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I suffer from Agoraphobia, will Xanax be sufficient to get me through a plane flight?

Posted Jun 28 2010 9:10pm

I have ridden many planes before without any problems before suffering from Agoraphobic panic attacks, but now I have them (they use to be so intense I couldn’t leave the house, but now I am working… relatively close to home though.) Is Xanax powerful enough of a drug to keep my head on during a cross country flight?

Unless you understand what is going on, you have little chance to remedy it. It is important to know what does not work:

* Medication is not effective. It actually makes things worse. Research at Stanford University School of Medicine showed that test subjects taking anti-anxiety medication had ten times as many panic attacks when flying than subjects taking a placebo.
* Hypnotism is “hit or miss”. It can’t be relied on.
* Courses by pilots offer statistics on how safe flying. Great. But planes so sometimes crash. How does a person deal with the fear that your flight could be the statistic?
* Cognitive therapy works for people whose feelings develop slowly, but not for those whose feelings develop too rapidly – or too intensely – for the the mind to remain clear enough to use the cognitive “tools”. What is needed is an automatic way to control feelings.

We are born with half of the emotion regulation system in place, the half that revs us up. The half that calms us down does not exist at birth. By eighteen months a part of the brain develops that can let the child calm itself. The child memorizes the steps caregivers use to provide calming. If the steps are highly effective, the child can calm itself independently using the steps memorized.

Obviously, caregivers – regardless of how much they care – vary in their ability to tune in the child and assure the child effectively. As a result, few of us get an optimal ability to calm ourselves.

During teenage years, we tend to think bad things only happen to others. This youthful optimism gets us by for a few years without excessive anxiety. But as we mature, we realize something can happen to us. We then turn to strategies to keep anxiety when dealing with uncertainty under control. The strategies typically involve control and escape.

Control: when control of anxiety is not naturally available, we depend on control of situations to avoid anxiety. When driving a car, we believe we can make everything work out alright. Though driving is not as safe as flying, we feel safer because the wheel is in our own, not someone elses, hands.

Escape: if there is a car accident, there may be a chance of surviving. If a plane, people mistakenly believe that if something goes wrong they are doomed. In a plane, if something goes wrong, backup systems are used. Backup systems make flying safer than driving. But these systems are in the cockpit where they seem theoretical. Though backup systems provide greater safety in a plane than is available in a car, the systems are not as real to a passenger as a steering wheel is in the hands of a driver.

Since the backup systems are not concrete enough to make passengers feel safe, many try to escape psychologically by keeping their thoughts elsewhere throughout the flight. If, due to turbulence, the person cannot keep the flight out of mind, there is no way to keep feelings under control.

I need you to understand that the feelings you are troubled by are caused by stress hormones, mainly adrenalin and cortisol. They rev you up. When you get several “hits” of these stress hormones – caused by several thoughts, worries, concerns, etc. – you get claustrophobia, high anxiety or even panic.

We prevent the release of adrenalin and cortisol by causing the release of oxytocin. Oxytocin shuts down the amygdala, the part of the brain that triggers the release of the hormones that cause fear.

We cause the release of oxytocin by linking each thing that happens on a flight, and each thing you worry about, to the memory of a moment that causes oxytocin to be released. Once the links are established between an oxytocin-producing moment and troublesome moments of flight, high anxiety and panic are automatically controlled. This is an advanced way of controlling the feelings, and it was not possible to do this until research using brain scan technology showed us how the brain works.

To establish the links, a person follows step-by-step the linking sequences. Videos with more information on how this is done can be found at http://www.youtube.com/watch?v=Zcx6ZsvKHSA

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