Cracks in the Cover Up

IMHO, the problem isn't so much that MDs over-diagnose (although of course they do), it's that people's first reaction to feeling bad is to "seek treatment" and see whether they can get some pills that'll just magically "fix it". Your dog died? You should be sad. Had a bad break up? Totally appropriate to be unhappy. Life is a sad vale of tears, but I'm not going to crash an airplane because of it. And the last thing that I want is to have my personality and psychology "fixed". I mean, I know we were all raised to believe that we were supposed to be transcendently, permanently happy for the rest of time, but I think we also all know, deep down, that that belief is really just a way of Selling Something, and a shameful lie. Nut up.
 
For the most part, you're very right.

There are times though, when what a person is experiencing goes beyond that. There is a huge difference between "feeling down" and full-out clinical depression. Clinical depression is real, and it's not something you just "nut up" from or just "get over". There are many things that can bring on depression, and the earlier it's stopped and dealt with the easier it is to get out of that hole. And it's not just about pill-popping either, there are non-pill ways of recovery. The hard part is A: recognizing the difference between the regular ups and downs of life and full-out clinical depression and B: seeking appropriate help, which may or may not even require visiting a doctor. There are plenty of online and print (book) resources for depression recover. If the person will seek it out.

Telling a person who is clinically depressed to "nut up" or "get over it" generally only worsens the conditions. They very much would LOVE to be able to just get over it. Sadly, by the time it's that bad, it takes more than that.

I'm not saying that anyone should rush out and go see a shrink every time something sad or bad happens in their life. But if those depressed feelings continue for a period of months, and it's so crushing that it interferes with living life, then it's time to seek some help of some kind.
 
Can this get moved to the lav? The comments some folks are leaving on this thread are going beyond the normal level of callousness we've all come to love and moving into, "My brother killed himself last week, and you're an •" territory.
 
MQAAord said:
For the most part, you're very right.

There are times though, when what a person is experiencing goes beyond that. There is a huge difference between "feeling down" and full-out clinical depression. Clinical depression is real, and it's not something you just "nut up" from or just "get over". There are many things that can bring on depression, and the earlier it's stopped and dealt with the easier it is to get out of that hole. And it's not just about pill-popping either, there are non-pill ways of recovery. The hard part is A: recognizing the difference between the regular ups and downs of life and full-out clinical depression and B: seeking appropriate help, which may or may not even require visiting a doctor. There are plenty of online and print (book) resources for depression recover. If the person will seek it out.

Telling a person who is clinically depressed to "nut up" or "get over it" generally only worsens the conditions. They very much would LOVE to be able to just get over it. Sadly, by the time it's that bad, it takes more than that.

I'm not saying that anyone should rush out and go see a shrink every time something sad or bad happens in their life. But if those depressed feelings continue for a period of months, and it's so crushing that it interferes with living life, then it's time to seek some help of some kind.
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Its hard to try and explain it to someone who has never seen it first hand. Once someone sees a grown ass man go into the fetal position and ball his eyes out for no reason at all, then people can understand what severe clinical depression is.
 
I don't think it's that they don't want help, or that they're too macho to admit a deficiency. The ONLY underlying reason I see when I read articles like this is that there's bills to be paid. I mean, unless you've got yourself set to stop working for awhile or indefinitely, seeking help for things that the FAA is going to freak out about(and subsequently take your source of income away) would be hard to do I imagine. Easier to say "I'll figure it out on my own", but if you don't, or do it wrong, you explode eventually. At that point you're REALLY F'ed. It's a short sighted way of thinking, but I can see why it happens.

"I have a mortgage and 2 kids in college. YES! I would LOVE to sever all income, lose my house, lose the ability to pay for my children's school, and eventually starve to death!"

Yes, I realize there's disability insurance and state help out there. Just being extreme...
 
Story sidebar!

I remember some years ago, my aunt went into the doctor's office for a normal check-up, shortly after my grandfather's (her father's) death. In the course of the appointment, she mentioned that she was feeling a little depressed and exhausted (she had been handling most of the funeral arrangements). The doctor immediately wrote her a prescription for anti-depressants. My aunt all but threw the scrip back in his face. "My dad just died," she told him, "I should be depressed." And, indeed, after a few weeks she was feeling better.

***

On the flip side, pilots need to be able seek assessment and potentially treatment without their career coming under the gun every time.
 
The reality is the FAA medical requirements far exceed what is really necessary for the job of airline pilot. They really need to settle on the basics. A set of vision requirements, conciousness and cognitive requirements. The system works on the honor system anyway so an individual can essentially hide anything they feel like, it's time to make it more pilot friendly instead of bureaucracy friendly.
 
Exactly. Clinically fine is clinically fine. This is OT, but some of the hoops they make you jump through that your normal doctor wouldn't even bat an eye at are ridiculous. Like you said, they won't find out anyways if you fib. Serious moving violations is the only thing they have access to. That and your pee, to put it frankly.
 
Not these type of visits. There is some guidance from the FAA about this. It is part of their attempt to let people get the help they need before it gets out of control.
 
One thing I've always wondered is how in the hell the FAA would ever find out you are seeing a doc. Heck you don't even have to put down routine visits. Like someone said above it's 100% honor system. I went thru hell over a muscle spasm that a bad doc diagnosed as something crazy and far off in left field, burned thru 75 hours of sick time in 3 weeks and was really close to completely losing my medical. Thank God for ALPA medical. I can totally see the allure of not saying anything and working it out on your own. You definably don't want to rock the FAA boat.
 
They find out when you crash and pilot fitness is the suspected cause; subsequently pulling your medical records. MOST things they'll never find out about unless there's an incident or accident. If your records are even complete. If you've moved a lot, chances are they're not. Mine aren't. HUGE 6.5 year gap from when I was living in Grand Forks.
 
Perhaps I wasn't sufficiently clear. Yes, of course there's such a thing as clinical depression, and it's a horrible thing. One of my best friends suffers from it, and I certainly don't tell him to "nut up". But he's also not a pilot, and he shouldn't be one. Either you can keep your poop together all by your lonesome 24/7/365, or you can't. And this seems to me to be a pretty reasonable dividing line between those who should be operating an aviation appliance and those who shouldn't. There are plenty of things I'm not constitutionally cut out to do, too. *shrug*
 
Boris Badenov said:
Perhaps I wasn't sufficiently clear. Yes, of course there's such a thing as clinical depression, and it's a horrible thing. One of my best friends suffers from it, and I certainly don't tell him to "nut up". But he's also not a pilot, and he shouldn't be one. Either you can keep your poop together all by your lonesome 24/7/365, or you can't. And this seems to me to be a pretty reasonable dividing line between those who should be operating an aviation appliance and those who shouldn't. There are plenty of things I'm not constitutionally cut out to do, too. *shrug*
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There are things that cause depression that are often times outside of your control. This isn't a combat situation, and I feel like there are plenty of people who deserve treatment, but can't get it without putting their careers in jeopardy. Just because you're depressed doesn't mean you're about to fly into the next school-yard-full-of-toddlers. What would you do? Take yourself off of flying status voluntarily or suffer through so that you can pay the bills? The part of you that says "nut up" to some people is the same part of you that will have you say "well, gotta pay the bills." I know plenty of pilots who have taken themselves off the schedule for being sick (thought not as many as should have) - I don't know many who have taken themselves off the schedule for things like being too stressed, or having a divorce ongoing, etc. The fact is, it is socially unacceptable at many companies and with many pilot groups for people to show any weakness - and that's wrong. We need to be a bit compassionate, because guess what, sometimes things do get tougher than an individual can handle.
About every pilot I know has some sort of coping mechanism to deal with the stresses of the job - most drink, some chase loose women, a lot more than you'd think smoke. Contrary to popular opinion, the ideas behind "the right stuff" are alive and well in this industry. You think fatigue was a problem? You can't ask people to perform at peak performance in difficult situations day after day after day while also constantly holding their careers and their livlihoods over there heads without there being problems. There are an awful lot of pilots offing themselves, and that's something that shouldn't be glossed over or told to "deal."
 
ppragman said:
There are things that cause depression that are often times outside of your control.
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I'm not unsympathetic, and I'm not even sure I'm right on this one (first time for everything). But in my mind, it's not a question of whether one can control becoming depressed, it's a question of whether someone who can't should be flying the thing. The only hard thing about our jobs (imho) is that we don't get to fall back on "support" when things go pear shaped. We can't just pull over at the next rest stop, we have to keep our poop together when things have suddenly gone from "making the mental grocery list" to "we're a couple of miles up and things might get explodey soon." In short, it seems to me that of all the things that people think are "unique" and "interesting" about operating aviation appliances, the only one that's actually true is that we have to be self-reliant in ways that, say, a UAV operator doesn't. And, yeah, I guess maybe I think that in our profession, unlike most others, being able and willing to "self-medicate" (whether it be with booze pre-8-hours, or women, or spending too much time on message boards, or what have you) is a positive thing. Because, again, there's no one to hold your hand when the field suddenly went 0/0 and your alternate did too and you're running out of fuel and oh hell the PFD just took a dump and...

It's not a question (at least in my mind) of being "better" than anyone else, but I do think that, ultimately, the most important skill a pilot can have is the ability to Handle Stuff...Keep Calm and Carry On, etc.
 
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