You can purchase internet minutes on board. OR when you get off, follow the crew, they know where the WiFi spots are.

Last year, we flew to San Francisco where we rented a car to explore for 3 days. Then a 15-day cruise to Hawaii and back - stay on the ship and went into the Sea of Cortez and back. Total = 25 days. We stayed in San Francisco for 3 days and rode Amtrak back to Illinois. We flew, drove, cruised and took the train. Not many can say that they have done something like that at one time. What a blast.

chi - I can't answer your questions about going on a cruise by yourself, but I can address the anxiety of flying.

I work for the largest aerospace company in the U.S. - I work for Boeing. Boeing and Airbus are the largest airplane manufacturers in the world. I too have some anxiety about flying. The feeling of not having any control, the feeling that something might happen to the plane mechanically, etc.

When I get to the airport and start feeling anxious, I remind myself that I know intellectually how safe aircraft are, that there are numerous systems that back up each other - every commercial airplane system is built with a primary, auxiliary, back-up, and emergency system (four systems) to ensure the safety of passengers. There are thousands of miles of wiring, and back-up systems to all of them. Airplanes can fly safely to their destination if one engine fails. If flying on a two engine plane, if one engine went out, the aircraft could fly with just one. In four engine planes, they could fly with three.

Anyway, I could go on and on about how safe an aircraft is, how many thousands of flights take off and land every day without incident, etc. I don't usually post my personal stuff on-line but did this time; maybe something I've written may be helpful to you. I hope you are someday able to resolve your anxiety - there are so many fascinating places in the world to see and experience.

I'm not going to let you off that easy.

Childhood anxieties shouldn't continue into adulthood, they all should have been jettisoned long ago. You're better than that and you know it. Part of being an adult is understanding the need to deal with things that are uncomfortable, that are difficult, that are unavoidable, that are unpleasant or even very disturbing. I'm going to guess that you've never really been pushed in your life and have been able to detour away from things you don't like.

Forget the excuses, forget the memories. Forget what did or didn't work. You need to put on your big girl pants and make a plane reservation. Do it cold turkey and don't give it another thought. Your attitude is wrong because it's really a nothing. Just as your saying that you're shy, there's nothing shy about your participation here. Push yourself to do what needs to be done. How you are is and can be different every day, and every situation. Hogwash to thinking otherwise. Try and fail, don't shy away from it. If you come back from the trip and say "Hey, next time, I'm taking Greyhound", fine. Don't decide in advance.

Really. And really, good luck. It's nonsensical to cling to this.

Edit for PS - enjoy your trip. Everyone has a different view but just the thought of spending so much time on ships would get me on a plane for sure. I find cruises exceedingly boring. You're stuck with a so-so room, so-so food or less, a not-so-interesting cast of fellow travelers (and many elderly) and not enough time to visit the ports of call. Nothing wrong with being elderly, I'll be there one day too, but for now, I'm not inclined to do my partying with people who look like they're on parole from their residential institutions.

Chi, I've been on several cruises in the last few years. Some with hubby, some with a friend. None alone ... but ... I'd go alone in a heartbeat if the opportunity came up. I's also choose a cruise over flying any time if I wasn't working. Not because of any anxiety issues but simply because it's fun!

I think the most awkward part would be eating alone while on shore but certainly not on the ship. There are always plenty of people to meet and get to know. You'll have gals to hang out with in no time.

Cruise Critic is a great way to meet people who are going to be on your cruise before the ship even sets sail. There will often be mixers/small parties set up by those on CC so that everyone can meet at the beginning of the cruise.

We did the Panama Canal in 2011 out of San Diego. Took the train from Irvine (though you might want to leave from San Juan Cap). The train station in SD is right across the street from where the ships leave. It was an easy walk from train to ship.

If you want to talk about our specific PC cruise (on the Celebrity line) and/or the ports we visited, contact me via Facebook. I've also sailed on a Holland America ship in 2006. I was 53 at the time and pretty much the youngest one on board so that might be something to consider when looking for a cruise line.

chi, have you considered paying to have your grandparents fly/cruise to CA to see you? :)

Could your DH take a few vacation days to accompany you on a flight to Florida? You could be practically comatose on anti-anxiety drugs as long as you had a 'minder' with you. You could take a ship or train home.

When was your last attempt at setting the child's anxieties aside?

Jodi, I forgot that you had done that cruise! Thanks for the tip on San Diego - I didn't realize the train goes right to the terminal. Seems much easier than LA. I've been using the Cruise Critic message boards - very helpful. We took Holland America up to Alaska last year and really enjoyed it, but we were definitely one of the youngest there. It didn't bother me though. The peace and quiet is nice. I haven't tried Celebrity, but I'm looking at that and Princess. The only one I want to avoid is Carnival.

Haha party_music, I wish! I would in a second but they don't like traveling. They came out for my wedding last year and warned me it was the last time, but they might make an exception when I have a kid. :)

chisue, I haven't flown in 10 years. My last attempt was 2008 when my mom died and her memorial service was in another state. I bought the tickets but just couldn't go. If I couldn't muster up the courage/guilt to go to my mom's funeral, I don't know how I can go on a vacation.

Thanks for everyone's advice and suggestions. I'm putting the cruise on the back burner for now because after calculating it out, it would be over $6,000 to go there and back and that's a lot for transportation. But I'm going to keep my eye out for good sales and take advantage in the future.

Chi, I am not so much afraid of flying, and I have flown a few times, but, I absolutely detest it, so much, it spoils my entire trip. Since I travel alone most of the time, I now do my traveling by Greyhound, and I enjoy every minute of it.

I should have worded my question differently. I'm asking when you last addressed the child's anxieties that are having a negative effect on your adult life. This would be a good time, while you have the extra motivation to visit your grandparents in Florida.

This isn't about willing yourself to fly. It's about being willing to look at how you became an anxious child -- and to *emotionally* realize that you are no longer that powerless child. Your present adult self has power and perspective; the child had neither. You could use it to explore a child's 'magical thinking' truths and identify what are today obsolete fears and defenses -- with psychological guidance.

I have benefited from doing this. I think of it as 'weeding'.

It's not really a child's anxiety. I have been anxious my entire life, starting in childhood. And yes, while I have power and perspective now, it's only intensified the anxiety as now I understand the things a child should never have to understand, like death, illness, etc.

I do have a rational understanding of fears, and realize they aren't logical. The chances of being in a plane crash are so low but that doesn't make me okay with going. I don't like heights. I don't like being completely powerless, like you are when you're strapped in a metal tube high in the sky. I don't like relying on machinery and human judgement with my life. I get that I do that in other ways every single day but that doesn't involve free falling 36,000 feet waiting to die like some poor souls have gone through. Or knowing a terrorist or suicidal pilot has taken over your plane and will be crashing it. I know bad things can happen on boats or trains or cars or even walking on the sidewalk but these things don't scare me as much as planes.

This is not something new. I've been dealing with it for almost 30 years. I've gone to countless doctors, therapists, tried different drug cocktails, tried exercise and meditation and visualization. Nothing works.

I'm okay with not wanting to fly. There are alternatives now where I can still see the world, though it takes a lot longer. Boats go to Asia and Europe and Australia and everywhere else.

I'm guessing you are taking the train then? I know Snidely and others mean well, but for those who have anxieties, it's just that that simple. Chi, my heart goes out to you. You've done what you could. I don't know, maybe there is some new therapy out there that you haven't tried?

Years ago , I thought I was afraid to drive.(We didn't have a car growing up) I went to a therapist and he told that it was a normal fear! Yes, things can go wrong in a car, in a plane, on a ship etc. It's normal to understand the possible dangers. But, by him stating this so simply, I took driving lessons and got my license.

Some people can't drive over bridges, or like my sister, won't drive on a highway.

Chi, LOL on Carnival ... during our two week cruise to Alaska in 2008, one of the gals at our dinner table told us the first night that she works as a gangplank registrar at Carnival in San Pedro where our Celebrity ship departed. Shocked, we asked her why then would she be cruising the competition. She said, "Are you kidding? Carnival cruises are way too wild and crazy!"

We love the Celebrity cruise line. We've been to AK (the Mercury), the Panama Canal (the Infinity), and Southeast Asia (the Millennium). Next month we will be on the Celebrity Equinox for a one week cruise of the Mediterranean book-ended by a week in Barcelona and Athens.

We love Celebrity and the way the cruise line runs their ships. And of course have worked our way up the echelon in the Captain's Club for more perks. Nothing beats a large suite jacuzzi, balcony and butler!

It would take a lot of consideration to cruise Holland America again. It was a three week repositioning cruise starting in Kobe, Japan. Made two more stops in Japan, then on to Russia, several ports in Alaska, the inside passage ending in Vancouver. Sounds like a dream cruise but so much went wrong. The ship broke down three times and a fire broke out during dinner the last night on board. I prefer to relax on vacation, not find my feet wet from the pool emptying due to severe listing or wonder why the entire kitchen and dining room crew simply disappeared after a series of bells were broadcast. Turned out they all quietly and quickly (as they should) headed to their post because of a fire leaving the early seating diners trying to figure out what happened to all the pomp and festivities that had gaily begun shortly before the mysterious bells. Of course we were all finally informed but it by that time, the late seating diners were lined up at the door and we were only halfway though our meals. We returned to our stateroom to find the door open in an attempt to clear out the smoke in our room. Thank goodness I am accustomed to using the on-board room safe.

crazy idea but what about flying there and then cruising home? that way you get there quickly, but can spend your trip relaxing and avoid the dread of the flight home. I think you will have a blast on a cruise alone. Cruisers are fun people who will embrace you and take you in:)

If I were you and I had a nice new car (don't know what you drive) I would just drive it. Would there by any chance be a bus tour going to Florida from California? I don't mean Grey Hound, I mean a nice tour bus. As to your first question, I would LOVE to take a cruise alone. I love love love cruising and have been on several and have loved them all! I love Princess the best!

We drove there 2 years ago. I do like road trips but they aren't as fun alone.

I ended up booking a train. I'm going back east this year anyway for a family wedding, so I'm going to just head south afterwards for the visit. It only adds an extra day and a half each way instead of 4 days each way. I bought a bedroom so I can relax and see the country. I'm looking forward to it! It goes from LA to Chicago, then to NY for the wedding, then down the east coast to Florida.

I still want to do panama someday, though probably only one way. I am watching for specials, and I'm lucky to have the schedule where I can do something last minute, at least till we have kids.

I've personally not done the train from NY to FL but a former boss did. They enjoyed the observation car throughout their trip!

i was in vegas caring for my mother when 911 hit and wasn't about to fly back to Detroit...so caught a train...it really wasn't that bad despite i had "seat" not sleeping car...where i lucked out was getting into the handicap car which wasn't full and so had set of double seats to myself...so stretched out as well as possible...the worst thing was the dining car dinner...having gone on the train as a kid all i remembered was the "white glove service" and really good food...omg that sure was long gone...so ended up at the "snack" bar, for the rest of the trip. oh for the days of santa fe..the feds do NOT know how to run a train service....but! the scenery is totally awesome...and the observation cars are great. btw you're really not confined to your sleeping room...although staying in one's jammies does have some appealing sides...

the only thing about the cruise is the amount of people on the usual ships that do the canal...(about 2-3 thousand on board) so you really can get lost in the crowd...that didn't bother my mom....she was an avid reader and went on few off ship (extra $) places...she did choose a trip in the less "weather' time (avoiding hurricane season)

last? would your grandparents be able to fly out to California? maybe an alternative and you could take them on a short or long drive up/ down the coast? know it can be quite busy in the summer...but ??

I've never been on a cruise, alone or with someone, but I wouldn't hesitate to go alone if I could and the opportunity presented itself. I am not a people person but I can make small talk as well as the next person, but even if you are an introvert, take some books, find a deck chair and just relax. I do eat out by myself quite often. Doesn't bother me. I have been eating alone and have had people ask to sit with me, and that is okay too. I think it is good to stretch your boundaries every now and then. Go and have fun.

I feel for you Chi, as I too have a fear of flying. I do it without pills now, which never seemed to help much anyway, because it's the only way to visit family members--I don't have the time to extend the trip. I have a cousin who hit bottom when she flew, drinking her way to a crying jag so that her husband couldn't sit with her anymore--so funny when she (dear cousin) tells it! Anyway, she took a Fear of Flying weekend class through Alaska Airlines and was able to fly after that with no problems. Amazing. Yep, it's loss of control and too much thinking. I can't sleep on planes because I have to be able to get up and take the controls, if necessary. :)

sjerin, the thought of your vigilant attention and willingness to 'spell' the pilot made me laugh :-)

chi, you're letting your imagination run wild and you're fooling yourself. You can't make up "facts" to justify your decisions. Here are some real facts:

-If something goes wrong in a plane, a train, a bus, or even a car that you're a passenger in, there's nothing you can do about it. If you're not driving, you're not in control, and even if you are, things can happen that are still beyond your control. Why would that be a factor in your mind?

-You want protection from terrorists? Take a plane, there's almost no security on trains.

- You want safety? There was just a fatal Amtrack crash last week. Fatality rates on US trains are TWICE the rate in Europe, TRIPLE the rate in Australia. See today's NY Times article linked below.

Poor US Train Safety

- You prefer the very newest equipment with the latest in safety features? Fly. You want to ride on dilapidated equipment, over rusting and ready to fail bridges, unmaintained roadbeds that can cause derailments, old and unsafe passenger units? Take a train.

- There has been a significant increase in train traffic and congestion because of crude oil shipments from the upper Midwest. The newly found oil being shipped is highly flammable and explodes because of its high natural gas content, it doesn't just burn. The crash rate is higher than it's ever been.

I've traveled all over Europe in their excellent train systems, including many times through the Channel Tunnel between London and Paris. Trains there often reach 200 mph. I've traveled many times on the Wash DC<---> NY Amtrak corridor, reputedly the based train segment we have, and it's like going back 50 years in time. Not in a good way. I'd NEVER take a train in the US that I could avoid.

(PS - my last cruise was on one of the newer ships Celebrity has. I wound up there because the choice was out of my control and made by friends. It was one I would never have made. It was awful, the only other word that would fit would be "mediocre". Everything was mediocre or worse. There were no calamities or unexpected events, just everything was blah. Those who like Celebrity, great, to each his own)

Of course I'm letting my imagination run wild. 99.999999% of the things I worry about never happen. And it's not even that I think these things will happen but my visualization of these events is enough.

I know trains have their own issues. So do cars. But unless I'm willing to never leave my house, I need to get around somehow and I'm comfortable with those options. Not with flying, regardless of the statistics.

I am glad that you decided to do what you are planning. It appears that you are set and that whatever happens will happen.
For those who have not been on Amtrak, there are three basic options. Ride coach. That is your chair and it reclines and you will use a common facility.
You can reserve a roomette. Wonderful for one person. You will also use a common facility. But, you will also get free food!
You can reserve a room! Wow! Much roomier and you have your own facilities. Of course you get the free food.
During the day, for a roomette or room, you can see only one side of the view. In that case, there are cars set aside for relaxing and viewing. There will be a lower level beverage place (not included). But you will have the opportunity to meet your fellow travelers and possibly get into an interesting conversation. Or, you can carry a book and be absolutely by yourself.
I don't mind flying, I hate the BS at the airport. We have considered renting a car and driving cross country, but the cost of lodging, food and tolls have discouraged us.

Snidely -- She has said she can't *reason* this away, and she evidently refuses to try again to find a psychologist to help her. People will put up with a lot of life-limiting handicaps rather than address childhood traumas. There are worse handicaps and coping mechanisms endured by individuals -- and their families.

(I'll give up if you will! LOL)

Jim, I reserved a full bedroom on Amtrak. Very excited! I like train travel.

You will have a blast!

Horse pronounced dead, done.

Thank you maire_cat. I do think some of these comments have been condescending and judgmental. I am not weak or stupid, and I fully understand the limitations of my choices. I have no desire whatsoever to get over it, or confront my fear, or whatever else other people choose to do with their phobias. That's great for them but I have no interest.

This phobia is not caused by childhood trauma. It's due to my general anxiety, which I have had my entire life, and which I am already addressing with my doctors. I will be going to additional therapy to work on my anxiety issues. If it solves my flying phobia, great. If not, no big deal. My general anxiety does affect my daily life so I am committed to trying to find help for that. Flying does not. It's simply a symptom of a much larger problem.

If I had posted asking for ways to get over my fear of flying or the psychology behind it, I would understand some of the responses a little more. But I'm looking for cruise information. Thank you to all of those who have been supportive sharing your stories and tips, and cruising advice. :) I really appreciate it.

You tell 'em, Chi. My relative has general anxiety that has affected her life, and has been receiving therapy for some time. She's still afraid to fly but will do it and take the consequences if need be. And those consequences are not pleasant, and last quite a long time! I completely agree that you've found a great work-around and commend you for taking the train trip on your own. I too think you'll have a wonderful time.

Snidely, you sound like my elderly neighbor's son. He's hale and hearty and thinks that if she would only exercise more (at 88 and she's thin,) and wake up early in the morning, she'll be right as rain. (She has very bad hip/back problems right now.) We are all blessedly different and it is not fair to judge without walking in the proverbial shoes. I'm sure you have at least one little weakness, and I'm also sure you're not told to just suck it up and be normal. :) General anxiety is no different than any other PHYSICAL illness, but meds don't work all that well on it. There is much research these days on a connection between the stomach (gut) and anxiety. Check it out.

sjerin, I don't want to say any more on the broader discussion, but I'll address your comment.

Like most of us (all of us?) , I have lots of shortcomings. Plenty. To your point, I do think I have some awareness of many concerns people deal with that are what you describe as not being of a physical illness nature. And some other thoughts on these topics too.

It seems to me that when there are different opinions voiced in a conversation, the best wisdom can often found in the middle. Call it as a compromise view. I sometimes deliberately express other than a moderate view, to make a point that moves "the middle" to the middle. In this thread as more generally no personal offense is intended, but I do tend to be direct.

I don't care to fly these days. Not because of anxiety, I loved flying but because it is no longer fun since 9/11. My preference when I don't drive is to take the train. It's fun, it's comfortable and despite the cutbacks the service still beats flying.

The roomettes are perfect for singles. Be aware that Amtrak pricing is like no other. To get the best rates you have to be a bit flexible with your schedule. Go online and "practice" buying your ticket. The fare part is pretty much set. But when you start to add a room or roomette it gets interesting. Those are sold by the bucket system. There are 4 or five tiers. The trick is to get the lowest price during the time frame you wish to travel. As the train fills up or even as it is predicted to fill up the price goes up. It varies by several hundred dollars. By punching in various dates during your travel time frame you can eventually figure out the lowest available. If you knwo you want to take the train grab it. It may be gone the next day or even in the next hour. The next step is finding a reasonable return cost. Your first price is what you are shooting for, that or lower.

When you see what the cost of meals and snacks is on a train the roomette starts to look like a bargain. You are assigned seating at tables for 4 at your preferred time. On some trains you can eat in a parlor car you can eat in your room but it certainly isn't much fun. You meet the nicest people on a train. At each meal you can add all you want to your main selection. Want soup and salad? Fine. Want dessert? No problem. Want bacon on your cheeseburger. great. No extra charge at during the meal. You do pay for snacks and drinks at non meals but you are free to bring your own including alcohol if you like.
Most room attendants work very hard at making your trip pleasant. Every car has a coffee/juice station and some have fresh fruit when it's available for snacking. Some attendants leave candy bowls out for their car occupants.

No luggage restrictions other than size which is generous. No one pawing through your things. Bring your whole bottle of shampoo or lotion. You do have to check baggage with firearms. There is plenty of room in a roomette for a carry on and a small cooler and a laptop if you are a single.

I loved reading about your train experiences watchmelol. Makes me want to retire and ride the rails for a few weeks (though I admit, I already wanted to retire) :-)

Thanks watchmelol, that's great advice. That's exactly what I did - with a flexible schedule I searched a two week window and found the day I leave for $300 less than the day before or after. I booked it right away as there was only one room left. I haven't booked the return trip yet but I'll do the same.

My husband and I shared a roommette when we took the train to Vancouver as part of our honeymoon last year. It was okay but a little cramped with two people. If we travel again together we'll probably get a bedroom. I booked the bedroom for the 48 hour leg to Chicago, but I have roommettes the rest of the time since it's less than 24 hours.

I actually find coach chairs more comfortable during the day but at night, the privacy of a compartment and being able to lay down makes all the difference. And it's nice that food is included since it costs a fortune. It's actually not too bad either. Not 5 star of course but certainly decent.

I really enjoyed the Parlour cars in the Coast Starlight in California. The seats were so comfortable I fell asleep sitting up in the middle of the day! I was so bummed on the return trip when the Parlour car was getting maintenance and was replaced with a regular lounge car.

If nobody *cared* we wouldn't go OT and offer other paths. Glad you are pursuing therapy. (Nobody remembers all of his or her life before the age of reason or remembers it accurately.)

Chisue, surely you don't think all anxiety is caused by childhood trauma. A predisposition to anxiety can be genetic, in the same way depression is often inherited.

Watchmelol, that was interesting, and sounds like so much fun!

I appreciate that people care chisue, and want to be helpful. It's just frustrating sometimes that people think anxiety can just be easily solved. It's like telling someone who is depressed to look on the bright side, or someone with addictions to just stop doing or taking the substance. It's not that easy, and if it were, no one would struggle. That's not to say that people can't get over it. They do all the time, and it's wonderful. But usually it has to be a serious, life altering issue to come to that point, and my fear of flying has never been that for me. However, my anxiety has and that's why I'm treating that.

Even just doing therapy has its hardships. A lot of insurance plans won't cover mental health issues, especially without a specific diagnosis. I don't know if anxiety is one of those. I've priced out good therapists and psychologists in the area and they are often $200 an hour to see. That is very limiting for most people. Luckily my insurance covers it, I think, but it's still $35 each time I go, which can really add up going once or twice a week for months for initial treatment and maintenance.

I'm not ignorant of anxiety problems or depression. DH has had problems all his life. He had a severe anxiety attack in 2010. It turned out to be a blessing in disguise. It led to his being 'himself' with the minimum dose of Cymbalta and a dose of Abilify so small (1 mg.) that it's not deemed therapeutic.

It did take going through two plodders before he found a psychiatrist who actually practices the talk therapy psychiatrists are trained to do. Many today are merely pill pushers -- a 15 minute appointment once a month to monitor your dosage.

A paperback by Dr. Claire Weekes helped get him through the worst of his anxiety attack.

I just want to re-mention what Chisue just said in her last sentence. I suffered a bout of crippling anxiety a number of months ago. It was really terrible; I thought I was loosing my mind and was deeply scared that I was going off the deep end. The classic book by Dr. Claire Weekes cured me. For anyone suffering from anxiety please consider reading it. It is a tad old fashioned--in a charming way-- but enormously sensible, and her simple techniques truly work! I had, of course, huge doubts that any book would effectively cure what seemed to be monumental symptoms. But I read the long, long list of testimonials on amazon and am so glad I went ahead and ordered it.

I kind of understand what you are saying about anxiety, chi. I have a neurological disorder that causes my arms and voice to shake. It is often mistaken for anxiety/nervousness. I can't tell you how often well meaning people have said to me "you don't need to be nervous around me" or "why don't you just relax". Okay. I don't have anxiety, true, but I can sort of imagine that a person with anxiety doesn't "just relax". I don't think it's that easy, is it?

With the subject of trains - I took a train trip about 20 years ago. I enjoyed it - saw some wonderful scenery, and I was able to walk around while traveling. Hard to do that while you are in a car. Except - the train stunk. It was a really awful combination, I guess, of food smells, bodily odors, bathroom stink - it was beyond awful, and permeated my belongings for days afterwards. Do trains still stink, or have they improved that problem?

I hope things work out for you. I wanted to support you and hope these people telling you what to do aren't bothering you.

I know what paralyzing fear of flying is, but fortunately, I respond well to meds and can now fly.

I'm no pro without any anxiety, but I manage.

Anyone who thinks they can tell you to do this or that, take this or that, needs to keep their judgement to themselves.

Have fun on your train ride; I did a long one and really enjoyed it. No airport hassel and free wi-fi. Not crowded so was able to spread out over 2 seats and sleep. Just wish it was less expensive than flying.

I have a dear friend, a very intelligent firefighter/paramedic. This guy does not hesitate to run into burning buildings, but he is afraid of flying. His wedding gift to his wife was to fly to their honeymoon location; if not for a heavy dose of xanax he would have missed his honeymoon.

Yes, generalized anxiety disorder is a diagnosis.

The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation, by requiring that most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace cover mental health and substance use disorder services. Also required are rehabilitative and habilitative services that can help support people with behavioral health challenges. These new protections build on the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) provisions to expand mental health and substance use disorder benefits and federal parity protections to an estimated 62 million Americans. http://www.mentalhealth.gov/get-help/health-insurance/

@chisue, If you are looking for "talk therapy" it is usually better to see a psychologist/PhD, as psychiatrists/MD's are primary used for medication management.

mdln -- I know that many psychiatrists are merely managing drugs, and I see that as a tremendous waste of time spent training psychiatrists. DH has seen a slew of 'psychologists' over his 70+ years. He'd seen a 'talk therapy' psychiatrist at 17 (who helped) and another one in middle age. (That one helped himself to payments for prolonged 'treatment').

One of our DIL's sisters is a psychiatrist, specializing in adolescent patients. She is a 'talk therapy' psychiatrist -- difficult for doctor and patient when insurance reimburses for 15 minutes of medication-monitoring.

I went alone on one of those room mate match things. I was recently divorced at the time, and my neighbor, a travel agent, booked me with 3 strangers. I enjoyed the cruise and the side trips, but wasn't thrilled with 2 of my mates! One knew it all, and NOBODY likes "know it alls." Another was a user. "Oh, are you going to the deck? Would you mail this for me?" "Can I borrow your sweater?" From then on, it was hers. YIKES! But, I adored one of my mates. She looked Hispanic and although raised by Mexican parents, was not allowed to speak Spanish because they wanted her to only speak English. We had a lot of fun and my two years of Spanish came in handy on that cruise to Mexico. We spent some time gambling at the ships casino and enjoyed some of the side trips together. You might make a friend, but I doubt you would enjoy a trip on a cruise alone. I think the train would be the best for traveling alone. Just don't watch any train based mystery movies prior to your trip! Have fun!

Thanks for the book recommendation. I'll check it out. I'm willing to try anything (within reason) to help.

I have panic attacks at least once a month and several have landed me in urgent care thinking I was having a heart attack. I actually just went through extensive cardiac testing after a particularly bad one last month, but luckily everything came back fine.

@chisue - insurance companies feel talk therapy can be done just as effectively by someone without a MD degree. In fact many only masters degree, it is getting more difficult to find PhD psychologists.

Psychiatrists/MD's are reimbursed at a higher hourly rate for medication management, than they are for talk therapy. For example, they may pay $150 for 15 minutes of "medication management" or 50 minutes of talk therapy; but will not pay $500 for 50 minutes of talk therapy. Thus, psychiatrists can make far more money in a day doing medication management than talk therapy.

Also, evidence has shown for many conditions no difference in outcome when comparing psychotherapy to pharmacotherapy and meds usually come out less expensive.

In my experience, psychiatrists are more for the diagnoses and management of more severe mental illnesses that rely on precise dosage or combinations of drugs. I had a severely bipolar ex who saw one because he was a danger to himself and others if he was off his medications. He had to be monitored closely and adjusted when necessary, but he was fine with the proper dosage.

For something like anxiety, I wouldn't treat it with a psychiatrist unless it was accompanied by severe depression or other serious issues. I have gotten standard anxiety medications from my regular doctors and then use therapists/psychologists to try to help resolve the issues and learn coping mechanisms.

mdln -- That was exactly my point. I have to wonder why a person would spend all those years beyond the MD to become a psychiatrist, then spend his days doling out meds or 'supervising' someone who has hung a shingle saying he is a psychologist. (Maybe he doesn't want to have to listen to all those tales of woe?) Why DO this?

My dentist's son needs to decide on his medical specialty. He was leaning towards dermatology -- no emergencies, regular hours, etc. Then he thought about spending his days doing botox injections. LOL (My late MIL claimed that dermatology was a great choice because, "Your patients never get well, and they won't die on you.")

Med students talk about the ROAD specialties as having the best balance of lifestyle and above average income. Radiology, Ophthalmology (and Otolaryngology), Anesthesiology and Dermatology. ER has also been very strong in the last 10 years and gaining in popularity.

These specialities are very popular and so can be the most competitive (difficult) to get into. Psychiatrist income is at the low end of the MD range, along with primary care folks, and so it is much easier to do. Based on what I've seen, there are fortunately still many in the pipeline who are smitten with a particular type of medicine and follow their hearts in those directions. For the remainder, multiple other factors including income, prestige, flexibility, etc, drive their choices.