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The question: I have bad travel anxiety. I get extremely worked up a few days before a trip. It's not fear of flying, but something deeper. How can I deal with it?

The answer: Travel-related anxiety is one of the most common fears. A fair proportion (10 to 15 per cent) of air travellers will experience situational-related anxiety and associated psychological/emotional distress. In some cases, they will also experience physical health problems such as headaches, insomnia or stomach problems.

The level of anxiety can range from mild discomfort all the way to disabling panic. Many people will experience high levels of anxiety related to the specific situation – flying – and a smaller percentage will develop a true flying phobia. A phobia is an intense fear caused by a specific object or situation, triggered either by its actual presence or even by the anticipation of it.

Travel-related anxiety is usually attributed to takeoff and landing, and to the air travel process more generally. Some of the common triggers include: actual or perceived adverse travel events, such as delayed flights; fellow travellers who may be loud or disrespectful; and a lack of trust toward airlines or airports on issues related such as travel security.

Although less common, some people with travel-related anxiety describe not having a fear of the flying process per se, as you say, but other issues related to the general situation and being away. Some people experience anxiety related to philosophical questions regarding life and death. These concerns are typically focused on oneself (What would happen to me if I died? What would happen to my body? What would happen to my soul?). These can raise questions that may be difficult – if not impossible – to answer, and may heighten awareness or challenge existing beliefs regarding religion, spirituality and the afterlife. Or people experience anxiety that is focused on others, such as worries about how one's death would impact loved ones left behind. Or there may be anxiety about not being present if something were to happen to a loved one.

To most effectively deal with anxiety-provoking situations in our lives, we usually need to do two things: Implement strategies that can relieve symptoms and gain insight into the contributing factors. These two things can happen in concert.

I would suggest working on cognitive and behavioural techniques that can target your specific symptoms, including physiological reactions (e.g., increased heart rate, more body tension, sleep disruption), as well as challenge the anxiety-provoking thoughts you are having and replacing them with ones that are accurate, realistic and non-catastrophic. Mastery of Your Anxiety and Worry by Michelle Craske and David Barlow is an excellent workbook grounded in evidence-based cognitive-behavioural principles that can help.

I would also try to clearly put words to what is causing your anxiety. Ask yourself questions such as: What specifically do I fear will happen? What is my worst feared outcome? What to me feels out of my control or unpredictable? What specifically about this is upsetting to me?

If you feel that you are struggling with articulating the deeper rooted issues on your own, you may benefit from a handful of sessions with a psychologist who has expertise in flying-related anxiety and phobias.

Send psychologist Joti Samra your questions at She will answer select questions, which could appear in The Globe and Mail and/or The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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