Flying without benzos

December 23, 2016 9:16 AM

The last few times I've traveled by air, I've had to take benzos to stave off panic attacks. I'm flying tomorrow and don't want to take them this time. Give me your tips for drug-free and panic-free flying. More details under the fold.

I'm not actually afraid of the flying (although I've been a bit of a nervous flyer since being on a plane that had to make an emergency landing about 15 years ago). What I'm afraid of is having a panic attack, with the worst possible imagined outcome being an embarrassing fit of vomiting. The anxiety cycle starts with some random observation -- my stomach flips, or my legs feel a little shaky -- after which I say to myself "Is this a panic attack?" And as soon as those words are in my brain the symptoms ramp up and I have to fight to keep it from becoming a full blown attack.

Benzos help, but they make me groggy. I've had an incredibly stressful few years, and every flight I've taken in those few years has been to see family and immerse myself further in that stress. They have also all been 3+ hour flights.

The majorly stressful situations I've been dealing with have mostly wrapped up in the past few months [knock wood], so my latent anxiety load is much reduced. And, my flight tomorrow is just under 90 minutes. Short flight! I don't want to take the drugs.

I think I can do it. I want to do it. Tell me how to do it.

posted by mudpuppie to Health & Fitness (32 answers total)

Response by poster: PS: I know about SOAR, but their package costs almost as much as my plane ticket, so.
posted by mudpuppie at 9:17 AM on December 23, 2016

Best answer: Does distraction help you avoid panic attacks? Music/books/tv programs/audiobooks/whatever. IF so, choose the one you're most likely to fall into and forget about the world with.
posted by Hactar at 9:22 AM on December 23, 2016 [1 favorite]

My secret is I get there an hour early and have two drinks at the bar. Airport bars are the best.

Then, when you're on the plane, do the crossword puzzle in the in-flight magazine.
posted by bondcliff at 9:28 AM on December 23, 2016 [1 favorite]

Two drinks at the bar, distractions on the plane, and when I get turbulence, I close my eyes, sit up straight, put my hands on my knees, breathe in through my nose, out through my mouth, and visualize that I'm on a bus, which are frequently just as rough but somehow not nearly so anxiety-inducing. That and remember that my in-law who's a pilot told me the last plane to be downed due to turbulence was sometime in the 80s.
posted by turntraitor at 9:32 AM on December 23, 2016 [2 favorites]

Response by poster: Forgot to mention: Drinks at the bar would be a no-brainer if it weren't a 9:30 a.m. flight. :(
posted by mudpuppie at 9:33 AM on December 23, 2016

This hasn't been an issue for me, but I have a couple of friends who were anxious about flying, and it helped them to learn about the entire process. Why does turbulence happen? How do airplane wings produce lift? What are all of the different noises you hear between getting on the plane and getting off? What do the flaps on the wings do? Etc.

I also wouldn't allow a 9:30a flight to stop me from drinking a bloody mary or two. Also, the little bottles you can get at camping stores can allow you to bring your own booze on the plane if you want to mix up, say, an early morning screwdriver or greyhound.
posted by craven_morhead at 9:35 AM on December 23, 2016 [5 favorites]

You would NOT be the only person at the bar for a 9:30 flight. Cocktails at breakfast is a thing.
posted by hwyengr at 9:36 AM on December 23, 2016 [33 favorites]

It's too late now, but if you happen to live in a state where marijuana is decriminalized for medical or recreational use, a couple of edible gummies taken an hour before takeoff really help (says my wife).
posted by infinitewindow at 9:38 AM on December 23, 2016 [5 favorites]

Couple thoughts:
1. I go the sugar-rush route vs. alcohol: about 30 minutes before a flight I eat whatever sugary thing I can get my hands on. By the time the plane is taking off I'm crashing from the sugar high and fall asleep.
2. Full immersion - watch a movie with headphones. Action movies are the best.
3. I remind myself that I'm just cargo on these flights, and cargo doesn't worry so why should I?
4. Honestly the thing that finally made me completely worry-free on flights was getting life insurance. Everyone's taken care of in case of anything.
5. Statistics - flying is the safest way to travel.

And I really don't worry too much about flying. I'm an aero engineer, I did crash investigations for the military, I've been on planes that have been on fire, I've been in helicopters that shouldn't have been in service - you name it. I still fly without question.
posted by Farce_First at 9:44 AM on December 23, 2016 [4 favorites]

Best answer: Remember, just because you have a benzo with you doesn't mean you have to use it. Reconceptualize. Since what you are most afraid of is the attack itself, you can remind yourself that you have the pill and can take it if you need to--you are not trapped and helpless. A surprising number of people find just the availability of the pill to be itself calming.
posted by praemunire at 9:55 AM on December 23, 2016 [29 favorites]

Best answer: Is there music that you love, but are maybe a little embarrassed to love, that you can play really loudly via headphones and lose yourself in? For example, I've overdosed on listening to Hamilton in my day to day life regularly, but on airplanes I will unabashedly put the cast recording on really loud, pull my hoodie up so nobody can seem my face, and passionately lip sync along. Airplane trips are also when I get most of my Harry Potter and Anne of Green Gables rereads done, because they're low stress books that I've read a million times so I can just sort of glaze in and out of concentrating on them. The Little House books are also good for this. I also try to have a variety of phone games so that my brain has something to focus on if the music alone isn't enough of a distraction. Alcazar and cribbage have been working very well for me on this front.
posted by ChuraChura at 9:57 AM on December 23, 2016 [4 favorites]

Something that has made a huge difference for me is taking 1 Sudafed (the real kind) and 2 Advil about an hour before boarding, and a GasX or Rolaids or whatever I can get my hands on when I get in my seat. A lot of what often reads to me as anxiety - and sometimes actual nausea/vertigo, and anxiety about getting nausea/vertigo - is related to pressure building up in my face/ears, and I get wicked gas pain/bubbles in my gut and esophagus (probably just as part of the general Eustachian-circuit issues) and I'm just physically uncomfortable, with symptoms that I also often get during a panic attack.

I also try to remember to take a Sudafed the night before, just to front-load a little.

I have found I'm also better off if I don't move my eyes/head a lot, so I load up on podcasts and audiobooks so I can fix my eyes on a point directly in front of me, or close them, and not jiggle around too much. So no sudoku for me on the plane.

And if you don't have to drive at your destination, a little bloody mary or mimosa (or be seasonal and have a poinsettia instead) and some carbs - croissant or bagel or something - is good padding, pre-flight. You're at an airport, it's totally normal there.
posted by Lyn Never at 9:58 AM on December 23, 2016 [4 favorites]

I also have anxiety about flying that is actually about having a panic attack and/or getting motion sick (even though I don't get motion sick on planes!). What works for me is one or two non-drowsy Dramamine, which comfort my mind into knowing that I won't vomit, and also usually put me to sleep without drugging me so much that I am super groggy upon landing. I take the pills an hour before take off, make sure I am one of the last people on the plane (no sense in sitting there longer than I have to), put headphones on with loud music as soon as I sit down, and usually nod off before take off.
posted by raspberrE at 10:01 AM on December 23, 2016 [1 favorite]

I have the same problems with flying that you do. When I get to the airport I get a large cup of ice from one of the shops in the airport. Rubbing ice cubes on my neck and face help a lot.

I always take a ginger capsule before the flight. You can sometimes find them at pharmacies, but I usually have to get them at CVS. They're the BEST thing for motion sickness/anti-vomiting that I have found. I also keep some ginger candies in my pocket and munch on them if I feel queasy.

I also use a breathing app on my phone that helps me regulate my breath.
posted by ilovewinter at 10:07 AM on December 23, 2016 [1 favorite]

I had a similar event that led to a short period of the same. What I've ended up doing instead is ritualizing the process of reading the emergency card and actually paying attention during the safety announcements. Then I can settle in with my earplugs and book. For a while I kept the same book, and that was my comfort read.

(It was Hunter S Thompson. I have weird comfort reads.)
posted by cobaltnine at 10:08 AM on December 23, 2016 [2 favorites]

I will often grab a Bloody Mary or two before a flight. Because why not? You're traveling!
posted by Geckwoistmeinauto at 10:12 AM on December 23, 2016 [1 favorite]

Best answer: You get through this like you get through any other anxiety-inducing thing. Remind yourself that all you need to do is sit there and breathe. Pay attention to your breathing.

Also, imagine your worst-case scenario all the way through to the end. OK so you vomit. Well they have the bags right there in the seat back. So you throw up into it, the flight attendant takes the bag, and you're done. You'll never have to see your seatmates again.

Along the lines of Farce-First, I remind myself that the flight attendants do this constantly. For them it's work. If they can do it over and over, I can do it once.

Are you in the air for 90 minutes, or is it 90 minutes gate-to-gate? I like to see how long I'll be in the air.

Good luck!!
posted by lyssabee at 10:33 AM on December 23, 2016 [3 favorites]

Best answer: I've done this. I had to go from Ativan to nothing when I was on a short flight with a rental car at the other end. What worked for me was, essentially, pretending I was on it. Reminding myself of how I felt when I was on meds. That the flight wasn't any different, just the chemicals in my body. I tried to call up the chill feeling from the meds, coupled with breathing exercises. It worked very well, over a few flights, and now I rarely take the Ativan unless I actually want to sleep. Basically it was re-wiring my brain to remember the benzo feeling rather than the anxiety feeling on the plane. Best of luck and lots of sympathy on this.
posted by gingerbeer at 10:43 AM on December 23, 2016 [6 favorites]

Best answer: Oh I recognise so much of this! I too have a fear of having a panic attack during a flight - the fear developed after i did have a panic attack during a turbulent red-eye over the Atlantic. Ever since that flight I've had trouble flying, but I am back to transatlantic flights and so far have been benzo free. Here's what has helped me:

A surprising number of people find just the availability of the pill to be itself calming.
This is the case for me. I have Valium tablets that i have never taken, but that I carry with me as a talisman to ward off any trapped-with-no-options feelings. I think just knowing that you can take one could be really effective.

I also have a routine for the plane. As soon as I get on the plane, I put in some seriously powerful earplugs (i'm too cheap to buy noise-cancelling earphones but those would be great too), then put a blackout face mask on, then headphones on top. I realised that the loud noises and harsh lights were really freaking out my heightened nervous system so I try to go as sensory deprived as possible. Then on my headphones I play guided meditations or just simple apps that prompt you to breathe in and out (if you don't know about belly breathing, it's amazing for calming you down). It's totally do-able to just follow the meditation for your 90-minute flight (or longer) - that's what I did for about a year's worth of flights, then i got down to just doing the meditation on take off and before cruising.
posted by ukdanae at 11:07 AM on December 23, 2016 [3 favorites]

Others have great suggestions for non-med ways to deal with tomorrow's flight, but I wanted to say, more generally, that what has helped me most with my anxiety about flying is regularly taking benzos before I feel like I really need them.

My anxiety is specifically about the flying part, not the panic attack part, but I've gone from not being able to sleep well for the three weeks before the flight because of agonizing anxiety to being able to get on the plane without a worry, take a benzo, relax and read, and get off the plane feeling fine. It's changed my life - maybe not in a daily way, but I look forward to traveling now instead of being terrified of it.

I take Xanax, and I've gotten to the point where I can take half a pill instead of a whole one. But I keep a bottle with me when I fly in case I need more, and if the flight is turbulent or I feel like I need more, I take more. Granted, I'm generally flying with my husband, who can drive if I get too groggy, but it's not usually a problem for me.

I think over time I could wean myself off them entirely, but a few years of taking them regularly has made such a massive difference to me. Obviously, this may not help for your flight tomorrow, but you might think through whether it's worth just taking some as part of your flying routine for awhile until you can train your brain out of associating flying with panicking. I can't say strongly enough how much this has helped me. Flying now isn't associated for me with white knuckles and hyperventilating, it's associated with a nice calm feeling and a good book to read.

I particularly like Xanax for this because it is so short-acting - generally by the time we land, it's pretty much worn off anyway. If you're taking a longer-acting benzo like Klonopin or Ativan, you might check with your doctor about switching to Xanax. Precisely the characteristics that make it less suitable for managing daily, pervasive anxiety - its quick action and short half-life - make it perfect for dealing with extreme anxiety in a short-term situation, like a flight. My doctor told me that I shouldn't while taking it (or presumably other benzos), which is fine with me as I don't drink much anyway.

Good luck!
posted by bananacabana at 11:36 AM on December 23, 2016

1. I use headphones/music (in my case, classical) as well.
2. I have a mantra: Yellow raft on blue water. I close my eyes for take off and imagine that instead of being on a plane (which I find scary), that I'm on a raft (I once went white-water rafting, which was scary fun instead of scary-not fun but featured many of the same sensations).
3. I coordinate my breathing with silently saying my mantra.

Other things that helped me:
A. As noted above, learning enough about flying that I realised there were actual wind currents, etc. and reasons why flying was both possible and safe.
B. Self-talk: Hi, fear. I know you're afraid right now but remember all the other safe things that feel like this: especially jumpy subway rides, amusement park rides, etc. I know these sensations are making afraid but we are actually safe. Stand down, dude. We are fine.
C. I have a friend who used to have a private pilot's license. After he explained how flying works, he then told me nothing would ever happen to me on a flight and I would always be safe. Because the plane was on one end of a rubber band and he held the other end. So even if the plane dropped, the rubber band would snap it back into his control and I'd be fine.

Oddly, the rubber band safety measure was so goofy and funny to me that I have literally laughed out loud after my flight has had a bump and dive. Because a second after the adrenaline starts to kick in, the rubber-band image just automatically pops up in my head and I start laughing to myself. If there's a goofy yet endearing and reassuring image you can come up with (a giant hand just below the plane, a giant trampoline, whatever), consider using that as a humorous counterpoint to your mis-calibrated nervous system.

I've got a history of panic attacks as well. I'm so sorry you are struggling with this issue. Best of luck with your flight and hang in there. Hugs!
posted by Bella Donna at 11:48 AM on December 23, 2016 [3 favorites]

So you are on the plane, you take off and your stomach flips. Is this a PANIC ATTACK!?!! Nah, it's not- it's the weird sensations of flying. Cool, huh? (With your question I realise that as an anxious person I have been experiencing anxiety symptoms while flying- and written them off as a normal thing! I love the rush and sensations of takeoff.)
posted by freethefeet at 1:13 PM on December 23, 2016

Possibly you already know this but SOAR also has a book that you can get on Amazon for less than $15. I have it but haven't read it yet because my own stupidhead fear of flying is so longstanding that I'm having a hard time imagining booking a flight. For you, though, it sounds like you have a more manageable fear and maybe this would help?

As to the meta-fear, I'd just echo some of the above advice. I have found the 4-7-8 breath helpful for panic attacks in the past. It doesn't make you totally fine with everything in the universe like a benzo can do, but it can pull you out of the worst of panic.
posted by Smearcase at 2:54 PM on December 23, 2016

Response by poster: Thanks all.

You would NOT be the only person at the bar for a 9:30 flight. Cocktails at breakfast is a thing.

To clarify, I don't want to go the Bloody Mary route not because of any moral reason, but because a) I want to be able to take the Valium if I need to, b) my destination is Las Vegas and I don't want to be groggy when I get there, c) I want to be able to have that Bloody Mary after I arrive, but I can't if I take the benzo. It's like three catch 22s wrapped up in a big ball of potential anxiety.
posted by mudpuppie at 5:26 PM on December 23, 2016 [2 favorites]

I sometimes get mildly anxious about flying (not to panic attack levels, YMV). What I have done in the past (which I understand might not be what anyone else should do) is looked at the crash statistics for that particular kind of plane. If they're pretty good, I tell myself I'm on a safe aircraft. If they seem to be crashier than I'd like to see, I tell myself that X # of crashes have already happened, so the odds are on my side. (Not perfect logic, but that's what I use.) Flying is safer than driving, good to remember that.

I've also been much less anxious when I've had to get up at some ungodly hour. (Have found it hard to maintain a high level of anxiety when very tired.)
posted by cotton dress sock at 7:42 PM on December 23, 2016

I also try to have a variety of phone games so that my brain has something to focus on if the music alone isn't enough of a distraction. Alcazar and cribbage have been working very well for me on this front.

Likewise. I've been playing 'kingturn plus' on flights. Only on flights, really. It's a mindless little turnbased battle game.
posted by sebastienbailard at 11:07 PM on December 23, 2016

Beta blockers are often a good solution for situational panic like this, although to get them you will need to get a prescription first. By lowering the blood pressure they undercut the somatic, physiological aspects of panic. Which, in turn, helps you out psychologically without zonking you...I take one or two whenever I know I'm headed into an anxiety-producing situation, but need/want to be on point. (Public speaking, I'm looking at you.)
posted by Bob Regular at 3:12 AM on December 24, 2016 [2 favorites]

Have you tried valerian root?
posted by floweredfish at 5:32 AM on December 24, 2016 [1 favorite]

Take the drugs with you and if you need them, take one.

Listen, I get you but if you haven't practiced mindfulness or learned CBT strategies, this isn't the right time to try to fly without carrying the benzos.

I'm not saying you have to take them! But I am saying, like so many upthread, that having them is often talisman enough to not need to take them.

You can and should learn how to deal with bodily sensations that feel like rising panic attacks and you can do that with even a few sessions of CBT. Super easy.

But also, I'm one of those people that feels like if your life is mostly in balance but you're a better traveler on benzos, then just take the damned benzos, relax and do your crossword puzzle.
posted by yes I said yes I will Yes at 5:32 AM on December 24, 2016

One small thing - do whatever you need to, to make sure you get an aisle seat. Knowing you can get out whenever you need to, to get to the toilet (or the open space at the back with the flight attendants), always chills me out a bit when flying. Near the back of the plane is even better as you're close to those facilities, and not visible to the rest of the plane.
posted by penguin pie at 5:51 AM on December 24, 2016 [3 favorites]

Along the lines of readiness=calmness, get a sick bag from the attendant when you board. They don't have them in seat backs anymore and it is VERY stressful to not have it handy when you need it. So just grab one to know you won't have that emergency no matter what.
posted by fingersandtoes at 9:14 AM on December 24, 2016

Not sure if this will apply to you, but the thing that I found that triggered panic attacks for me while flying was, believe it or not, caffeine. I loooove coffee and tea and would always treat myself to some before a flight, but once the engines roared up to full power I would FLIP OUT and begin an hours-long balancing act between panic attack and anxiety attack. Xanax did little but make me feel like I was still panicking but from under eight feet of water.

Now, if I'm flying, I drink no caffeine or vitamin B-enhanced drinks at all that day. I even avoid too much chocolate, and now, with some of the other coping mechanisms mentioned above, I can almost enjoy flying. Almost. Makes catching those early-morning flights tougher in some ways, but having been through several flights now where I did not panic has helped break that mental habit.
posted by inky_the_pinky at 5:11 PM on December 24, 2016