person to another.
  
  In hypnotherapy, I guide my clients in getting into the state of deep relaxation, making them more receptive to positive suggestions. With anxiety and phobias, hypnosis can help a person in coping with the negative feelings involved in it including feeling of being loss in control, the need to escape, and feeling overwhelmed.

Using the public transport is oftentimes the better option for many people who want to go from one place to another, be it for business or leisure. If you or someone you know suffer from anxiety or intense fear in using bus, trains, airplanes, or other form of public transport, then know that you can do something about it and there’s help available for you.

Image: Yuya Tamai

References:
[1] “Attention To Phobic Stimuli During Exposure: The Effect Of Distraction On Anxiety Reduction, Self-Efficacy And Perceived Control”. Sciencedirect.com. N.p., 2016. Web. 30 July 2016.
[2] File, Sandra E., Luis E. Gonzalez, and Nick Andrews. “Endogenous Acetylcholine In The Dorsal Hippocampus Reduces Anxiety Through Actions On Nicotinic And Muscarinic-Sub-1 Receptors.”. Behavioral Neuroscience 112.2 (1998): 352-359. Web. 30 July 2016.
[3] J.N. Han, , K. Stegen, , C. De Valck, , J. Clément, , K.P. Van de Woestijne. “Influence of breathing therapy on complaints, anxiety and breathing pattern in patients with hyperventilation syndrome and anxiety disorders.” Journal of Psychosomatic Research, Volume 41, Issue 5, November 1996, Pages 481-493.
[4] Amanda Mercer, Elizabeth Warson, Jenny Zhao. “Visual journaling: An intervention to influence stress, anxiety and affect levels in medical students.” The Arts in Psychotherapy, Volume 37, Issue 2, April 2010, Pages 143-148.