Flight anxiety
How to fight flight stress and anxiety: what works, what does not
Flight anxiety responds to specific things, and reassurance is not one of them. What works, according to the treatment research: understanding what the aircraft is doing, slow breathing you have practised, graded exposure to the parts you fear, and cognitive behavioural therapy for the fear that stops you flying. What does not work: alcohol, avoidance, and white-knuckling it. If your fear is really a fear of being sick on board, that part has its own plan, and it starts before the airport.
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Key facts
- Reviews of fear of flying treatment find cognitive behavioural and exposure-based approaches consistently more effective than reassurance.
- Knowing what turbulence is and what the sounds mean removes much of the fear of the unknown.
- Slow breathing at fewer than ten breaths a minute is linked to higher heart rate variability and lower reported anxiety.
- Alcohol worsens both anxiety and nausea and is the most common mistake nervous flyers make.
- Many nervous flyers are afraid of being sick, not of flying. That fear has a motion sickness plan.
First, name the fear
Fear of flying is several fears wearing one coat. Fear of crashing. Fear of heights. Fear of being trapped with no exit. Fear of panicking in public. Fear of being sick. Each one responds to a different plan, and a review of the research on fear of flying found that people often have more than one at once. Spend five minutes writing down what exactly you picture going wrong. If the picture is you with a bag in seat 23C, you are on the right site, and the pre-flight plan is yours.
What works
Knowledge. Learn what the sounds are: the thump of the gear, the whine of the flaps, the engine note dropping after take-off as the pilots reduce power. Learn that turbulence is a comfort problem, not a safety one, and check the forecast so the bumps are expected. Fear feeds on the unknown.
Slow breathing. In through the nose for about four, out through pursed lips for about six, for a few minutes at a time. A systematic review links slow breathing to higher heart rate variability and reports of relaxation and lower anxiety. Practise it at home so it is there when you need it. Our breathing page has a pacer.
Graded exposure. Short flights before long ones. Sitting in a parked car at the airport watching aircraft take off. Airline and clinic fear-of-flying courses are built on this, and the treatment reviews find exposure-based approaches consistently effective.
Cognitive behavioural therapy. For a fear that stops you flying, CBT is the best-supported treatment. It teaches you to catch the thought, test it against what is actually happening, and stay in the situation until the alarm fades. Ask your doctor for a referral or look for a therapist who treats phobias.
A plan for the nausea. If being sick is part of the fear, lower the odds of it: window seat over the wing, light meal, vent open, screen away, and a sound session 10 to 30 minutes before boarding if you use Dizzout. A fear that has a plan is a smaller fear.
What does not work
Alcohol: it makes anxiety worse once it wears off, usually mid-flight, and it upsets the inner ear. Avoidance: every flight you cancel confirms the fear. Reassurance alone: being told it is safe does not reach the part of the brain that is frightened, which is why the treatment research finds it so weak. Gripping the armrest and waiting: the body cannot tell the difference between bracing and danger.
Take the nausea off the list of fears
Stop Motion Sickness Now
Dizzout is drug-free sound therapy through any headphones, for the motion sickness side. Run Prepare Me in the 10 to 30 minutes before boarding, and Motion Sickness Relief from your seat if the bumps get to you, with relief in about 90 seconds. Free to download.
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Questions people ask
How do I calm flight anxiety?
Before the flight: learn what the sounds and bumps are, practise slow breathing, check the turbulence forecast, and skip alcohol. On board: breathe out slowly for longer than you breathe in, look at the wing, tell the crew you are nervous. For a fear that stops you flying, cognitive behavioural therapy and graded exposure have the best evidence.
Is fear of flying treatable?
Yes. Reviews of the treatment research find cognitive behavioural therapy and exposure-based approaches, including structured courses, consistently more effective than reassurance. Many people improve enough to fly comfortably. A doctor can refer you, or you can find a therapist who treats phobias.
Why do I feel sick when I'm anxious about flying?
Anxiety slows the stomach and increases acid, which is nausea with no motion at all, and it primes the body so that real motion lands harder. If the sickness is the thing you fear, lower the odds of it: window seat over the wing, light meal, vent open, slow breathing, and a sound session before boarding if you use Dizzout.
Related
Sources
None of these studies tested Dizzout. They are the general research on anxiety, expectation and breathing.
- Oakes and Bor, 2010: the psychology of fear of flying, part I: nature, prevalence and etiology (Travel Medicine and Infectious Disease)
- Oakes and Bor, 2010: the psychology of fear of flying, part II: approaches to treatment (Travel Medicine and Infectious Disease)
- Zaccaro et al., 2018: a systematic review of the psychophysiological correlates of slow breathing (Frontiers in Human Neuroscience)
This content is for general information only and is not medical advice. Dizzout is a wellness app for motion sickness and is not intended to diagnose, treat, cure or prevent any condition, including anxiety. Speak to a doctor if symptoms are severe or persistent, and to a doctor or therapist if fear is stopping you from travelling.