Anxiety conditions and mobility

Most of the research and about accessible transport focuses on people with physical and sensory disabilities. But people with anxiety conditions experience mobility challenges as well. Consequently, they adapt or restrict their movements to minimise anxiety triggers. Sometimes the trigger can begin before leaving home when information about the trip is lacking or inadequate.

Not much is known about the travel behaviours of people with anxiety conditions, but they are complex and varied. However, active travel in familiar surroundings lessens the impact on their anxiety.

An aerial view of crowd of pedestrians walking closely together. They are wearing summer clothes. Anxiety conditions and mobility.

People with anxiety disorders can be restricted in their mobility because of their concern about having an anxiety attack away from home. This can be as a driver or passenger in a car, travelling by public transport and even going on foot.

Anxiety disorders take many forms: panic attacks, fear of open spaces, fear of social embarrassment, and specific phobias such as fear of dogs. The researchers look at these and related cognitive conditions as well as different modes of transport triggering anxiety.

It’s complicated

While some reduced their anxiety triggers by driving a car, others experienced higher levels of anxiety as a driver. That also means that for some, catching a bus is preferable, while for others this raises anxiety levels. One of the key factors is the sense of being in control of their situation. Anxiety levels for most interviewees are increased when more than one travel mode is needed

Staying in familiar environments was an important coping strategy for most interviewees. Travelling with a family member of friend also helped. Taking a universal design approach to make transport systems, information and infrastructure can help mitigate anxiety levels. Knowing what to expect and when provides a the necessary sense of control.

Co-design processes should include people with anxiety disorders as well as people with physical and sensory disabilities.

Two young women stand at a pedestrian crossing. One is holding the arm of the other. There is a car in the background on the crossing. Are they feeling safe?

From the abstract

People with anxiety disorders may encounter anxiety triggers when (planning to) travel(ing) to a destination. This affects their ability to actively participate in society.

In-depth interviews were held with 40 Dutch adults which revealed that most interviewees experience a mix of problems in using various transport modes. Interviewees often experience the feeling of being locked up and not being able to escape as anxiety triggers. They perceive the mobility system as complex and overwhelming, while mobility-related information can trigger panic attacks or lower respondents’ stress level.

Coping mechanisms include: avoidance of transport modes; avoidance of highways, bridges, tunnels; remaining in a familiar, predictable environment; asking for social support when travel is necessary; and searching for adequate travel information to use before and during travel. 

Coping with anxiety disorders and mobility-related problems impacts on professional life, including job switching and job relocation. It is almost impossible to develop a ‘one-size-fits-all’ approach to alleviate this population’s problems. We end with transport interventions that could benefit people with anxiety disorders.

The title of the paper is Moving around with an anxiety disorder.

This study brings to light some of the hidden barriers to mobility that are experienced by people with anxiety disorders. It adds to the literature on barriers experienced by people with physical and sensory impairments.

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