Overcoming Aerophobia, the Fear of Flying

Aerophobia is a type of specific phobia that involves a fear of flying or air travel. While statistics suggest that air travel is actually safer than traveling by other means including car and train, flying remains a common source of fear.

Research suggests that between 2.5% and 40% of people experience flying-related anxiety each year. Estimates on the low end likely represent instances where the condition is diagnosed by a mental health professional, while those on the higher end are likely the result of self-rated symptoms of flying anxiety.

So while many people are afraid of flying to some degree, only a much smaller proportion actually meet the criteria for a phobia diagnosis. Whether or not your fear of flying has developed into a phobia, it can have serious effects on your quality of life.

Symptoms

People who have aerophobia experience persistent and intense anxiety when they think about flying or when they travel by air. The symptoms of aerophobia, also known as aviophobia, are similar to those of other specific phobias. Physical symptoms of the fear of flying may include:

• Chills
• Choking sensations
• Clouded thinking
• Disorientation
• Flushed skin
• Gastrointestinal upset
• Increased heart rate
• Irritability
• Nausea
• Shaking
• Shortness of breath
• Sweating

In some instances, people may even experience a full-blown panic attack. A panic attack is an episode of intense fear that can be accompanied by symptoms such as heart palpitations, feeling detached from reality, and a fear of dying.

Some people with a fear of flying are reasonably comfortable at the airport, but begin to experience symptoms just before boarding the plane. Others have difficulties that begin as soon as they reach the airport.

Related Conditions

The fear of flying may be caused or worsened if you have certain other phobias and anxiety disorders. Some of these include:

• Claustrophobia: People with claustrophobia often experience a fear of flying due to the confined quarters and lack of personal space.
• Fear of heights: A general fear of heights (acrophobia) can also lead to a fear of flying.
• Social or germ phobia: Those with social anxiety disorder or a fear of germs often develop a fear of flying because they will be forced to spend long periods of time with strangers.

In many cases, addressing these underlying fears can help relieve symptoms of aerophobia. The treatments for these related fears are often the same as the treatments for other types of phobias.

Some physical disorders can contribute to a fear of flying, including:

• Sinus or middle-ear blockage, which can cause pain or dizziness during flight.
• Having a cold, chronic sinus problems, or conditions such as vertigo or ear disorders can cause a very real fear of developing physical discomfort.
• Cardiovascular disease or other conditions that increase your risk of blood clots, which can prompt concerns about developing deep vein thrombosis during a flight.

Causes

The exact causes of a fear of flying are not known, but a number of different factors may play a role. One review found that the fear varies greatly from one individual to the next and is influenced by a complex array of physiological, psychological, and social factors that are unique to each person.

Some of these factors may include:

• Experiencing a traumatic flight or plane crash: Even watching extensive news coverage of airline disasters can be enough to trigger a fear of flying. For example, many people experienced at least a minimal fear of flying in the wake of the September 11 attacks.
• Environment: If your parents also had a fear of flying, you may have internalized their trepidation. This is a particularly common cause of aerophobia in children but affects many adults as well. You might pick up the fear of flying from another relative or friend, but parents seem to have the biggest influence on phobias.
• Other related circumstances: Your aerophobia might also be rooted in an entirely different conflict. For example, a fear of flying that develops soon after a job promotion that requires travel could be caused by concerns about the job itself or its impact on your daily life. Likewise, children who must fly frequently to visit divorced parents sometimes develop aerophobia as a coping mechanism for the trauma of the divorce.

Research also suggests that triggers such as bad weather, take-off, and turbulence tend to be the most anxiety-inducing aspects of flying. Travel delays, common when flying at popular times, may make the fear of flying worse.

Treatment

Fortunately, the fear of flying is a treatable condition, even without knowing the underlying cause. Some common treatments include:

Psychotherapy

Cognitive behavioral therapy (CBT) is usually the first-line treatment for phobias including the fear of flying. CBT is an approach that focuses on changing the negative thoughts that contribute to fearful behaviors. Many specific treatments for phobias are based on CBT, but other treatment options are sometimes used as well. Some of the most frequently used approaches include:

• Exposure: Experts agree that the best way to overcome the fear of flying is controlled exposure, whether that's through virtual reality, a flight simulation, or actually flying.
• Systematic desensitization: This involves gradually progressive exposure to a fear object or situation, which is often used to treat phobias such as the fear of flying.
• Individual therapy: Individual CBT, hypnotherapy, and virtual reality techniques can also improve your fear of flying. One study found that an internet-based exposure program was effective in the treatment of flying phobia.

Group Classes

If you do not have other physical or psychological disorders, you may be a good candidate for a fear of flying course. These classes typically last two or three days, often over a weekend, and are sometimes offered by airlines.

During classes, you may meet pilots, talk about airline safety, and even get a chance to board a real plane. Sometimes just becoming more familiar with the process and environment can help you feel more comfortable.

Medication

Medications may sometimes be prescribed to help alleviate certain symptoms associated with the fear of flying, such as nausea or anxiety. For example, your doctor might recommend that you take a medication designed to reduce motion sickness before your flight. They might also prescribe an anti-anxiety medication such as Xanax (alprazolam) or Valium (diazepam). 

Living With a Fear of Flying

In addition to getting treatment for your phobia, there are also things that you can do on your own to help cope with the fear of flying:

• Educate yourself about the flying process. Learning about how airplanes work, why turbulence happens, and what various sounds and bumps mean can help make flying less frightening.
• Identify irrational thoughts. Negative and catastrophic thinking can contribute to your fear of flying. Learn how to recognize these negative thoughts when they happen, then practice replacing them with more realistic and helpful ones.
• Learn to recognize triggers. When you think about flying or when you experience anxiety during a flight, pay attention to the thoughts or situations that preceded your fear. If you begin to notice that certain aspects of flying tend to trigger feelings of anxiety, you'll be able to better plan for how to deal with those situations when they arise.
• Practice relaxation techniques. It can be helpful to build a "relaxation toolkit," or repertoire of relaxation strategies that you can use when you begin to experience feelings of fear. Employ techniques such as deep breathing, visualization, and progressive muscle relaxation with the things that trigger your anxiety. Over time, these techniques may help lessen your fear of flying.

If you are experiencing a fear of flying that is negatively affecting your life, it's best to make an appointment with a qualified mental health professional. They can diagnose the phobia, determine whether you have any concurrent disorders, and develop an individualized treatment plan.

The fear of flying can have a major impact on your quality of life. With proper treatment, however, you can learn to manage and even overcome this common phobia.