Cologne - It happened all of a sudden as Martina Kaiser was driving her Porsche sports car down one of Germany's largely speed-unlimited motorways at a brisk 150km/h an hour.
She felt warm all over and her stomach began to tighten up. Seconds later Kaiser was trembling and sweating and her pulse was racing.
As she lost her grip on reality, the cars whizzing by seemed dangerously close, as if they wanted to run her off the road. This was Kaiser's first panic attack at the wheel. But why did it happen? She is a passionate driver and enjoys driving fast.
Panic attacks and phobias
Driving phobias are not rare, yet experts point out that the anxiety manifests itself in different ways. Alexandra Baerike, psychologist and driving instructor, said: "Around 90% of my patients suffer panic attacks while at the wheel."
She blames mental pressure.
Kaiser was certainly a hard worker. She put in long hours on the job and spent her days off looking after her sick mother. She had to spend a lot of time on the autobahn travelling back and forth.
Baerike said: "Phobias prey on people who are already worn out by stress." Panic attacks at the wheel are not necessarily linked to actual driving.
Naturally motoring produces other forms of tension. People are afraid of losing control of the vehicle, or of causing an accident or of upsetting other road users. Traversing a tunnel frightens many.
Sven Rademacher, Germany's DVR road safety council, said: "Fears can come in many guises. When anxiety rears itself, it often triggers a panic attack."
Even experts cannot say for certain how many people suffer from the debilitating problem. In surveys, respondents tend to be unwilling to talk about the fears.
Germany's Federal Highway Research Institute (BASt) determined that one in four of those who had been involved in a serious car accident went on to suffer psychologically.
The panic attacks are what led to Kaiser's driving fears. It started when she found herself always heading for the slow lane in heavy traffic until she started avoiding the autobahn altogether, despite needing twice as long to travel to work.
On arrival at the office, she was so exhausted that she felt as if she had just run a marathon. She told herself the attacks would fade away but they just got worse: "In the end, I just couldn't sleep at night and I started to be afraid of being afraid."
Fear of the road
Psychologist Alexandra Baerike is aware of the problem: "Fear tends to get generalized. You start off by not being able to drive down the motorway and before long you can't drive anywhere."
The expert say this vicious circle can be broken. Baerike recommends self-help literature. He says taking along a partner or a friend when setting out on a drive often helps.
DVR's Sven Rademacher: "Fear is often set off by uncertainty in particular traffic situations."
A couple of hours with a driving instructor can help nervous drivers regain their confidence. Another idea is to keep telling yourself out loud that you can cope, said Baerike. Recalling driving situations that a person has successfully managed can also help.
Sufferers cannot always translate the theory into practice and to help cope with sudden fear attacks, experts do have tips. Rademacher suggests pulling over and walking briskly. But what if there is no hard shoulder to stop on?
Kaiser said: "You have to endure the situation even if it is hard."
Rademacher said: "Those who suffer from full-blown panic attacks should seek some kind of therapeutic help. Of course the fears didn't just vanish as if someone had waved a magic wand."
Kaiser chose this path and it cured her fears.
After a brief course of therapy sessions, Kaiser opted to return to the highways. The butterflies in the stomach were still there at first, but she has since learned to conquer her fears and they no longer enter her head as she speeds down the fast lane in her Porsche.