This is a big thing in Eastern Kentucky. One goes “up” or “down” the Kentucky River and its forks, so one in Jackson goes “up” to Hazard or Whitesburg or “down” to Beattyville.
This is complicated because the river flows roughly to the northwest. So going “up” is really going southeast. But it’s a bit intuitive because you’re also going “up” into the mountains.
Anyone over 50 who has lived here all their life will correct you on this quickly.
Growing up in Philly, we would go down the shore, even if it was to Long Beach Island which is east. On the other hand we would go up to the Poconos. Here in Montreal you go down east since it is down the river.
I also generally use up/down/over for north, south, and east/west. Sometimes it seems to changed based on how one gets to the other location.
For example, when I used to live in Medford, OR, it wasn’t uncommon to hear people speak of heading “up” to Grants Pass, even though it was basically due west. However the most direct route there was northbound on I-5.