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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have been suffering from anxiety past 7+ years.

Customer Question

I have been suffering from anxiety for the past 7+ years. The first panic attack I experienced was in an airport and the a plane that's when two of my favorite places became DANGER zones from me.
I was put on Capralex 10mg for a year. Things did get better for a while but planes, airports, unfamiliar places, elevators and high floors all remained places that I faced issues with. With time I got over some of those phobias. I managed to get myself on flights from dubai to lebanon and back approximately a 4 hr flight. I managed those flights with the help of 2 0.5 Xanax pills they got me though 85% of the flight comfortably. I also managed to get myself up to the 20th floor in an elevator.
6 months ago I had a very discomforting experience in a restaurant on the 7th floor where I experienced a panic attaché and for the first time in 7 years I actually used a Xanax pill in a situation other than flying. On another note I use to due the lebanon round trip twice a year so I was on a maximum of 8 Xanax a year in addition to the daily dose of cipralex.
This experience put me back at ground zero fear of flights, elevators and everything else. I did manage to get on a flight to lebanon after that and I have been training myself into using elevators once again after having several sessions with my psychologist. I have to admit he was great help.
The reason for my long boring email is because I have a 7 hr flight to Paris from dubai this Thursday and I'm terryfied the whole experience airport, airplane going to a country I have never been to etc. so I asked my psychologist to refer me to a psychiatrist in case I need to take something.
I visited the psychiatrist on Saturday his recommendation was that i double my cipralex doze to 20mg which I already did and I'm on my fourth pill now and he prescribed 0.5 Xanax and inderal 10mg so his idea was that I take 2 pills Xanax and 2 inderal when I leave my house and second similar doze when I get on the plane and a third one towards the end of the flight if I felt I needed it.
I would really appreciate advice on this dosage or any other advice that I can get to make it through this trip.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Z replied 2 years ago.
*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.
Hello, I believe I may be able to help you with your question. I am very sorry that you suffered from this resurgence in your panic attacks, I can understand how distressing this can be for you. It sounds like your new psychiatrist is putting you on a good as needed treatment plan to help lessen your overall anxiety and panic while on the flight. The Xanax works fairly quickly (30-60 minutes), so taking the prescribed dose around 30-45 minutes before take off will probably work well for you or if your anxiety and panic starts in the airport, you can take it at that time too. This medication may only be effective for you for around 6-8 hours, so if during your flight you feel more anxious you may be required to take another dose of the Xanax while on the flight or just one .5mg pill, so be prepared for that.
The Inderal is a good beta blocker and is used as an off-label treatment for anxiety. This medication works by helping to lessen the physical symptoms of the anxiety and panic so that you will not have a racing heartrate, your breathing will be normal, no sweating, etc...The goal here is for the Inderal to make you feel relaxed in a physical sense so that your own body's sensations do not trigger a panic attack in your mind.
Another technique you can try on the plane or before your flight (minutes before), would be Progressive Muscle Relaxation (PMR). This is a great technique meant to help you achieve a sense of calm and peace in a matter of minutes so that you do not feel as anxious, and so that it will not lead to a panic attack.
In addition, here are some other great relaxation techniques that you can use alongside the medications including deep breathing.
And lastly, I would also recommend bringing music or videos that you find relaxing while on the plane and at the airport, as this can be a very good distraction for you and help you to better cope with the stress of the situation.
I hope this answers your questions and provides you with some guidance on this issue. I truly wish you all the best with your flight and I hope the prescribed treatment works well for you and you do not have any panic or anxiety issues on your trip.
My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. If I answered your question satisfactorily I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much