Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Intrusive thoughts around bridges? You’re not alone

By Taylor Haught

Feb 21, 20248 minute read

Reviewed byApril Kilduff, MA, LCPC

Iconic structures like the Golden Gate, Brooklyn, Mackinac, and Chesapeake Bay bridges are traversed by millions, playing an essential role in our morning commutes and daily lives. However, for a specific group of people, these crossings — along with other, less notable bridges — can be a source of intense and overwhelming anxiety. Even thinking about driving across the suspension can make your heart race, your breath tighten, and your mind go to the darkest places.

This fear, known as gephyrophobia—derived from the Greek words for bridge and fear—can transform a routine drive into an absolute nightmare. It can cause you to experience panic attacks that manifest as dizziness, shortness of breath, rapid heartbeat, and an overpowering sensation of losing control. 

The key word here is: overpowering. That’s what distinguishes gephyrophobia from the normal and fleeting kind of paranoia that anyone might feel crossing a bridge—especially if, say, it’s high in the air, or over water.

Phobias in general are relatively common. In fact, more than 9% percent of adults in the United States meet the criteria for a phobia,” says April Kilduff, MA, LCPC, LPCC, LMHC, a Licensed Therapist and OCD and ERP Specialist. Yet she adds that the data on specific phobias, including gephyrophobia, are less definitive, making it difficult to know the exact number of people affected by this particular fear.

Still, gephyrophobia can have such a huge impact that organizations such as the New York State Thruway, Maryland Transportation Authority, and the Mackinac Bridge Authority actually offer assistance to those impacted by the condition—like offering help transporting you or your car over a bridge. Annually, thousands of drivers benefit from these programs

If the thought of crossing a bridge fills you with dread, know that you’re not navigating this journey alone. Identifying your triggers is key to effectively managing these intense emotions and breaking free from anxiety’s hold.

Is it a phobia or OCD?

Both phobias and Obsessive-Compulsive Disorder (OCD) can cause significant distress that impact your daily life. Figuring out what sets them apart comes down to understanding the fears they stir up and how you react to them. Recognizing these differences can help you find the right kind of help and support you need to overcome them.

Phobias involve deep, unfounded fears of certain objects or scenarios, leading you to avoid them. They’re typically focused on a specific trigger, and don’t usually come with the repetitive thoughts or actions seen in OCD.

OCD, on the other hand, involves not just obsessive thoughts, but compulsions—repeated behaviors or mental rituals aimed at alleviating the anxiety caused by these intrusive thoughts. They’re often designed to keep a feared thing from happening.

Such intrusive thoughts are unwanted, involuntary, and often cause significant distress, making them hard to control. While it’s common for anyone to experience them now and then, if they’re persistent to the point where they interfere with your everyday life, and create constant worry or distress, it might indicate OCD.

“The key distinction between a phobia and OCD lies in the presence of compulsions,” explains Kilduff. “OCD revolves around ego-dystonic thoughts, which are intrusive thoughts that contradict your true self-perception and values. Because they go against your beliefs, you can become fixated on these intrusive thoughts, perceiving them as a genuine threat that must be managed or controlled. And that can escalate into obsessions that dominate your mental landscape—as well as trigger compulsive behaviors to try to deal with your obsessions.” 

Compulsions can offer relief in the short term, she adds—that’s why you want to perform them—but they only underscore your fears and create a loop of obsessions, and compulsions that run on repeat in your brain, causing long-term discomfort and distress.

Understanding whether a fear is a phobia or a sign of OCD depends on the presence and role of compulsive behaviors and the nature of the fear itself. If the fear is specific and isolated, with avoidance as the primary response, it may indicate a phobia. Conversely, if the fear involves persistent, intrusive thoughts that lead to repetitive behaviors or mental acts, it might be OCD. Either way, it’s important to see a licensed mental health professional to get an accurate diagnosis.

The root cause of a fear of bridges

So, why might you have intrusive thoughts about bridges? It often ties back to deeper fears—like a fear of heights, losing control, or being trapped. And if you have gephyrophobia, crossing a bridge might trigger a cascade of intrusive thoughts like the bridge collapsing or your vehicle plummeting into the water below.

Let’s break down some of the common fears behind a phobia of bridges:

Acrophobia (Fear of Heights)

Imagine you’re crossing a really high bridge, and all you can think about is the possibility of the wind knocking you off, or your car somehow tumbling down into the water. Or maybe just looking down at the sheer drop makes you dizzy. The taller the bridge, the more intense the fear likely is.

Claustrophobia (Fear of Small Spaces)

Now, you might wonder, How does being on a bridge make me feel trapped in a small space? Kilduff says that it’s all about feeling stuck on it with no quick way to get off. That sense of entrapment can really spike anxiety.

Aquaphobia (Fear of Drowning)

The thought of a bridge collapsing and falling into the water below is terrifying for someone with a fear of drowning. It’s the intrusive thought of being submerged and helpless that’s anxiety inducing.

Panic Attacks

For those with anxiety disorders, just the thought of crossing a bridge can trigger a full-blown panic attack, complete with a racing heart, difficulty breathing, and an overwhelming urge to flee.

With OCD, however, a fear of bridges involves a cycle of intrusive, distressing thoughts (obsession) and repetitive physical or mental actions (compulsion) or done to ease those thoughts. ). Here’s how that can play out with bridges:

Obsessions

These could include: 

  • Constant worry about a bridge collapsing
  • Fear that your actions on the bridge could somehow cause an accident
  • Intrusive thoughts about harm coming to yourself or others when you cross a bridge.

Compulsions

Here are some of the compulsions that might follows your obsessive thoughts:

  • Avoiding any route that includes a bridge
  • Performing safety checks on the car over and over before any trip that involves bridge crossing
  • Engaging in specific rituals for safety while crossing. “These rituals might involve playing a particular song every time you go over a bridge, or a compulsion to verify the safety of every bridge before you cross it,” says Kilduff. 

How to get treatment

There are several therapeutic approaches and techniques that can be beneficial for both phobias and OCD.

Cognitive-Behavioral Therapy (CBT)

CBT is a widely-used treatment that addresses the thought patterns and behaviors associated with a phobia. It helps you challenge and change negative thoughts related to crossing bridges, replacing them with more realistic and positive ones.

Mindfulness-Based Stress Reduction (MBSR)

MBSR focuses on mindfulness meditation to help you become more aware of the present moment and less overwhelmed by distressing thoughts and feelings, including those triggered by the phobia of crossing bridges. This technique of letting go of unwanted thoughts is also helpful for OCD.

Dialectical Behavior Therapy (DBT)

Although DBT is primarily designed for borderline personality disorder, its focus on distress tolerance and emotional regulation can be beneficial for those with phobias, including gephyrophobia.

Acceptance and Commitment Therapy (ACT)

ACT teaches you to accept your feelings and thoughts without judgment, and commit to actions aligned with your values, even in the presence of fear. This can be helpful for facing and overcoming the fear of bridges, both for phobias and OCD.

Medication

Sometimes, to help control anxiety symptoms linked to the phobia, doctors might recommend medication. This approach is often explored if the phobia or OCD is severely affecting everyday life, and it’s usually combined with therapy for the best outcomes.

Exposure and Response Prevention (ERP)

ERP stands out as a highly effective method for addressing intrusive thoughts associated with gephyrophobia, and is the go-to method of treating OCD, and may also help with anxiety disorders. This therapeutic approach involves a very gradual and repetitive exposure to a fear—in this instance, bridges—coupled with coaching to resist engaging in compulsive behaviors. Research shows that ERP can significantly alleviate symptoms for people with a range of phobias and OCD.

In ERP therapy, a specialist will tailor a plan just for you, starting with understanding your symptoms. Together, you’ll rank your fears from least to most stressful and begin facing them—starting with the least distressing ones, and working your way up. This process teaches your brain that there’s no real danger, helping you manage discomfort better than expected.

Initially, Kildiff explains, you might simply view pictures of bridges and be coached on how to avoid your compulsions. Then you may progress to watching videos of bridges, and examining footage of bridges that have collapsed. Eventually, you’ll face more challenging fears, applying what you’ve learned in real-life situations beyond the therapist’s office. This graduated exposure aims to bolster your confidence, enabling you to cross bridges confidently without succumbing to compulsive actions.

In addition, Kilduff says your therapist will work to identify and challenge your fears—like whether they pertain to bridges at all, or are a symptom of something else, like a fear of heights, or whether your anxiety around bridges only applies to specific ones, or under certain conditions. This can help you manage your distress and your response to it more effectively.

The result? The overwhelming fear caused by intrusive thoughts and—in the case of OCD, the urge to perform compulsions—diminishes significantly. This allows you to focus on what truly matters, like enjoying a road trip with loved ones, free from the constraints of your phobia or OCD. The journey is not just about crossing physical bridges, but also about crossing mental and emotional ones towards recovery and confidence.

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