Anti depressants

[captain_flynn]

Hi all,

I've been abit low recently for various reasons, I saw my doctor today (for a unrelated matter) but told her how low I had been feeling. She wanted to prescribe me some anti-depressants but I declined as I said I think that it will prevent me from flying. I'm a PPL student with 43hrs. I only have to do my cross country and skills test (on the flying part) but I still have a few exams to pass aswell.

If I had accepted anti-depressants would they have prevented me from flying? Did I make the right choice in declining anti-depressants and opting for counselling instead?

[vs69]

I know the CAA regard anti depressants as having the effect of depressing the alerting system and being a contributory factor to mistakes / accidents although I am partially lifting this from airworthiness notice 47 which applies to certifying engineers but I would imagine they take a similair line with flight crew, not sure if they would list it on their website, I think its www.caa.co.uk, good luck and I hope things start looking up for you..

[captain_flynn]

Hey

I couldn't find anything on the CAA site but thank you for trying to help me. I'm going to be having counselling instead of taking anti-depressants. However as i've got my ground exams to do I will focus on them and won't fly for a while to keep on the safe side.

[Hawk]

Hello Captain.
http://www.pprune.org/forums/search.php?searchid=144695Some more information on anti depressants from the archives.

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[captain_flynn]

Hey

Thanks for the reply.. when I clicked the link I got this come up...

vBulletin Message

Sorry - no matches. Please try some different terms.

[Agaricus bisporus]

It is truly horrifying that doctors leap in with drugs on the first mention of depression. Depression is always caused by some external factor/s and it is only by removing them or modifying our attitude towards them that the depression can be solved. Prescribing drugs does nothing but mask the symptoms, and I really wonder at a doctor's attitude if they prescribe first and do nothing to identify or sort out the stressors. Its a bit like giving a walking stick to a patient with a broken leg and telling them to get better soon!

Back to flying though, your av-med examiner will tell you that the CAA don't allow any antidepressants at all (this info for a class 1 medical) except St Johnswort - which is surprisingly effective. You'll get more sense from an aviation doctor than your GP on this I think.

Don't be tempted to fly on antidepressants, if the symptoms persist go and see a psychiatrist and get it sorted properly.

Exercise is cited as by far the best treatment for depression. Do you do enough? (Dr Nick Bayliss, C. Psychol)

Good luck!


You might find the links below interesting. Moodgym is a seriously good tool for use in countering depression.

http://www.moodgym.anu.edu.au/moodlogin.asp

http://www.nickbaylis.com/

[astra1]

HI.

My husdand is an airline pilot for a major european airline.He has recently seen a doctor due to his mood not being quite as it should be and his form being low.(due to life stress)

He is considering taking anti deprestants which have being prescribed by his doctor which is NOT an aero medical doctor.

from a page in his operations manual it states that anti depressants are forbibben for active crew memebers to use.Do any of you new on renewal of medical, are antidepressents tested for.

hope i can get your help here guys/gals.

regards
A worried wife
astra

[Coanda F. Eckt]

No, antidepressants are not tested for at renewal.

[modtinbasher]

[quote] Back to flying though, your av-med examiner will tell you that the CAA don't allow any antidepressants at all (this info for a class 1 medical) except St Johnswort - which is surprisingly effective. You'll get more sense from an aviation doctor than your GP on this I think. [unquote]

You have to be very careful with St Johns Wort. I was informed some time ago by a physition that if you were to contemplate an operation, the you should discontinue the Wort some time before surgery, as it's presence in the body can react with some aneasthetics and other drugs. I suppose everything would be OK if you took this into account, but what if you were unfortunate enough to have an accident......?

[Coanda F. Eckt]

Take a look at this http://www.caa.co.uk/default.aspx?categoryid=49&pagetype=90&pageid=2251. Regarding SSRI's (most commonly used anti depressant) and medical 1. Scroll down to the 2005 and 2006 part.

Don't know if this has taken effect or if it's just suggestions though.

[Mac the Knife]

Depression is always caused by some external factor/s and it is only by removing them or modifying our attitude towards them that the depression can be solved.

Please! This is completely untrue. Endogenous depression is a very real illness that can vary in severity from the mild to the catastrophic. There are various classifications and types which respond to patient-tailored drug therapy. Psychotherapy/group therapy may help in addition. It does not respond to exercise, "Dr" Bayliss to the contrary. Serious untreated endogenous depression can lead to loss of job, loss of partner, addiction and suicide. Response to treatment varies from good to fair.

Exogenous depression (which you are talking about) is a different matter.

"I really wonder at a doctor's attitude if they prescribe first and do nothing to identify or sort out the stressors. Its a bit like giving a walking stick to a patient with a broken leg and telling them to get better soon!"

I quite agree.

[Horatio Leafblower]

I have to back up Agricorus the Mushroom - MoodGym is a great tool for getting yourself out of a rut. In the first quarter last year I had a nasty confluence of stressors in several areas of my life and the result was a bit of a spin-out. Throw in a lot of social drinking and it was a minor disaster - I regard 2005 as a year wasted from my life.

It was the constant support of a few close friends, shared experience with a couple of school mates, and a mindset changed thanks to MoodGym that pulled me through and back on the right path.

It was only once I was on the way back up that I recognised there had been a serious problem. :uhoh:

MMSOBGYTAST

[bloggs99]

A very interesting article on the SSRI sertraline and research done for aircrew and psychomotor performance: http://www.biopsychiatry.com/zoloft.html

Why not in the correct and controlled circumstances? In the majority of cases SSRI's, combined with Cognitive Therapy, are very effective and the drug mostly does not affect a pilots ability to fly once stabilised - you only get to hear the bad stories and not the good ones. SSRI's are not perfect and a lot of caution is needed in their prescribing, however, they can really work and not impare a pilots judgement after being settled on the drug. I know someone who swears that an SSRI literally saved his life - and he flew throughout his treatment! An SSRI can get you out of the hole and the Cognitive Therapy can keep you out.

I am sure that grounding a pilot will make his condition a lot worse in the long run. I am certain that the fear of grounding makes conditions a lot worse due to the self feeding nature of anxiety and depression related disorders. I think the current policy probably ends up with most cases going unreported (time bombs waiting to go off) and some self prescribing born of the fear of grounding and loss of livelihood.

[Flyin'Dutch']

Often it is not the medication that is the problem when it comes to flying but the condition for which it is prescribed/taken.

If people suffer from depression they should not be flying.

A lot of people confuse 'depression' with 'not feeling brilliant for a little while due to some stresses' (Although you best not fly when you are feeling like that either.

Depression gives lots of symptoms. Amongst these are slowing down of thought and physical processes; loss of cognitive function; changed view on life issues and attitudes etc.

That is why depressed folks should not fly.

It is comforting to see that common held beliefs get repeated here by those with little or no knowledge of mental health problems.

It is truly horrifying that doctors leap in with drugs on the first mention of depression.

And the proof that this happened here is..................?

Depression is always caused by some external factor/s

As Mac says 'Rubbish'

Prescribing drugs does nothing but mask the symptoms,

Not true.

Its a bit like giving a walking stick to a patient with a broken leg and telling them to get better soon!

Diagnosis people's illness by taking a comprehensive history, doing appropriate tests and treating them with appropriate choices of the whole scope of treatments available means that you take the patient and their problem serious.

To suggest to someone with a 'proper depression' to go to the health shop for some St John's Wort or some internet sourced self help stuff may seem kind but potentially denies patients the opportunity to access health services they may well require to get better.

But we know that it is only doctors that:

prescribe first and do nothing to identify or sort out the stressors[...]giving a walking stick to a patient with a broken leg and telling them to get better soon!"

:sad:

[MNBluestater]

Hi all,

I've been abit low recently for various reasons, I saw my doctor today (for a unrelated matter) but told her how low I had been feeling. She wanted to prescribe me some anti-depressants but I declined as I said I think that it will prevent me from flying. I'm a PPL student with 43hrs. I only have to do my cross country and skills test (on the flying part) but I still have a few exams to pass aswell.

If I had accepted anti-depressants would they have prevented me from flying? Did I make the right choice in declining anti-depressants and opting for counselling instead?



<<DEPRESSION >> Treatments, experience and advice
Having had depressive episodes in the past (three major since 1991), please allow me to comment. I am no longer in aviation, 3 employer bankruptcies was enough for me, but perhaps you can learn from what I have learned. (You may want to print this out, as a depressed person tends to forget the positive stuff that is read or heard).

In my experience, talk-therapy has done little for me in the past to alleviate the symptoms, and prayer/meditation isn't helpful either. A person can pray until they are blue in the face and that doesn't help a medical problem, in most cases. I believe that I have inherited the problem genetically and that it became a health concern in my 20's and 30's. Sometimes additional steps need to be taken to get help.

That said--first five steps:

1. Eat a varied diet, making sure you're getting your vegetables and taking a supplement of vitamin b complex (stress) vitamin e, ZINC, and two capsules of GINSENG daily. The zinc and ginseng help restore your TESTOSTERONE production. Testosterone is much lower in the bloodstream of men with depressions.

St. John's Wort has been tested repeatedly in the US and does nothing to resolve depression.

2. Rest on as normal a sleep pattern as possible, daily keeping the same schedule. Do not stay awake until the wee hours. You need to get the dream sleep times. Also, testosterone production occurs as a man sleeps, as well.

3. Get exercise. A depressed person just feels like laying on the couch or in bed just watching the tv, which makes it worse. Just getting out and walking for 30 minutes will help ( you CAN do it--just 30 minutes). This will also increase your testosterone production. Weight training will also help.

4. If possible, get regular sex- (are you married? girlfriend?). Try to avoid the "guilt-related" sexual encounters--I won't go into guilt-related but whatever that means to you, it's a spiritual thing, and can bring a person down.

5. Keep fighting it by keeping occupied. Find a way to help another person. This has been found to alleviate the depression, if only for a short time.

Give yourself a week or so on the above plan.

Next: Have you had depression in certain times of the year? If you are not flying regularly and getting sun exposure "above the clouds," seasonal affective disorder (SAD) can be causing this in the extreme northern or southern geographic regions of the world (it is common in Minnesota, USA). It comes on in the fall and winter, and remains winter into early spring. It is EASILY treated with bright light therapy; a person gets a high-spectrum light box and are exposed to the light the first 30 waking minutes of the day. You will feel better in 3 to 4 days. Definitely worth a shot, for a mere $300 to $400 USD or you can probably get them cheaper on ebay. It can help avoid going on the meds! If nothing else, it is pleasant to wake up to, expose yourself to the light, and think about nothing ! Very relaxing.

Next: See physician first for a complete physical, to eliminate other conditions that may be causing it--thyroid issues, early stages of diabetes, high blood pressure due to heart/arterial prob's (MAKE SURE you do a treadmill test) etc, etc.

Next: If other conditions are ruled out, and exercise/diet/lights don't help THEN consider the medication to get past the negative thought patterns (repeated thoughts and downward spiral of thoughts). Rx treatment can be short-term but may continue depending on the success of getting rid of depression. A person has to communicate with the dr. on their own, it is unlikely that your dr. will call you to see if it's successful for you or not. If depression continues after three weeks, you either have to go higher on the milligrams or switch to something else.

Also, don't self medicate (more one day, less the next). And when through with the meds, a person can't go "cold turkey" when you are feeling better or you risk a 'high' manic episode; these are psychotropic drugs and require a slow tapering off.

As for SSRI's--my experience is to avoid Prozac (too scary in the first 3 weeks, anxiety, nightmares, and continued thoughts of suicide) and to avoid Paxil, it makes you feel like you are "out of it" and can't remember anything. Zoloft (sertraline) works for me. I hear Wellbutrin is pretty good but doctors have found that it makes people horny as hell.

A tendency towards depression is often genetic, other research has shown that running high fevers as children may cause depression later in life.

IF at anytime suicidal thoughts and actions are considered seriously, get on the meds right away.

Good luck and God bless to you on this very :mad::mad::mad: annoying condition. May I encourage you to rely on those who care about you, and share with them your condition and progress or lack thereof. Be assured that I will keep you in my prayers.

(But, obviously, sharing with employers or coworkers is really risky in aviation-- due to the tremendous amount of disinformation out there and the remaining stigma of society).

Sorry so long, best of luck to you.

J., Minneapolis

[robbor]

Hi Capt Flynn

Sorry to hear about how things have been for you of late. It is amazing the responses you have received and great ideas for what you can do even without medication. Yes, the CAA are strict about this and antidepressants will lead to grounding:
The better news is that the aviation authorities are coming around to being more open-minded about medication of this kind but this is still some way off.

Whatever you may be feeling and whatever your doctor thought (which may be correct), it requires careful and sensitive exploration. Yes, there are many things that can be done without medication. Depression can also be a sign of many other things too and those underlying co-factors may well be driving the problem.

There is much more to say and I would be happy to chat with you if you want.
Regards
Rob

[captain_flynn]

Hey,

I just want to thank everyone for their replies. When I was posted the topic I was feeling very low indeed and was having a very hard time. However, things have picked up alot for me in the last few months and I am much much happier with my life now. I am glad that I declined the anti-depressants and i'm happy I was able to deal with my problems without the aid of prescribed medication.

Thank you all for your great advice and useful input.

:)