Panic attacks in an airliner? Try a smaller airplane, with a friend as your pilot.
- By Jeremy Davis
- Air & Space magazine, January 2013
The Latin agora means “open public spaces,” but it’s actually a fear of panic attacks that drives agoraphobics from public life. The sudden spikes of adrenaline and random spells of unprovoked terror are typically treated with therapy and benzodiazepines like Xanax, but I made my greatest strides in recovery with the help of a private pilot.
My first episode came soon after being hired as a structural engineer on the space shuttle program. Columbia had gone down a year earlier, and Discovery was in the early stages of making its comeback. I had just wrapped up a whirlwind tour of suppliers in California and was watching the Arizona desert unfold beneath the wing of a Delta Airlines 767 when the rush of a sudden drop went through my body. I gripped the seat, and as the airplane swung from freefall to recovery to sharp climb and slow, rolling bank, I closed my eyes to keep from getting sick.
The engines changed pitch from a high whine to a low hum and back again. I imagined the pilots up front, fighting off alarms and unresponsive controls, calling the controllers in the Phoenix tower for clearance to land. All the while I could not stop the thought: This had happened before. The same airplane, the same passengers, the same empty desert below. This had happened before and somehow I knew how it would end.
When I opened my eyes, the cabin was not filled with the chaos I had expected. People were reading newspapers, typing on laptops…the man next to me was snoring softly.
Back in Florida, a doctor explained panic attacks. They're not harmful, he told me, just uncomfortable. You cannot die from a panic attack, even if the speeding pulse and tunnel vision last for more than a few minutes. Panic attacks don’t spawn more serious mental disorders. Often the most immediate cure for an attack, he said, is to step out of the situation you’re in and allow the anxiety to dissipate.
The next week, another business trip brought me back to Orlando International. This time, the smell of Jet A and the hum of idling engines triggered aftershocks of panic, little rumblings of anxiety that threatened greater tremors if I followed the other passengers down the jetway and into the cabin. The gate agent made the announcement for final boarding call, adding that they were still waiting for one more passenger. I ran through the doctor’s assurances in my head, weighing the psychological pain of boarding with the occupational risks of failing to take a business trip. The gate agent raised her microphone again and called my name. She stared out at me, the only passenger sitting within 50 feet of her gate, and notified the rest of the terminal that this would be my last chance to board Flight 2515 to Huntsville, Alabama.
I stood, gathered my bags, and walked away. Minutes later, I watched my airplane push back from the gate. As it taxied out to the runway, my panic subsided, and I was left with the realization that after half a lifetime of window seats, frequent flier miles, and red-eye flights, I was now afraid of flying.
Over the next few months, the process repeated in various places to varying degrees. A small panic attack at a grocery store would spawn a temporary preference for fast food, while a larger one at a movie theater would turn me into a renter of videos. Regardless of what was added to my growing unable-to-do list, I missed flying the most.
According to Elke Zuercher-White, a psychologist who specializes in cognitive behavioral treatment of anxiety orders, “Agoraphobia essentially involves the fear of internal sensations in external situations. Both components need to be treated. Panic attacks are treated by doing little exercises that bring on the feared sensations. When a person is willing to do exposures [to what they fear] in spite of anxiety, one begins mastering one’s anxiety. We should learn to let anxiety work for us, in real-life danger, rather than against us, in everyday, low-threat situations.”
If driving on the interstate is the problem, you start by simply sitting in a car in your driveway. Then you drive around the block. You gradually work your way to streets, two-lane highways, and interstates so that each step brings you closer to the fear without being hit with it all at once. With flying, it’s not as simple. As Zuercher-White says, “Flying is an all-or-none exposure.” You can’t taxi out onto the runway, then ring for the flight attendant to let you out at the next intersection.
So I tried other methods. I would buy a ticket to whatever city was cheapest that weekend, and as I got closer to the boarding area, I would try to push past the surge of adrenaline and catastrophic thoughts. When that repeatedly failed, I got more creative.