Fear of heights & illness from heights

Fear of heights (not being happy with sheer drops) and altitude (thin air) are two different things.

Going up some of the high mountains in cable cars can make you light-headed. For example Titlis (3020 metres) or Jungfraujoch (3454 metres). This is slightly thinner air than in a pressurised plane, and can make you feel light-headed, ecstatic and a bit tipsy, especially if you are a bit energetic up there (you are normally not energetic in a plane). But this is part of the fun. This is not recommended for certain medical conditions.
The scenic train rides do not go up anything like that high. Ospizio Bernina (highest station on the Bernina Railway) is a mere 2253 metres. I have never heard of oxygen being provided in Switzerland.
By comparison Mauna Kea, the highest mountain in Hawaii is 4207 metres.

Fear of heights (vertigo, fear of looking at big drops) is another matter. You could get this on many trains, and on cable cars. If you have this problem you could encounter it anywhere in Switzerland.
For example, would you be OK with this (cable car going up Titlis): https://www.youtube.com/watch?v=KiYSQ9MOurk

Last year:
Kahului, Maui, Hawaii - the Haleakala Crater
Hilo, Hawaii - Volcano National Park

Chris - Yes, I have fear of heights but I usually close my eyes and fret. No, I'm not ok with the cable car, but I do it once in a while on trips. I've heard of altitude sickness in South America, where you get headaches and it can stop your vacation. I will check to see what the conversion is for 2253 metres. Thanks.

Interesting that your fear of heights doesn't include flights and air travel. However you are thinking about going to Switzerland, but given all you have revealed about yourself you shouldn't be asking anyone to advise you or tell you if you should worry or not. As for your personal dizziness and breathing issues - again, this is really TMI and no one here knows you or your medical condition and again, this has to be your decision. How could even the best well meaning strangers advise you on this ?

As for the "express" trains, they are actually slow moving - but again, no one can tell you how you will react.

Perhaps the best thing for you to do is consult a doctor if this is a medical condition or psychiatrist to discuss your fears.

I, too, am afraid of heights. That being said, the trains are fine and there are many beautiful areas that don't require you to go beyond what you can manage (as long as your condition isn't medical). Do your homework; read about how (and how much) altitude can affect people; and use good judgement.

I know I missed some stunning scenery by not taking all the really high cable cars or walking the bridges out over glaciers because of my fear. But stunning scenery is everywhere, so it's absolutely worth the trip. It is the same as not having time to see everything or not being able to walk as far as when I was younger: you enjoy what you can do/see and don't worry about what you can't!

If you are worried about altitude sickness, check with your doctor or a travel clinic before you leave. There is at least one medication that helps with altitude sickness, but you might not need it on a train unless you have a prior experience of suffering from altitude sickness issues.

As far as fear of heights goes, I understand that as I share it. I managed the Swiss Alps just fine, although there were times when looking down was a little too much for me at certain points. But I knew about that issue ahead of time, and sometimes I just didn't look down as much when we were high up in the Alps. It sounds like you are aware of your issue as well! That's the first step.

You could always ask which side of the train has the best views of the mountains and sit on the OTHER side. No, you won't have the best view, but if looking down is going to bother you, then that might be a doable option to allow you to see Switzerland and not panic because of the heights.

2250 meters is over 7000 feet. Altitude sickness can effect people at those heights. Most people are comfortable up to about 5,000'. After that, it's individual. The usual symptoms are headache, dizziness, and/or nausea. Staying hydrated (drinking lots of water and avoiding diuretics like caffeinated and alcoholic drinks) helps, but the only real cure is to descend to a lower altitude. The higher you go, the thinner the air, making physical movement a little more taxing.

The Lauterbrunnen valley is at about 3000' with cable cars to the peaks. You can enjoy the scenery at villages in the valley and higher up the mountains.

I, too, have fear of heights and flying is no problem at all.

I have to make myself get on a cable car and try to either sit on one of the benches or stand in the middle of a group of people so I can't see out. The payoff in Switzerland is worth it.

I have not done one of the scenic trains but I have done the cog train from Lauterbrunnen up to Mannlichen and back down from Kleine Scheidegg and had no problems looking out in the valley but it is not along a sharp drop off.

Altitude sickness is different. If you are in Switzerland a few days before your train ride you'll have adjusted to that elevation before you take your train ride so you won't have as much a difference as going from sea level up. I agree with staying hydrated (don't drink alcohol). Many websites recommend ibuprofen but you'd need to check with your healthcare provider to see if that is OK for you.

I do travel to Yellowstone at least every year and it is around 8,000' for much of the park. Whether I feel ill is random. Sometimes I do (headache, yucky stomach, spacey brain), sometimes I don't. It also does not really matter if you are very fit or not. A few years ago my brother and SIL went with me. He was very fit, then was a forester working in the mountains daily at 4,000-5,000' My SIL and I were, uh... under-fit, lol. He got a headache and upset stomach coming in over a 10,000' pass, she and I were fine. He got queasy a few days later at 9,000', we didn't.

Have a wonderful time!