When I fly....

NO ALCOHOL... that is #1.... Alcohol dilates blood vessels and will make ear fluid pressure problems much worse. ( And these days alcohol is also disinhibiting and creates behavior problems in some people which could lead to your getting on a banned list!) You won't need alcohol for anxiety if you do the next suggestion.

But my best thing to use is Antivert..on RX (which is also called Dramamine II or Bonine OTC). This is long acting, and cuts any dizziness from pressure changes, and is mildly sedating.
Experiment with it at home... sometimes 1/2 of a tablet of Bonine is enough for most people. This drug: meclizine is related to tranquilizers.

When I was younger, I used Sudafed about an hour before takeoff, because my ears used to hurt severely. But the newer planes are much better, and I don't need it anymore ...which is good because this drug is not good for anxiety or high blood pressure people.

I am terrified of flying. But I do it when I have to. In years past I almost ruptured an eardrum! So these suggestions are the result of some very unpleasant flying experiences. (dizziness, nausea, air sickness, panic...you name it).

For anyone with pressure/ear pain/problems... there are special earplugs available called EarPlanes. These are very effective--I've used them--- for take off and landing issues.