Overcoming fear of flying.... hopefully
October 5, 2010 11:10 PM   Subscribe

It's high time I get back on an airplane, but I've had difficulty doing that in the past, even with the assistance of medication. How do I make this happen?

With a boyfriend in Vancouver and a dad in Arizona, I really need to get over my flying anxiety. It's been about 3 years since I've been on a plane, and that was a shortish 2 hour flight.

My fear is not of a plane crash or anything like that, but I have a general fear of not being able to escape situations or scenes, as well as agoraphobic tendencies. One of the highest-anxiety situations I can recall was being on a bus whose driver wouldn't open the doors to let me out before the next stop, while I was mid-panic-attack. Being on a plane seems like an even worse type of that situation, since there are no doors to open and nowhere to go if I freak out. I feel like I might be less panicky in a less-crowded first class seat, but I can't afford that.

I have been given both Xanax and Klonopin in the past- even on a healthy dose of Xanax, I remember 'fighting through' the drugged calm most of the flight, and having mini (but not full) panic attacks. I should also mention that I have developed a weird fear of taking prescription medication and generally try to avoid it unless necessary. I understand I'm probably going to have to ignore that, though, and maybe try a new drug.

Have you successfully flown on a plane using a medication, as well as some sort of relaxation technique? How did you feel? Are there any other options I should seek?
posted by rachaelfaith to Health & Fitness (16 answers total) 10 users marked this as a favorite
Exposure and response prevention is one of the most effective therapies in existence for what it treats (specific phobia), and seems appropriate given your situation. Find a good therapist who offers this in your area.
posted by emilyd22222 at 11:22 PM on October 5, 2010

Best answer: To add- in exposure and response prevention therapy, one of the things they will address is the feeling that you have to get out to calm down. They will work you up to a place where you find that nothing bad happens even if you are unable to escape. You will explore scenarios that provoke varying degrees of anxiety and find that you are totally prepared to handle them, even though you probably don't think you are now. You won't have to start off in an airplane; a good therapist won't put you in one til you're ready for it.
Good luck!
posted by emilyd22222 at 11:29 PM on October 5, 2010

It sounds like at this point that the memory of your last flying experience is making things worse for you, because you feel that even with the drugs, you'll be freaking out, so it all feels hopeless. The therapy suggestions above are good, but I wouldn't discount pharmaceuticals too. Why do you feel the need to fight the "calm" of the xanax? What happens if you close your eyes and wear earplugs? Better yet, relaxing music on earbuds?

Also, as long as the seatbelt sign is off, there's always someplace to go. You're not literally trapped in your seat. You can always wander back to the galley, ask for a drink of water, and pace back and forth for a bit. If you tell the flight attendants that you feel claustrophobic on planes, I'm sure they wouldn't mind you hanging out for a while (I do it all the time on long flights and I don't get claustrophobic). If the beverage carts aren't out, you can walk up and down the aisle a few times. I know you really want to open the door and get out, but you've still got a fair amount of freedom to move around during most of the flight.

And be sure to get yourself an aisle seat. Reserve it in advance. If that fails for whatever reason, talk to the gate agent when you arrive. Be clear that it's not a comfort issue, but necessary to avoid panic attacks.
posted by zachlipton at 12:49 AM on October 6, 2010

Best answer: Zachlipton's suggestions may work in the short term, but in the long term, emilyd22222 is right. What happens if this time you can get an aisle seat, but some other time the flight is too crowded and you can't? Having medications, sitting in a certain place, etc., are all "safety signals" - they implicitly teach you that the only reason you're able to get calm this time is because of those details. Just like emilyd22222 said, the only way you'll get through this is is to teach yourself that anxiety can't actually hurt you, and you can handle it and do what you want (take the trip) despite feeling it. Also, once you're able to sit there and tolerate the anxiety, you'll probably find it eventually declines (it's difficult for the body to stay hyperaroused for too long).

None of this is meant to diminish how profoundly difficult it is to tolerate anxiety. Find a good therapist to cheer you on!
posted by synchronia at 1:11 AM on October 6, 2010

Fear of being in an aluminum tube, 5 miles up, travelling at 500 MPH is probably not entirely irrational.

I know it doesn't help much, but repetitive exposure seemed to help my wife a lot. When you don't have a choice, it starts looking better. Also, anti-anxiety meds. (She no longer uses them, but they were useful.)

You may actually die on a commercial airplane. Last year, in the USA, if I am not mistaken, no one did, at least not from a crash. On the other hand, 45000 of your fellow citizens bit the dust in their cars. Math can be your friend here. Fear the things that are actually dangerous, and worry about the trip home from the airport, not the flight to get there. Consider your fear to be a manifestation of your innumeracy and try to hide your shameful lack of math skills!
posted by FauxScot at 4:12 AM on October 6, 2010 [1 favorite]

There are some relevant links here at http://airtravel.about.com/od/educationandinformation/tp/Fear-of-Flying---Aviophobia.--Iv.htm
posted by 3mendo at 4:33 AM on October 6, 2010

One answer people sometimes give to these questions is "Take flying lessons" - it gives you "exposure" to what you fear and knowledge about why your fears are mostly unfounded. So you could consider that - but in the same spirit I would recommend Patrick Smith's "Ask the Pilot" blog for Salon.
posted by rongorongo at 4:47 AM on October 6, 2010

There's a similar thread here that might have more good advice. In that thread I recommended meditation, which to this day feels so goofy and woo woo to recommend, but breathing exercises really can make a difference in heading off a panic attack. For me, at least. Good luck.
posted by lillygog at 5:04 AM on October 6, 2010

Seconding rongorongo's recommendation of Patrick Smith's blog. I have found it incredibly comforting before I had to bite the bullet and make a flight.

I'd also recommend a book called "The Fearless Flier's Handbook". I hadn't flown in over twenty years and had a very long flight to Australia to fret and worry about. This book probably helped me more than anything else.
posted by BrianJ at 6:44 AM on October 6, 2010

Best answer: Yes, there are definitely previous conversations here on this site, with contributions from your fellow members who are also insanely phobic about flying (hello!).

One thing some of us agree on (none of us agree on everything!) is that drugs are helpful but are also masking. They can help to acclimate (and, to be honest, I think I have to fly next month and I think I'm going to take a pill! Oh yes!) but drugs aren't treatment. Treatment starts with interrupting panic, learning about how planes work (what those sounds are!), learning about turbulence (it doesn't matter!) and otherwise changing how we think and feel about airplanes from the bottom up. There are resources for this. The good news is: treatment can be effective. And flying phobias are very common--why wouldn't they be? You're out of control of the situation and up in the air.

One thing I've worked on is recasting flying in my mind as a great private time to get things done. I try to look at flying as a great modern luxury. Just think, for centuries one had to take A HORSE at best!
posted by RJ Reynolds at 9:33 AM on October 6, 2010

(Also the number one thing these treatments will encourage you to do is: arrive early and meet the pilot! It works wonders.)
posted by RJ Reynolds at 9:34 AM on October 6, 2010

I am a person who has flown so many times - especially over the last twelve years - that my carbon footprint weighs a ton, and then some. And yet I used to be really anxious about flying. I suppose, at some level, I still am, but familiarity has bred... if not contempt, then perhaps philosophical resignation. My gut still lurches when the turbulence hits but I can get past it fairly easily now. Because it's happened to me so many damned times. As someone else has mentioned: like most things, the more you do it, the easier it gets. Not much help until you reach that stage, of course...

So I'm thinking back to the days when I wasn't able to be so blase about flying. And I'm going to suggest something that honestly did help me but which would probably be disapproved of by (I use the term advisedly) sober people. I used to have a few drinks before boarding. Not enough to get drunk, just enough to take the edge off the anxiety. Even better, I'd try to be tired when I arrived at the airport. Make sure I hadn't had enough sleep. That, coupled with the drinks, used to make me sluggish and sleepy enough not to care so damned much about my anxiety. It wasn't a perfect system but it definitely helped me a bit.

Finally, do try to rationalise. Phobias are, of course, irrational things, yet it is still, sometimes, possible to recognise that, absorb it, accept it... and even so gain a measure of reassurance by rationally going over just how unlikely it is that your flight will involve anything more unpleasant than tedium, stiffness and perhaps a degree of unpleasantness with ear-popping. Oh, and that goddamned screeching baby in the seat in front and the jerk behind you who keeps banging your seat. I have found comfort in thinking about just how very, very mundane and ordinary flying is, in this day and age. This works better if you've had a few drinks, too. :-)

Good luck!
posted by Decani at 1:45 PM on October 6, 2010

Response by poster: I definitely agree that drugs alone might help in the moment, but that I need to address my anxieties and learn how to talk myself down.

A couple of points- thinking about how few airline crashes there are, et cetera, isn't really applicable as my fear is not about an airline disaster. Also, drinking isn't really on the table for me personally (but more power to you if it works for you).

I'm going to look around in my area for someone who can hopefully work with me in exposure/response therapy. I never really looked into it much (more of a CBT girl myself) because I associated it with specific phobias. I suppose it really is becoming a phobia, though, so I'll see what I can do.

Thanks to all.
posted by rachaelfaith at 3:10 PM on October 6, 2010

Best answer: I too suffer from a debilitating fear of flying, and have tried many things to overcome it: from "Fear of Flying" workshops (x2), hypnotherapy, alcohol to Valium. None of it actually really worked for me and, like you, I felt the fear fighting through the Valium, which was exhausting during and after flights, and in the end just not worth it.

Also like you, I have developed some kind of irrational fear of medication which doesn't help... However, while I was searching through metafilter a while ago, I came across somebody suggesting Beta-Blocker.

My GP told me I could take up to 6 a day, but with my paranoia about prescriptive drugs I took half a tablet before arriving at the airport and the other half before boarding: it was enough to take the edge of! It basically stops your heart from racing, so while you might still have all those annoying thoughts about being out of control or dying in a plane crash, your body doesn't mirror those feelings and you stay calm. Quite an amazing drug in my view, however, trains are still my preferred method of transport...
posted by jp021272 at 4:25 PM on October 6, 2010

I never really looked into it much (more of a CBT girl myself) because I associated it with specific phobias.

It's a good thing you're a CBT girl, because ERP is actually a type of CBT! :) Most CBT-trained therapists will be able to do ERP with you.
Even if you don't feel like it's phobia-level now, it's interfering with your life and causing you distress, which means it's something worthy of your attention. Might as well nip it in the bud now before it gets worse!
I wish you the best of luck.
posted by emilyd22222 at 7:26 PM on October 6, 2010

I, too, have a fear of flying -- one time I was having a panic attack so severe I made them let me off the flight after the doors had shut.

I am generally anti-medication, but did take Ativan when I flew (yes!) to Italy. It worked like a charm (I made it there and back). It also helped that my (now) ex was very sympathetic, understood my anxiety and held my hand most of the way.

About a year ago I moved out of state from both work and family, during the winter the drive is too hairy and, frankly, the flight is only 1.5 hours. I forced myself to learn what works best for me on flights and do that most every time I fly -- slightly OCD, I guess, but I don't know another way to manage my flight anxiety.

Here's what I do:
- take Hyland's Calms Forte, it's a homeopathic stress reliever, you can find it at your local natural foods store.
- Sodoku, I grab my pencil, head down and focus on those puzzles
- sit in the aisle close to the back of the plane, don't know why, but it eases my mind a bit
- listen to This American Life on my iPod, also engages my mind and makes me laugh
- Majority of the time I let the flight attendant know that I am scared of flying or mention it to the person I'm sitting next to (have to gauge that one carefully...I've met some really nice people by doing that and ended up talking with that person the whole flight, which worked to calm the anxiety too.).
- tell yourself that everything is fine, self-talk -- if the flight attendants aren't freaking out, then you're fine
posted by gertrude at 11:03 AM on October 8, 2010

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