Fear is a natural psychological and physical response to danger. The body releases stress hormones and activates fight-or-flight mechanisms. These reactions are vital for survival when real danger is present. However, problems arise when fear is disproportionate or triggered by non-threatening situations, as is often the case with flying phobia therapy counselling.
For individuals suffering from a fear of flying, even the thought of boarding an airplane can provoke intense anxiety. In some cases, fear of flying treatment medication may be recommended alongside therapy to reduce symptoms.
This condition can be extremely distressing, especially for those required to fly for professional reasons. Specialized travel anxiety treatment in India and structured therapy for fear of flying in India offer safe and effective solutions to help individuals manage their phobia.
Fear of flying, also known as aviophobia, is classified as a specific phobia—a term used when someone experiences intense fear related to particular objects or situations, in this case, flying.
People with aviophobia, experience such severe anxiety that they cannot tolerate flying at all or only endure it with extreme distress. Even thinking about an upcoming flight causes them nervousness and sweating. Often, flying phobia is accompanied by other fears or other psychiatric disorders such as depression.
Traetment of Flying Phobia at CHMC
Symptoms of Flying Phobia
When confronted with flying, people with this condition develop anxiety which becomes very intense, it may even lead to panic attacks.
Flying phobia is associated with physical symptoms such as a racing heart, muscle tension, and rapid breathing, which can lead to excessive carbon dioxide loss. This may cause dizziness and a sensation of suffocation.
Negative thoughts trigger the vicious cycle of fear. Even before the flight, sufferers imagine everything that could go wrong. Many fear they might die from a heart attack.
People with a flying phobia tend to avoid air travel. However, job requirements often involve frequent business trips. For such individuals, a flying phobia can be especially disruptive.
Causes of Flying Phobia
Several underlying factors can contribute to a flying phobia. The causes are as unique as the individuals who experience them.
Often, the fear of flying originates in early life. If children observe that their parents are afraid of flying, they may develop this fear themselves—even without explicit verbal cues. Children are highly sensitive to their parents’ tension and nervousness and may adopt these responses, sometimes without ever having flown.
Fear can also be conditioned through traumatic events. For example, a terrifying emergency landing may trigger panic and cause the individual to associate all aspects of air travel—such as specific smells or sounds—with fear.
Biological factors play a role as well. Our genes influence not only our physical traits but also our vulnerability to anxiety disorders. Genetic predispositions, when activated by environmental triggers, can make some individuals more prone to developing phobias. Family and twin studies suggest that the tendency toward phobias is partly hereditary.
Diagnosis of Flying Phobia
Fear of flying is not always considered an illness. It only becomes “pathological” under certain conditions. The diagnosis of flight phobia is typically made using the ICD-10 (International Classification of Diseases). In this classification system, fear of flying is listed under “specific phobias.”
For a diagnosis of flight phobia, the following criteria must be met:
- The symptoms are solely attributable to fear and have no other psychiatric cause.
- Flying is avoided as much as possible.
- The fear is specifically limited to flying.
- Additionally, the person experiences significant emotional distress.
Differentiating between common fear of flying and a pathological flying phobia can be challenging. It is also possible that an underlying anxiety disorder, such as panic disorder, may be present behind the fear of flying.
The Most Common Reasons for Fear of Flying
People can develop a fear of flying for various reasons. Some of the most common include:
Loss of control
Flying can be frightening for some because they feel they have no control over the aircraft.
Fear of heights
Some individuals are afraid of great heights and feel uncomfortable being high up in the air on a plane.
Fear of crashing
Others worry that the plane might crash or that a serious problem could occur during the flight.
Negative past experiences: People who have previously had unpleasant experiences with flying—such as turbulence or long delays—may develop a fear of flying.
Some people feel anxious about the cramped environment of an airplane or being in social situations, such as flying alongside strangers.
It’s important to understand that fear of flying is a very common form of anxiety, and there are many strategies and techniques available to manage and overcome it. If the fear significantly interferes with someone’s daily life, seeking professional help can be beneficial.
Treatment of Flying Phobia with Psychotherapy
There are several methods available to help individuals overcome fear of flying. Psychotherapy as a stand alone method can be used in mild symptoms and low frequency of flights. However, a severe flying phobia should be treated with medication and in paralle with psychotherapy.
Cognitive Behavioral Therapy
CBT is particularly effective. Key components include exposure therapy, restructuring of negative thoughts, and relaxation techniques. Medications are used only rarely.
Exposure Therapy
helps individuals confront their fear instead of avoiding it. Avoidance reinforces fear by preventing the realization that flying is actually safe. Even if a person knows their fear is irrational, it won’t go away unless they face the situation.
Gradual exposure begins with imagined scenarios. The therapist first guides the client to picture a flight and become accustomed to it mentally. Eventually, the client progresses to real-life situations, such as visiting an airport or boarding a plane. This is known as in vivo exposure and may take weeks or months.
Restructuring Thoughts
is another vital component. Negative thoughts can both trigger and intensify anxiety. With the therapist’s help, the client learns to question irrational beliefs.
Treatment of Flying Phobia with Relaxation
can also be helpful. One option is deep abdominal breathing: placing a hand below the navel and inhaling slowly. After exhaling, a pause for 6–10 seconds is recomended to reduces over-breathing and helping the muscles relaxation.
Progressive Muscle Relaxation
involves tensing and then relaxing different muscle groups. This releases bodily tension and calms the mind. It’s simple, effective, and usable even while flying.
Autogenic Training
is another technique, especially for stress reduction and sleep problems. It can be learned with professional guidance or through audio instructions.
Hypnosis
Hypnotherapy and hypnosis can be applied to address past traumatic experiences and “reprogram” the unconscious mind. The treating psychiatrist can prescribe medication that addresses the intense mental anxiety and the physiological symptoms of panic attacks.
How to Avoid Fear Escalation During Flights?
Before the flight, the individual can familiarize themselves with accident statistics related to commercial aviation. Compared to other modes of transportation, flying is actually very safe.
By practicing physical relaxation techniques such as autogenic training, yoga, or Qi Gong, one can gain greater calmness and learn to experience situations without panic reactions.
If possible, the person should fly with someone they know and trust.
Talking to fellow passengers or the cabin crew about one’s fears can be liberating and helps reduce the anxiety of standing out due to fear-based reactions.
Distraction can also be helpful—using the in-flight entertainment system or reading an engaging book are good options.
Alcohol should be avoided, as it can intensify the sense of losing control and thus increase anxiety.
It is also advisable to book an aisle seat near the wings, where turbulence is typically felt less.
Treatment of Flying Phobia with Medications
When symptoms of severe aviophobia include a rapid heartbeat, nausea, or even panic attacks, medication is often the only effective option.
Before prescribing such medication for a flying phobia, doctors typically conduct a thorough consultation. During this conversation, they assess the causes, symptoms, and severity of the fear and discuss the appropriate course of treatment.
Long Term Treatment of Flying Phobia with Medication
For the long-term treatment of fear of flying, the same medications used for treating panic attacks are generally considered—primarily antidepressants. Drugs from the group of Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Norepinephrine Reuptake Inhibitors (SNRIs) are often prescribed.
SSRIs and SNRIs
These medications belong to the class of antidepressants. They can relieve anxiety symptoms and also help with depressive complaints, which many sufferers experience alongside their fear of flying.
It usually takes about 2 to 6 weeks for SSRIs or SNRIs to produce an anti-anxiety effect. However, they only help a portion of those who take them. Therefore, it may be necessary to try several different agents. Among the SSRIs, escitalopram and paroxetine have been well studied for treatment of anviety, such as flying phobia. Also SNRIs such as duloxetine and venlafaxine are effective in treatmef of fear of flying.
Once antidepressants begin to improve symptoms, it is recommended to continue taking them. If the medication is discontinued too early or the dose is reduced without medical supervision, symptoms of flying phobia may return. To avoid this, experts advise continuing the medication for 6 to 12 months, followed by a gradual tapering of the dose. In some cases, longer-term use may be appropriate.
Acute Treatment of Flying Phobia with Benzodiazepines
Benzodiazepines are sedatives that produce a rapid anti-anxiety effect. However, these medications are recommended only for the short-term, acute treatment of fear of flying.
The most commonly prescribed active ingredients include diazepam, lorazepam, and oxazepam, each with slightly different effects:
Lorazepam
Lorazepam has a strong calming and anxiolytic (anti-anxiety) effect. The tablets usually take effect after about 30 to 45 minutes and, depending on the dosage, can last up to 12 hours, which makes lorazepam particularly suitable for long-haul flights. Since Tavor works mainly to relieve anxiety, its effects are primarily psychological. Mild impairments—such as difficulty concentrating, confusion, or short-term memory lapses—are common side effects and can persist for up to 20 hours after taking the medication.
Diazepam
Diazepam helps relax muscles and is more sedating, often functioning like a sleeping aid. People taking diazepam before flying should be aware that it can cause drowsiness and sedation. The body breaks down diazepam more slowly, so izs effects last longer.
Oxazepam
Medications containing oxazepam are less commonly used but can represent a good middle ground for many people with fear of flying. Oxazepam is especially effective against anxiety but has a shorter duration of action than lorazepam and causes less drowsiness than diazepam. However, it’s important to note that oxazepam may take a bit longer to reach full effectiveness, which should be taken into account when planning for a flight.
Treatment of Flying Phobia. Summary
Flying phobia is a widespread condition that can significantly impact daily life. Fear of flying can begin at any point in life. In about half of all cases, the trigger for developing a flying phobia is a negative flying experience. Other contributing factors may include heightened stress levels, anxiety sensitivity, and physiological influences.
Flying phobia is often reinforced through avoidance. Because air travel is avoidable for many people, relatively few seek treatment. However, without therapy, a flying phobia can persist for a lifetime. For those who choose to seek help and follow through with treatment, aviophobia can be successfully managed.
Studies have demonstrated that cognitive behavioral therapy (CBT), combined with in vivo exposure, is the treatment of choice. Specialized treatment programs have been developed, including fear-of-flying seminars—often offered by airlines—as well as virtual reality exposure therapies. Research has shown both approaches to be highly effective.
In severe cases or when frequent flying is required, the fastest and most promising method is the use of medication, which “blocks” anxiety and enables individuals to fly. This approach can also serve as a gateway to further psychotherapeutic treatment.