For many, the thought of flying can trigger significant anxiety, ranging from mild nervousness to full-blown panic attacks. While the decision to use medication is highly personal and requires a doctor's consultation, there are a variety of pharmacological and non-pharmacological strategies available.
The Critical First Step: Talking to a Doctor
Before considering any medication, it is essential to consult a healthcare professional. A doctor can assess your health and symptoms to recommend safe and appropriate options, discussing risks, benefits, side effects, and drug interactions. Self-medicating is strongly discouraged.
Prescription Medication Options
Prescription drugs can offer relief for severe flight anxiety but require careful consideration.
Benzodiazepines (e.g., Xanax, Ativan, Valium)
Benzodiazepines are sedatives that reduce anxiety and fear by enhancing calming brain chemicals. While effective for acute anxiety, they carry risks of dependence, addiction, and side effects like drowsiness and impaired coordination, which can be dangerous during a flight. Combining them with alcohol is particularly risky.
Beta-Blockers (e.g., Propranolol)
Beta-blockers target the physical symptoms of anxiety like a racing heart, sweating, and tremors by blocking adrenaline. They don't cause the mental fogginess associated with benzodiazepines and can be a safer option for those primarily experiencing physical symptoms. However, they do not address the emotional aspects of anxiety.
Antihistamines (e.g., Hydroxyzine, Dimenhydrinate)
Some antihistamines have sedative effects that can help manage mild anxiety and motion sickness. They are generally considered safer than benzodiazepines, but their effectiveness for anxiety varies, and they can cause drowsiness.
Over-the-Counter and Natural Remedies
Several non-prescription options may help with milder anxiety, though results can differ between individuals. These include Melatonin for sleep on overnight flights, L-Theanine for calming effects without drowsiness, Magnesium which some studies suggest may help reduce anxiety, and herbal supplements like Chamomile and Valerian Root, though their efficacy is largely anecdotal.
Non-Pharmacological Strategies
Therapy and coping techniques can provide lasting relief for many nervous flyers.
Psychological Techniques
Cognitive Behavioral Therapy (CBT) helps challenge irrational fears, while exposure therapy gradually exposes individuals to their fear of flying to build tolerance.
Relaxation and Mindfulness
Techniques such as breathing exercises (like box breathing) can calm the nervous system. Distraction with movies or books can prevent anxious thoughts, and grounding techniques like the “5-4-3-2-1” method can help stay present.
Preparation and Environment
Learning about how airplanes work and understanding turbulence can reduce fear. Choosing a comfortable seat and informing the flight crew about your anxiety can also help.
Comparison Table: Medication and Treatment Options for Nervous Flyers
| Option | Mechanism | Primary Effect | Risks & Considerations | Suitability for Travel | Best For |
|---|---|---|---|---|---|
| Benzodiazepines | Enhances GABA activity, depressing central nervous system. | Strong sedation, reduced anxiety, sleepiness. | High potential for dependence, impaired coordination, legal issues abroad, potential for increased long-term anxiety. | Can be effective, but carry risks. Requires prescription and careful use. | Acute, severe panic attacks; short-term use only. |
| Beta-Blockers | Blocks adrenaline's physical effects (heart rate, sweating). | Reduces physical anxiety symptoms like palpitations and tremors. | Does not affect cognitive anxiety (fearful thoughts). Requires prescription. | Good for managing physical symptoms without cognitive impairment. | Anxiety with dominant physical symptoms. |
| OTC Sleep Aids (Dramamine/Melatonin) | Induces drowsiness. | Promotes relaxation and sleep. | Effectiveness is less certain, may cause grogginess. Varies in potency. | Can help with travel-related sleeplessness and mild anxiety. | Mild anxiety, difficulty sleeping on planes. |
| Psychological Techniques (CBT/Exposure) | Challenges irrational thoughts; gradually desensitizes fear. | Long-term coping skills, builds resilience, reduces overall anxiety. | Requires effort and time with a therapist. | Can be practiced before and during travel for lasting effects. | All levels of flight anxiety, particularly long-term solutions. |
Important Safety Considerations
Always test any medication, including OTC options, at home before flying. Never combine medication with alcohol due to dangerous interactions. Be aware of international laws regarding carrying medication. Inform your travel insurer about any medications you plan to take.
Conclusion
Choosing what to take if you're a nervous flyer should involve a discussion with a healthcare provider. While prescription medications like benzodiazepines and beta-blockers can offer relief, they have risks and may not be suitable for everyone. OTC and natural options may help with milder anxiety but are less predictable. Non-pharmacological strategies like therapy and relaxation techniques offer sustainable ways to manage the root cause of anxiety. A personalized approach combining these options can lead to a more comfortable flying experience.
Talkspace's guide on how to get on anxiety medication provides further insight on discussing treatment with a doctor.
