For my entire life I have always fainted whenever I have gotten a shot or had blood drawn or seen an injury to myself or anyone else. I have also fainted on several (more than a dozen) occassions when other people were simply talking about injuries they have experienced or seen. I can come near fainting simply by thinking about a hypothetical injury.
Other than that, though, although I have alwasy been extremely shy, I had never experienced anything like a panic attack until adulthood, when, a few years ago, I started feeling like I was going to pass out at random times that had nothing to do with injuries or thinking about injuries. I thought I was experiencing bouts of low blood sugar or something, though, and did not realize that what I was feeling had any psychological connection at all. It took me several months and doctor's visits before I finally realized I was experiencing panic attacks.
For a long time the panic attacks happened at completely unpredictable times and places, with no seeming trend. Eventually, though, seemed to settle into certain situations - unfortunately and ironically those situations were the very situations I used to enjoy and find the most calming before these panic attacks began occurring: in social situations, at church, in movie theaters, in classrooms, and while driving - with driving being the most sure-fire trigger for a severe "oh my gosh oh my gosh oh my gosh I'm seriously for real going to die this time" panic attacks.
When driving it is now VERY common for me to suddenly feel like I am going to pass out. Before I get in the car, I worry about whether I will have a panic attack, and I also will often start to worry about what will happen if I pass an accident with injuries and I pass out and crash, or I will have an intrusive thought about an injury that I've seen or heard about in the past, and it will make me start to feel light-headed and then I'll try to stop thinking about it or freak out about the fact that I'm thinking about it and/or feeling light-headed and I start to panic that I might pass out and I start really feeling like I am on the very edge of passing out at any second and then I'll crash and die, etc. etc. etc.
These panic attacks are much more likely to happen, or to be more severe, in situations where it would be hard to
pull off the road safely - for example, on the highway, on on-ramps, on bridges, etc. These panic attacks are extremely severe, and they are getting more and more frequent lately, to the point that they are now happening pretty much every single time I get behind the wheel, and they are severely limiting how often I leave the house and where I am willing to attempt to go when I do. I worry that if I don't start taking some serious actions to fix the problem, I will not even be able to force myself to drive the 10 minutes to work some day.
Driving is certainly not the only situation where I experience panic attacks, but it is definitely where panic attacks are causing the most serious disruptions to my daily life.
Soooo, what this whole super-long introduction has been leading up to is this question: what is a safe and effective way for me to approach exposure? I worry that it may be possible for me to actually pass out during one of these panic attacks - particularly when fears or thoughts of seeing or thinking about injuries are so frequently involved, and these things alone have made me actually pass out in the past, before I started having panic attacks. I have not fainted even once since I started having panic attacks, but with my history, I feel like it's a realistic possibility. Obviously, it is not safe at all to pass out behind he wheel. On the other hand, I know from experience that avoidance only reinforces the panic attacks. How do I push myself to keep driving through a panic attack without endangering others (or myself)?