Simone Biles recently gave fans a candid peek inside her travel routine, unintentionally restarting an important conversation about mental health. In a lighthearted Instagram video, the legendary gymnast walked viewers through the contents of her brown Birkin bag packed for a trip to Singapore. Alongside everyday travel essentials (like her passport, a backup phone, a charger and a compact mirror) she pulled out something a bit more personal: emergency anxiety medication for flights.

“I also have my emergency anxiety meds, which, there’s a story behind that,” Biles told viewers, with her husband, NFL safety Jonathan Owens, standing nearby. She added that she keeps them “just in case I get nervous on flights or before flights.” Biles never returned to the story, and she kept the medication name private.

While the video was casual, the timing feels particularly meaningful. Biles, who typically guards her privacy closely, has recently had a surprisingly open stretch with her followers. In June, she shared that she needed a full week of rest following a health scare she described as nearly fatal, and later posted from a medical office ahead of an unspecified procedure in late July. While she hasn’t detailed those specific incidents, sharing her flight anxiety routine offers another relatable look into how she manages her well-being, continuing a transparent mental health dialogue she has championed for nearly a decade.

Does Simone Biles take anxiety medication?

Yes. Biles has spoken openly about her prescription since 2018. That year, she appeared on Good Morning America and told Robin Roberts she was “on anxiety medicine now” and in regular therapy. She framed the decision around processing abuse by former USA Gymnastics team doctor Larry Nassar. She and hundreds of other athletes accused him of assault.

“I had a lot of ups and downs throughout the year and trying to figure out what was wrong,” Biles said at the time. “I go to therapy pretty regularly.”

She has stayed consistent since then. At the 2024 Paris Games, Biles filmed a get-ready-with-me video before the all-around final and described anxiety that kept her out of the Olympic Village cafeteria. “Whenever I sat down to eat my anxiety was so bad I was shaking,” she said. She won the all-around that week, then posted a photo of herself meditating in Bercy Arena with a two-word caption: “Mental health matters.”

Accepting a mental health award at the Global Wellness Summit in Miami, Biles put it more plainly. “I take anxiety medicine, just because I feel that if you need an inhaler, you get an inhaler,” she said, per The Messenger.

What she hasn’t said

Importantly, Biles has never publicly identified which drug she takes. Neither her team nor her physicians have released that information. Because of that, no outlet can responsibly name a specific prescription.

Her reticence looks deliberate. While promoting her Netflix docuseries in 2024, Biles said she keeps the details of her therapy sessions private. She explained that the space is hers and that what works for her may not work for someone else. That reasoning extends naturally to her prescription. Still, she has described anxiety medication as something she uses before or during flights. In other words, it is an as-needed prescription rather than a pill taken every morning.

How anxiety medication works

Doctors generally prescribe anxiety medication in two broad categories, and they behave very differently in the body.

The first category is daily maintenance treatment. Selective serotonin reuptake inhibitors, or SSRIs, are the most common example. The Mayo Clinic notes that doctors frequently use SSRIs for anxiety disorders. The FDA approved them for depression. The class includes sertraline, escitalopram, fluoxetine, paroxetine and citalopram. These drugs slow the reabsorption of serotonin in the brain. As a result, mood regulation gradually improves. However, they take four to six weeks to reach full effect. Therefore, they cannot help during a single stressful flight.

The second category is short-acting, as-needed medication, often abbreviated PRN. Benzodiazepines such as alprazolam, lorazepam, clonazepam and diazepam fall here. They amplify a calming brain chemical called GABA. Consequently, they can reduce acute panic within roughly 30 to 60 minutes. Doctors sometimes prescribe alternatives instead, including the antihistamine hydroxyzine or a beta-blocker like propranolol.

Scarlett Seyeon Kang, a board-certified psychiatric mental health nurse practitioner and founder of CareStone Psychiatry & Wellness in Los Angeles, told Blavity Health that the two categories do fundamentally different jobs.

“The main difference is that daily medications treat the underlying anxiety disorder over time, while as-needed medications are designed to reduce acute symptom spikes,” Kang said.

She also described how she uses the short-acting kind. “I often use PRN medications cautiously as a temporary bridge while a first-line maintenance medication begins working, with frequent reassessment to ensure the patient is needing the PRN less over time rather than relying on it long term,” Kang said.

What patients get wrong

That timeline trips people up. Jessica Tate, a licensed clinical counselor and board-approved clinical supervisor who serves as chief clinical and compliance officer at Milton Recovery Centers, told Blavity Health that patients often walk in expecting the wrong thing.

“A common misconception is that anxiety medication should work immediately and remove all anxious feelings,” Tate said. “Some medications take several weeks to have their full effect, and even then, the goal is usually to make symptoms more manageable rather than eliminate every uncomfortable emotion.”

She added that medication works best alongside therapy and practical coping skills.

Kang hears a different worry. “One of the most common misconceptions is that antidepressants will change a person’s personality,” she said. “I explain that the goal is not to change who someone is, but to reduce the overwhelming symptoms of anxiety or depression so they can think, function, and respond more like themselves.”

If a medication instead causes emotional blunting, Kang treats that as a reason to adjust treatment. “The goal is stability, not losing one’s identity,” she said.

Common side effects

Side effects vary widely by drug class and by person. Still, a few show up often enough that prescribers routinely warn patients about them upfront.

Sedation is the most predictable effect of benzodiazepines, which is partly why they calm acute panic so quickly. Mayo Clinic also lists sleepiness among the frequent side effects of SSRIs, particularly during the first few weeks. Consequently, doctors often advise patients to avoid driving until they know how a new prescription affects them.

Upset stomach, vomiting and diarrhea are common with SSRIs. Mayo Clinic notes that many of these effects fade after the first few weeks. Some patients also report headaches, dry mouth, restlessness or trouble sleeping.

Kang counsels patients about one effect that catches them off guard. She prepares them for “early nausea, gastrointestinal symptoms, sleep changes, fatigue, activation or increased anxiety at first, sexual side effects, weight changes, and the fact that improvement is gradual rather than immediate.”

With short-acting options, her counseling shifts. Kang said that conversation focuses on “sedation, dizziness, impaired coordination, memory effects, tolerance, dependence, withdrawal risks, and avoiding alcohol, opioids, or other sedating substances.” Reactions differ sharply between individuals. Therefore, a drug that works poorly for one person may work well for another.

Rare or serious side effects

The most significant warning applies to benzodiazepines. In September 2020, the U.S. Food and Drug Administration updated the boxed warning across the entire class. The warning now covers abuse, misuse, addiction, physical dependence and withdrawal. According to the agency, physical dependence can develop within several days to weeks. That holds true even when patients take the drug exactly as prescribed. Stopping abruptly can then trigger withdrawal reactions, including seizures.

The FDA also warns that combining benzodiazepines with opioids, alcohol or other sedatives raises the risk of overdose and death. That warning is a major reason many prescribers reserve these medications for occasional, situational use rather than daily treatment.

Kang said the update reshaped her own practice. “The FDA boxed warning reinforced the importance of careful patient selection, the lowest effective dose, the shortest appropriate duration, and clear exit planning,” she said.

She now reserves benzodiazepines for narrow situations. “When prescribed, I discuss risks up front, monitor use closely, review prescription monitoring data, and work with patients on tapering rather than allowing indefinite continuation without reassessment,” Kang said.

SSRIs carry different risks. They are not habit-forming, according to Mayo Clinic. However, stopping them suddenly can cause discontinuation symptoms. Those include dizziness, irritability, flu-like aches and unusual sensations. Rarely, these drugs trigger serotonin syndrome. That medical emergency brings agitation, high fever, rapid heart rate and muscle rigidity. Additionally, antidepressants carry an FDA warning about increased suicidal thinking in patients under 25.

What to do if you notice symptoms

Do not stop a psychiatric prescription on your own. Instead, call the prescribing clinician. Describe exactly what you are experiencing and when it started. Many early side effects ease within a few weeks. Often, a dose adjustment or a switch within the same class resolves the problem.

Kang encourages patients not to wait at all. She tells them to reach out “whenever they have questions or concerns about a new medication rather than waiting until the next scheduled appointment, especially during the first few weeks or after a dose change.” A quick message, she noted, often prevents someone from abandoning a treatment that would have worked.

Tate laid out the specific signals that warrant a call. “Someone should contact their prescriber if their anxiety suddenly gets worse, side effects become difficult to tolerate, or they notice major changes in mood, behavior, sleep, or thinking,” she said. “They should also call if they are taking more medication than prescribed or feel they cannot function safely.”

A smaller set of symptoms cannot wait. “Suicidal thoughts, severe confusion, a seizure, extreme sedation, or trouble breathing require immediate emergency help,” Tate said.

If you and your doctor decide to discontinue, expect a gradual taper rather than an immediate stop. This applies to both SSRIs and benzodiazepines, though the risk of abrupt discontinuation is far more serious with the latter. Meanwhile, keep an updated list of every drug and supplement you take. Interactions drive a large share of serious reactions.

Alternatives

Medication is one tool, not the only one. Cognitive behavioral therapy has strong evidence behind it for anxiety disorders, and exposure-based approaches work well for flight anxiety. Notably, Biles has said she pairs medication with regular therapy rather than treating either as a substitute for the other. “I’m currently in therapy, seeing a therapist every Thursday for about 100 minutes, and that helps me so much to stay in the moment,” she said at the Global Wellness Summit.

Both experts flagged the same diagnostic trap. “When anxiety is tied to one clear trigger, such as flying, the first step is understanding whether it is a specific phobia or part of a broader anxiety pattern,” Tate said.

Kang goes further. “In my practice, I also evaluate whether the ‘specific trigger’ is actually part of panic disorder, generalized anxiety disorder, or another condition requiring longer-term treatment,” she said. In other words, fear of flying may not be about flying at all.

Treatment then depends on severity and impairment. “For some patients with isolated situational anxiety, short-term PRN options may be considered, while others benefit most from evidence-based psychotherapy such as exposure therapy, which helps retrain the brain’s fear response,” Kang said.

Other non-drug options include structured breathing, mindfulness practice, consistent sleep and regular physical activity. Buspirone offers another daily option without the risk of dependence. However, it also requires several weeks to take effect.

Cultural fit matters too. Many Black patients report better outcomes with providers who understand their context. A growing group of Black mental health advocates has advanced that work. Black-owned mental health platforms can help narrow the search.

Are Olympians allowed to take anxiety meds?

Yes, in nearly every case. The World Anti-Doping Agency does not prohibit antidepressants, SSRIs, SNRIs or benzodiazepines. Evidence that they enhance athletic performance is insufficient.

Beta-blockers are the exception. WADA restricts them under category P1. That rule covers only a short list of precision disciplines where steadier hands offer an advantage. Per the American College of Cardiology, the list includes archery, shooting, darts, billiards and golf. Gymnastics does not appear on it.

When an athlete genuinely needs a banned substance, the therapeutic use exemption process permits it. Biles has already navigated that system. In 2016, hackers leaked WADA records showing she held a TUE for ADHD medicine. USA Gymnastics confirmed that she had filed the required paperwork and committed no violation. Biles then said publicly that she had taken ADHD medicine since childhood and had nothing to hide.

Bottom line

Simone Biles’ anxiety medication travels with her for flights, and she pairs it with weekly therapy. These prescriptions fall into two very different groups. The short-acting ones carry real risks of dependence, so medical supervision is essential. Talk to a clinician about which category fits your symptoms rather than borrowing a plan from a celebrity.

Frequently Asked Questions

What is the best anxiety medication for athletes?

There is no single best option, though doctors often favor SSRIs because they are not habit-forming and anti-doping rules do not restrict them.

How do I know if I need anxiety meds?

Consider talking to a clinician if anxiety regularly disrupts your sleep, work, relationships or daily routine.