Anxiety on the train-what to do?

I've had anxiety on the train on two occasions. It's almost like a panic attack when I saw the surge of people boarding the train. I've been commuting for a while now and this has probably happened to me only once about 4 years ago, But lately it seems to always be looming around. I've travelled quite a lot this year on a plane but was not faced with the same feeling of claustrophobia. Notice I've used a lot of words to describe it Bc I don't really know which one it was. I've seen my MD and was given a pill for anxiety and was advised to take it as needed Bc long term use may cause dependency on the drug. Any tips on how to deal with this when it happens again? I don't want to rely on the pill, I want to try and deal with it the natural way. Breathing exercise maybe?Thanks in advance!

I find that having a distraction such as listening to music, reading, or playing a game helps. You may also want to read up on meditation.

PetuniaBird said:
I find that having a distraction such as listening to music, reading, or playing a game helps. You may also want to read up on meditation.

I do read. But on those two occasions, I couldn't seem to focus on the book. I moved to the vestibule and slowly I was fine. I will read up on meditation like you said. Thanks

floorline said:
Notice I've used a lot of words to describe it Bc I don't really know which one it was.

I think it's called, "get these f***ing people away from me." But seriously, it's not a joke. I have been commuting by train for 35 years and sometimes, it's just overwhelming. It's too easy to be distracted from reading, so if I am having a bad day, I put on my headphones and listen to some classical music (adjusting the volume to suit the situation) and play a game, like Bejeweled or Dice Match or something else mind-numbing.

You could also try sensory deprivation. Noise cancelling headphones, eye mask, etc. Just make sure you set an alarm that you will hear (or feel) so you don't miss your stop. I've seen people do this, but I've never tried it.

It really can be overwhelming. I think both breathing exercises and meditation would be perfect for this situation.

For now, when you feel the anxiety rising, try closing your eyes (if it's safe to do so) and picture a place you would love to be instead. Focus on your breath as it goes in and out, and make sure each breath is deep and full. When we are anxious, the tendency is to take short, shallow breaths. Make each breath is long and deep, and keep focusing on that place you want to be. Picture every detail, and keep breathing.

Also, there are plenty of meditation exercises you can find online. Just check YouTube or do a Google search. Guided meditation could be very helpful, and you can probably download recordings onto your smartphone or iPod or some such device to carry with you in case you get into difficulty.

I used to have a combination of fatigue and anxiety last year when I was really overextending myself with work and home responsibilities. I would say that finally getting myself to take some time to exercise made handling all these situations easier. I take kickboxing and the way it helped me handle stress was a life-changer. It's been incredible.

I hope you find your own way to overcome this. I would recommend staying away from the Path which I feel it's oppressive in a good day (bad air quality, no space, crowded, just a peach of a day kind of place). Good luck.

Breath deeply. Feel into it. Be mindful about what you're feeling and accept that its a feeling you have - and then in your mind let it go. You may need to do that many times a minute, and its a pretty un natural thing to practice, then after you've done that for a week or so, it comes naturally. IMO music/ etc. does not help. You can do this!

Here is a useful website for learning about mindfulness meditation.

http://www.mindful.org/mindfulness-practice/free-mindfulness-apps-worthy-of-your-attention

Also doing something very concrete like counting something or really observing in detail some object can help shift your state.

Cabameyers has a point about exercise. Do you have a regular exercise regimen? It might be helpful overall with anxiety, although it's not going to help much on the spot when you get that feeling on a crowded train.

I suspect a two-prong attack is good for this. First, you can work on anxiety in a general way, with meditation and exercise. But you also need some techniques for addressing anxiety events when they happen, on the spot. I think self-talk and breathing will help there.

Have you tried looking up how to cope with anxiety? There is a lot of information out there on the Internet, and plenty of books on the subject. You would get a lot more information than we can give you here...

I don't really think medication is needed or would be helpful, unless you are anxious most of the time or have anxious responses to a lot of things, not just the train.

Have you tried taking a earlier train that might be less crowded? Maybe sitting in the center of the car where there will be less of a crowd?

While on the train, I like to listen to podcasts from NPR. I find them to be a good, soothing distraction from the commute.

Good luck.

I forgot to mention about a great app called Calm. You can do meditation or just set your earphones to waves, rain, etc sounds that really helps tune out the outside noise.

http://www.calm.com

Assuming you are commuting through Penn Station, you might find it less anxiety-producing to board the train from the 8th Avenue side of the station. I go over there when the crowds look too big in the 7th Avenue waiting area.

Is it the crowds that lead to anxiety, or is it, perhaps, because you have time on your hands with nothing to do but wait?

I experienced a couple of alarming pain attacks on NJtransit in the months following 9/11 (trains to midtown were so crowded - lots of stressed out people on board, it was winter we were all jammed in, overheating in our winter coats - awful) One time I actually fainted and the only reason I didn't hit the floor was because it was standing room only and I had nowhere to fall! Anyhow - commuting by train was a reality for me and so I had to find a solution. I began to practice meditation - I purchased a couple of books (I love one called 'The Tibetan Art of Positive Thinking' and anything by Thich Nhat Hanh is amazing) and used the ideas in them faithfully and it made a huge difference.

Also - agree - earlier trains much less crowded and the back of the train tends to have more room as well.

Wishing you the best of luck - anxiety is awful -

Try to take manual control of the train.

Direct it at a comfortable speed while allowing Amtrak full use of its right of way.

Deep breaths.

When the conductors come to you with complaints of not stopping at stations, fill them in about your deeply felt fears of overcrowding.

Above all: laugh.

You will be respected and admired by all.

If you can get Bill Murray to tag along, all the better.

Is it possible for you to slightly alter your work schedule? I had to do this when, because of physical disabilities, I either couldn't get a seat on the trains or could not deal with the horrible crowds. I switched to the 8am train from Maplewood, which only has 2 more stops before Penn and you always get a seat (stick to the last car in the train). I also switched to the 6:09pm (or whatever it was then) which was also a "Maplewood Express" coming home, which was a much more civilized (relatively speaking) train -- they tended to call it earlier than the other rush hour trains, so the rush to board wasn't bad at all. I feel for you -- good luck and I hope you find some modicum of peace.

There are different options for anxiety medications. Most like xanax are benzodiazopines and can cause dependence/addiction and quit working.

Buspar is a different type i think as is one called Vistril. I would try those before a benzodiazopine. Ask you doctor about those options.

Last year, when I was dealing with bad allergies, I had a choking fit on a crowded train. Literally could not catch my breath, wheezing with tears streaming down my face & an uncontrollably runny nose. i was in a window seat & couldn't get up or move. And everyone ignored me. Not a word of concern, not an "are you OK," not a "do you need a tissue" -- nothing. I thought I was going to choke to death right there. And ever since, when the train sits for a long period of time in a tunnel, I can feel my throat closing up again.

I hate commuting.

It might help to do a breathing exercise where your exhale is longer than your inhale. A therapist suggested this to me when I was dealing with anxiety and I have since found it helpful. Here is one website that tells a bit more about it:

http://www.mindbodygreen.com/0-4386/A-Simple-Breathing-Exercise-to-Calm-Your-Mind-Body.html

I have similar issues when stuck in traffic on route to the GWB every morning and in the afternoon on my way home from work. Gets to the point where I start to have serious stomach pain and at times I've had to pull off the highway. Recently I've started listening to spa music in my truck. Tibetan gong or nature sounds seems to work best for me. Doesn't eliminate the anxiety but takes the edge off enough for me to get over the bridge. I wish I had the option to take a pill I'd pop them like skittles if I could.

Thanks for all your responses! To answer your questions. Yes, I do exercise on a regular basis. I walk and try to ride my bike from time to time. Unfortunately, there is no way to adjust my commute time due to work schedule. I will try medication and will download the apps suggested that I could use while commuting. I have had high blood pressure since it happened so I wasn't sure if it was the high blood pressure that caused the panic attack or it was the other way around. I was given a pill for both. I don't mind taking the blood pressure medication, but am hesitating taking the anxiety pill unless I badly need it or cannot control the feeling.

@beppolina what you described was something similar to what happened to me. I just closed my eyes and stared outside once the train got out of the tunnel. When we hit the first stop and a lot of people unboarded the train, I felt a lot better.

Thanks again guys! Anxiety is a pain. But I'm still thankful that it only happened twice while on the train. I never felt anxious any place else.

For me? When I started having panic attacks is when I knew I needed to go on BP medicine. I could just tell somehow.

Do you have a regular practice of yoga, meditation, tai chi or qi gong? All of these practices will give you the tools you need to keep calm in the long run. It’s also highly beneficial to get a massage or energy work once a month if you can afford it. These will go a long way to treating problems related to anxiety and stress. Also, more relaxation on a regular basis, this could be whatever works for you and makes you feel happy and free. That being said, you can start right away by having a practice of meditating on your breath and your body sensations while you are on the train. Let in all the sounds and sensations of the people around you and the environment. Rather than shutting it our or rejecting it, as best you can, allow it all in along with your breath and your own bodily sensations. You can also add in a compassion practice where you breath in the suffering of all the beings who are suffering in the same way you are and you breath out all of your ability to deal with it and transform it into your practice, or your “spiritual” path… Hope that helps..? Or, just listen to something really interesting and engaging on your Personal Device and get thee to a yoga class regularly!

I agree that yoga does help... I don't know who I'd be if I didn't have my practice.

Many people will have one or two panic attacks and never have another one, so don't assume that you'll suffer from this anxiety for the rest of your life. Act as if these were isolated events. The less emphasis and thought you give to them, the less big they become.

However, they might recur and there's nothing wrong with carrying around a Xanax. It might become that proverbial condom that the teenage boy has in his wallet and never gets to use. Xanax works fast but if you're in the midst of a panic attack it won't help fast enough. It is nice to have them at your disposal if you anticipate a panic attack, e.g. fearful about a flight or a trip on a train, etc.

Cognitive behavioral therapy is the most effect nonpharmacologic treatment for panic and anxiety. Chronic anxiety is best treated by CBT plus an antidepressant. Antidepressants should actually be called antieverythings since they are effect for depression, anxiety, OCD, and a host of other conditions. They are not habit forming and are completely safe.

Good luck.

Jeff Levine

I would rule out anything physical, sometimes when the body experiences a physiological shift (such as a change in blood pressure or a skipped heart beat) it can be perceived as a threat (external stimulus like a crowd can do the same). The resulting apprehension can trigger sensations in the body (rapid heartbeat, sweating) which then increase the cognitive perception of catastrophe. Knowing this can help you to soothe yourself cognitively, giving yourself pep talks and reminding yourself that you are okay and that this will pass. All panic attacks have a limited capacity to continue - they all end at some point.

I teach people with stress, anxiety or panic to do square breathing:

http://www.ehow.com/how_2276767_do-foursquare-breathing.html

http://www.sweetescapeyoga.com/simple-stress-relief-wsquare-breathing/

but one of the important things is to practice square breathing daily rather than waiting until you are already anxious. You will train your body to have a relaxation response which will make it much more effective when you really need to use it to manage panic.

I also really like the app "Calm" that @cabameyers mentions above.

Also, knowing that you have Xanax with you in case you need it can be very comforting so bring some on your commute. I have found that sometimes having it with you can be nearly as effective as taking it!

Finally, if these things aren't enough a brief period of Cognitive therapy should help you develop some tools to address it. Anxiety is so very uncomfortable and very treatable.

Hope you feel better soon!

What anti-depressants aren't habit forming? (And/or what do you mean by that phrase?) That's not my experience with or understanding of that class of medication. To me, any med that requires 'gradual weaning' to be discontinued is 'habit forming'.

I've done it now for 8 years, not that I ever enjoyed.

Improvements could so easily be made--noise reduction, inside and out; cleaner and more spacious (more numerous) cars--but, this country does not and cannot prioritize its public transportation; that would be socialistic.

Drones and other increasingly misused military equipment, on the other hand--all government/taxpayer funded--are where it's at!

I'm finding this thread both unsettling and comforting, strange to say. I thought I was the only person who suffers anxiety that can occasionally be crippling, and I thought I was in a tiny minority of people who felt that way about commuting in the horribly crowded trains. Now I know I'm not alone in those things! Which is, as I said, both comforting and strangely unsettling. I'm sorry so many people have to suffer that way in order to get to work.

I love the comments here about things like Thich Nhat Hanh (who is, indeed, wonderful), yoga, meditation, and the app "Calm," which I didn't know about. I will have to try all of these things. The comments about medications are also helpful.

For this kind of anxiety, which is so strongly tied to specific events, I would not take a medication that has to be taken regularly, build up in the system, then be weaned off when you want to stop. That doesn't seem right, to me. I think it makes a lot more sense to try to address the anxiety in other ways, or with Xanax.

I also have a bottle of Xanax that I keep for emergencies, and as others have pointed out, just having that bottle in my purse is sometimes enough to prevent a problem. Placebo effect of a sort?? I will never become addicted, because I only take it once a month or so, or a couple times a week when things are just too much to bear, e.g. the week of my mother's funeral. It's very good for situational stuff, unless you have an addictive personality. If that were the case, I'd say be very careful about any kind of medication for this purpose.

But definitely take the blood pressure medication religiously. The meditation/exercise/yoga/tai chi/and so on should help with that, also.

Books or plays on recordings could be helpful, too. I know how difficult it is to concentrate on reading when anxiety strikes, but hearing a recorded voice reading the book in your ear might be quite different and soothing. I used to listen to recorded Shakespeare plays to go to sleep.

Hang in there. You will find something that helps!

Weaning off of antidepressants is no big deal. It doesn't make them dangerous drugs. You get no high from them. You get no immediate effects from taking them. They aren't addictive. Some people have to take them forever but they're happy with the trade off of feeling "normal" for the first time in years. That being said, Thich Nhat Hanh is the man. Peace Is Every Step may be my favorite "self help" book ever.