Fear of Flying

Yesterday’s tragic accident has no doubt magnified the fear of flying for many people (and let me add prayers of sympathy for those directly affected, as well as kudos to the brave pilot, Tammie Jo Shults, and flight attendants who helped save the rest of the passengers.) Despite the fact that this type of accident has not happened before, and is very unlikely to happen again, hearing and reading the horrific details add fuel to any anxiety surrounding flying. If you suffer from this fear, know that you are not alone- and that your family physician can offer you a few different medications that may reduce your stress. Many patients have told me they were afraid to ask for any medication, because they did not realize these drugs could be used situationally for a single event such as a flight. Of course our wonderful colleagues in psychiatry can also offer Cognitive Behavioral Therapy (CBT)- talk therapy that has excellent success for social phobias such as aviophobia, but if you have an upcoming flight next week, the medications might be more accessible before this trip.

Medication options include:

  • Beta-blockers- this class of medication simply keeps your heart from racing, and lowers your blood pressure. When the physical symptoms of anxiety are reduced, the brain feels calmer too. (We also prescribe this drug for public speaking.)
  • Sedatives- although when used frequently these medications are definitely addictive, taking a short-acting sedative for a flight is a very reasonable option. Alprazolam (trade name xanax) is commonly prescribed in small doses (and very small quantities). Note that these pills should never be combined with alcohol.
  • Sleep aids-these are longer acting sedatives indicated for treatment of insomnia; physicians consider prescribing these for flights longer than 6 hours, such as fully across the country or overseas.

Behavioral modifications are also key to help the time “fly” by; consider:

  • Noise-cancelling headphones make a world of difference, especially if you can use them to engross yourself in a visual media as well, such as your favorite television series or movie.
  • Music by itself, particularly a very familiar whole album or musical.
  • Crazily addictive games on your phone or iPad.
  • Puzzles or word searches.

Avoid stimulants like caffeine and decongestants- no need to ramp up your heart rate before you even get on the plane!

If you have the luxury of time before you travel, consider CBT with a trained clinician, biofeedback, hypnosis, or meditation training.

BOTTOM LINE: Fear of flying is common- plan ahead and talk to your doctor if you would like to consider a medication to lesson your stress.

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