Coping with Motion Sickness

Q:  Every time I get in a car, airplane or ship, I feel dizzy and nauseated. I want to learn how to drive a car but cannot because of my motion sickness. Can this be treated?

A:  Motion sickness occurs when sensory information about the body's position in space is contradictory. It's more likely to happen when people are sitting in a closed space or when reading, because the eyes cue the brain that the environment is stationary, while the inner ear senses motion. It may help to look forward out the window, but looking at a curving or undulating road could make motion sickness worse.

Although most people will experience motion sickness while boating during a severe storm, far fewer experience motion sickness with an ordinary car ride. Motion sickness is more common in women, especially during pregnancy or menstruation, but in general little is known about individual susceptibility.

Signs and symptoms usually cause mild to moderate discomfort but in severe cases can be incapacitating. They include dizziness, nausea, vomiting, pallor, and cold sweats.

Travelers who are susceptible to motion sickness can minimize symptoms by choosing seats with the smoothest ride (front seat of a car, forward cars of a train, and the seats over the wings in an airplane), focusing on distant objects rather than trying to read or look at something inside the vehicle, minimizing head movement, and if necessary lying flat. (Obviously most of these solutions are not possible when driving.)

The usual treatment is an antihistamine such as diphenhydramine (which is available over-the-counter in a generic version or by the brand name Benadryl) or a prescription drug, but these medicines will make you sleepy and thus in no condition to learn to drive.

According to the CDC's information on motion sickness, nonpharmacologic methods for motion sickness may benefit some people but have not been proven to have consistent efficacy, although high levels of ginger have been helpful for some.

There seems to be a strong psychological component to motion sickness as well. Navy researchers have found less seasickness when they confidently tell recruits that they will not get seasick. You may be getting carsick simply because you are anticipating it. Try to free yourself of this pattern by talking positively to yourself or by having someone else talk you through your symptoms.

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices internal medicine at the Froedtert & Medical College General Internal Medicine Clinic - East. Her column also appears in the Milwaukee Journal-Sentinel.