Along with sharks, masked intruders, and apocalyptic disasters, the film industry has done a damn good job at making air travel seem more terrifying than it already is. If your first exposure to a Hollywood flight gone wrong—whether it was The Twilight Zone’s The Odyssey of Flight 33 or Tom Hanks’ deserted island epic Cast Away—was enough to make you anxious about planes for life, you’re not alone. For some people, though, that fear is so insurmountable that they can’t even bring themselves to think about flying in a plane, let alone visit an airport to board one. Such is the experience of people with aerophobia, or the clinical diagnosis of a “fear of flying.”

Flight anxiety is normal, but if your fear of flying keeps you permanently rooted to the ground, it may be time to seek professional help. Luckily, psychologists say there are proven treatment methods to help people with aerophobia overcome their fears. If you think you may have aerophobia or know a loved one who does, keep reading to learn more.

What is aerophobia?

Aerophobia, also referred to as aviophobia, is a fear of flying. Aerophobia falls under the wider umbrella of anxiety disorders and is classified as a specific phobia since it involves a distinct fear of air travel. This includes any combination of air travel methods (helicopters, hot air balloons, blimps, and so on), but is usually used to describe a fear of flying by plane since that’s typically the most accessible form of air travel.

Symptoms of aerophobia

Symptoms of aerophobia can vary from person to person and are usually influenced by the individual’s past experiences with flying. However, some common psychological and physical symptoms often associated with aerophobia are outlined below.

Psychological symptoms may include:

• Heightened anxiety about flying in airplanes
• Avoidance of air travel
• Anxiety about upcoming flights
• Difficulty concentrating or relaxing during flights
• Obsession with the possibility of an airplane crash

In addition to these symptoms, “most phobias have a lot of overlap with the symptoms of anxiety, because it is, in fact, an anxiety disorder,” explains psychiatrist Gail Saltz, MD, clinical associate professor of psychiatry at NewYork-Presbyterian. To that end, some physical symptoms of aerophobia may include:

• Increased heart rate or palpitations
• Sweating
• Trembling or shaking
• Nausea or stomach discomfort

What are the causes of aerophobia?

Aerophobia may stem from past trauma regarding air travel, but it could also be due to other factors. According to clinical psychologist Kevin Chapman, PhD, founder of the Kentucky Center for Anxiety and Related Disorders, all phobias (including thanatophobia, somniphobia, cherophobia, and scopophobia) typically stem from three primary pathways.

The first pathway is observational learning, or modeling a behavior we were exposed to in childhood, says Dr. Chapman. Research shows that many fears are taught to us at an early age¹; rather than learning to fear certain dangers through experience (like getting stung by a bee), we often learn about them through modeling the behaviors exhibited by our parents. For aerophobic folks, this could look like, while a child, observing a parent or caregiver who was overly suspicious or scared of flying in planes.

The second pathway, trauma, is the one you may be most familiar with, says Dr. Chapman. With this pathway, a fear of flying is developed after living through one or multiple negative past experiences with flying. This experience could be an especially violent or turbulent flight, or even something as severe as an aviation accident.

This final pathway for phobias to develop is through information transmission. This happens when someone learns about the threat of danger² of flying. This could look like watching news clips of an airplane crash, watching a scary movie about a plane crash, or reading a personal account from someone who survived an aviation accident.

As for who is most likely to be diagnosed with a fear of flying, research shows that women are more likely to be diagnosed with a specific phobia than men³. Dr. Saltz echoes this, adding that genetics do play a role, as well.

While research surrounding the heritability of phobias is sparse, science suggests that people who have someone diagnosed with a phobia in their family⁴ are more likely to be diagnosed with one, too. “We don’t know exactly what the genetic component is—as in, I can’t tell you the specific gene—but it does run in families,” says Dr. Saltz.

Additionally, Dr. Saltz says that those with certain mental health conditions are more likely to develop a phobia. “Generalized anxiety disorder, panic disorder, or even depression or substance abuse disorder may raise the risk of developing a specific phobia,” she adds.

Aerophobia vs. flight anxiety

Aerophobia and flight anxiety may sound like one and the same, but they are two different things. Feeling nervous or uneasy before flying is totally normal. Unless you travel often for work or pleasure, most people don’t travel via planes very often: The average American passenger can expect to take only 208 flights throughout their lifetime, which comes out to roughly two to three flights per year.

While many people deal with flight anxiety leading up to a trip—research indicates roughly 40 percent of all adults⁵ have experienced some form of it—the actual number of people diagnosed with aerophobia is much lower at 2.5 percent. To be diagnosed with aerophobia, “the symptoms need to be such that they have risen to the level of significantly impacting your life in more than one arena,” and those symptoms must persist for six months or more, explains Dr. Saltz.

The primary dividing line between aerophobia and flight anxiety is that aerophobia usually prevents the sufferer from participating in air travel. People with aerophobia may be so afraid of flying, says clinical psychologist Sanam Hafeez, PsyD, that they never attempt to take one. Their fear of flying may be so profound that “it could even be difficult [for them] to watch planes or other people fly in movies,” she adds.

Flight anxiety, on the other hand, is not an actual medical diagnosis, and “is much more generalized,” says Dr. Hafeez. People with flight anxiety are often able to quell their feelings in order to board a flight; aerophobic folks, on the other hand, are usually unable to push past their fear and fly in an airplane.

Are acrophobia and aerophobia the same thing?

Acrophobia and aerophobia are both specific phobias revolving around elevation, but they are two different diagnoses with unique sources of fear. Aerophobia specifically deals with a fear of flying, but acrophobia is a fear of heights.

Aerophobic people aren’t necessarily afraid of standing inside a skyscraper or riding on a tall rollercoaster. Their fear is specifically tied to air travel. People with acrophobia, on the other hand, have a fear of heights, regardless of the context.

In other words, acrophobic people may be anxious about flying in an airplane because they’re afraid of heights, but not because they’re afraid of the idea of traveling in a plane. And people with aerophobia aren’t always afraid of how high the plane gets. People with aerophobia may struggle with several other aspects of air travel, like airplane turbulence or sharing a cramped space with strangers.

Is aerophobia curable?

It’s possible to get over a fear of flying, though it may take some effort to overcome, says Dr. Saltz, and according to the United States National Institute of Mental Health, approximately 75 percent of people with specific phobias overcome their fears with professional treatment.

One of the primary treatment methods for phobias includes exposure therapy. Exposure therapy is a mental health treatment method that involves exposing a patient to the source of their fears in progressive doses to help confront them. Many people with phobias tend to avoid the source of their fear altogether, which often makes the irrational fear even worse.

For people with a fear of flying, some progressive examples of exposure therapy could include talking about boarding a plane, then visiting an airport, then touring a plane, before finally boarding a plane and taking flight. “With a fear of flying—which is very common—there are places where you can go and actually visit an airplane, walk on an airplane, sit down, strap in, and even listen to someone talk as if they were about to take off,” adds Dr. Hafeez.

Doctors may also prescribe certain medications to help patients push past their phobias. “Medication can really be helpful,” says Dr. Saltz. She adds that in the case of phobias, doctors will usually prescribe specific serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) to lessen the psychological levels of anxiety to help someone more easily progress through exposure therapy. Once the patient can get over the “hump” of initial exposure therapy, Dr. Saltz says that the medication is typically then decreased until the patient has completely weaned off of it.

How do I overcome flying anxiety?

You may feel compelled to avoid the thought of flying altogether before a big trip, but Dr. Saltz says that thinking more about it can help you gradually overcome your fear of it. “Exposure starts with literally thinking about the thing,” says Dr. Saltz.

Thinking and talking about your fear is a form of systematic desensitization, a graduated form of exposure therapy, says Dr. Hafeez. “You break out each component of the trauma or the phobia, and you desensitize a person to it,” she explains. She suggests taking slow steps: Try reading the word “flying in an airplane” first, taking slow, measured breaths, and maintaining a relaxed posture. Once you’ve mastered that without feeling anxious, look at a photo of a person in an airplane seat while trying to stay relaxed, then progress toward watching a video of a plane taking off or people talking on a plane.

“The goal is to relax the body, to deep breathe, to relax the muscles, and to acclimate yourself slowly,” says Dr. Hafeez. “And if you’re not there, go back to the step prior until you are physically ready to go back to it.” While simple, Dr. Hafeez says that systematic desensitization is an incredibly effective, yet underrated, exposure therapy technique that can help people push past their fears.

When to seek medical treatment for aerophobia

For people with severe aerophobia, the above exposure therapy technique may feel impossible. “If you can’t do that without having a lot of anxiety, then I would say that it’s going to be very difficult for you to expose yourself to [flying or planes],” says Dr. Saltz. If this is the case, or if your symptoms of aerophobia begin to significantly disrupt your quality of life and hold you back from being able to fly, you may have a severe case of aerophobia. In this scenario, Dr. Saltz, Dr. Hafeez, and Dr. Chapman agree that professional help should be the next course of action.

That’s because people with severe phobias often miss out on certain opportunities because of their fears. For a person who has a fear of flying, this could include job opportunities that involve travel or relocation, being able to visit far-flung family or friends, or exploring other areas of the world. If your fear of flying keeps you from living your dream life, consider enlisting medical help.