Outlooks & Setbacks Saturdays

“I'm not afraid of flying. Once you get on a plane, you hand your life over to the pilots and hope they know what the hell they're doing. If you reach your destination in one piece, you get your life back, and on you go - Russian Roulette with wings.” ― Stewart Stafford

What is aerophobia?

Aerophobia is an extreme fear of flying in an airplane. People with aerophobia may be scared about different aspects of flying, such as take-off, landing or getting locked in the plane. You might know that your fear is irrational — statistics show that air travel has the lowest death rates among other forms of transportation — but you can’t reason your way out of the anxiety. Another name for this condition is aviophobia.

Most people with aerophobia aren’t actually afraid of the plane crashing. Instead, you might fear the overwhelming anxiety that comes with being on the plane. The anticipation of flying, or thinking about flying, is often as troubling as being on the flight itself.

What is a phobia?

A phobia is severe worry or panic about certain activities, objects or situations. A specific phobic disorder is a type of anxiety disorder.

How common is aerophobia?

Fear of flying is common. Research suggests it affects about 25 million adults in the U.S.

SYMPTOMS AND CAUSES

Who is at risk for aerophobia?

Aerophobia is most common in people between the ages of 17 and 34. This is a time in life when significant changes occur, such as graduation, marriage or childbirth. People may be scared that flying jeopardizes their life at such an important time. It’s possible for someone to fly without anxiety for years, and then develop aerophobia.

What causes aerophobia?

Aerophobia usually doesn’t have a specific cause. It’s very rare for aerophobia to stem from a traumatic experience on a flight. Specific triggers might include:

• News stories about terrorism, crashes or violence on airplanes.
• Take-off and landing.
• Thoughts about fire or illness spreading through the plane.
• Turbulence (bumps during the flight).

Other phobias can also make aerophobia worse:

• Acrophobia (fear of heights).
• Agoraphobia (fear of leaving the house or not being able to escape from a place or get help if something goes wrong).
• Anthropophobia (fear of people).
• Claustrophobia (fear of crowded, confined spaces).
• Mysophobia (germaphobia, or fear of germs).

What are the symptoms of aerophobia?

If you have aerophobia, you might avoid flying at all costs. This could mean missing family vacations or refusing to travel for work. You might insist on other modes of transportation, such as cars, buses or trains — even if they’re less convenient than flying. If you have aerophobia, you might also avoid movies, books or news stories that relate to air travel. Or you may become obsessed with learning about security measures at airports and on planes.

It’s also possible for people with aerophobia to have panic attacks before or during a flight. Symptoms may include:

• Chills.
• Dizziness and lightheadedness.
• Excessive sweating (hyperhidrosis).
• Heart palpitations.
• Nausea.
• Shortness of breath (dyspnea).
• Trembling or shaking.
• Upset stomach or indigestion (dyspepsia).

DIAGNOSIS AND TESTS

How is aerophobia diagnosed?

There isn’t a specific diagnostic test for aerophobia. Your healthcare provider will carefully review your symptoms and ask you a variety of questions about your fear of flying. Aerophobia can range from mild (you’ll fly if you have to, but it makes you anxious) to severe (you’ve refused to fly for more than five years).

Your healthcare provider may diagnose you with a specific phobic disorder, such as aerophobia, if you:

• Develop symptoms at the thought of the fearful object or situation, such as airplanes or air travel.
• Experience your fear for six months or longer.
• Go out of your way to avoid the object or situation you fear.
• Have difficulty functioning at home, work or in social situations due to your fear.

MANAGEMENT AND TREATMENT

How is aerophobia managed or treated?

Many people can work on overcoming their fear of flying with psychotherapy. Your healthcare provider may recommend:

• Cognitive behavioral therapy (CBT): CBT focuses on helping you change the way you think about flying. It might include learning about how planes work, or reviewing safety statistics for air travel versus other forms of travel. Your therapist can also teach you techniques to manage certain triggers. For example, deep breathing or meditation during take-off, landing or turbulence can reduce your symptoms of anxiety. You can also learn to “talk back” to negative thoughts about flying when they arise.
• Exposure therapy: This type of therapy gradually exposes you to places, thoughts or situations that relate to air travel. You may visit an airport and watch planes arrive and depart. Virtual reality tools, such as computer simulations of flights, can also help you overcome your fear of flying.

Psychotherapy may be one-on-one with a therapist or in a group setting. Some cities in the U.S. have group therapy programs at airports that include a “graduation flight” at the end of the treatment program.

Medication isn’t very effective for the long-term management of aerophobia or other specific phobic disorders. But if you have to fly and worry about having a panic attack, your healthcare provider may recommend anti-anxiety drugs on an as-needed basis.

PREVENTION

Is there a way to prevent aerophobia?

There isn’t a way to prevent aerophobia. But you can reduce its effects on your life by:

• Avoiding things that can make anxiety worse, such as caffeine, drugs or alcohol.
• Sharing your fears and anxieties with a support system of family members, friends or peers.
• Talking to your healthcare provider about your concerns.

OUTLOOK / PROGNOSIS

What’s the prognosis (outlook) for people with aerophobia?

Most people with aerophobia respond well to treatment such as psychotherapy. One study suggests that some people’s symptoms improved for two to three years after CBT. It’s possible for aerophobia to return after treatment, so some people may need ongoing therapy.

LIVING WITH

When should I call the doctor?

Contact your healthcare provider if you experience:

• Difficulty functioning in your daily life due to fear of flying.
• Symptoms of a panic attack.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Can medication help me get through a flight without panicking?
• Do I need psychotherapy and for how long?
• How can I find support for aerophobia?
• Will I ever get over my fear of flying?

A note from Cleveland Clinic

Aerophobia is an extreme fear of flying. People with aerophobia might feel intense anxiety before or during a flight. This condition can interfere with your ability to travel for work or pleasure. If aerophobia is affecting your quality of life, talk to your healthcare provider. With psychotherapy, most people can conquer their fear of flying.

Fears & Phobias

Do you experience a fear of flying? What aspect of flying do you fear the most?