There are better and permanent ways to address anxiety and panic attacks. I lived the hell of anxiety and panic attacks and was very bad. Anti-anxiety meds are not the way to go IMO. I can write a book on this topic.
Hookem,
Most here would be wise to give thought to your posts. Behavioral adjustment (self or with the help of a therapist or psychiatrist) is the only safe and effective approach to especially flight phobia.
Benzodiazepines (such as XANAX, ATIVAN, and VALIUM) are very controversial in general. When each first came out, they were touted as entirely non-addictive. Today, we know that they are at the top of the list of addictive medications......especially XANAX. Once dependency is established, getting off these meds is more difficult than getting off heroin. Many psychiatrists will not prescribe them. They are prescribed frequently by physicians who are not familiar with the research that shows they do not work for flying, but actually CAUSE panic when flying.
No single event dose anti-anxiety medication is effective for flight anxiety.
When the medication fails to provide relief, a person in a state of panic may be tempted to take more medication and/or to combine medication with alcohol. WHEN THESE MEDS FAIL, YOU DONT TAKE MORE. YOU DONT COMBINE THESE MEDS WITH ALCOHOL. DOING SO DURING FLIGHT WHERE THE AIR IS THIN CAN BE FATAL.
The majority of psychiatrists never prescribe them or prescribe them only with great caution with carefully screened clients.
Doctors who are not psychiatrists often do not understand the risks (or, just give patients what they want in spite of the risk).
Fatal Interaction With Alcohol. When in the throws of high anxiety, when one has already taken Xanax and finds it is not working, it is common for the person to take another dose and then have a few drinks. This can be fatal. Alcohol and Xanax (or Ativan or Valium), especially when combined causes a disturbance in the regulation of breathing..........a severe slowing. You may want to be knocked out, but you dont want to stop breathing when knocked out..........something that kills thousands of people every year?
Once you know the risks - and lack of effectiveness for flying - of Xanax and Ativan, whether to use them or not is a no-brainer.
These medications are not a responsible way to deal with anxiety on a daily basis and make flight anxiety worse.
If you need medications on a daily basis for anxiety, and you are being prescribed Xanax or Ativan, you need to find a responsible psychiatrist who will switch you to a non-addictive alternative.
If you think you need Xanax or Ativan for flying, think again. At safe levels, they provide no relief at all, and increase panic attacks ten-fold.
[A word about meds for long-term day-to-day anxiety (non flying anxiety). If a doctor prescribes Xanax or Ativan for routine use, find another doctor. That is simply not responsible, and there is no question about it. Why? Because there are anti-anxiety medications which are effective and which are not addictive such as Buspar, and anti-depressants which help with day-to-day anxiety such as Lexapro, Zoloft, and other SSRIs.]
Though Xanax or Ativan can relax you effectively for day-to-day anxiety on the ground (still for only 1 out of 3 patients), it is HOW the relaxation is achieved that is the problem when it comes to flying.
The relaxation is gained by shutting down the part of the brain that gets involved with conflict. In a normal state of mind, imagination conflicts with reality. And when you recognize that conflict, you know what is real and what is imaginary.
But when that part of the brain is shut down, the person is no longer as able to distinguish the conflict between reality and imagination, and thus no longer able to tell what is imagined from what is real.
Thus, when flying, what is imagined (feared) is not recognized as imagination. When the person starts to believe something that is imagined (feared) is really happening, it causes panic and terror.
This is why the research shows that though you get the edge taken off prior to the flight, you pay for it big time. The research shows TEN TIMES as many panic attacks happen when meds are taken versus placebo.
Acute and Delayed Effects of Alprazolam [XANAX] on Flight Phobics During Exposure
There is a self-help program that I have suggested to my patients who have spoken to me about this phobia. Its called the The SOAR Fear of Flying Program
http://www.airsafe.com/issues/fear/soar.htm and it has been used successfully by them.
Its been shown that for those who believed they HAD to have Xanax to fly, found that when they completed the SOAR program which set up automatic control of the feelings, they did not have high anxiety and did not panic. Some continued taking Xanax for a while, believing it helped. But when they finally did try flying without Xanax they discovered - to their amazement - they had LESS anxiety. Though they did not realize it, Xanax had caused them trouble when flying before the SOAR program and it had caused them trouble when flying after the SOAR program. It was only after encouraging them to try flying without Xanax that they discovered Xanax was part of their problem; they had believed it was helping. It wasn't. It was making things worse.
The responsibility question is a red herring. This argument is typically employed by people who have addictive tendencies. They ARE the people who have no business taking Xanax. They feel they are not capable of dealing with feelings without help, and have little tolerance for anything other than instant gratification or instant relief. Not only do they see no problem with instant relief, they often believe they have a right to it. If anyone ever gets between a borderline and their medication, they are in for big trouble. They assert that if they doctor gave it to them, then - "because the doctor knows what he is doing"- it is fine for them to take it. In other words, people with addictive personalities ARE the ones to make this argument. People who do not have addictive personalities rarely even ask for Xanax.
No physician can determine who will and will not engage in risky behavior in a time of stress unless the doctor is trained to do psychotherapy and has had years of experience as a psychotherapist and have treated the client in question as a psychotherapist for dozens - if not hundreds - of therapy sessions.
But as to effectiveness. There are some people that just BELIEVE in Xanax. The research is clear, though. It shows that people taking Xanax for fear of flying have ten times as many panic attacks when flying as people taking a placebo. Yet - and this is the point - those people who took the Xanax BELIEVED Xanax was helping them EVEN WHEN IT WAS MAKING THEM WORSE AND, IN FACT, CAUSING PANIC ATTACKS.