Fear of flying and medication - need creative solutions.

I have a friend whose miracle cure for airplane anxiety is a sleep mask. She gets to her seat, puts on her seatbelt, and puts on the mask... and keeps it on until the plane has landed and the doors are open. If I recall correctly, she said it helps her define her own controlled space, and stops her from focusing on the size of the plane, the number of people on it, the pressure to interact, etc.. Before the flight she practices with the mask on sitting in a comfortable chair at home, so she gets used to the feeling and later can mentally transport herself back to that comfortable place while in-flight. Might be worth a try? You can listen to music/podcasts with it on if you like, too.

It's a control issue. [snip] -Helping someone who's more anxious or more-in-need than me. Find an organization (perhaps http://www.tripsinc.com/home/tr3/index_main.html, for example) that could match you up with someone (child? special needs?) you would accompany from place to place? Then you would have to stay in control of yourself and the situation for the sake of the person you are helping. Of course, I don't know if they would want to hire someone who has even the slightest chance of barfing in someone's lap and fainting dead away exactly when you need to be in control. But maybe there's a very young or old person among your family and close friends for whom you could arrange such a trip informally. You and your little cousin or aged aunt both fly out to visit your parents, and you are in charge and in control of everything -- getting to the airport, getting a baggage cart, finding a toilet, finding snacks, getting magazines, checking in, getting through security, finding a toilet again, carrying tickets and boarding passes and carry-on luggage, finding another toilet, knowing when to board (maybe first, because of who you're with), finding your seats, helping your charge to the airplane bathroom, explaining how long it is going to take, where you are now, how much longer, the aircraft type and all about it, knowing how to get the flight attendant, knowing when it is OK to turn things on and off or buckle or unbuckle your seatbelt, understanding and explaining the air masks and flotation devices and emergency exits, etc. There are a million things you could be the master of if you accompanied someone on a flight.

However, there are a couple of generic life situations that do a great job of getting my mind off myself and circumventing my physical response to stress. They are: -Being completely afraid that the person I'm with will yell at me, judge me and think less of me if they see my anxiousness. (This works only with acquaintances - not with strangers or people I'm very close to.) Can you put an ad on Craigslist? "Trying to get to City X? I would like a traveling companion for the flight and offer to pay half your airfare. I like traveling companions who are fearless and no-nonsense (or any euphemism for "more likely to be judgmental of my anxiety" you prefer.) Would like to meet for coffee a few times to get to know each other first, my treat."

I'm anxious though generally love flying (window seat only), but I've tried flying drunk twice and it was a disaster. This? It was early, I was drunk, I hadn't eaten.. would have wrecked me. I'm terrible at eating before flights, but it's really important, especially with the joke they call food service. My last 6+ hour flight, I brought my iPad with me to make music with. I'm just an amateur dinking around, but it was something that really made me focus on it and not the people/things around me. It wasn't interesting enough to the kid sitting next to me to lean against me the entire flight like last time with a game, although I also enjoyed a few rounds of AI Ticket to Ride that made time go by even quicker. I see a lot of people using their tablets/laptops to write journal entries or stories. Maybe projects or ideas you could map out/strategize on a notepad? Maybe just some noise-cancelling headphones and a sleep mask, as the thing that gets me irked about flying is hearing the inner-workings of the plane and the constant sound of the engine in conjunction with people talking/moving or babies crying. Alas, this might not be an option for you, but I find medical marijuana edibles (a brownie, a cookie, etc.) right before you go through security really helps me out and doesn't set in until I'm either boarding or already settled in and ready to avoid contact for the next few hours.

If you're OK with the klonopin, considering your general phobias, I might just take it anyway, even though it doesn't do the job for you. I think it's better than the drinking option anyway. Also, I don't have airplane anxiety, but I've had lots of insomnia and anxiety about sleep, and I swear by sleep masks. I'd get one ahead of time and spend time with it to get used to it. To me, it's a way of telling my brain "ok, relax, sleep now." It really helps. I know your focus isn't necessarily to be asleep the whole time, but this could help. I hear you on the vasovagal response. I don't have the same triggers but I'm pretty sensitive to this. My main training from doctors/my mother (who is a doctor) since childhood is to sit right away if I feel something strange coming on. I know this is difficult with all the procedures at airports but it's something to think about -- get off your feet ASAP. Can you try to get early, special needs boarding? This could help you get seated with less hassle. Good luck, I think you can do this.

Seconding marijuana edibles, although only if you've had them before. Sometimes they're great but sometimes they make me freak out HARDCORE. I get claustrophobia so I usually take just over the counter Target brand sleeping pills, like 2-3 of em and that's the whole flight. Especially effective if you can wash it down with some wine. Otherwise make friends with the people next to you, practice your social engineering and see if you can get to their interesting core? Write it down, make it a short story? Or hopefully you'll develop a crush and that'll keep your mind off floating in the air. Otherwise sleep mask and listening to an ipod is good. If you can download a bunch of This American Life's that'd probably be good because it's highly absorbing and will keep your mind somewhere else.

This may come from left field, and may be totally inappropriate for you, but have you considered trying a flying lesson? In a small airplane you have a much better view, an ability to put your hands on the controls, and an understanding teacher sitting next to you who can both get you back down safely and explain exactly what is happening. Maybe it is just a reaction to your description of general health, performance response under pressure, better at pushing yourself right in rather than slow exposure, not sure what, but I wonder if it may not be a positive and exhilarating experience in its own way. If you do consider this, ask around for an experienced instructor and one who is sympathetic to your goals. There are plenty of folks who take a lesson or two just for the experience, to try it out, or even to get over a fear of flying. So, you don't need to commit to anything more than a discussion and sitting in the airplane with the engine off. If things are going well at that point, take the next step. Get an agreement ahead of time that you'll only take things as far as is comfortable. You might surprise yourself.

I bought the http://www.fearofflying.com/, and it's actually pretty darn good at reducing anxiety.

This_Will_Be_Good's tip about listening to the United flight radio helped me hugely, but I don't think it will do much for you, honestly, since it's more about fear of flying than fear of confinement. That said, if you start chatting up your seatmate as soon as you board, you can make them into an acquaintance whose approval you would totally care about by the time you take off. I don't know how ethical it is to annoy people around you in the name of maintaining your sanity (and some people DO like to be talked to), but I've definitely done it on flights for the greater good. Also, crosswords are well and good but I've had much better escapism luck on something where I can really get serious flow -- for me that's number puzzles.