Dear doctor;

I have an acute fear of heights. When on the second floor of a building, I cannot look down without my getting dizzy. These are avoidable, but the real problem comes when I have to fly. The whole idea that a plane ‘floats in space’ keeps my heart thudding throughout a flight. Sadly, it is next to impossible for me to sleep during a flight. Are there some drugs that I can use to fall asleep to avoid such scenarios? Can these fears be medically related in some way so that it can be treated?

Aline, 38.

Dear Aline,

fear of heights or acrophobia, as it is called is not uncommon. Two to five per cent of people suffer from it. It is different from the vertigo or spinning sensation some people feel on looking down from heights.

Some studies suggest that acrophobia is not an irrational fear as defined for other kind of phobias. It is a kind of protective instinct of the body, where one does not go beyond a certain limit to prevent a fall. One may develop this fear due to witnessing or suffering from some accident involving fall from a height in the past. Some people can get it due to some disorder causing loss of good balance as  with cerebellar disorders or   eye problems.

You can try using some anti anxiety drugs like benzodiazepines  while flying. But the effect would be transient. Best way is to condition your brain to overcome this fear. Try climbing up heights, a hill or building, increasing the height climbed on every occasion. While climbing try to look down, hold gaze for longer period each time. Once you realise that it is safe and no harm has befallen, the fear of heights will also gradually disappear. Same thing applies to flying. Deep breathing or counting slowly mentally while on a height or flying will also help to relax gradually.