Ex-investigator and sufferer of reactive depression (caused in part by chronic pain).
Has a
reason been given for the sick note? A lot of people are jumping to conclusions that it was due to his mental state.
EDIT: earlier post clarifies it was for a physical illness.
http://www.pprune.org/8921665-post2112.html
This may change the context of what is below, or give more depth to it - physical and mental illness go hand in hand.
I know many people who have suffered and have recovered from depression. Some are the most well-balanced and thoughtful people I know, and thanks to treatment, many can now identify when the Black Dog is coming for a visit, and seek support. Very few have good things to say about anti-ds. When they are handed out like Smarties, it is rarely explained that that they are addictive and can necessitate a very long, fractious weaning-off period.
Anti-depressants can also interact with other drugs, and make certain conditions, such as tremors, worse. (I don't take them for these two reasons, as I also have a familial tremor, and after years of pain managment, I really don't like taking pills.) Anti-ds take a while to 'kick in' too, around 6-8 weeks. So, even if you start taking them, and you don't have any undesirable side-effects, you still have to get through those 6-8 weeks.
(Sidenote: Although my tremor is not disabling, I am conscious of it, and people notice it. Would it be a reason for failing a medical?)
In addition, anti-ds are not recommended for cases of mild to moderate depression, because there is insufficient evidence that they work.
Placebo treatment in mild to moderate depression
Regarding assessment and support: every time I have attended the GP or counselling treatment, I am handed a form to complete to assess my mental state, and the presence of suicidal feelings/plans. One day, I was in so much pain, I ticked the wrong box, handed the form in, then went home. Half an hour later, my phones started ringing incessantly, from withheld numbers. I missed the first few calls (I have trouble getting around), eventually picking up a call on my mobile. Apparently, they were on the verge of sending the police around, and weren't particularly mollified when I explained it was just a genuine error.
I have never felt suicidal (although at one time I could have happily given up my life should it have saved someone else's), and never felt murderous (apart from echoing wishicouldland's views of a certain HR manager).
IF the reason for the f/o's sick note was his mental state, IME, to visit the GP in the first place and/or admit to feeling mentally unwell takes a lot of guts. A lot. To place your well-being in the hands of others? You need to rely on them to spot if you really are a danger to yourself (and others), because you can be unable to see it yourself.
IF the reason was serious physical illness, a GP should expect and be looking for a recurrence of mental problems. This is well recognised.
It appears that is the point when the f/o (and the other deceased) was let down, and this chain of events was started. I wonder what kind of assessment took place?
Also, as coastalpilot stated, 'There are many medical reasons for depression, which, when addressed, completely cure the disease and the symptom, depression.' Was his earlier depression properly investigated?
(In group counselling sessions I recently attended for those suffering life-limiting illnesses, 9 out of 10 of us were incorrectly diagnosed. Would we have become depressed if it wasn't for our physical problems?)
As others have pointed out, many depressives think by killing themselves, that their family and friends would be better off. QDMQDMQDM's post about possible psychosis is enlightening on the psychosis aspect.
Link to QDMQDMQDM's post
...If the copilot did indeed deliberately fly the aircraft into the Alps, as seems very likely, then that is at first sight completely baffling. If you just want to commit suicide, why on Earth would you want to take 150 innocent people with you? It's just not rational. And that's the thing -- this act was not rational, so therefore we have to look at what could plausibly make someone act in such an irrational manner.
In this case, it is actually very easy to see what could have made him act in such an irrational manner. We know he had a history of significant mental illness -- 18 months of what seems to have been fairly severe depression -- although we don't know the details. There has also been talk that he may have been in a situational crisis recently, precipitated by breaking up with his girlfriend. Against this background, it is entirely possible he could have developed either a psychotic depression or a brief reactive psychosis. Not all psychoses are accompanied by florid delusions and odd, thought-disordered behaviour. Some can be quite encapsulated and the person can appear normal in most respects:
Delusional disorder as a partial psychosis. - PubMed - NCBI
So if he had an encapsulated psychosis for whatever cause, it would be easy to see how he could believe, say as an example, (and I'm plucking contemporary iconography out of thin air to create a random, ludicrous proposition, which is how the delusions of people with psychosis are constructed) that in order to avoid a war between Russia and the West he had to crash his aircraft and kill himself and everyone on it because he and they were all agents of Vladimir Putin.
It's crazy and very unlikely, but this whole event is crazy and very unlikely and mad people can sometimes have crazy and very unlikely delusions (though obviously the vast majority of them are not any danger to the rest of the population) and we do know he had a history of mental illness.
I can't help remembering the engineer I saw in psychiatry as a medical student. He held down a responsible job, but he had an unshakeable, encapsulated delusion that his bosses had implanted a chip in his nose through which they kept an eye on him. In all other respects, he appeared totally plausible and functioned very well. It was quite an eye-opener and I've been thinking of him a lot in the past few days.
This was not a rational act and you really don't have to stretch that far to imagine a scenario whereby it could have occurred. The more difficult question is how you might prevent such a thing again and there is no clear answer to that, especially as we are now learning these things are not quite so unlikely as we once thought. Having two in the cockpit at all times is no panacea. A sharp push on the control column at 100 feet could have the same effect as a descent from 30,000 feet.
To pick up every pilot who might fly his aircraft into the ground, you would have to have a screening test so sensitive that it would be totally non-specific, which means that you would end up screening out tens of thousands of pilots, maybe even hundreds of thousands. And that's if you can even decide what the risk factors actually are. By the very nature of the action, the perpetrators are not around to be interviewed afterwards and it's quite possible, indeed likely, that each case has a set of unique, unpredictable precipitants and characteristics.
If you want further examples of temporary psychosis:
https://youtu.be/9-bIWm08eJc
The two sisters were apparently 'totally normal' shortly afterwards, and have remained so.
Investigator hat on: very glad to see this bit of news
BFMTV en Direct: regarder la chaine info en live - BFMTV reporting that X has been indicted regarding the leaking of information to the press, X potentially being the senior French military officer, listed as the original source of NYT
http://www.pprune.org/8920844-post1872.html