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Panic Attacks on Planes

Air travel has become an increasingly available, affordable, standard, and convenient way to reach destinations worldwide in the last two decades. With this development, those prone to high anxiety in situations involving heights, enclosed and crowded spaces, or maybe even general social situations would find air travel particularly challenging and triggering. 

Signs of an anxiety/panic attack on a plane

A major factor in taking preventative measures toward an anxiety attack is being aware of what one would feel like from its initial onset. While there may be variations between each person, the general signs according to the Diagnostic and Statistical Manual of Mental Disorders include four (or more) of the following:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying
  • Paresthesias (numbness or tingling sensation)
  • Chills or hot flushes.

Triggers to prepare for

An aircraft could serve as the perfect cocktail of several triggers for a number of different phobias. Gaining self-awareness of your psychological and physiological responses to certain triggers would help in better preparing for your upcoming journey. 

Acrophobia is the fear of heights and can trigger an anxiety response when faced with situations involving heights. The best way to manage symptoms would be to 

  • use a distraction 
  • change your line of sight to something stationary in front of you (e.g. focusing on a movie)
  • use mindfulness relaxation.

Agoraphobia is an intense fear of an impending attack or situation in which the person has no escape while claustrophobia is a fear of enclosed spaces. Both can be triggered by being in crowded and enclosed spaces. Ways to manage symptoms include: 

  • developing relaxation techniques
  • cognitive reframing with professional help
  • lifestyle changes, such as cutting out or reducing coffee and alcohol intake, getting exercise, and improving sleep.

Mysophobia or ‘germophobia’ is an intense fear of germs, dirt, and/or contamination. Since the pandemic, we have noticed a drastic increase in anxiety relating to germs, viruses, bacteria, and contamination. Managing symptoms of mysophobia is an ongoing process that includes

  • professional help and exposure therapy 
  • lifestyle changes and seeking support
  • learning and developing relaxation techniques that suit you.

There are variations in the types of phobias, and you may not meet the criteria of a full-fledged phobia to feel the intensity of an anxiety attack related to flying. The main strategy common to managing all symptoms and triggers is to prepare ahead of time. The first step in understanding how to prepare is knowing what to prepare for. 

Flying with anxiety or panic attacks

The onset of an anxiety/panic attack can be due to numerous reasons that you may or/not be able to predict. It is important to be self-aware of your physiological responses to situations around flying and more so, your mindset before and during the experience.

Try exposure therapy 

As you anticipate an upcoming flight, engaging in exposure therapy with professional help, or self-learning may help you better prepare for your journey. Exposure therapy consists of skills designed to gradually desensitize your fears and anxieties toward a trigger, which would be in this case, being in an airplane. 

Ask your doctor about medication

Consulting a doctor or psychiatrist could help assess your need for medications that would mitigate the intensity of anxiety symptoms. Medication may also make it easier to engage in other de-escalation techniques. 

Mindfulness breathing techniques

You could practice mindfulness breathing techniques before and during your journey. Specific techniques include color breathing, progressive muscle relaxation, and visualization of a safe place.

Color breathing is a relaxation grounding technique in which you visualize a ‘color balloon’ in your abdomen expanding throughout your body as you breathe. It helps in being aware and controlling physiological sensations, while being able to bring yourself to the here and now. 

Progressive muscle relaxation is a great technique to gain awareness of and actively relax your body. This skill progressively targets muscle group,s tensing and relaxing parts of your body from head to toe, while maintaining rhythmic breathing. 

These skills are effective in stress management and grounding oneself during an episode of high anxiety. 


Several days before your journey, you could engage in visualizing what the experience would be like. Visualization helps in the anticipation and preparation of what to expect. A study conducted in 2003 found that visualization through virtual reality as a treatment for aviophobia was effective even three years post-treatment.   

What happens if you freak out on a plane

There is no appropriate or convenient time for the onset of an anxiety attack, and you can only do so much preparation prior to its onset. If you feel your anxiety levels escalating, it is important to listen to what your body is telling you. 

Have a calming playlist

The saying “music is an escape,” bears quite some truth in that focusing your emotions on music could help channel your thoughts into that less anxiety-provoking. It offers a distraction and could be a supplement to visualizing a safe place to help calm your nerves. 

Practice mindfulness relaxation

The same skills you would use before your journey can be helpful during it. And since you have already had practice, it would be that much easier! If you prefer guided relaxation/meditation, apps such as Headspace and Calm could provide you with a guided experience. 

Distract yourself

Watching a movie, paying attention to conversations around you, reading, listening to music, or playing a game could serve as good distractions from your anxious thoughts. A key factor in this is figuring out which task captivates your attention most effectively. 

Like anything else, practice and repeated exposure makes any situation increasingly bearable. As you continue to fly more, your expectations improve in accuracy, hopefully lowering your anxiety and enabling you to find ways to improve your experience.    


Written by
Shenella Karunaratne, Staff Writer

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