How To Travel To Tokyo When You Have Panic Disorder

“We never had a honeymoon…” 

My husband sighed because this conversation had become almost redundant. He had started a new job right before we got married, so while we did get 4 days in the far away from New Jersey in Toronto, Canada, we didn’t exactly spend a moon’s worth of time enjoying being newly married. “I am not spending 12 hours on a plane so that I can lay on a beach in Hawaii,” was his verdict. 

Touché, we’re both more of the exploring type.  

Eventually, we realized the only place that two nerds like us would spend a long time traveling to would be Japan. We fancy ourselves huge fans of the culture (pop and otherwise) but always assumed it was an impossible trip due to our chronic illnesses. Between the two of us we share a basket full, and Panic Disorder is included in my husband’s portion.  

As is the case with many mental illnesses, this one restricts the activities we can enjoy quite a bit. Panic Disorder and a 14.5-hour flight sounds... well, that’s enough to get a healthy person nervous. His previous max for flying was 5 hours to a wedding in California. I am sure anyone with general flight anxiety would even balk at that, so I was grateful that his sheer stubbornness got us that far.  

I always figured that 5 hours by plane would be our maximum travel distance. Then one day, we decided we would “just go.” 

Here are the steps that got us to Nov 27th, 2018 when we finally got on a plane and made it over to Nihon.  
For details on exactly how to survive a flight specifically, stand by for another upcoming piece. 


Be Ready To Discuss Minutia and Plan Everything 

Spontaneity takes on a different meaning for us. Everything and anything was planned. Not only to sooth those traveling jitters, but also to ensure we were prepared for potential triggers (listed below) in places we went. With an emphasis on preparedness, not on avoidance. A huge portion of such preparation involved the next point.  

Time for Cognitive Behavioral Therapy 

In cognitive behavior therapy  (CBT) the goal is to take the thoughts and ideas that contribute to our unpleasant world view, or in this case—excessive fears, and reprogram our minds to see things more productively.  

Because my husband had previously went through therapy, we were aware of his regular triggers—confined spaces (Claustrophobia) and feeling like you need to vomit (Emetophobia) — and had already been hard at work ensuring that the list did not expand. The issue in this new place would be experiencing unknown food in a new country as well as being inside a metal tube for 14.5 hours in one direction and 12.5 hours to return. 

The most painful caveat was this: having been to therapy is no indication that you are willing to go back. It’s extremely likely that there will be resistance from the person who needs help to accept it. It’s hard to admit that the problem didn’t go away.  That is no “cure.” That you need more healing. This was superseded by our desire to really enjoy our time after saving up so much money and having to take off work, and that was the final reason he did end up going. I mention this, because I wanted to take a moment to acknowledge the difficulty of this piece alone. 

Do not hesitate to see a professional just because you think you can handle something on your own. You probably can, but what if someone with an outside perspective offers you insight which makes traveling that much easier? Either you go on your own and just know it will be good enough, or you try and talk to someone. In the best case, you may come out learning something that makes things easier. Why not try? 

Create a Game Plan, Then Communicate It 

Panic only gets worse when we feel the situation we’re in has gone out of control. A great way to feel worse is to have someone next to you panicking about your panic because they are unsure of what they should do to help –the meta panic. 

In the moment, an attack can onset with physical symptoms (shortness of breath, inability to speak) that make it impossible to tell those with you what you need. Needless to say, a game plan can help alleviate unnecessary stress in an already tense moment. For example, for my depression, people around me know not to leave me alone, even though that is something I might request when I am at my lowest.  

For my husband’s panic attacks, I can detail exactly the steps I take when I see one setting in every time. 

Ask if there is any specific action that could help 
Yes? Do as told. No pressuring him to “try something else,” or telling him to “drink some water” as now is not the moment to experiment. 

No? Go through our communicated list 
a. Light tapping on the wrist where his pulse is 
b. Getting something cold to place on the back of his neck 
c. Stopping to do a breathing exercise 
d. Reminding him that the panic is temporary, and he is okay 

Panic attacks are not fun for anyone. Whether you’ve only had one once or you get them regularly it helps to have someone prepared by your side. In addition, I have found that just the exercise of talking to someone and explaining what to do should X happen helps put them at ease, even if they are not familiar with what the issue is.  

If you frequently find yourself without a buddy to help you through, the advice still applies to you. Note what helps you and have those things at the ready when you are feeling unwell. Whether it’s a talisman or tapping yourself. Spend time getting to know what helps you feel your best and be ready to apply that as needed. Which brings me to:

Learn New Coping Mechanisms 

The details of the exact exercises my husband went through for exposure therapy will be light, because of confidentiality and because they are precisely individualized between each doctor and patient. Two things stand out as universal assists: 

A) Mindfulness – the practice of acknowledging the moment and remaining in the present 

B) Breathing exercises—your doctor can help you determine which ones will work best for you, but I found some good ones that align well with my yogic background here and here

Both were to be used whenever either aforementioned trigger was present to avoid excessive panic rolling into an attack. 

Prepare an Awesome List 

Have a list of things you want to do that you start putting together the moment you buy plane tickets. The list helps in one of twofold. First, it serves as a great reminder of why you are willing to put yourself through this tough time. Second, it will help you plan your trip and reduce the amount of surprises you experience. You can still be spontaneous, if that’s what you prefer, but that’s no reason not to have some cornerstone places to set as goals. In the end, you will also get a list of everywhere you’ve been. We used Wunderlist and Google Trips to help us out. 


Here is our list of areas we wanted to go to to jump start your own adventure: 

  1. Disneyland Tokyo 

  2. DisneySea Tokyo 

  3. Authentic Ramen 

  4. Sushi-go-Round 

  5. Tokyo Tower 

  6. Ginza district shopping 

  7. Shibuya Crossing/Shibuya 109 

  8. Hachiko Square 

  9. Akihabara district 

  10. Takeshita/Harajuku Street 

  11. Hello Kitty Store 

  12. Sailor Moon store 

 I want to know what you do to make your trips easy and fun? How do you navigate so that your mental illness gets in the way minimally so that you can enjoy yourself and have a great time? Let me know in the comments!