Ok ow this is going to be a real difficult one to talk about! Do you suffer from depression. It's a real taboo amongst holders of class one medicals but what to do? Declare it and loose your medical or try to work it out with out medication? Thus you are alone!!! Loose your living or .....? This is the dilemma many find themselves in. Can you continue to function or shoud you stop. The thoughts of suicide are not an option for most of us just work through the misery hoping it will work out. I'm aware that there have been incidents of professional pilots using the aircraft as their tool for ending it all. But that is categorically unthinkable. We are there to protect the safety of our passengers not endanger them. So here's the rub. Continue, knowing that to function in the role that you have been trained for for many years might delay your recovery or cease functioning as a professional and risk the unknown. In the knowledge that the grass is no greener on the other side. Again chancing recovery

Hi SA,

I wrote this post a few years back:

http://www.pprune.org/medical-health/334812-low-mood.html

I read it now and it's hard to believe that I wrote it! It scares me a little bit to be honest but I remember the utter turmoil I was in.

I felt as you are probably feeling now. I had a few sunny periods and then some bad but overall I came out the other side a stronger person. Life can improve, please believe that.

I realize that everyone is different and depression comes in many very different varieties and severities and I wouldn't be so naive as to suggest that what worked for me would work for you but for information I can share some things that worked for me.

The first, and this was incredibly hard was to get up off the sofa/out of bed and get out of the house everyday and face the world. Sounds incredibly simple to non sufferers but it took the most incredible act of willpower for me.

The second was to keep busy and pack as much into a day as I could. I like being busy and need it. Empty time meant time to dwell.

Thirdly was copious amounts of heavy exercise. I feel a natural high after sports and the gym and it meant I could sleep soundly for the first time in a long time.

Fourth was finding and reengaging the cog within me to socialise. Being around groups of people opened up new avenues, new routines and new people.

Lastly and most importantly was finding a good doctor to talk to. My GP was fantastically supportive and I can promise you that any Doctor worth their salt will make you feel better for opening up. Therapy was painful for me but it was worth doing and some issues came out that surprised me. Cognitive behavior therapy was also wonderful for me.

I have to warn you in the strongest possible terms NOT to discuss this with any colleagues or your AME. The stigma is very real and career limiting.

I have managed to keep myself on track within the last 4 years. I managed to find happiness again and I learned the warning signs when I start to slip back into my low mood and depression and can usually keep it at bay. I wish you the best of luck.

Saddest aviator, this is the rub isn't it?....in a profession where one would expect the encouragement of depressed people to share their feelings, such action is likely to lead to a massive change in that persons career. Which why some may rely on self medication.

Having said that, the pilot's wellbeing has to be balanced against the passengers safety.....I'm not quite sure, (and it sounds like others, including the authorities, are equally unsure) as to where the pivot point should lay. Have we got the evidence to soundly say using antidepressants is safe (or indeed unsafe) in pilots ?

From a prescribers perspective, it's important to remember that there are very effective adjuncts, or alternatives to reaching for the prescription pad......although dishing out citalopram often seems the easiest answer. I often joke with my surfing buddy, that if I could transport my patients to Cornwall for a few weeks, and give'em a surfboard, I'd drastically cut my rate of antidepressant prescribing. And for that matter, I'd rid my patients of backache, blood pressure, diabetes etc etc.

I've never used valium to treat depression.

Of course we have to take the risk of suicide seriously, and we are now much better at risk managing this, although we all have experiences that haunt us. Suicide is a real threat (and the biggest cause of death in 15-25yr old males), but from my experience the vast majority of people with depression are sad and tired of living, rather than actively wanting to die.

I've got no clever answers I'm afraid folks.

The important issue is that depression is treatable and curable, and does not always require antidepressants.
Your AME can be a great support and many pilots return to flying without any limitations.
Find an AME who has an expertise in well-being and treating depression with aviation related psychological support.
If Stansted is not too far away for you, do try Prof Peter Orton - I know he has successfully supported and helped many pilots.