As a cruise ship physician for 14 years, my experience aboard ships has shown me that a controlling personality is the single most frequent determinant for the development of seasickness. Anxiety and fear exacerbate this potential.
On the other hand, certain factors seem to exert a protective influence. Any spiritual or religious belief system where one’s destiny is not solely determined by individual volition, but by “heavenly” or cosmic forces, seems to stave off the nauseating turmoil of seasickness. Following this train of thought, I verified my hypothesis with the traveling clergy and discovered that whether Jewish, Catholic, or Protestant, faith acts to safeguard against gastric reaction to the sea’s swell.
Medical studies have also identified certain high-risk groups for seasickness. Women are affected more than men. Pregnancy, menses, and birth control pill use increase risk. Adults are found to be more susceptible than children. Typically children under the age of 2 do not suffer seasickness. People with a diagnosis of vertigo/dizziness from a pre-existing medical condition or migraines are at high risk for seasickness. Numerous remedies from scientific to anecdotal have been described with different success rates. For those who prefer to refrain from taking medications, certain simple measures may be tried initially.
If seasickness occurs when the brain receives conflicting signals as described above, sitting on an open deck and looking at a far horizon will decrease this sensory clash and relieve the symptoms. On most ships, the Medical Center is located on the lower decks, midship. There is an obvious reason for this and passengers who suffer repeatedly from seasickness should book a cabin midship on the lower decks where the movement of the ship is felt the least. Also, lying flat relieves seasickness by decreasing the sensory stimuli.
Medications are more effective taken prior to symptoms rather than waiting for them to develop, so if seasickness is a recurrent issue, you would be well advised to take the medication before setting sail.
Most cruise lines use meclizine to prevent seasickness and distribute it free of charge. It has few side effects and has a chewable formulation. It’s marketed in the United States as Dramamine Less Drowsy (the name speaks to its decreased side effects on sedation). Similar medications include Dramamine (dimenhydrinate) and Benadryl (diphenhydramine), which are more sedating.
Transderm Scop, or the “patch,” is also popular with cruise ship passengers as it allows you to “wear” your medication and needs to be changed every 72 hours. I’m not particularly fond of this option, since I have been confronted repeatedly with agitated, confused elderly passengers in the throes of side effects. In fact, it’s considered an inappropriate medication for people over 65 years of age.
If oral medications are unsuccessful, the Medical Center will most likely carry injectable medications such as promethazine and metoclopramide, both with sedation side effects. These services are typically billed to your cabin.
Certain alternative therapies claim to be effective as well. Medical studies do substantiate benefits with 1 to 2 grams of ginger taken orally. Acupressure and wristbands are controversial, but are safe and allow relief for some passengers. If you do want to try this, turn your hand upward, identify the wrist crease closest to the hand, put three fingers alongside this crease, and apply pressure in the mid-forearm at the level of the finger closest to you ( Nei Guan or P6 point).
Reassuringly, exposure to continuous stimuli confers habituation and a decrease in symptoms after 24 to 36 hours no matter what you do. In other words, the body gets used to the motion of the ocean. The general mood of the ship improves after one day at sea as everyone develops their “sea legs” and gets down to enjoying the amenities of the ship and port calls. As the sailors say, “fair winds and following seas” to all.
PASSENGERS WHO SUFFER REPEATEDLY FROM SEASICKNESS SHOULD BOOK A CABIN MIDSHIP ON THE LOWER DECKS WHERE THE MOVEMENT OF THE SHIP IS FELT THE LEAST.
Ginger has been shown to relieve nausea.