When it comes to phobias, aviophobia, or "fear of flying" counts among the most widely-held. The tight cabin quarters, unpredictable turbulence, and fluctuating temperatures can all contribute to an unpleasant environment, and if you're already prone to anxiety, these factors will only exacerbate the problem.
Luckily, plenty of options exist to help ease your flight-related fears and get you from Point A to Point B with your serenity intact. INSIDER asked nine medical professionals and flight specialists for their favorite flight medications and relaxation techniques, and here's what we learned.
Whether you choose to use an over-the-counter medication or a prescription pill to smooth out your flight anxiety, it's important to try the drug at home before relying on it while you're in the air. According to co-founder Dr. Polly Meyers of Break Free from Anxiety, "people with genetic anxiety (which is most of us) are generally very sensitive. [Because of] this genetic variation, we can overreact or have a bad response to medications."
Also, a University of Cincinnati report indicated that high altitude can affect the potency of certain medications, citing an increase in red blood cells and a reduction in plasma proteins as the culprit.
For these reasons, you'll want to establish a strong baseline with your anti-anxiety medication before trying them out in flight. Obtaining your OTC or prescription medication a couple of weeks before your flight and beginning your regimen in advance will acclimate your body to the drugs and make their in-flight effects less unpredictable.
If you're in the market for a prescription anti-anxiety medication to take on your travels, a version that works quickly and can sustain your level mood for the duration of a cross-country or international trip will likely be your best bet. Los Angeles-based psychiatrist and travel blogger Dr. Brian Cassmassi of The Ambitious Trekker particularly recommends two popular prescription meds for this purpose: Xanax and Ativan.
"Physicians can prescribe medications as needed for flight anxiety. The most common class includes benzodiazepines like Xanax and Ativan, which are relatively fast-acting to relieve anxiety and stay in the body for several hours, which is the duration for most cross-country flights. Some people may feel a bit groggy after the flight with these medications. They can become addictive with frequent use, so caution is advised, and they should not be mixed with alcohol, as the effects are additive and can lead to over-sedation or decreased breathing," Cassmassi told INSIDER.
Overnight flights can prove particularly stressful for the anxiety-prone, due to the potential for sleep disruption. In these circumstances, the use of melatonin, a natural supplement that can be purchased over-the-counter, may prove useful.
"I recommend melatonin as a natural supplement to my patients with flight-related anxiety. Melatonin induces sleep and adjusts your circadian clock to help you function better when you reach your destination. I suggest taking melatonin a few days before your trip so that you're ready to sleep thirty minutes to an hour earlier than normal. It will decrease jet lag if taken close to your target bedtime at your destination, and there are no major side effects to worry about. Plus, your flight will be over before you know it!" advised Dr. Khalid Saeed of Tampa Bay Concierge Doctor.
While comprehensive research still needs to happen to fully establish magnesium supplements as a beneficial palliative for anxiety, early research supports the usefulness of this over-the-counter mineral.
Dr. Chirag Shah of PollMed cited a 2017 article by Nutrients to back his support for magnesium's anti-anxiety properties, claiming that "magnesium supplementation has shown some early promise as a potential way to reduce anxiety in susceptible people. While more thorough research needs to be done, one review of multiple studies suggest that magnesium can have a beneficial effect on flight-related anxiety symptoms."
Dramamine, an over-the-counter medication typically used to fight motion sickness, can perform double-duty as an anxiety reliever for air travel.
Aerospace expert Kathleen Bangs, a former commercial pilot who now teaches flight classes and covers air travel for multiple publications, explains that "many people think the OTC drug Dramamine is only taken to combat nausea, but it's actually quite effective at inducing drowsiness and reducing anxiety in nervous flyers. I recommend it to passengers as an alternative to that pre-takeoff or in-flight martini. Besides, alcohol dehydrates the body on a cellular level, and the last thing anyone needs while traveling in the ultra-dry air of an airline cabin is more dehydration."
Of course, not everyone who deals with flight-related anxiety feels comfortable using medications or supplements to ease their discomfort. In many cases, meditative visualization can prove highly effective in calming your psyche and keeping your in-flight thoughts from veering toward the negative side.
Travis McNulty, a licensed mental health counselor practicing in St. Petersburg, Florida, recommends the following visualization regimen for anxious flyers:
"The night before your flight, visualize how the day will go before your flight. Be as detailed as possible in your imagining; picture how you'll get there, think of what you'll see on the way to the airport, imagine what you'll hear at your terminal, will you get a bite to eat before? It's important to get as detailed as possible. During this imagination breathing through your nose for a 3-count and exhaling at a 5-count will put your nervous system at a state of relaxation.
It's important to add the breathing with the visualization because while you're not actually experiencing the exact experience the day of your journey, you're conditioning your brain to think that it's already done this. It's important to go from beginning to the end of the flight as well. I segment the breathing and imagery for my clients in three separate parts:
According to McNulty, guiding your imagination through these steps will allow you to perform some valuable brain trickery, resulting in a more serene travel experience.
"The more you repeat this series of guided visualizations which is essentially imagining the day of your flight in as much detail as possible, the brain will think it's already happened while you were in a relaxed state. I've seen clients go from a self-reported 10/10 anxious the night before, to a 2/10 the day of the flight. The more repetition you can imagine the three separate segments in as much detail as possible (some clients do this to the point of exhaustion), the more prepared your mind will be for the day of the flight. It will be a perceived walk in the park because you've visualized it so many times in a relaxed state that our mind won't focus on the alternatives," McNulty told INSIDER.
A cup of coffee before a flight, especially if you're traveling in the early morning, often seems like a good way to stay energized and alert for your travels. But if anxiety is a concern, stimulants like caffeine can work against you, and your flight will likely proceed more smoothly if you avoid them altogether.
"[I believe that] the best mitigation practice against in-flight panic attacks is to avoid stimulants (i.e. coffee, Red Bull, etc.) prior to any flight. Stimulants can make a flyer jittery and cause their anxiety levels to increase while in-flight," advised Dr. Robert Quigley of MedAire.
Because plane cabins and seats aren't known for their spacious conditions, physical discomfort frequently occurs during flights, which adds to already-existing anxiety issues. However, a vigorous workout prior to takeoff can counteract the negative effects of cramped quarters, putting both your mind and body at ease.
"Exercise pre-flight! I go for a long easy swim or run the day before or the morning of the flight. It gets your blood flowing and keeps you from feeling cooped up on a long haul," recommended Dr. Byron Pitts of ParaDoc Worldwide.
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