Fear of Flying

Many people report a recurring fear of flying. This is known as Pteromerhanophobia. 
If you were afraid of flying once or twice it is not a phobia. The fear is normal when experienced in life threatening situations where the danger is real i.e. sever weather conditions, strong turbulence, the plane is on fire,there is a bomb at the airport etc.

1. Signs of Pteromerhanophobia

a) Experiencing recurrent fear/ emotional distress while:

- thinking about flying

- on the way to the airport

- waiting for boarding

- boarding

- getting on the plane

- taking off

- during the flight

- landing

b) Recurring Thoughts

"What if the plane crashes?"

"What if I have a panic attack?"

"What will other people think if something happens to me?"

"I don't have control over the plane"

"How do pilots take care of turbulence, what if they lose control? "

"I am going to have a heart attack"

"What if I die?"

"I may die"

c) Recurring Physical symptoms:

- muscle tensions (particularly around shoulders and neck area)

- back pain

- chest pain and/or tightness

- stomach pain

- hot or cold flashes

- sweating

- buzzing sensation in the arms, hands, fingers, legs, feet, toes

- low level of energy / hyperactivity / too much adrenaline

- dizziness, feel like passing out or fainting

- heart palpitations, racing heart

- trembling or shaking

- difficulty breathing, shortness of breath

- difficulty swallowing

 2. Avoid

 a) - watching plane crash documentaries 

     - action movies including hijacking, terrorist attack on the plane etc

     - talking about plane crashes

Feeding your imagination with negative, scary images is a bad idea. Would you advise your friend to watch horror movies to overcome fear? I can assure you that it won't help you. It is not true that the more you watch the more control you gain. It is like being on a diet. Think about it. Is it possible that by looking at cookies and fast food you will gain control over your diet? Will you stop eating? Or maybe it will get worse?

Instead think about facts:

According to http://www.eurocontrol.int on average, about 26,000 flights are handled daily over Europe. In 2010, there were just under 9.5 million flights in the European area. In Europe, there were 95 million flights  over the last ten years about. 

Statistics show that driving to the airport has a greater risk of you being involved in an accident than your next flight to any of your destinations.

b)  avoid alcohol and drinks containing caffeine before and during the flight as they lead to dehydration and tiredness

3. Prevention is better than intervention

a) Attention

When it comes to fear and panic attacks it could come down to the way you pay attention to the negative information related to flying.

The more attention you give to your fearful thoughts and scary memories of the stories you've heard the worse you feel. The thoughts can often be so absorbing that you not always notice what they really are. Once you realize that you are thinking about flying check what physical symptoms come with it. Don't fight with your negative thoughts. Gently explain to yourself that it is ok, that you don't need to worry as it won't make things better.You can't control the flight, but what you can control  are your thoughts! You need to calm yourself down by taking deep, long breaths. Gently shift your attention to the activity that you find calming like breathing, listening to relaxing music (I recommend the sounds of nature), reading a light book or a magazine, watching a comedy or talking to a friend. The fearful thoughts may go back and this is normal so remember to gently shift your attention and calm yourself down. 

To reduce possible discomfort drink water or try sucking sweets when taking off and landing.  

This will help equalize the pressure in your sinuses and prevent ear and sinus pain.

b) Checklist

• ipod or mobile phone with relaxing music
• laptop / notebook/ ipad
• favourite game
• good book / ebook/ favourite magazine
• bottle of water
• sweets or chewing gum
• talk to a person next to you
• practise breathing exercises

4. Therapy

One of the available options is a short term therapy called CBT - Cognitive Behavioural Therapy. The therapist will provide psychoeducation and will teach you how to manage and control negative  thoughts and emotions. You will gain new useful skills. I recommend to disuss with a therapist the possible root of the problem, as nothing happens without a reason. The cause of the problem may be straight-forward i.e. previous experience of severe turbulences or it may be rooted in i.e. childhood experience. The better you understand the issue the better you will be able to cope with it.

* I will post more about the different types of therapies soon.

5. Medication

If you choose not to manage the issue by attending therapy and if after applying the above your fear remains extremely uncomfortable and distressing you may need to ask your doctor for a prescription for Xanax or Ativan. The pills will help you relax and reduce anxiety. Remember medication won't sort out the problem it will only reduce the symptoms! Next time you will have to go through the whole process of preparation and thinking about the flight again. Until the next pill is taken the fear and distress won't stop.

6. Difference between a Fear of flying/ Panic Attack and a Heart Attack

The symptoms of a Panic Attack/ fear and a Heart Attack may seem similar.

Fear of flying / Panic Attack - psychological causes

Heart Attack - physical causes

Heart Attack

A blockage of blood supply in the heart's arteries can cause a blood clot to form and totally stop blood flow in a coronary artery, resulting in a heart attack. 

According to http://www.healthcentral.com these are warning signals of a heart attack:

• Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes.
• Pain spreading to the shoulders, neck or arms. The pain may be mild to intense. It may feel like pressure, tightness, burning, or heavy weight. It may be located in the chest, upper abdomen, neck, jaw, or inside the arms or shoulders
• Chest discomfort with light-headedness, fainting, sweating, nausea or shortness of breath
• Anxiety, nervousness and/or cold, sweaty skin
• Paleness or pallor
• Increased or irregular heart rate
• Feeling of impending doom

7.  Carry a document in the event of an emergency

Outline any allergies or special medical conditions that you experience.

8. What if I need a medical help while on the plane?

EU:

If you can't cope with the problem, report it to the air hostess immediately. You will be asked about the issue and you may be given an oxygen mask and water. If your symptoms remain unchanged the air hostess can announce to the passengers that the doctor is needed. If there is a doctor on board he or she will take care of you. If the doctor isn't present try to remain calm. It is important that you breathe slowly and regularly to calm down your body and mind. Ask the air hostess to call the airport to ask for a medical team to meet you at the airport. The medical team will get on the plane to conduct a basic examination. If your condition is not stable they will ask if you would like to be taken to the ambulance. It is important that you get a full check up to make sure that you are physically healthy.