What is Aerophobia?

Aerophobia, a fear of flying, is a relatively common specific phobia in the UK. Although many phobias go undiagnosed, it is estimated that between 2.5% and 5% of people in the UK experience aerophobia. This equates to between 168,000 and 336,000 people.

Today, we are going to look at aerophobia in more detail, including the common triggers, symptoms and treatments.

What is aerophobia?

Aerophobia is an extreme fear of flying, specifically of flying in an aeroplane. Sometimes known as aviophobia, aerophobia is a type of specific phobia which refers to a lasting, overwhelming and unreasonable fear of a specific object, situation, activity or person, in this case, flying.

A person who has aerophobia experiences overwhelming and irrational fear, anxiety and panic when they are flying or anticipating flying. Aerophobia can be so severe that it causes you to avoid flying completely.

Feelings of fear and anxiety surrounding flying are relatively common.

However, to be classified as a true phobia, your thoughts, feelings and behaviours around flying must:

• Involve feelings of intense fear, panic or anxiety that are irrational and difficult to control or manage.
• Be out of proportion to the potential danger.
• Last longer than six months.
• Negatively impact your day-to-day life.

Aerophobia often involves fear that is overwhelming and irrational. Although many people are afraid of flying, it is actually the safest way to travel, with the lowest death rates of all forms of transport. Mile-for-mile, flying is 100 times safer than driving in a car, and a huge 3,000 times safer than riding a motorbike. However, we don’t often hear of people fearing cars and motorbikes.

Even though flying is a safe and reliable form of transport, there are several aspects of flying that could cause aerophobia:

• Being enclosed in the aeroplane with no way to escape.
• Having a lack of control over your own safety.
• A lack of understanding of how aeroplanes work and function.
• Over-portrayal and sensationalising of crashes and other incidents involving planes which can make plane crashes seem more traumatic and terrifying compared to other forms of transport.
• Experiencing turbulence.
• The fear of illness, infection or a fire spreading through the plane.
• Fears related to take-off and landing.

A person who has aerophobia may not only experience fear, panic and anxiety when they are on an aeroplane, but they may also experience anticipatory fear in the lead-up to flying. They may also experience symptoms when thinking about flying. Even if you understand that your phobia is excessive and unrealistic, you may be unable to control your fear or prevent your symptoms from occurring.

Some people with aerophobia fear having a panic attack or experiencing extreme fear or anxiety whilst on an aeroplane and are unable to escape.

Aerophobia can be connected to and appear in conjunction with other phobias, such as:

• Acrophobia: An extreme fear of heights.
• Claustrophobia: An extreme fear of confined spaces.
• Agoraphobia: An extreme fear of places or situations where you are unable to escape.
• Mysophobia/Germaphobia: An extreme fear of germs.

How common is aerophobia?

The fear of flying is extremely common, with approximately 24% of people in the UK experiencing some fear or anxiety around flying, equating to more than 16 million people.

However, negative thoughts and emotions about flying can occur on a spectrum, ranging from low levels of fear and anxiety to severe fear, panic and anxiety that can affect your day-to-day life and can impact your decision-making, resulting in avoidance behaviours surrounding aeroplanes.

This can make it difficult to determine exactly how many people are experiencing aerophobia, rather than lower levels of fear and anxiety surrounding flying.

Many people with aerophobia will avoid flying rather than seek a diagnosis. However, it is thought that between 2.5% and 5% of people experience aerophobia.

Who is at risk of aerophobia?

Although anyone can develop aerophobia, certain risk factors can increase your likelihood of developing the condition, including:

• Having another relevant phobia, such as claustrophobia or acrophobia.
• Having a history of anxiety, depression or panic attacks or previously experiencing other irrational fears.
• Having a close family member, such as a parent or sibling, with aerophobia.
• Having a close family member, such as a parent or sibling, with another phobia.
• Being exposed to the fear of flying during childhood or adolescence.
• Having a negative or traumatic experience involving flying.
• Hearing traumatic or scary stories about flying or seeing frightening pictures or videos, such as of plane crashes, particularly during childhood or adolescence.
• Being a naturally more anxious or fearful person.
• Experiencing high levels of stress or experiencing a significant life stressor.
• Having a substance use disorder.

Aerophobia most commonly occurs in people between the ages of 17 and 34. Having previous experience of flying, even if those experiences have been positive, may not mean you won’t develop aerophobia. A fear of flying is also more common in women, compared to men. A person may also be more likely to develop aerophobia following childbirth.

It is important to keep in mind that even if you have some of the above risk factors, this does not mean you are going to develop aerophobia. A person who has an anxiety disorder and has a parent with aerophobia may never develop the phobia themselves. On the other hand, a person with none of the above risk factors may develop aerophobia.

How to deal with aerophobia

Many people with aerophobia engage in avoidance behaviours, meaning they will avoid flying and other triggers, even if it means they miss out on social, work and family opportunities. However, this may not be an effective long-term solution. Ignoring your phobia and not addressing your triggers could result in your symptoms becoming more severe in the future and you having a more severe phobic reaction.

Learning long-term and short-term coping strategies can help to reduce and alleviate the symptoms of your phobia and reduce the impact it has on your day-to-day life and overall wellbeing. It can also help you to reduce avoidance behaviours and manage your phobia more successfully.

Some long-term and short-term coping strategies you can implement include:

• Educate yourself
  Many people fear the unknown or fear something going wrong with the aircraft. Learning about how aeroplanes work, why turbulence happens, the safety features and mechanisms of a plane and what you can expect during the flight, including what different sounds and movements mean, can help to alleviate your fears. Flying is an extremely safe form of transport with minimal risks. Eliminating thoughts related to the risks and dangers can help you to overcome your phobia.
• Learn about your phobia
  Understanding what initially caused your phobia and what your triggers are can help you rationalise your thoughts, emotions and behaviours. This can help you to manage your symptoms more effectively and reduce your phobic responses.
• Identify and challenge negative thoughts
  Identifying irrational thoughts and negative thought patterns can help you to quickly recognise these thoughts when they occur and address them or replace them with more realistic or positive thoughts. Negative thoughts can exacerbate your symptoms and worsen your phobia and learning how to address these can be beneficial. Remind yourself that you are not in any danger and that your negative thoughts are irrational.
• Learn about your triggers
  Learning what your triggers are and how you respond to specific triggers can help you to recognise and deal with your triggers. You can implement calming and coping strategies before you encounter your triggers and can reduce your physiological and psychological responses to your triggers.
• Practise yoga, meditation or mindfulness
  Yoga, meditation and mindfulness teach you how to control your breathing and your body’s physiological responses. The skills you learn can help you to feel more in control and calm and help to reduce the physiological and psychological responses you may have when flying or encountering your other triggers.
• Practise deep breathing techniques
  Deep breathing is an effective way of lowering stress and relieving tension in your body. This is because it sends a message to your brain to relax and calm down. It can help to reduce anxiety and can help you to control your nervous system, which is central to your phobic responses.
• Implement visualisation techniques
  Visualisation has been found to be an effective coping strategy for reducing the symptoms of phobias. When faced with your trigger, visualising a place or memory that keeps you calm or elicits positive emotions can help to alleviate your symptoms.
• Avoid negative stories or frightening videos and pictures
  Hearing negative stories about flying or aeroplanes or watching a news channel, film or TV show where they are portrayed negatively or where there are scenes involving frightening incidents, such as crashes or terrorist events, is likely to reinforce the negative connotations your brain has already attached to flying.
• Implement lifestyle changes
  Phobias can be made worse by factors such as lack of sleep and excessive stress. Take steps to reduce stress in your everyday life, eat a healthier, more balanced diet, exercise regularly and ensure you have a good sleep routine. These lifestyle changes can help to reduce the symptoms of your phobia long term. This is because these lifestyle factors can impact your anxiety levels, your stress levels and your feelings of depression. Avoiding caffeine, sugar and other stimulants can also be beneficial, particularly in the lead-up to flying, as these can increase your heart rate and blood pressure and worsen your physiological symptoms.
• Talk about your phobia
  Sharing your fears and anxieties with a family member, friend, or another support group can help to alleviate your phobia. You could also contact a phobia support group or a mental health organisation to discuss your phobia with mental health professionals or other people who have experienced a phobia.

What triggers aerophobia?

Aerophobia can have different triggers for different people. Your triggers can depend on what initially caused your phobia, the severity of your symptoms and your current mental health.

Some of the most common triggers for aerophobia are:

• Flying.
• Getting on to an aeroplane.
• Thinking about flying.
• Booking a holiday or a flight.
• Someone close to you, such as a family member or friend, travelling on an aeroplane.
• Going to an airport.
• Seeing an aeroplane in the sky.
• Being in an enclosed space that reminds you of an aeroplane.
• Hearing stories about plane crashes and other incidents on the news.
• Hearing a noise that you associate with an aeroplane.
• Watching a film or TV show involving flying or aeroplanes.

Some people with aerophobia have multiple triggers whereas others don’t experience symptoms until they are boarding the plane or the plane is about to take off.

What are the symptoms of aerophobia?

The symptoms of aerophobia can vary from person to person and situation to situation, depending on the severity of your phobia, your triggers, your current mental health and wellbeing and your coping strategies.

The symptoms are often similar to the symptoms of anxiety or panic attacks. Some people experience mild symptoms, whereas others experience more severe symptoms. You can experience symptoms when directly faced with flying or at other times, such as when you think about flying or are booking a holiday. Your symptoms may be more severe in certain situations compared to others.

Some people with aerophobia engage in avoidance behaviours, meaning they will avoid flying at all costs. They could miss out on holidays with their family or friends or even miss work opportunities and professional development if they have to travel for work.

Symptoms of aerophobia can be both physiological and psychological and can include:

Physiological Symptoms:

• Sweating or chills.
• A choking sensation or difficulty swallowing.
• Clouded thinking or feeling like you cannot organise your thoughts.
• Confusion or disorientation.
• Dizziness or light-headedness.
• Shortness of breath, rapid breathing or difficulty breathing.
• Elevated blood pressure.
• Flushed skin.
• Nausea or stomach upset.
• Increased heart rate or heart palpitations.
• Shaking or tremors.
• A dry mouth.
• Loss of appetite.
• Insomnia or being unable to sleep (particularly in the lead-up to flying).
• Freezing or feeling like you are unable to move or escape.
• Headaches.

Psychological Symptoms:

• Overwhelming feelings of fear, anxiety or panic.
• Being unable to control your fear, anxiety or panic, even if you are aware that they are out of proportion to the risk.
• Irritability.
• A sense of impending doom.
• A fear of death or dying or feeling like you are going to die.
• Avoidance behaviours, including avoiding flying or going on holiday.
• Difficulty functioning when faced with your triggers.
• Feeling like you want to run away and hide.

What causes aerophobia?

Aerophobia often does not have one specific cause. In some cases, a phobia of flying can develop with no obvious cause or reason. Other people can attribute their phobia to one specific cause, whereas in some situations aerophobia can have multiple causes.

Some of the most common causes of aerophobia are:

• Traumatic events and media portrayal
  In the last couple of decades, we have seen several traumatic news stories in the media involving aeroplanes, such as the 9/11 terrorist attacks that killed 2,996 people and the Malaysian airlines’ flight 370 that disappeared with 239 people on board. These news stories are still revisited today, and it would be almost impossible to avoid the many traumatic videos, pictures and stories published by newspapers and news channels around the world. Following 9/11, 40% of Americas reported a new fear of flying and airlines in the U.S. lost $60 billion over the following five years. These statistics show how dramatically a traumatic incident can affect people’s thoughts, perceptions and feelings toward flying.
• A negative or traumatic experience involving flying
  This could include experiencing turbulence, a forced landing, the deployment of oxygen masks or even experiencing a panic attack or extreme anxiety on a previous flight. Any negative experience involving flying can become a direct learning experience and can develop into a phobia.
• A learned phobia
  If you have a close family member, such as a parent or sibling, who has aerophobia or has a fear or anxiety surrounding flying, you are more likely to develop aerophobia yourself. This is particularly true if you were exposed to the fear during childhood.
• Fear rumination
  Fear rumination is when you (often subconsciously) engage in repetitive negative thought processes. This could include repeatedly recalling a negative experience involving flying, recalling or thinking about scary situations that have occurred on planes (such as 9/11) or thinking and talking about flying in a negative way. Over time, your memories and thoughts can become increasingly upsetting and intrusive, reinforcing your fear response and resulting in you developing a phobia.
• Exposure to information that scares you
  This is known as an informational learning experience and can happen if you discover facts or information about flying that scare you. Even though flying is significantly safer than other modes of transport, if you read information about aeroplane malfunctions, engine failures and other things that can go wrong with aeroplanes, this can result in you associating flying with danger or fear.
• Having another health condition
  Aerophobia can develop as a result of other health conditions. For example, a person who has experienced ear pain or dizziness on a flight because of conditions such as vertigo, sinus blockage or ear disorders may develop a phobia of flying because of the association with pain or fainting. Someone with a condition that increases the risk of blood clots, such as cancer or cardiovascular disease, may develop aerophobia because of the risk of deep vein thrombosis.
• Life changes
  A life change or another lifestyle factor can result in a person developing a phobia of flying. For example, having a baby can result in a phobia as you may become afraid of something happening to your child or your child becoming parentless if something happens to you.
• Significant stress
  Significant, long-term stress can result in disproportionate fear responses or an inability to manage intense situations. This can make it more likely that you will develop a phobia. A stressful and distressing event such as a death can also trigger a phobia, as people may be less able to manage their emotions and thought processes when experiencing grief.

How is aerophobia diagnosed?

Many people with aerophobia do not seek a diagnosis and instead avoid flying. They may not even realise that they are experiencing a phobia and instead think they are just scared of flying. By engaging in avoidance behaviours, you may never (or very rarely) encounter a trigger, so may not realise that your fear of flying is severe and overwhelming. This means that many people with aerophobia never receive an official diagnosis.

If you are unsure whether you are experiencing a fear or a phobia, you should consider whether your fear of flying:

• Impedes your ability to function in your everyday life.
• Has a negative impact on your quality of life.
• Causes you to avoid certain situations or places.
• Has a negative impact on your mental health or wellbeing.

If you suspect you have aerophobia, you should first visit your GP. Your GP will ask about any previous anxiety disorders, panic disorders or other mental health difficulties you have faced and whether you have previously experienced extreme fears. They will also ask about your family history related to phobias. Your GP will also look at any medication or supplements you take to ensure your symptoms cannot be attributed to another source.

Your GP will then refer you to a psychologist or another mental health professional.

The psychologist will perform a phobia questionnaire, looking closely at:

• Your triggers.
• The type of symptoms you experience.
• The frequency and severity of your symptoms.
• How much your phobia interferes with your everyday life.
• When your phobia began and what caused the onset of symptoms (if you know).

To confirm a diagnosis of aerophobia, the psychologist will need to compare your symptoms to the diagnostic criteria for specific phobias.

Your symptoms must fit with the seven criteria listed below:

1. The fear must be persistent, excessive and unreasonable. It can occur either in direct situations, either when you are flying or are about to fly, or in indirect situations, such as when you see something relating to aeroplanes on the news.

2. Exposure to flying or aeroplanes leads to an immediate anxiety response in the majority of situations.

3. The fear is excessive and disproportionate to the threat, and this is recognised by you.

4. You avoid places or situations where you could encounter aeroplanes or typically fly (such as airports or TV shows about flying). If you encounter a trigger, you will experience extreme fear, anxiety or distress.

5. The anticipation of flying and the avoidance behaviours you may implement can have a significant impact on your day-to-day life.

6. The fear has lasted for a minimum of six months.

7. The phobia is not associated with another disorder or mental health condition.

If your symptoms fit the diagnostic criteria, you will receive a diagnosis of aerophobia. Depending on the severity of your phobia, you may be offered treatment.

How is aerophobia treated?

There are several treatment options available for aerophobia. Depending on the severity of your symptoms, you may not require formal treatment and may instead be able to implement coping and calming strategies to help you overcome your fears and alleviate your symptoms. However, if your symptoms are severe or impact your day-to-day life, treatment will likely be recommended.

The GP or psychologist will recommend treatment and create a personalised treatment plan.

This plan will be based on:

• How severe your symptoms are and how frequently they occur.
• What the root cause of your phobia is.
• How significantly your phobia impacts your life.
• Your overall health and wellbeing, including your mental health.
• What your triggers are.

The most common types of treatment for aerophobia are:

Cognitive Behaviour Therapy (CBT):

Cognitive behaviour therapy is the most popular type of treatment for aerophobia and is the type of treatment most commonly recommended. It focuses on changing negative and harmful thoughts and thought patterns that contribute to negative emotions and responses. CBT can change the way you think about flying. You may focus on removing the fear of danger or dying by looking at how planes work, how safe they are and the safety procedures that are in place.

You will also work on coping and calming strategies such as deep breathing and challenging negative thoughts to help you manage your symptoms. CBT will also help you to identify and address the root cause of your fear. Sessions can be conducted 1:1 or as part of a group.

During CBT sessions, you will:

• Discuss your triggers and symptoms.
• Explore what caused your fear of flying.
• Explore your fears in more detail.
• Learn how to recognise your negative thoughts and change the way you are thinking.
• Learn coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.

Exposure Therapy:

Also known as systematic desensitisation, exposure therapy gradually and systematically exposes you to places, situations, thoughts and triggers related to flying. You will do this in a safe, controlled environment to ensure you feel safe throughout.

As part of your sessions, you may create a fear ladder of scenarios and situations involving flying that are ordered from the least to the most frightening. They will then create a series of flying-related exposures for you to face.

The exposure will be gradual, for example, it may begin with looking at a picture or video of aeroplanes. Once you are comfortable with this level of exposure, you will then move on to the next level, which could be visiting an airport.

You may then progress to using Virtual Reality (VR), to watch a flight simulation before eventually being exposed to the inside of an aeroplane. Exposure therapy can address the negative thoughts and emotions you experience in relation to flying and can help you to change your physiological and psychological responses.

Hypnotherapy:

Clinical hypnotherapy is another popular treatment option for people with phobias. Hypnotherapy uses guided relaxation techniques and focused attention to help you to identify the root cause of your fear and help you change your thought patterns and any negative feelings you have about flying and aeroplanes.

Although different hypnotherapists will run their sessions differently, you will likely be put into a relaxed, hypnotic state and then a combination of techniques will be used to re-pattern your thoughts and memories related to flying. Hypnotherapy can also teach you calming strategies, such as deep breathing and relaxation techniques which can help you to reduce your symptoms in the future.

Medication:

Medication is not a common treatment option for people with aerophobia. It is not usually effective as symptoms usually occur infrequently. However, you may be prescribed medication, such as anti-anxiety medication or beta-blockers if other treatment options fail, or if your phobia is particularly severe. You may also be prescribed medication if you experience anxiety or depression alongside your phobia.

Alternatively, your doctor could prescribe medication to treat the physical symptoms of your phobia, such as medication to reduce motion sickness or ear pain.