London is a city severely affected by anxiety; one major survey* found that 41.3% of Londoners suffer from high levels. As for taking public transport in London; that can create something of a perfect anxiety storm — especially when you throw the pandemic into the mix.
With the help of Professor David Veale from Nightingale Hospital London, we look at the effects that taking the tube, train or bus can have on Londoners — and what we can do to to help ourselves and others.
What makes us anxious about public transport?
The top three anxiety-inducing factors on the London Underground, according to a pre-Covid study**, were found to be anti-social behaviour, overcrowding, and high levels of noise.
Another factor to bear in mind, say Professor Veale, is that things are largely out of our control — not the case when we're walking, cycling or driving.
And that's before you get into the likes of claustrophobia, or PTSD from a previous public transport experience.
One or a combination of the above can make public transport seem a scary place at times. But you are most certainly not alone.
What new anxieties are there for passengers in 2021?
A YouGov study from May 2021 found that half of Londoners felt uncomfortable about taking the tube due to Covid-related fears. Covid has undeniably changed the way we perceive and experience public transport — and generally not in a positive way.
In particular, that fear of overcrowding has a whole new spin on it.
"Overcrowding and not being able to socially distance from other passengers on public transport remains a highly common anxiety for many commuters," Professor Veale says. Such fears aren't without merit, either. As one scientist told the BBC: "If you're close enough to smell someone's garlic breath on public transport, then you're also potentially inhaling any virus that's carried with it."
Though TfL has (quite rightly) mandated that all non-exempt passengers must wear a mask on public transport, the reality is that not everyone is following the advice. Even Siwan Hayward, TfL's director of compliance recently acknowledged that compliance was falling.
It's a shame, to say the least, that many Londoners don't realise (or otherwise don't care that) they're triggering anxiety in their fellow passengers.
So what can we do to fend off anxiety on public transport?
"For individuals prone to anxiety and panic attacks using public transport, you could consider alternative transport, such as walking, cycling, using taxis, or travelling during off-peak times," suggests Professor Veale.
Even waiting a few minutes for a quieter train or bus can help.
When you don't have much of a choice about travelling (and many Londoners have now been summoned back to the workplace) — or you're confronting your anxieties head-on — simple 'grounding techniques' have been said to help against panic attacks. These include things like:
- Breathing in and out deeply, focusing on each breath
- Picking up or touching items near you and focus on how they feel
- Stamping on the spot, which may help control your breathing
And if we continue to feel anxious?
"If you are having panic attacks on public transport," says Professor Veale, "I'd encourage you to seek a psychiatric or psychological assessment, so an expert can work with you to understand the root of the problem you are experiencing."
Cognitive behavioural therapy (CBT) can be a balm if you suffer from anxiety and panic disorders, by helping you face your fears and learn to tolerate with uncertainty.
How can we help our fellow passengers?
Ask if they'd like any help!
"If you notice a fellow commuter in distress on the tube, asking them carefully if they need any assistance is a great first step," says Professor Veale.
Just by being there, having a few words of comfort and assurance can go a long way. Even if that does mean facing an anxiety that almost all London's commuters seem to have... talking to people.
Can public transport also be an antidote to anxiety?
Absolutely! The familiar red, white and blue glow of a roundel signifies somewhere that people can feel safe, connected and among others.
For instance, the importance of the night tube to women's safety was recently the subject of a petition. Let's not forget that while public transport can be the cause of much anxiety, sometimes it's the antidote, too.
Professor David Veale is a consultant psychiatrist at Nightingale Hospital London, and an internationally recognised expert in many mental health conditions including obsessive-compulsive disorder, health anxiety and body dysmorphia.
**Kim & Gustafson-Pearce, 2016