Fear of flying, if it is serious, is one kind of anxiety disorder called "specific phobia," one of the most common psychiatric disorders in the United States. Although many may be tempted to seek prescription medication, or self-medicate, fear of flying is one disorder that is best treated without medication.
Fear of Flying
According to the National Institute of Mental Health, "[a] specific phobia is an intense, irrational fear of something that poses little or no actual danger" In the case of fear of flying, potentially there are a number of fears involved including: enclosed or crowded spaces, heights and lack of control. Symptoms are 1) somatic (bodily), (e.g., muscle tension, difficulty breathing; heart palpitations; sweating; stomach upset); and 2) psychological (e.g., memory problems, decision-making trouble). Most commonly, these later symptoms take the form of rumination (thinking over and over again); self-blame; and catastrophizing (thinking about awful consequences). If you avoid flying to the detriment of your work or other vacation planning, for example, you may have a specific disorder, not just simple stress.
Little evidence on the effects of medication on specific phobias in general, or flying phobia specifically. The general consensus, however, is that phobias, including fear of flying, do not respond well to medication. Other treatments are effective.
A 1998 study by researchers from Baylor College and Houston VA Medical Center reported two cases of patients who, after taking fluoxetine (prozac) for depression, also reported losing their fear of flying. A year earlier, researchers at Stanford University found that patients who took the benzodiazepine alprazolam, prior to flight, experienced less self-reported anxiety symptoms than a group taking placebos. On a repeat flight one week later, however, with no medication, the group that took alprazolam reported higher rates of panic attacks than the placebo group. These studies were also small-scale and would require much more research to confirm findings. So the effects of medication are limited at best and, at worst, benzodiazepine, could actually increase fear of flying.
Fortunately, a number of treatments that do not include medication appear effective for fear of flying. Systematic desensitization, a means for confronting ones fear through visualization, can reduce patients self-report of anxiety in flight, with up to 60% of those treated reporting continued flying 3.5 years later. A similar treatment method that involves actually confronting the feared object, in vivo exposure, showed similar effectiveness; but a comparison with virtual reality exposure, (using computer simulation), may be equally effective and, of course, less expensive. Forms of cognitive behavioral therapy, where patients learn to replace negative thoughts with positive ones, may help with symptoms, but does not clearly help with avoidance of flying.
Rhere is little research on fear of flying. A number of considerations, including cost and need to fly, make this phobia difficult to study.
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