Q. I get very nervous driving on the freeway now, especially on curved roads. When I drive through the curves I feel like my car is going to flip over and turn upside down. I've been driving this same freeway for about 11 years. I haven't had any accidents. I commute 25 miles one way. I didn't have this problem before. It started about 2 years ago and is now getting worse. My doctor gave me clonazepam 0.5 mg to take one a day. It helps me calm down when I'm driving on the freeway but I'm still very nervous. I don't have any problems at home or at work. Freeway driving is the only problem in my life bothering me almost all the time.

A. I can understand how this unusual type of anxiety would be distressing to you. I can't speculate on the cause of your anxiety, but it does strike me that your fear of flipping over in the past two years coincides with many reports, during this same period, of SUVs flipping over or going out of control. I wonder if there could be a connection? In any case, I think it would be very useful to consult a mental health professional about this problem.

Very often, some short-term, cognitive-behavioral therapy (CBT) can be of great help with problems of this type. CBT emphasizes conscious, here-and-now strategies to cope with phobias and related anxiety disorders, and is often provided by specially-trained clinical psychologists. (CBT is not the same as relaxation therapy, and you will need to ask the therapist specifically if he or she provides CBT). Depending on how therapy goes, you may also want to ask your doctor (who I assume is not a psychiatrist) to refer you for a psychiatric consultation, to see if a different type of medication would be of more help.

One problem with medications such as clonazepam is that--while they are often effective for some types of anxiety--they can impair alertness and driving performance. Other types of medication (for example, SSRIs, such as Prozac or Zoloft) might be an alternative, depending on the exact nature of your problem. These would be less likely to impair driving performance, for the majority of patients.

In the mean time, you might find the book, "The Anxiety and Phobia Workbook", by EJ Bourne Ph.D., of interest. I wish you well in your quest to overcome this problem.

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