The first time Ashley Lauretta had a panic attack while travelling, she was sitting with her husband in a restaurant at Heathrow Airport, nearly 5,000 miles from home. It started the way her attacks usually do: a hot flash spreading from the top of her head to her feet, followed by a racing heart and trembling body, leaving her drained and exhausted.
Panic attacks can produce a wide range of symptoms, including racing heart, shortness of breath, dizziness and hot flashes, and because they can occur without warning and vary in length, some people develop a fear of future attacks that becomes its own obstacle. The good news, according to mental health professionals, is that there are concrete ways to manage anxiety on the road without giving up on travel altogether.
Start with practice trips close to home
Short day trips near home can function as a form of exposure therapy. Simon Rego, professor and chief of psychology at Montefiore Medical Center in the Bronx, who specialises in anxiety and stress disorders, recommends approaching these outings like a scientist: imagine what you think might happen, then evaluate afterwards how accurate those predictions were. A guided tour of a nearby museum or a walk through a busy market can mimic common travel experiences in shorter, more manageable doses, helping you learn what your body needs and how you would handle an attack on a longer trip.
Accept anticipatory anxiety rather than fighting it
It may seem counterproductive to welcome any form of anxiety, but Jenny Matthews, a mental health therapist who leads flying-anxiety workshops at Minneapolis-St. Paul International Airport, argues that anticipatory anxiety can actually help you prepare. "It's part of your brain's warning system, trying to alert you to a dangerous or scary thing, and it's trying to get you to take some kind of action," she said. Pre-travel anxiety is not exclusive to people with anxiety disorders, and it does not mean a panic attack is inevitable. Accepting it as normal can reduce its power, and the energy it generates can be redirected into practical planning.
Pack a panic attack kit
A small bag of targeted supplies kept close at hand during travel can make a significant difference. This should include any prescribed rescue medications such as Xanax or Ativan, as well as over-the-counter options like paracetamol or ibuprofen for headaches and Dramamine if motion sickness is a trigger, since research suggests motion sickness can provoke anxiety. Alcohol prep pads, the kind found in first-aid kits, may help with nausea, as studies indicate that smelling isopropyl alcohol can reduce it. A handheld fan or cold pack can address sweating or elevated body temperature, and a 2023 study published in the Journal of Clinical Medicine found that applying cold to the side of the neck is the most effective location. Matthews also suggests including sour or spicy sweets, whose sharp flavour can help jolt the mind away from a spiralling panic response. Rego notes that a panic kit is not a long-term treatment, but a practical tool for managing symptoms in the moment.
Tell someone
People experiencing panic attacks often try to conceal what is happening, which adds pressure to an already difficult situation. Matthews encourages travellers to speak to a companion, a flight attendant, a tour guide or even a fellow traveller in a group. Being specific about what you need, whether that is simply an encouraging word or someone to sit with you, can ease the isolation. For solo travellers or those who prefer not to disclose, meditations, audiobooks or podcasts can provide distraction and a sense of companionship. Apps such as Calm and Open allow users to download meditations for use without an internet connection.
Be realistic about what you can do in a day
The instinct to pack every possible experience into a trip can conflict with the realities of managing panic attacks. It is worth accepting limitations and choosing one priority activity per day, then making whatever accommodations are needed to reach it, whether that means taking a taxi instead of walking, or having dinner delivered to the hotel rather than eating in a noisy restaurant. Focusing energy on one meaningful experience per day, rather than exhausting yourself across many, tends to make the trip more enjoyable rather than less.
Source: The New York Times
