Singapore publishes lists of the drugs that are banned or restricted, which provides the assurance that you can at least check to see if you are okay, well before you leave home.

All medicines containing any one of a number of ingredients require specific authorisation from the Singapore authorities before you can safety take them with you.  But if you have obtained the authorisation, and have the necessary documentation with you, then you will not experience any problem with the authorities.

Judicial system

The rules of the Singaporean judicial system are such that you basically want to avoid even being regarded as a suspect.  The law constrains judges to apply sentences harshly and there are very few extenuating circumstances permitted.  Attempts by foreign governments to apply pressure for a lighter sentence are frequently seen as interference.  Recent changes to the sentencing laws in 2013 give the judges some leeway in commuting mandatory death sentences to life imprisonment if they find that there are special circumstances.

Recreational drugs

The Misuse of Drugs Act (1972) creates a presumption of trafficking based on specific quantities of drugs found in your possession.  So in a legal sense, “trafficking” does not need to be proved, merely possession.

You may be searched or required to provide a urine sample for analysis, by any police officer without a warrant on “reasonable suspicion” that you may have a controlled drug or other contraband.  Any premises may likewise be searched without a warrant on “reasonable suspicion”.

If a urine sample tests positive, you will be charged with drug possession, even if you consumed the drugs prior to entering Singapore.  If you use recreational drugs, you should stop sufficiently far ahead of your trip to Singapore that you are “clean” on arrival.

Mandatory death penalties

Mandatory death penalties are applicable for amounts exceeding the following:

• cannabis mixture: 500 grams
• cannabis resin: 100 grams
• cannabis: 500 grams
• cocaine: 30 grams
• hashish: 200 grams
• heroin: 15 grams
• methamphetamine: 250 grams
• morphine: 30 grams
• opium: 1,200 grams

It has been estimated that 70% of the death sentences carried out in Singapore are for drug offences.  For lesser amounts the penalty may be life imprisonment.  For really tiny amounts you may be sentenced to judicial beating.

Official list of restricted medicines

It can take quite a bit of searching to locate the official list of medicines restricted in Singapore.    We provide a summary list below.  At the time the article was written the authoritative link was at http://www.hsa.gov.sg/publish/hsaportal/en/home.html   There you should scroll down and click on the menu item on the right that says “Bringing Personal Medications Into Singapore”.

Authorisation is required for medicines

If your medication contains ANY of the substances in the “Appendix A” list (copied below) then you should complete a form available on their web site and apply for authorisation to take it into the country.  This must be submitted no less than ten days before entry.

Once you have completed the form the official procedure is:

Email the form to: hsa_info@hsa.gov.sg   or

• Fax to: (65) 64789068; or
• Mail to:
  Audit and Licensing Division
  Health Products Regulation Group
  Health Sciences Authority
  150 Cantonment Road, Cantonment Centre
  Blk A, #01-02, Singapore 089762

The following documents and information are required to be submitted with your application:

1. Names and dosages of the medicines (both trade/brand names and names of active ingredients contained in the products)
2. Total quantity of each type of medicines that will be brought into Singapore
3. Your doctor’s letter or medical prescription verifying for the need of the medicines
4. Your flight details and intended length of stay in Singapore (applicable for visiting tourists)
5. Your passport or identity particulars and contact details (address, fax number and/or email)

No more than three month’s supply of ANY medication (even if you have applied for authorisation) may accompany you.  For prescription medicines not on the list  you are required to have a letter from your doctor and a copy of the medical prescription with you as proof that the medicines are for your personal use.

Singapore Health Products Regulation : “Appendix A”

The Singapore Government’s Health Services Authority maintains a list of scheduled substances on their web site.  This is their “Appendix A” of Controlled Substances subject to Import/Export controls.

The list below was retrieved from their site on 6 April 2013, at which time it had last been updated on 2 April 2013.  We do not regularly maintain this list, which is here to give you a general overview of the medicines that are restricted or forbidden in Singapore.  You should check with their web site for updates.

The following substances and products or any stereoisomeric form, ester or ether, and salts of a substance specified below,

n-(1-methyl-4-piperidyl)-N-phenyl formanide, 1-Hydroxy-3-pentyl-6a, 7, 10, 10a-tetra hydro-6, 6, 9-trimethyl-6-H-dibenzo [b, d] pyran, 2-Methyl-3-morpholino-1, 1-diphenylpropanecarboxylic acid, 1-Methyl-4-phenylpiperidine-4-carboxylic acid, 2,5-Dimethoxy-4,alpha-dimethyl-phenethylamine, 2,5-Dimethoxy-alpha-methylphenethylamine, 2-amino-1-(2, 5-dimethoxy-4-methyl) phenylpropane, 3-(1,2-Dimethylheptyl)-1-hydroxy-7,8,9,10-tetrahydro-6,6,9-trimethyl-6H-dibenzo [b,d] pyran-1-ol, 3,4,5-Trimethoxy-alpha-methylphenethylamine, 3-Methoxy-alpha-methyl-4,5-(methylenedioxy)phenethylamine, 3-Methyl fentanyl, 3-Methylthiofentanyl, 4-Bromo-2,5-alpha-methylphenethylamine (also known as Brolamfetamine), 4-Bromo-2,5-dimethoxyphenethylamine, 4-Cyano-1-methyl-4-phenyl-piperidine, 4-Cyano-2-dimethylamino-4, 4-diphenylbutane, 4-Ethyl-2,5-dimethoxy-alpha-methylphenethylamine, 4-Methylaminorex, 4-Methylthioamphetamine, 4-Phenylpiperidine-4-carboxylic acid ethyl ester, 5-Methoxy-N,N-diisopropyltryptamine,

Acetorphine, Acetyldihydrocodeine, Acetylmethadol, Alfentanil, Allobarbital, Allylprodine, Alphacetylmethadol, Alphameprodine, Alphamethadol,Alpha-Methyl fentanyl Acetanilide, Alpha-Methyl fentanyl, Alpha-Methylthiofentanyl, Alphaprodine, Alprazolam, Alpha-Methyl-3,4(methylenedioxy) phenethylamine (also known as Tenamfetamine), Amfepramone, Aminorex, Amobarbital, Amphetamine, Anileridine.

Barbital, Benzethidine, Benzphetamine, Benzyl fentanyl, Benzylmorphine(3-benzyl-morphine), Betacetylmethadol, Beta-hydroxyfentanyl, Beta-hydroxy-3-methyl fentanyl, Betameprodine, Betamethadol, Betaprodine, Bezitramide, Bromazepam, Brotizolam, Bufotenine, Buprenorphine, Butalbital, Butobarbital.

Camazepam, Cannabinol derivatives, Cannabinol, Cannabis and cannabis resin, Carfentanil, Cathine, Cathinone, Chlordiazepoxide, Chlorphentermine, Clobazam, Clonazepam, Clonitazene, Clorazepate, Clotiazepam, Cloxazolam, Coca leaf, Cocaine, Codeine, Codoxime, Cyclobarbital.

Delorazepam, Desomorphine, Dexamphetamine, Dextromoramide, Dextropropoxyphene, Diamorphine,(Heroin) Diampromide, Diazepam, Diethylthiambutene, Difenoxin, Dihydrocodeine, Dihydroetorphine, Dihydromorphine, Dimenoxadole, Dimepheptanol, Dimethylthiambutene, Dioxaphetyl butyrate, Diphenoxylate, Dipipanone, Drotebanol.

Ecgonine, and any derivative of ecgonine which is convertible to ecgonine or to cocaine, Estazolam, Ethchlorvynol, Ethinamate, Ethylloflazepate, Ethylmethylthiambutene, Ethylmorphine (3-ethylmorphine), Eticyclidine, Etilamfetamine, Etonitazene, Etorphine, Etoxeridine, Etryptamine.

Fencamfamin, Fenetylline, Fenproporex, Fentanyl Fludiazepam, Flunitrazepam, Flurazepam, Furethidine, Gamma hydroxybutyric acid, Glutethimide, Halazepam, Haloxazolam, Hydrocodone, Hydromorphinol, Hydromorphone, Hydroxypethidine, Isomethadone, Ketamine, Ketazolam, Ketobemidone.

Lefetamine, Levomethorphan, Levomoramide, Levophenacylmorphan, Levorphanol, Lofentanil, Loprazolam, Lorazepam, Lormetazepam, Lysergamide, Lysergide and other N-alkyl derivatives of lysergamide, Mazindol, Mecloqualone, Medazepam, Mefenorex, Mephentermine, Meprobamate Mescaline, Mesocarb Metazocine, Methadone, Methadyl acetate, Methcathinone, Methamphetamine (also known as Methylamphetamine), Methaqualone, Methyldesorphine, Methyldihydromorphine (6-methyldihydromorphine), Methylphenidate, Methylphenobarbital, Methyprylon, Metopon, Midazolam Monoacetylmorphine Morpheridine, Morphine methobromide, other pentavalent nitrogen morphine derivatives Morphine N-oxide, Myrophine.

n,alpha-dimethyl-3,4-(methylenedioxy)phenethylamine, n,N-Diethyltryptamine, n,N-Dimethyltryptamine, n,[alpha-methyl-3,4-(methylenedioxy) phenethyl] hydroxylamine, n-ethyl-alpha-methyl-3,4-(methylenedioxy)phenethylamine, Nicocodine, Nicodicodine, Nicomorphine (3, 6-dinicotinoyl-morphine), Nimetazepam, Nitrazepam, n-methyl-alpha-ethyl-3,4-(methylenedioxy)phenethylamine, Noracymethadol, Norbuprenorphine, Norcodeine, Nordazepam, Norketamine and its dehydro derivatives, Norlevorphanol, Normethadone, Normorphine, Norpipanone.

Opium, Oxazepam, Oxazolam, Oxycodone, Oxymorphone, para-fluorofentanyl, Parahexyl (3-hexyl-1-hydroxy-7, 8, 9, 10-tetrahydro-6, 6, 9-trimethyl 6h-dibenzo [b, d] pyran), Pemoline, Pentazocine, Pentobarbital, Pethidine, Phenadoxone, Phenampromide, Phenazocine, Phencyclidine, Phendimetrazine, Phenmetrazine, Phenobarbital, Phenomorphan, Phenoperidine, Phentermine, Pholcodine, Piminodine, Pinazepam Pipradrol, Piritramide, Poppy-straw and concentrate of poppy-straw, p-methoxy-alpha-methylphenethylamine, Prazepam, Proheptazine, Properidine (1-methyl-4-phenyl-piperidine-4-carboxylic acid isopropyl ester), Propiram, Psilocin, Psilocybine, Pyrovalerone.

Racemethorphan, Racemoramide, Racemorphan, Remifentanil, Rolicyclidine, Secbutabarbital, Secobarbital, Sildenafil, Sufentanil, Tadalafil, Temazepam, Tenocyclidine, Tetrazepam, Thebacon, Thebaine, Thiofentanyl, Tilidine, Triazolam, Trimeperidine, Vardenafil, Vinylbital, Zipeprol, Zolpidem.

While every effort has been made to verify the contents of this list, we advise travellers to check their medication with the Singapore consulate before travel and to apply for prior permission.

Web site bug

On the Singapore Health Sciences Authority web site there is a Frequently asked questions section.  You can only access that using Internet Explorer.  More modern browsers fail with a Javascript error that says “POST requests are not permitted from foreign domains.”

Complementary medicines

Many complementary medicines contain no pharmacologically active ingredients and would consequently not run foul of regulations, other than perhaps on the import of alcohol.  However, those that contain Schedule 1 or Schedule 3 “Poisons” (according to the list available on the Health Services Authority web site) are subject to similar regulations to medicines. viz. doctor’s script (must be a registered medical doctor, not a shaman, beauty therapist or coach, etc.) , the documentation required, and a 3-month limit on supplies.

The Singapore Health Sciences Authority recommend on their web site that for further information you should contact: hsa_info@hsa.gov.sg  Alternatively, you may call Tel. (65) 6866 3522 or (65) 6866 3592 for assistance.

Consequently, it is recommended to leave all but absolutely essential medicines at home if you are going to or via Dubai, even as a transit passenger.  In some cases the consequences are pretty severe, but many other people have been inconvenienced to the extent of being detained for some hours before being released.  One might say “no harm done”, unless of course, it happens to you.  A few hours of detention by customs officials is not at all pleasant anywhere in the world, but all the more so if people are shouting at you in a language that you do not understand.

The UAE uses highly sensitive equipment to search for the slightest trace of drugs.

Some of the horror stories

Some of the cases that have been reported by the BBC:

• Keith Brown: Four-year jail term for possession of 0.003g of cannabis, stuck to the bottom of his shoe
• Robert Dalton: On trial for alleged possession of 0.03g of cannabis
• An un-named 20-year-old: On trial for alleged possession of 0.02g of cannabis
• Tracy Wilkinson: Held in custody for eight weeks for possession of a painkiller containing codeine (prescribed for back pains) before release
• Swiss national: Four-year jail term after three poppy seeds found on his clothes
• Cat Le-Huy was arrested in Dubai for carrying Melatonin jet-lag tablets, which are sold over the counter in the US and Dubai.

Extent of the problem

Carrying more than 10 paracetamol tablets has been known to cause trouble at Dubai customs.  (“Trouble” meaning being detained, strip searched and interrogated.  It’s best avoided.)  Even such traveller’s basics such as Lomotil are banned!

Catherine Wolthuizen, chief executive of Fair Trials International, said Dubai customs authorities were using highly sensitive new equipment to conduct thorough searches on travellers.

“So many people now travel to Dubai and, as we’re seeing, many have no idea what risks they’re taking or their vulnerability to this very strict approach,” she said.   “If they find any amount – no matter how minute – it will be enough to attract a mandatory four-year prison sentence.

“What many travellers may not realise is that they can be deemed to be in possession of such banned substances if they can be detected in their urine or bloodstream, or even in tiny, trace amounts on their person.”

Strict Islamic principles

“Dubai’s culture is rooted in Islam, providing a strength and inspiration that touches all aspects of everyday life.” — Dubai Government web site.

Even international web sites promoting drugs banned in Dubai are blocked.  The Ministry of health coordinates with the Telecommunications Regulatory Authority to block them.

So what sorts of drugs are banned?  Dr. Amin Hussein Al Amiri, Assistant Undersecretary for Medical Practices and Licenses gives the official perspective that these are “especially weight loss, body building, hormones, sexual stimulants and other unapproved medicines”.  In reality, any medication could cause you problems.

No official list available

No list of banned or restricted substances is available from UAE embassies, web sites or other official UAE sources!  That makes compliance considerably harder and leads some to the conclusion that the intention is to catch people out rather than to keep the country drug-free.

Furthermore, in addition to a banned list, the Dubai customs authorities also reportedly are using an “approved” list.  A particular medicine may not be on the banned list, but if it is not yet on the approved list then you will still be treated as a criminal suspect!

Take lots of documentation for life-sustaining medication

If you absolutely must take medication with you, because it keeps you alive, then ensure that you have as much documentation as possible.  Not only should you have a prescription to cover each medicine, the doctor should explain in a letter what the purpose of each drug is.  Get letters from specialists and hospitals.  Have it authenticated by the local UAE embassy well ahead of your travel date.

In practice, it is not safe to take any medicines with you to Dubai.  Passengers on aircraft diverted to Dubai, or in transit, who did not expect to pass through customs have been arrested and spent time in jail, even when in possession of valid prescriptions.

Fair Trials International list of banned or restricted substances

Fair Trials International has compiled an unofficial list of controlled medicines for Dubai and the UAE.  This is based in part on the schedules to the UAE Federal law No. 14 of 1995, and the General Authority for Health Services Guide to the Management of Controlled Drugs in the Private Sector, March 2007

Narcotics

Banned outright.  May not be imported into UAE. Possession of these drugs, with or without a prescription, may lead to a prison sentence. In addition to the medications listed below, this category includes cannabis, cocaine and opiates, from heroin to poppy seeds (the kind used in everyday baking).

Listed narcotics (active ingredients):
Alfentanil, Amphetamine, Buprenorphone, Codeine, Fentanyl, Ketamine, Methadone, Methyphenidate, Morphine, Pentazocine, Pethidine, Remifentanil, Sufentanil

Listed narcotics (some trade names):
Ketalar, Physeptone, Ritalin, Sosegon, Subutex, Ultiva

Class A Psychotropics

These are drugs for which a prescription must be held. The more verifying paperwork from the authorising doctor which can accompany any drug in this category, the better. In UAE, they can only be dispensed upon production of a registered (health authority-approved) prescription. They include some common sleeping tablets, painkillers, anti-depressants and hormone replacement therapy

Listed Class A Psychotropics (active ingredients):
Acitretin, Alprazolam, Aripiprazole, Bromazepam, Buprenorphine , Butorphanol, Chlopromazine, Chlordiazepoxide, Clobazam, Clonazepam, Clorazepate, Diazepam, Dihydrocodeine, Droperidol, Flumazenil, Flupentixol, Fluphenazine, Haloperidol, Isotretinoin, Lorazepam, Medazepam, Mephenoxalone, Midazolam, Misoprostol, Nalbuphine, Olanzapine, Phenobarbitone, Pimozide, Prazepam, Prochlorperazine, Propofol, Prostaglandin, Quetiapine, Risperidone, Sulpiride, Sultopride, Temazepam, Thiopentone, Tiapride, Tramadol, Trfluoperazine, Zaleplon, Ziprasidone, Zolpidem, Zuclopenhtixol

 Listed Class A Psychotropics (some trade names):
Abilify, Anexate, Arthrotec, Ativan, Barnetil, Buccastem, Clopixol, Cytotec, Deanxit, Dehydrobenzperidol, Demetrin, DHC continues, Dialag, Diapam, Diprivan, Dogmatil, Dormicum, Dorsilon, Frisium, Gardinal, Genprid, Haldol, Intraval, Largactil, Lexotanil, Limbitrol, Neotigason, Nobrium, Noctran, Nubain, Orap, Prolixin, Propess, Risperdal, Rivotril, Serenace, Seroquel, Sonata, Stadol, Stelazine, Stemetil, Stesolid, Stilnox, Tekam, Temgesic, Tiapridal, Tramal, Tramundin, Tranxene, Valium, Xanax, Zaldiar, Zeldox, Zyprexa

Class B Controlled medicines

Possession of these drugs must be accompanied by a prescription. Many of these drugs are available over-the-counter in other countries (or even in Dubai!) and travellers to or through UAE should ensure they obtain a prescription before carrying any of these drugs to that country. They include many common cold and cough remedies.

Class B Controlled medicines (active ingredients):
Amitriptyline, Baclofen, Benzhexol, Biperiden, Buspirone, Carisoprodol, Citalopram, Clomipramine, Codeine, Cyclobenzaprine, Dextromethorphan, Diphenoxylate, Dotheipin, Duloxetine, Escitalopram, Estradiol, Ethinylestradiol, Etonogestrel, Fluoxetine, Flupenthixol, Fluvoxamine, Imapramine, Isotretonin, Lithium Carbonate, Maprotiline, Menotrophin, Meserolone, Methocarbomol, Mianserin, Milnacipran, Minaprine, Mirtazapine, Moclobemide, Naltrexone, Nandrolone, Nefazodone, Norethisterone, Norethisterone, Norgetrol, Noscapine, Octreotide, Oestradiol, Opipramol, Orphenadrine, Oseltamivir, Oxazepam, Paroxetine, Pholcodine, Pimecrolimus, Procyclidine, Propoxyphene (with paracetemol), Pyrisuccideanol, Reboxetine, Sertraline, Somatrophine, Testosterone, Ticlopidine, Tizanidine, Tretinoin, Trimipramine, Vecuronium, Venlafaxine

Class B Controlled medicines (some trade names):
123 Cold, Actifed Compound, Actifed DM, Activelle, Adol Cold, Adol Compound, Adumbran, Akineton, Algaphan, Anafranil, Andriol, Artane, Athymil, Aurorix, Benxtrone, Bepro, Broncholar, Broncholar forte, Bronchophane, Buspar, Cancolite, Cantor, Cipralex, Cipram, Climen, Codaphen, Codaphen plus, Codilar, Codipront, Codis, Coldex-dD, Cymbalta, Deca durabolin, Decutan, Dextrocuf, Dextrolag, Diarsed, Diaxine, Dicton, Distalgesic, Edronax, Efexor, Elidel, Estracomb, Estrofem, Faverin, Femoston, Flexiban, Flozak, Fluanxol, Flumed DM adult, Fluneurin, Fluoxone, Fluran, Flutin, Fluxetyl, Genotropin, Insidon, Intard, Ixel, Kafosed, Kemadrin, Kliogest, Lagaflex, Linz, Lioresal, Lomotil, Ludiomil, Menogen, Muscadol, Myogesic, Noracod, Norcuron, Norditropin, Norflex, Norgesic, Nuvaing, Oxetine, Paracodol, Phensedyl, Primotestone, Progyluton, Prothiaden, Proviron, Prozac, Remeron, Revacod, Rhinotussel, Riaphan, Roaccutane, Robaxin, Robaxisal, Robitussin-CF, Romilar, Saizen, Salipax, Sandostatin, Saroten, Sedofan DM, Sedofan-P, Seroxat, Serzone, Sirdalud, Somadryl compound, St Joseph cough, Sterandryl, Stivane, Surmontil, Sustanon, Tamiflu, Ticlid, Tixylix, Tofranil, Trexan, Tripofed dm, Trisequens, Tryptizol, Tuscalman, Tussifin with codeine, Unified DM, Vesanoid, Virormone, Zoloft

While every effort has been made to verify the contents of this list, where in doubt, we advise travellers to check their medication with the UAE consulate before travel.

Fair Trials International  recommend on their web site that for further information you should contact: UAE Embassy Medical Department 71 Harley Street, LONDON, W1G 8DE Phone: 02074866281

Related: Other interesting and informative articles

Dubai sights:  “A day in Dubai”, with an interesting way of seeing the city.

Similar drug information for Singapore: “Singapore risks: medicines, drugs, death sentences and tourism”.

Over the next few minutes you inexplicably start to feel unease.  You experience some of the following sensations:

• Feeling faint or dizzy
• Your limbs tingle or go numb
• Tightness, discomfort or pain in your chest
• Your throat closes up and you can’t swallow
• You become fearful of dying
• Your heart speeds up, pounds or palpitate
• You start shaking
• Shortness of breath, or you feel there is not enough oxygen in the air
• You start sweating profusely
• You have a cold chill or a hot flush
• Your tummy feels disquieted
• You feel nauseous
• You become detached from yourself
• Things start feeling unreal

Copyright DIY Travel Expert

You could be suffering from a panic attack.  (You could also be having a heart attack.  If you are at all unsure, ask the cabin crew for help right away.  As with other medical conditions, panic attacks need to be properly diagnosed by a medical professional.)

Panic attacks are extremely unpleasant, scary and disturbing; and typically last from a few seconds to around half an hour.  They are triggered in part by the anxiety that one experiences in the build-up to the flight, which makes it a much bigger deal than it really ought to be.

The first bit of hope that we can give you is that, although you feel that you are going to die, one does not die from anxiety or panic attacks.  It will go away, and you will get over it, however you may feel when in the grips of one.  The physical symptoms you experience at the time make the psychological strains that much harder to bear.  Some admit to having prayed for death.

What can you do about panic attacks

For a number of people anxiety precedes the panic.  If you are able to reduce the anxiety, you may well be able to ward off the attack.

It is said that the writer Tolstoy and his brother claimed to be members of an exclusive club.  Membership was obtained by standing in a corner for half an hour and not thinking about anything white.  If you try it you will soon find that you are thinking of the word white and white things.  The brain cannot unthink any idea – it is made to think about something.

You can’t “fight” anxiety any more than you can concentrate on not-thinking about something white.  You have to replace you’re anxious thoughts with peaceful, calm and pleasant thoughts.  Or put another way, you must divert your attention elsewhere.

1. Medication.  Responsible physicians can prescribe non-habit-forming drugs that can provide support to alleviate the anxiety and panic, without impacting on your intellectual capacity or reducing you to a zombie-like state.  Anxiety can also be a side-effect of medication that you might be taking for other conditions, in which case your medical practitioner may try changing the prescription to alleviate the symptoms.  Diet pills and cold and flu medication can heighten anxiety.  You may also be advised to avoid certain foodstuffs, for instance caffeine, that can heighten anxiety in many people.  Certain anti-depressants may take a month before they are fully effective, and you would need to take them even when you are not experiencing an attack.

Benzodiazepines are not recommended by many medical practitioners.  They take 30 minutes to an hour to act, by which time the panic attack would have subsided by itself, and they are highly addictive.

2. “First-aid”.   Relax.  Options that you may have when on the ground, like going for a walk outside, are clearly not available to you when you are in the air, which can greatly heighten the tension of the experience.  If you feel the beginnings of a panic attack, close your eyes.  Breathe in and out deeply a few times.  Try to relax any areas of your body in which there is muscular tension.  If you are travelling with a loved one, get them to massage the back of your neck.  Physical contact is a deep-seated need in humans and appropriate physical contact can provide silent reassurance.  Hugging or grabbing the hands of strangers will create additional problems of a different kind.

3. Think positive thoughts.  Having a Polly-Anna outlook on life is not what we mean.  When you are experiencing a panic attack, imagine being in a happy, peaceful place.  What is important is that you must push your thoughts in a positive direction.  By thinking about something nice, you drive out the anxious thoughts, at least for a while.

4. Eliminate sources of anxiety.  This is something that you can only do before or after the attack, not during one.  In fact if you try address these causes during an attack you are likely to just make it worse.  If you are going through a crisis in your life then you probably need to get help with that rather than looking at the travel aspects – it is best to attend to root causes.  And you may need professional help with that.

If the source of anxiety is the travel itself then you are already doing something useful about it by reading DIY Travel Expert.  Understanding the symptoms is a good starting point.  We also have articles that explain what is happening during various stages of the flight and considerations as to how you can ensure your personal safety.  Knowledge about flight operations is one established way of fighting fear of flying.

Psychologists specialising in travel anxiety are likely to use two approaches: cognitive behavioural therapy or exposure therapy.  Cognitive behavioural therapy unpacks the thinking and behaviours that lead to the attack and help you to understand your fears in a realistic way.  Reading our series of articles on fear of flying and anxiety will provide much information that can assist with this.

Exposure therapy typically means taking a course in which you are shown around the aircraft, get to sit in it when it is not going to go anywhere and gradually desensitise yourself to your fears.  The good news is that this is not needed for most people.