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For travelers with anxiety and panic disorders, vacations did not always feel like getaways, even before covid-19. A century ago, Sigmund Freud described these feelings as "reiseangst," from the German for "travel fear." Travel anxiety has since become a catchall for symptoms and fears that, left unchecked, might spoil an otherwise relaxing trip.
"If it's fear of riding on an airplane, for instance, it doesn't take too much to stir that up in certain people," explains Lily Brown, the director at the University of Pennsylvania's Center for the Treatment and Study of Anxiety. Once, Brown had a patient who would get nauseous whenever they got a whiff of the airplane's "cabin smell."
In most travel contexts, the pandemic has exacerbated our anxieties. And it's no longer only fears of contracting the virus. For a significant share of the traveling public, the thought of getting back out into the world weighs heavily on their minds even after inoculation.
As the U.S. vaccination campaign continues, there is now a term for these concerns: Mental health professionals say "reentry anxiety" is on the rise. According to a recent study by the American Psychological Association, nearly half of adults are anxious about returning to in-person activities, with little variation between unvaccinated and vaccinated respondents' worries.
"Some people who might have had anxiety about social situations or travel earlier in their life pushed themselves to overcome those fears, basically, by putting themselves in anxiety-provoking situations and learning about their ability to tolerate it," Brown says. "But there's this phenomenon in experimental psychology called 'spontaneous recovery.' In other words, because people are out of practice, anxiety is slowly starting to rear its ugly head again."
Thankfully, there are proven ways to move forward as travel continues its return over the next year. We asked several leading mental health and travel experts to share their guidance for dealing with anxiety as some prepare to take their first post-vaccine trips.
- Before you book, consider exposure therapy
"The single most important criterion determining how comfortable we are with something is how often we do it," says Martin Seif, a licensed psychologist and a founder of the Anxiety and Depression Association of America (ADAA). The past year has certainly kept a historic number of travelers grounded.
"The effort you use in pushing anxiety away goes right into making that anxiety stronger," says Seif, who is one of the foremost specialists on overcoming the fear of flying. "The active ingredient for overcoming anxiety is exposure. It has to be done the right way."
Psychologists call this "exposure therapy," an evidence-based treatment that is proven to be highly effective in treating problems including anxiety, stress and panic disorders. There's a wide range of exposure therapy methods, which psychologists tailor to a patient's situation. For example, therapists might use imagined scenarios or virtual reality (VR) flight simulations. In other cases, treatments might prioritize real-life experiences.
If you have acute anxieties around travel, search for a therapist specifically trained in cognitive behavioral therapy, Brown recommends. "This is the kind of therapy that I exclusively practice because it has the strongest evidence base for anxiety," she says. Tools such as ADAA's Find a Therapist Directory as well as APA's Psychologist Locator help you make virtual telehealth appointments with relevant specialists.
- Ease back in by practicing close to home
Even if you are not seeking professional care right now, the general principles behind exposure therapy can help many travelers ease back into traveling. "The idea here is to identify what the core fear is," Brown says, "and then push yourself to practice - slowly approaching that fear at a gradual pace."
The key is to "start off slowly," says ADAA board member Ken Goodman, who has produced several at-home anxiety courses. He suggests practicing in your home area first to help with the transition. "Do some of the activities in your local environment that you might do on a trip," he says.
Take, for example, restaurants. If eating out remains a source of stress, "go to restaurants in your hometown that you're already familiar with." The same is true for many anxiety-inducing activities you would do in another place: You can more confidently ease back into it if you first venture out in a familiar setting.
- Consider a 'trial run' trip before a bigger trip
Even in the best of times, air travel induces anxiety in many people. Recently vaccinated travelers might consider an easier trial run to get some practice before booking extensive trips, Goodman says. "Pick a destination that would be either a familiar one - a place that you've been to before - or a place that's not too far from home."
Expect that anxiety will invariably creep up on your first few trips, says Ebony Thyme, a traveling nurse practitioner who runs @frontpage_eb, an Instagram account focused on solo traveling.
"In the beginning, I struggled with anxiety around traveling during a pandemic," she writes in an email. Thyme spent a large part of the pandemic helping out at understaffed hospitals, where she struggled with anxiety on a day-to-day basis in her work. "Eventually I said to myself, I would take the same precautions I would with travel as if I were working among covid patients," she says.
When it comes to airports and airplanes, this is how she suggests approaching reentry anxiety: Accept that you'll feel anxious, book shorter and direct flights whenever possible, and keep following the same techniques you practice at home. For your first run, you might also try booking seats with more space. "I believe this would ease a lot of those who have anxiety and are just getting back out there," she says.
- Keep 'what ifs' at bay by focusing on the present
Even for vaccinated travelers, anxiety around cleanliness in hotels and vacation rentals may linger when the actual risk is minimal. While the Centers for Disease Control and Prevention provides guidance on accommodations, many such anxieties are less about the facts and more about anticipating scenarios where everything goes wrong. Similarly, those with social anxiety and discomfort in public places may find it unsettling to stay in lodging properties with busy lobbies and hundreds of guest rooms.
In cases like these, Seif suggests first spending a few nights where you're most comfortable. "Renting an Airbnb in a gated community with a restricted pool is less dense than staying at a hotel nearby with a public pool and many public spaces," he says as an example. "That reduces the social anxiety as well as the covid-related fears."
But he stresses that we should not allow ourselves to get stuck in the rut of avoiding certain experiences because of "what if" catastrophic thoughts. Or, for that matter, overpreparing for your trip and overthinking every minor detail. "Anticipatory anxiety is a powerful force. And when we don't do things, anticipatory anxiety just begins to take over." Part of the solution is continually refocusing your thoughts on the present.
- Self-conscious in public? Slowly practice the opposite
The paradox of travel anxieties is that they may have little to do with the actual act of traveling. In the past year, depression has surged and addictions have increased. Consequently, many people are struggling with their self-image, worsened by pandemic-driven fatphobia and the body shaming of pandemic diet culture.
"People are really self-conscious now," Brown says. It's no wonder some travelers might want to avoid crowded beaches or busy tourist sites. But that's when we may need to look inward for the solutions. "It's important to notice how the anxiety makes you want to change your behavior. Practice doing the opposite of what the anxiety tells you," she says.
"So if this anxiety or shame is telling you to hide or to avoid people, practice slowly doing the opposite of that. The negative emotion will correct itself. But you do need to give yourself enough time to practice."