Bridges are their nightmare. The Baltimore collapse made it a reality.

“It’s exacerbating their anxiety because it’s proving to them that their fear of bridges and their fear of heights is not unreasonable — that … this could have happened to them when they were on this bridge,” Aboujaoude said.

The horrifying scene of an out-of-control cargo ship taking down an 185-foot-tall bridge has triggered anxiety in people who struggle with several fears, including claustrophobia, amaxophobia (driving) and gephyrophobia (crossing bridges). It’s not a far leap to watch video of the collapse and picture yourself falling into the Patapsco River. For some, it feels like a bad dream came true.

Retired sales executive Dave Scarangella, 67, wrote on X on Tuesday that the Key Bridge collapse was his “recurring nightmare in real life.” He gets panic attacks on high bridges, he wrote — and more than a dozen people replied to share their own fears.

“I don’t know if it’s an innate fear of control, that the car will somehow take a right turn and dive into the water or something,” Scarangella said in an interview Wednesday, noting that the fear really grips him at the top. “It doesn’t make any sense.”

Taking lengths to avoid bridges

Bridges are a part of daily life for many. They factor into our holidays and vacations. People like Scarangella, of Ashburn, Va., may plot an elaborate course to circumvent an anxiety-inducing crossing.

Aboujaoude said one patient’s commute is three hours instead of the 30 minutes it would take to use a bridge. Scarangella said he has delegated bridge driving to colleagues and family members for years. He has avoided the Francis Scott Key Bridge and the Bay Bridge in Maryland. Family getaways are carefully planned.

“Wherever we choose to vacation won’t have a high bridge there,” he said. “And if we were to come across one by accident, we would look at a map and drive around it.”

At several bridges around the country, nervous drivers can hand their car keys over to a professional driver. The escort programs are run by a mix of bridge operators and private transportation companies.

The Chesapeake Bay Bridge-Tunnel in Virginia has been assisting nervous drivers since at least the 1990s. In 2006, the authorities formalized the free program, which is available year-round.

“We get just as many calls in the middle of the night as we do in the middle of the day,” said Corporal Spencer Parks.

Travelers in passenger cars should book in advance, preferably 24 hours before their arrival time. They will meet an emergency crew worker at either end of the bridge and pay the toll ($16 or $21, depending on the season). If a crew member is not available — their other responsibilities include driving wreckers and assisting in the toll booth — a police officer might take the wheel.

Edward Spencer, the director of operations and chief of police for the Chesapeake Bay Bridge and Tunnel District, said 500 to 600 people request an escort each year. Spencer, who was answering the phone Tuesday night, said he highly doubts the Key Bridge collapse will cause an uptick in calls.

Drivers can get a hand crossing the Chesapeake Bay Bridge in Maryland from the Kent Island Express, which promises to “let you relax and enjoy the ride and the view.” The service, which is not affiliated with the Maryland Transportation Authority, costs $40 in cash and $50 by credit card during regular business hours, according to the website. Drivers need to give at least an hour of advance notice.

Patty MacEwan, 60, used Kent Island Express a couple of years ago when she needed to attend a work meeting on the Eastern Shore. She said it was worth the cost. While short bridges made of concrete don’t bother her much, she has issues driving on bridges with grates where the water is visible and long bridges.

It was a windy day when she used the service, and “I thought to myself, ‘God, I’m so glad you did this,’” she said. “Because I’ve driven over that bridge before and it just is a white-knuckle experience for me.”

MacEwan, now retired from fundraising for nonprofits, called the company and scheduled a meeting time, then followed up when she was nearby. A young woman got into the Chevrolet Spark at a spot near the bridge; another employee followed them over, and the driver pulled over near a business on the other side, where MacEwan took over again.

“Very efficient,” said MacEwan, who lived in Alexandria, Va., at the time and now lives in New York state. She remembers complimenting the driver on how well she was doing, even if she wasn’t technically watching what was going on. “I probably closed my eyes,” she said.

The 440-foot-high Delaware Memorial Bridge, which spans the Delaware River, offers a similar program. Travelers, who should call 10 to 15 minutes ahead of time, will receive directions to a safe pull-off where they can wait for an officer. Dispatcher Dionna Glasglow said they typically receive a bump in calls over the holidays and on days with extreme weather — excessively windy or rainy or spectacularly sunny.

“Summer is a huge peak time for us,” she said.

The service is free, but the car owner must pay the $5 toll.

The roughly five-mile-long Mackinac Bridge, which connects Michigan’s Upper and Lower Peninsulas, has offered an assistance program to nervous drivers since the 1980s. Partly to blame for those nerves: high winds, which can prompt advisories and closures — and cause the bridge to move.

At all hours, any day of the week, drivers can make a request for a bridge staffer to drive their car across the “Mighty Mac.”

The service was suspended in the early days of the pandemic, but it returned in late 2021. By then, officials had reviewed the cost of the formerly free program and decided users needed to pay. The cost now: $10 plus toll per trip, increasing to $15 in 2025. The average cost to provide the service is about $33 per trip, according to the Mackinac Bridge Authority.

Overcoming fears through exposure

The fear of bridges can be a singular phobia or a tangle of anxieties, such as driving, heights, loss of control, tight spaces or mistrust of infrastructure. The type of bridge could also trigger a panic attack.

“For some people, it’s how high the bridges are. For other people, it’s the structure of the bridge, or the length, or whether it’s over water,” said Martin Antony, a psychology professor at Toronto Metropolitan University. “Of course, there are people who are afraid of all bridges.”

Robert Dupont, a clinical professor of psychiatry at Georgetown University, said he did not encounter patients who feared a bridge collapse. They were afraid of their own behavior while driving across a bridge — like jumping off it.

“It’s a common phobia,” he said, adding that “it’s one of the phobias that people keep a secret. Driving across a bridge becomes something they won’t do. This [collapse] may prompt people to confront it again.”

Antony, who wrote a book about overcoming fears, said the most effective and evidence-based therapy involves exposure. He takes his clients to bridges, where the patient or a friend of the individual will repeatedly drive across the structure. The idea is to exorcise the fear by normalizing the experience.

“We will go back and forth long enough for the people to learn that whatever they are predicting isn’t going to happen,” he said. “Their fear comes down over time, usually.”

“The only treatment is to do it,” DuPont said. “You’ve got to get on the bridge and do it often. … The peace lies on the other side of the fear.”

For the cognitive segment of therapy, Aboujaoude uses rationalization techniques, such as pointing out how his client’s worst fears rarely materialize. For the behavioral portion of treatment, he will safely and gradually expose them to their fears through virtual reality and other technologies.

He said bridge escort programs are a “Band-Aid,” but not a long-term solution. The traveler won’t always have this service or the time or logistics to circumvent bridges. To expel their fears, they need to face them head-on.

“A small minority of patients with acrophobia actually seek treatment,” he said. “Most of them deal with it through avoidance.”

Scarangella, the retired executive in Virginia, said he has watched videos of drives over bridges “in the interest of trying to cure myself,” and found his heart rate elevated after watching. He’s skeptical more treatment would help.

“The only thing a therapist could really do for me is drive me over the bridge,” he said.

Marlene Cimons contributed to this report.