Worries about flying seem to be taking off. Here's how to cope with in-flight anxiety

NEW YORK — Adelynn Campbell's last plane trip ended with a panic attack that she got through largely with the help of a kind flight attendant.

That was last year — before 67 people died in January when an American Airlines jet collided with a helicopter over Washington, D.C., in the deadliest U.S. air disaster in almost a quarter century.

Now, Campbell is even more hesitant to book a flight.

''It's definitely spiked my concern about getting on a plane and it's making the whole situation a little more stressful than it used to be,'' said Campbell, 30, who manages a coffee shop in San Diego.

Being at least a little nervous about flying is understandable. As Mel Brooks once said: ''If God wanted us to fly, He would have given us tickets.'' But for some people it causes deep anxiety that could require professional help.

Here's a look at air travel anxiety and ways to cope with it.

More people seem to be nervous about flying

The evidence is anecdotal, but psychologists and flight attendants say they've seen and heard increased worries — and not only in people who already had anxieties about flying.

''Even people who didn't have a fear of flying are talking about it, given recent events,'' said Jennifer Dragonette, a California-based psychologist who treats people with air travel anxieties.

U.S. air travel was down in March and early April compared with last year, according to TSA statistics. Airlines have attributed the decline to economic uncertainty, a decline in government and corporate travel and — yes — concern about recent aviation incidents.

FAA officials recently acknowledged they weren't doing enough to ensure air safety. Recent polling by the Associated Press-NORC Center for Public Affairs Research shows that fewer Americans report feeling safe about flying this year.

Flight attendants who work planes out of the Washington, D.C., airport were particularly rattled by the January collision, said Sara Nelson, president of the Association of Flight Attendants union. Some asked for time off to process their emotions, and at least one flight attendant left the job, she said.

What is fear of flying?

Fear of flying — sometimes called aerophobia — goes beyond just being nervous about a flight. It is an intense form of anxiety that centers on certain aspects of air travel. Many aerophobes get most rattled during take-off and landing, or when they think about being locked in a plane.

Some research has suggested it affects about 25 million U.S. adults. Psychologists say it often surfaces in adulthood, developing in people who didn't mind flying as kids but grew more rattled as they aged.

In many cases, it starts when people are in their 20s or 30s, at a time they are experiencing big life changes and new responsibilities — like getting married or becoming a parent — and they start to think that ''everything counts,'' said David Carbonell, a Chicago-based psychologist who authored a workbook to help people cope with flying fears.

A bad flight with heavy turbulence or some other problem may trigger an anxiety that persists, he said.

Campbell, who has other forms of anxiety, developed a fear of flying a few years ago. She is transgender, and said travel can be stressful because of concerns about how she'll be treated by airport security or in other interactions.

Aerophobia can be complicated, Carbonell said. For many people, it's not so much a fear of crashing as it is claustrophobic feelings of being in an enclosed cabin and not having control.

Campbell said that's what she experiences: ''feeling trapped and unable to breathe.''

Nelson said flight attendants regularly deal with suffering passengers: ''We've had people have panic attacks, and we've had to give them oxygen. It can be quite intense.''

How to cope with flying anxiety

Statistics have long shown that airliners are probably the safest way to travel. According to the National Safety Council, the odds of dying in an airplane crash are too low to be calculated, based on 2023 statistics — making them far, far lower than of being killed in a motor vehicle crash or, for that matter, walking on a sidewalk or crossing a street.

But experts say you can't really reason your way out of an anxiety disorder.

Carbonell spends little time on statistics, telling patients: ''I know you already looked at them all, and they're not helping you.''

For people with milder levels of aerophobia, deep breathing often works. Longer exhales help the body relax, said Dragonette, who counseled Campbell for aerophobia and other anxiety disorders at a Newport Healthcare residential facility in Temecula, California.

People suffering more extreme cases can be helped with exposure therapy. It can start by simply getting patients to become comfortable looking at photos of planes, watching videos of planes flying safely, or putting on a virtual reality headset that shows recordings of being inside a plane, Dragonette said.

It's a matter of getting patients to learn to live with their feelings and better handle them.

Carbonell recommends patients take practice flights that do not involve work trips or any other responsibilities. When they have symptoms, he recommends they keep a written inventory.

''They're keeping a simple count,'' he said. ''We're using counting as a proxy for acceptance.''

It's OK to ask for help

Nelson, who was a longtime United Airlines flight attendant, says: ''I've had situations where I'd sort of sit in the aisle and hold someone's hand."

On a Frontier Airlines flight last year from Detroit to San Diego, Campbell tried breathing and other coping skills, but they didn't halt her panic attack. The passenger next to her noticed she was increasingly anxious, and summoned a flight attendant.

The flight attendant took deep breaths with Campbell and helped her get through it, and also took down Campbell's phone number and checked on her a day later.

''I was really impressed,'' she said.

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