What follows is an unedited account sent to us by a Pilot who was motivated to share his own experience of depression. He makes no claims about his experience other than hoping it may be of interest and possible help to other pilots. We are tremendously grateful to him.
"I had everything I wanted; a loving wife, a beautiful family, a good job that I enjoyed, a nice house. Why, then, was I so constantly miserable? It is difficult to say where it definitely started, but I believe now that it was around the time of the birth of my first child. At the time I had just been promoted and was getting to grips with a new job role, whilst at home the house had to be prepared for the new arrival.
The birth process itself was traumatic; I was consumed with anxiety over what to do with a newborn baby; worry and sleep deprivation became a way of life; yet I did not feel entitled to express any form of hardship: I had to ‘keep going’. I couldn’t permit myself any respite. I had two weeks off – unpaid – and then went straight back to work full-time in the midst of the summer schedule.
I was tired and under stress. I was assaulted by waves of strong emotions, but whilst it may have been helpful to address these concerns I felt that I was not entitled to feel sad or to be tired, or, for that matter, to be enjoying my job. My response, instead, was to become increasingly emotionally detached.
A couple of years later my wife became pregnant with our second child and we decided to move house. This was a thoroughly fraught process and it did not help that, at the time, I was away in the simulator a lot, often working through the night. I saw it as my job to provide for my growing household and that I was failing adequately to do so. Eventually, our second child was born. What is shocking to me now looking back is that that didn’t make me happy. It didn’t make me unhappy either; primarily what I felt was detached. And I berated myself inwardly for my failure in that respect.
What, it seems, had happened was a breakdown of the limbic system of my brain. The limbic system acts as a regulator for various bodily functions – one of these is mood. When things happen to a person, the limbic system will act on the basis of memory and learnt modes of thinking or beliefs to produce an impulse. This impulse may be to do a certain thing or to feel a certain emotion. So, if a tiger runs towards me, the brain will, for most people, act on the belief that ‘tigers do harm to people’. The limbic system release chemicals including adrenaline which produce an emotional reaction of fear and a physical impulse to run away. Terribly fast.
What was happening to me was more complex, but similar; my child was born; my brain acted on the deeply held beliefs ‘you are responsible for this life’ and ‘you are a failure and always will be’. This would release certain chemicals, including adrenaline, producing the emotional response of anxiety and the impulse to shout, scream or sit in a corner and cry. However, rather than do any of these things, I repressed and repressed. The problem with that is that the emotional ‘energy’ had to go somewhere. With nowhere else to put it, I turned my emotions in on myself. I beat myself up: ‘what’s wrong with me’, ‘cheer up, for goodness’ sake’. ‘A decent father would do better’.
And then this particularly nasty and insidious thought: ‘all that’s required of you is to be happy – if you can’t manage that, what’s the point of it all?’
I became increasingly unhappy. It was harder and harder to get out of bed and go to work. It was nigh on impossible to enjoy anything. I would feel guilty for going to work and I would dread being at home. When, at the age of one, my second child was hospitalised with pneumonia and, shortly before Christmas my mother revealed that she was leaving my father after over thirty years of marriage my brain finally gave up. I became totally emotionally withdrawn. I succumbed to almost perpetual colds, fevers and bouts of food poisoning. I continued to drag myself into work, slating myself for my perceived weakness. But inwardly I was beset by feelings of hopelessness; hardly a day went by when I didn’t consider ending it all.
As one might imagine, all this put tremendous strain on my marriage. I had come to believe that I was fundamentally unworthy of happiness and that life – mine in particular – was ultimately meaningless. Hence, my wife’s increasing efforts to make me happy were to no avail and her distress - and anger – became more and more apparent. Eventually, with the relationship on the point of collapse, I admitted to myself that I might be mentally ill. I saw my GP; he referred me to a psychiatrist who diagnosed moderate clinical depression. He recommended that I start therapy and go onto anti-depressants; I knew that this would invalidate my medical certificate and prevent me from flying but I could see no other option. That evening, my managers and the CAA were both informed that I was mentally unfit to fly.
This is, perhaps, a key point. I was in mental turmoil. Yet it was sufficiently hidden that none of my colleagues saw it. Other than my wife, none of my family saw it. My medical examiner had given me a clean bill of health at my Class I medical check not two months previously. Yet I was deemed to be so mentally unwell as to make me unsafe to operate an aircraft.
Therapy is not a pleasant experience. It involves nothing less than fundamentally changing how one thinks. It involves overturning sometimes lifelong habits of thinking and behaviour. It involves revisiting one’s history and engaging emotionally with past events – sometimes confronting strong feelings that have been supressed for years. If, as I was, one is already emotionally unstable, this can be quite dangerous. Finally forcing myself into this deep self-examination, I realised the true extent of my breakdown. Simple conversations would leave me inconsolably weeping. I could not recall ever being happy. My self-esteem became critically low: I was convinced that I was harming my children; I believed myself to be a failure, unworthy of happiness and of life. And about now is when I began to entertain genuine suicidal thoughts. I mentioned this to my therapist; my condition was upgraded from moderate depression to a severe depressive episode and I was admitted to a psychiatric hospital. I would eventually spend six weeks as an in-patient.
The therapy increased in intensity and I was now in full time. I went into something of an internal emotional tailspin. I became convinced that I was a terrible person who had let everyone down. I enjoyed nothing; I could see no way that I ever would enjoy anything again. I thought that my very existence was harmful and that my children would be better off without me – I couldn’t even think about them without crying uncontrollably. On some level, I knew this wasn’t true and that to kill myself would be a terrible thing to do. But on the really dark days I thought “so what – you’d be dead, and past caring”. And my suicidal thoughts became actual plans; I even went so far as to write a suicide note.
I never got so far as to attempt suicide, but what scares me now is how logical and sensible an option it seemed at the time. I thought ‘I am not strong enough to ever be happy, which is my only real purpose in life. Life itself is ultimately meaningless. Dying is the only way out’.
In all this, was I supported by the company? Or, perhaps the better question: did I feel supported? When I became ill I felt very supported, insofar as I was largely left alone to get better. True, my salary was stopped after six months sick leave and the loss-of-license insurance payments were substantially lower. But at least I had loss-of-license insurance. And access to first-class psychiatric treatment owing to the private medical insurance. And when I returned to work, it was at my old rank, seniority and pay grade.
However (and this only an opinon), I do think more could and should have been done to prevent things getting as bad as they did. It is for employers (as well as employees) to recognise that aviation is not an environment conducive to mental well-being. Rosters that frequently approach the legal limits are truly safe only if all of one’s ‘rest’ time is spent actually at rest – there is insufficient allowance for a full life outside of work. Decent quality food and appropriate breaks are not luxury perks for aircrew – they are an essential pre-requisite of good mental and physical health. Crew members who are, on a given day, too tired (not fatigued, tired) or too stressed to operate should feel that they are allowed to report unfit for duty as such. Too many feel that they will in some way be prosecuted by either management or colleagues and either report sick with some more ‘acceptable’ physical ailment or – I suspect more commonly – drag themselves into work when they shouldn’t be.
Moreover, owing to the nature of the job it is hard (particularly at the larger bases) to form relationships with colleagues that are close enough to allow people to talk openly about how they are feeling or what they are thinking. Rarely does the opportunity arise for conversations of that nature or depth. So many cases of stress-related illnesses can be mitigated simply by talking to a sympathetic ear. Here again, companies can put things in place: British Airways has a 24-hour counselling service called ‘CrewCare’. Other organisations make use of an Employee Assistance Programme, where services such as counselling or therapy are made available to those employees who have need of them.
Everyone has the potential to suffer with their mental health from time to time. Very often, those worst affected will be those who told themselves over and over again that they didn’t need help – that they didn’t deserve help. That the thing to do is just to push through, to ‘Keep Calm and Carry On’. And I believe that employers, particularly airlines, have a duty to let their staff know that this is not the case.
Which is not to say that we as employees do not have personal responsibility for ensuring our own mental and physical fitness; and indeed to look out for each other.
For my own part, having finally explored the depths of my breakdown I turned a corner. Eventually, given enough time, the limbic system heals, and the chemical balance in the brain returns to normal. I began to experience normal moods again. I was taught and practiced the skill of assessing the reality, the here-and-now of life (rather than my default opinion of it). I began to make myself take personal credit for what I have achieved in life. And I learnt a variety of techniques both mental and behavioural to maintain my mind in a healthy state. I became well enough to go home and, ultimately, back to work. Incidentally, this last was not so straightforward. I am still on a daily dosage of anti-depressants. Because these are of the type SSRI (selective serotonin re-uptake inhibitors) I am allowed to fly, but I had to pronounced fit not only by my psychiatrist and my GP, but also by the CAA’s own psychiatric advisor, and to undergo a medical flight test in the simulator. But I am now back flying. I am still on medication; I am still under scrutiny by the CAA and I still see a therapist on a regular basis. But I am happier and more relaxed than I have been in a very long time. The challenge now is to see that that continues."
"I had everything I wanted: a loving wife, a beautiful family, a good job that I enjoyed, a nice house. Why then, was I so constantly miserable?