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View Full Version : Depression/Stress -- Don't talk about it to your doctor or a psychiatrist.


RatherBeFlying
14th Jul 2008, 21:25
The current Aviation Safety Letter makes it quite clear that Transport Canada will suspend your medical if you report taking "mood altering medications" such as "Prozac, Paxil, Zoloft, Luvox, Serzone and Effexor to name a few" and will not restore your medical until such medications are discontinued and a satisfactory report is received from the attending psychiatrist or physician.

By contrast CASA, the Australian CAA, does allow at least Effexor with the limitation that there's no flying for two weeks after any change in dosage.

So in Oz, pilots suffering depression or stress can seek treatment with the reasonable hope that they can continue flying with minimal interruption while in Canada, pilots have to suck it up or stop flying for who knows how many months.

Flight Safety article (http://www.flightsafety.org/asw/feb08/asw_feb08_p24-27.pdf)

CD
14th Jul 2008, 23:19
Same limitations with the FAA apparently...

Psychopharmacology is the new wave of psychiatry. One of the newer texts contains over 500 pages describing some of the medications used in treating mental disorders.

The most common medications used today to treat depression —we all know someone on them—are the Selective Serotonin Reuptake Inhibitors (SSRIs). Serotonin is a chemical the brain needs for maintaining a good mood—SSRIs keep the level from being depleted. Prozac, Zoloft, and Paxil are among the most prescribed SSRIs.

The FAA does not presently certify persons who use mood-altering medication. The reasoning is twofold: The underlying condition that requires the medication and the potential adverse side effects from the medication itself. The good news is that the FAA is willing to return virtually all clinically depressed pilots back to flying after successful treatment.
Just of the Health of Pilots (http://www.faa.gov/library/reports/medical/hop/media/depression.pdf)
Virtual Flight Surgeons - Medication Class — Antidepressants and psychoactive medications (http://www.aviationmedicine.com/medications/index.cfm?fuseaction=medicationDetail&medicationID=12)

Glorified Donkey
18th Jul 2008, 13:45
I'm sure there are side effects from taking these drugs that would make you unfit to fly. If a pilot is suffering from heavy stress or depression he/she should not be flying and should voluntarily take themselves offline, take care of themselves and comeback when he/she is healthy and ready.

J.O.
18th Jul 2008, 14:23
The thread title suggests that pilots violate the air regulations when seeing their aviation medical examiner. Personally, I would never make such suggestions, not even on an anonumous forum.

To put this in the proper context, I'd like to add a couple of quotes from the same Aviation Safety Letter article:

While major depression exists, we consider the pilot unfit.

Also:

... anyone taking these medications should be aware of the wide array of potential side effects. While most of the effects are of little significance, a small number of pilots may experience some serious alterations in thinking, mood, judgment and personality. Of even greater concern is the possibility that these effects may go unrecognized by the pilot.

I have seen literature that suggests there has been an increase in the number of suicides by patients taking some SSRIs. I can think of some other substances that can cause similar side effects to those quoted in the ASL article, such as alcohol, cocaine, heroin and many others. Are we suggesting that we allow pilots to fly while under the influence of these substances? I certainly hope not. If you or someone you know has been negatively affected by this policy, then all I can say is I hope you'll take solace in the fact that there is a "road back" to flying at the end of a successful treatment program. I'd be more than happy to share the name of a couple of doctors I know who are excellent in providing support for pilots who are suffering through situations such as depression and addiction. I can provide them via a private message with no questions asked.

Please try to remember that Transport Canada's mission is to provide a safe transportation system for Canadians. If I'm a member of the travelling public, I want to hear that they've put policies in place such as those that restrict pilots suffering from depression, addiction and other afflictions that can negatively effect cognitive ability.

I also want to remind folks that the regulations require us to tell our aviation physician about all medications we're taking. They also require us to remove ourselves from duty if there is any question as to our fitness to do the job safely. Personally, I would not want to take the chance of leaving my family with the legacy of knowing that I flew when I knew I shouldn't have, and that I caused an accident that harmed others partly because I didn't remove myself from duty.

FWIW

Jeff

dwj
18th Jul 2008, 14:46
Having been through severe burnout/depression due to stress myself (although not a commercial pilot) I agree that you definitely do not want to be anywhere near the controls of an aeroplane when in this condition, especially if there are any passengers.

If anyone is in this situation, please PM me and I will be happy to give advice on getting through this.

RatherBeFlying
19th Jul 2008, 01:06
If you're feeling stressed out enough that you don't think you should be flying, taking a couple or weeks or months off to get over a family breakup or other affliction will not result in a psychiatric diagnosis on your medical record -- and spare you jumping through the bureaucratic hoops when you get over it and are ready to fly again.

You can't get on SSRI's without seeing a physician, but in Canada or the USA your medical is suspended until treatment is completed.

By contrast Australia has a protocol that allows a return to flying while taking certain SSRIs as noted in the link in my first post and has been doing so successfully over the last ten years.

The practical difference between Australia and North America is that stressed out pilots in North America have a major incentive to avoid treatment to keep their medicals "clean".

yokuba
29th Jul 2008, 06:42
well there's nothing to be stressed out or depressed about if you're in aviation in North America...:rolleyes:

Pilot DAR
30th Jul 2008, 19:12
I firmly agree that if you have decided that you have a condition which requires medical attention or assistance, and that condition is within the scope of those which require you to not act as a pilot, you should not even consider acting as a pilot! You decided right?

Anyone who would fly during such treatment must be the kind of person who say to the mechanic: "I think this aircraft has a defect, and needs maintenance before it flies again - but I think that I'll take these people for a ride in it first...I'll bring it to you later..."

I have personally assisted carrying the broken body of a good friend of mine, out of the aircraft he had just crashed, while out "workin out his frustrations" in his company plane. It was not his first time flying irresponsibly. We did not know he was being treated for depression with medication, but once told in the accident report, it did not surprise any of us. We should have been better friends to him while we could, instead I was a friend to him only one last time. Dozens of people were profoundly affected by his careless behaviour.

So now I'll be a friend to those who read here, If the standards say don't fly if.... Don't fly, okay? Medical, maintenance, weather, weight & balance, and all of the other words to the wise....

This is the "Professional" Pilots Rumour Network right? Let's act like it!

Pilot DAR

Flatface
16th Aug 2008, 05:39
I recently was suspended from my aviation job (30 years) for submitting a Health and Safety Concern. To get my job back, I had to get my doctor to clear me to return, he did so and his medical certificate was refused, I got another medical certificate from a psychologist who I had been seeing for job related stress, he gave me clearance to return, this was rejected by my employer. My aviation medical came due and the contract medical firm who checked us for fitness to return to work happened to be an AME and cleared me to return to work and gave me clearance to continue flying, these were submitted to the company occupational health doctor who cleared me to return to work. My employer still refused my return to work, he said I needed additional medical evaluation. I agreed to it (against the advice of my legal council) and was subjected to a total of 14 hours of evaluation by a forensic psychiatrist. He eventually gave me the all clear and I was returned to work. Now my medical is due again and I will have to answer the questions on the medical form, "did I receive any psychological counciling or psychiatric counciling"? I will answer yes and when the AME asks for the report, I will not be able to produce it, my employer has refused to provide a copy. Even when my grievance went to arbitration, my employer refused to supply a copy ( it seems there may have been some liabilous allegations made to the psychiatrist by my employer during his interview) what should I do if my licence is revoked on medical grounds since I am unable to prove that all of these problems have been resolved and I am fit to fly? The other AME has retired since he gave me my last aviation medical.

J.O.
16th Aug 2008, 14:14
Flatface:

I would suggest that you ask for your medical file from your former doctor and present it to the new one when you go for your medical. Also, if you were treated and given an all clear to return to work, then your medical file at the aviation authority will have that information in it.

Flexable
16th Aug 2008, 19:12
Last time i listen to the CEO message it had the same effect
("mood altering medications").

I had to book off for a couple of days.:eek:

RatherBeFlying
18th Aug 2008, 04:49
Flatface -- there is a difference between counselling and evaluation. It seems you saw a psychologist for counselling; so, you will need his report if it is asked for.

You saw the forensic psychiatrist for evaluation; that is not counselling and I doubt it is reportable -- check with your lawyer.

777300ER
18th Aug 2008, 13:55
BBC NEWS | Health | Depression link to poor driving (http://news.bbc.co.uk/2/hi/health/7563901.stm)