Please help me survive a flight without panic

August 6, 2011 9:09 PM

Please help me survive a flight without panic

I have to fly out to see an extremely ill family member immediately. It's 11-12hrs each way and I'm traveling alone. I'm also severely agoraphobic, and just thinking about having to navigate security, the airport crowds, and the flight itself surrounded by strangers is already ramping up the anxiety that I'll freak out, not be allowed on the flight and then I won't have a chance to say goodbye in person to someone who I love.

I've been denied entrance to the US due to a panic attack before; this isn't an entirely baseless fear. The connecting flights are in the US.

I'd appreciate any suggestions you folks might have for keeping the panic in check.

posted by soft and hardcore taters to human relations (24 answers total)

Anti-anxiety drugs. Does your doctor have an emergency contact line you could call? If you have to fly before Monday I would think this situation would qualify.
posted by animalrainbow at 9:15 PM on August 6, 2011 [7 favorites]

A prescription for an anti-anxiety medication. I knew someone who was terrified of flying and would always spend the flight thinking the plane was going to crash at any moment.

After she told her doctor about this the doctor wrote a rx for a few pills, to take one when flying and she was much, much more relaxed and able to fly without the terror she had always experienced.
posted by mlis at 9:16 PM on August 6, 2011

I'm guessing you've thought of this, but since you didn't mention it, there is medication that may be able to help you as a short term fix for the anxiety and panic. It's not clear from your question exactly how soon you have to fly - do you have time to see a psychiatrist and ask for a prescription?

Anyhow, here are some other possibilities that might help (sorry if these aren't helpful - I'm familiar with anxiety, but not with agorophobia).

1. Take off your shoes. Always makes me feel calmer and more relaxed for some reason.
2. Fly first class - much more room, much less crowding (requires money)
3. Can you find a good friend who will fly with you and sit next to you?
4. Get a sleeping mask?
5. Fill an ipod with music, books on tape, anything to keep you distracted and occupied
6. Take some Benadryl. It puts me to sleep, might do the same for you.

Good luck.
posted by Salvor Hardin at 9:21 PM on August 6, 2011 [1 favorite]

3rd-ing getting some meds. Pretty common reason to get them; can't imagine your doc not being sympathetic.

But I do have to ask why your post is somehow selectively US centric? I've seen people tossed off of flights in a dozen countries for loosing their shit. For good reason.
posted by kjs3 at 9:23 PM on August 6, 2011

But I do have to ask why your post is somehow selectively US centric?

The OP indicates the connecting flights are in the US.
posted by dfriedman at 9:29 PM on August 6, 2011

Good point - I need enough meds to cover my while I'm away, and one of my regular meds is ativan. I don't know how much and how often to take them to keep me calm enough for an 11 hr stretch. but the doctor should, right?

kjs3 - I've been denied entrance to the US before specifically because of a panic attack at the border, and there are no direct flights - the only way is via the US. I'm terrified that they won't let me through if I lose my shit, and there is no other way to get there.
posted by soft and hardcore taters at 9:30 PM on August 6, 2011

In terms of the agoraphobia--do you have a comfort item or something that you can bring with you that will keep you from feeling disoriented?

The doctor should be able to help with the ativan. It might be best to take it only in the most troubling situations (I am going to guess that the transfer between flights and the trip through customs). There are other fast-acting benzodiazapenes that might be more appropriate if you have immediate panic reactions to certain things. Again, though, that's something a doctor can help you with.

Good luck.
posted by the young rope-rider at 9:44 PM on August 6, 2011

[Folks, OP is not anonymous, you can MeMail non-answers directly to her.]
posted by jessamyn at 9:53 PM on August 6, 2011

I use anti-anxiety meds to travel because I am terrified of flying. I bounce around among Xanax, Ativan, Valium and Klonopin. Your doctor or the person you may be seeing for your agorophobia will know which one is best--definitely call the on-call line and have someone talk to you and call in a prescription. For me, Xanax does the best job of taking the edge off of my fear of flying, but Klonopin puts me in a bit more of a stupor/less aware of my surroundings, which may be better. (I'm still functional and can interact with agents, etc. as needed, but I'm pretty much in my own world.)

It may also help to think of things in terms of steps rather than one overwhelming experience. Also, make the process as easy as you can on yourself. Wear shoes that you can slip off fast, make sure any liquids are in little baggies for security, your laptop (if you are taking one) is out of its case and ready to grab. Have your ID and boarding pass in your hand before you get to security. That way you can just easily go through step-by-step without having to feel overwhelmed getting things together at security. (I kind of like to make it a game of "how efficient can I be" which helps distract me from the fact that I'm about to get on a fucking plane--it keeps you very focused on process/self rather than everything happening around you.) If you can, check in online and print your boarding pass the day before so you don't have to deal with the ticketing counter and its lines. Also, if you check in early, see if you can upgrade to or get an early boarding group. That way, you don't have to lurk with the groups of people waiting to board and then you can just get on the plane and in your seat and bury yourself in a book or some other solitary activity. (Maybe get a really awesome book or something else you'd be excited to look at so you can look forward to that. "Once I get through security I can sit in the gate area minding my own business reading my awesome book, then just get right on the plane when boarding begins and get back to it.") At the other end, make sure you have your passport and customs documents easy to hand so you can just zip right through.

I'm usually a get-to-the-airport-at-the-last-possible-second-type, but it may be less stressful for you to get there with plenty of time. Yes, you'll be exposed to people and the airport environment longer, but you won't have the address stress of worrying about how long the security line is and will you make it to the gate. And, as above, once you are at the gate, you can pop in earbuds, read something, and pretty much shut out the world. (You can also do this walking through the airport to minimize external stimuli, and even in the security line up until you get to the point where you have to show your docs and go through the actual security area.

This is something else to remember: even though there are a lot of people, everyone is pretty much creating their own little travel bubble. Each group or individual is pretty solitary within their own experience and apart from a "can I help you get that into the overhead bin?"you really don't have to interact or have conversations ready.

(And yes, your doctor will be able to tell you how much Ativan and when. I am not a doctor or your doctor, I've just spent a fair amount of time experimenting on what works best to minimize my panic when traveling. On a travel day, I usually end up taking 1-2mgs depending on if my flight is direct. Half 30 minutes before going to the airport, half as I get to the gate, another half about an hour before my next flight (depending on connecting times) and then the final half as I'm boarding the second flight. It works about to about one milligram every four hours, staggered in half milligram doses about 30-60 minutes apart. I have it timed so the full effect hits during my most stressful time: take-off.

I'm sorry to hear about your family member and best of luck.
posted by HonoriaGlossop at 9:55 PM on August 6, 2011 [2 favorites]

Salvor Hardin - I think I can manage the music, sleep mask and shoes off.
The young rope-riper - I'm bringing along a snuggie and hoping the music can help with that too.
posted by soft and hardcore taters at 10:01 PM on August 6, 2011

1. Take off your shoes. Always makes me feel calmer and more relaxed for some reason.

Remember the opening scene of Die Hard, where they land and the guy next to Bruce Willis advises him to 'walk around barefoot making fists with your toes'? I actually do that, whenever I'm on long international flights. Once we're an hour or two into the flight and everyone else is settled in, I'll periodically stand up and walk the aisle for a minute or two flexing my feet.

(only once has a flight attendant asked me to put my shoes on, but still now I like to plan and put a pair of light flip-flops in my carry-on)
posted by mannequito at 10:06 PM on August 6, 2011

The only way I fly anymore is with a couple Xanax. Find my seat, put my stuff away, pop a couple and zonk out, tuning out all the whining kids and crying babies for the rest of the flight. Almost makes it enjoyable.
posted by xedrik at 11:46 PM on August 6, 2011 [1 favorite]

Normally when I fly I am a clenched up freaking out and sometimes crying wreck. The last time I flew I took Halcion, and shortly thereafter I was reclined in my seat feeling like I was floating in a pool in the Bahamas. The feeling went beyond normal relaxing to being the decadent kind of relaxing. I might have even been smirking. Then I closed my eyes for a second and when I opened them, they were making the landing announcement. So, I recommend it.
posted by Ashley801 at 1:31 AM on August 7, 2011 [4 favorites]

I always try to be either one of the first or the last to board the plane, because I hate fighting my way through the crowds of people trying to put away their stuff. If you have a small carryon, I recommend waiting until the end because you won't need to worry about finding overhead space. Just make sure you don't miss your flight.
posted by acidic at 1:53 AM on August 7, 2011 [1 favorite]

Man.. just the fact that you have a close family member that's sick enough to warrant this kind of emergency travel scenario is just.. the suck. I hope that everybody's healing and relaxed as soon as possible.

But to have something so scary to have to digest on top of all that is just too much..

So, ditto on the medication solution. Go meds.

Wasn't the best part of the A-Team when they had to fly somewhere they'd always have to sneak up on Mr T and jam a syringe of some industrial-strength sedative in his neck? :) Meds are great.

But whether or not you can even go the B.A. Baraka route, I think it's also important to really try and remember a couple of things you probably know already, but which bear repeating..

Learned statistical types say your odds of dying in a flight are debatable, but hover somewhere around one in eleven million and less than that if you're on an 11-hr flight, so pretty much impossible.

Meanwhile, as convincing as that aggressively noisy, probably very old voice sounds, it's just running on some command you gave it, who knows how long ago. (Maybe you were four and someone made the mistake of letting you watch a plane crash movie.) It's well-meaning. It wants to help, but its a shit listener, it's completely illiterate and it's way misinformed. It shouldn't be ignored any more than a friend would with the same intentions, but don't let it make the rules. You deserve only peace and clarity, especially now.

The best advice I ever got about panic attacks was from a psychologist I work for who counsels cancer patients. Panic attacks can be scary, but they're all bark. No one ever dies from a panic attack and you won't be the first. She said to approach the panic with a gentle curiosity. What happens in your body? Does it feel tight anywhere? Does it move? More importantly, how does it change when you begin to notice it? Treat it as the obnoxious house guest that it is and you can ride it out while you gather intel on what it wants and how to better keep it at bay next time..

Take extra good care of you!
posted by missy_b at 3:25 AM on August 7, 2011 [1 favorite]

A friend of mine had great success with Rescue Remedy for flying anxiety.
posted by Sabine3283 at 6:04 AM on August 7, 2011

Oh, hello! So, I can tell you a little bit about my experience with anxiety disorders, as it seems quite related to your fears of airports, planes, crowds, people and the heart of the matter: control.

I didn't fly for almost exactly twenty years. (This included taking trains and buses and driving back and forth across America.)

Now I commute regularly by plane. (I have three plane trips coming up this month.)

Anxiety disorder treatment is pretty consistent across phobias. We are, essentially, mis-wired--we learned to panic in certain situations, and then we learned to dig in and exacerbate it.

I worked on this in a couple steps. First, because I was pretty well riddled with anxiety disorders, I went to an exceptional psychiatrist, and we Dealt With Some Stuff, including "learning to have feelings in front of another person" (heh) and also including doing some short-term medication. He also gave me a mild prescription for flying to use at first. Much later, I took a short online fear of flying course (called SOAR). (This is not a commercial shilling; I'm just a satisfied client, I have no investment there.)

So, while I largely agree with everyone that it's likely that you should try to damp your phobic reactions with medication, I have to tell you that medication is not a fix. When I was just trying to start to fly, before I'd really addressed things (I was also having trouble with elevators and moving vehicles of all kinds! Yikes!), I would take a pill and I ended up just sitting at the airport and on the plane terrified and very, very sleepy. Sort of the worst of both worlds, really? It was like being in a waking nightmare. Drugged and panicking! Yuck.

The only things that are going to help you with your agoraphobia and related anxieties are anxiety reduction techniques, right? You need to learn some and master them. Instead of spiraling out of control, you need to learn to peacefully turn inward.

Your brain is trying to keep you safe by telling you to flee these situations. It's trying to do you a favor! But it's not a favor you need any more. The chemicals flooding you during this panic fight/flight situation get resolved a bit when you make a commitment to being where you are: "Yes, I am going to take off my shoes and belt and wait in this line with all these people"; "Yes, I am going to board this plane down this long tube." Acknowledge what's going on, that it'll end, that you're being brave, and that what you're doing is worth it--and that you'll feel proud of yourself after.

And all the while during these panic triggers, you need to be observing things you can feel, see, hear, smell. When we panic, we try to leave our bodies. Instead, we need to come back in, acknowledge where we are, and bring ourselves a maximum amount of peace.

One thing we see is that panic attacks take some time to brew; we don't acknowledge that they are coming, and we see them as "sudden." But in fact they grow slowly, and can easily be derailed with meditation and relaxation techniques. (And, sometimes, food! Never skip out on a meal when you're in a situation in which you might panic.) In particular, studies show that people who panic are starving themselves of oxygen, which also exacerbates the entire situation.

You can start helping yourself now by visualizing yourself in your most-frightening situations, alternating those images with imagery of places you find most safe and loving—in the end, you'll learn to manage these "scary" situations (which are not actually scary) if you can find a strong emotional connection to safety and love. I mean that quite literally.

In fact, since you're suffering, I will thoroughly embarrass myself here: One way I deal with brewing feelings of anxiety is by visualization of my old cat (RIP). When I get distracted or jarred--by security lines, by turbulence, by what I see as the scariness of airports or airplanes--I return to deep breathing and imagery of this very Buddha-like ol' alley cat and his bemused, loving expression. And I think: what would Cat do? Cat would laugh at all this from the beyond. I find that helpful; your mileage will vary.

But I want to leave you with this: you are not particularly special. You are hardly the first person with an anxiety disorder. And anxiety disorders are actually quite curable. You owe it to yourself to make treating your anxiety disorder a major priority in your life. This is absolutely not something you can put on the back burner. This is a choice you're making every day: do you want to be crippled in this way, and be unable to take part in things that most other humans can navigate without terror? Or do you want to be free? Let's get going, my friend. Life is short and you deserve better.
posted by RJ Reynolds at 6:24 AM on August 7, 2011 [17 favorites]

I used to be agoraphobic and remember how hard it was to fly, so my heart goes out to you. Still, it is totally doable and you have a very good chance of being just fine on your flight. Everyone is mentioning medication and it seems like you've got that taken care of. Something else I would suggest that used to make me feel better when flying, was finding a flight attendant during boarding and telling them that I have anxiety issues and that I might need to be reassured at some point during the flight. That usually helped to lessen the initial tension I felt. Another thing that many say and I have found it to be true, is that fear and deep feelings of gratitude cannot be felt at the same time... I know it is a difficult time for you, having someone close to you who is ill, but maybe you could focus on your gratitude that they have been in your life and that you are able to see them because of your courage and willingness to get on a plane.

Claire Weekes has a great audio book called "Pass Through Panic" which you can find on iTunes... I would highly suggest you get it before going and even bring it with you on the plane so you can listen with headphones.

Having been severely agoraphobic in the past (I didn't leave the house) I just want to say that I credit Cognitive Therapy (and the audio book I mentioned above) for my recovery.

All my best wishes to you on your trip, and I hope your family member gets better soon.
posted by seriousmoonlight at 6:43 AM on August 7, 2011 [1 favorite]

I also have agoraphobia, though strangely I don't have a fear of flying, just the confined spaces. I nth medication. I've never taken ativan, so check with your doctor about the dose, but klonopin works great for me.

Other things that work for me: having something to keep my mind busy. This can be a game on your phone, a crossword puzzle, an absorbing podcast, a mantra you chant silently, etc.

Breathing is crucial. Keep bringing the focus back to your breath whenever you feel the anxiety ramp up.

Have plans for "worst case scenarios" even if they're unlikely. If I get stopped by Customs, I will do X. If someone in the crowd is too close to me, I will do Y. This helps me overcome the feeling of being out of control and trapped.

But I agree with RJ Reynolds that this is an opportunity to address a long term issue head-on, and I wish you success.
posted by desjardins at 7:52 AM on August 7, 2011

I'm a big fan of ambien for flights.

But since you specifically mention being worried the US won't let you in if you have a panic attack, why not get a letter from your doctor in advance that explains about your anxiety and panic attacks that you can show to the TSA jerks in the airport to increase the odds of them understanding the medical reason for your freakout in case you in fact do freak out at the wrong moment?
posted by Eshkol at 8:28 AM on August 7, 2011 [1 favorite]

The SOAR online course RJ Reynolds links to looks to be a 107minute downloadable movie or audio version and 100% free, and only 107 minutes long.
posted by K.P. at 10:12 AM on August 7, 2011

One key thing you can do to address many of these issues is to communicate. As mentioned above, get a doctor's letter explaining your proclivity for panic. Also, tell the flight crews on your flights of the issue; they've undoubtedly seen far, far worse and will try to check in on you. In short, ask for help, especially if you feel comfortable telling people *why* you're traveling. They'll be sympathetic and want to help you.
posted by anildash at 10:36 AM on August 7, 2011

I dont have an anxiety disorder all official like, but I used to be really really afraid to fly. I got past it (after many cancelled trips) by doing some visualization techniques. First I closed my eyes and didn't look out the window and thought a soothing, positive manta over and over again as we took off (mine is specifically a prayer but yours can simply be something about conquering fear or being a good person or whatever you wish!). After the plane was up I would bury myself in a funny book I bought specifically for the plane [thank you Terry Pratchett] and plug in headphones and listen to tuneful music. Anytime the plane did something weird and I started to freak I would return to the eyes-closed interior monologue. Eventually, I just stopped being afraid. Now I actually like to fly! I can even have a drink or two without worrying that it will make it worse. Good luck!
posted by Potomac Avenue at 8:54 PM on August 7, 2011

Thanks all. It was so important to me to see my grandfather, and I made it there and back with your help.
posted by soft and hardcore taters at 6:57 AM on August 18, 2011 [3 favorites]