FAA allows pilots to take antidepressants
Join Date: Apr 2008
Location: Durham
Age: 62
Posts: 187
Likes: 0
Received 0 Likes
on
0 Posts
Fine line
johns..
Depression in the main takes two forms ( there are exceptions) - reactive and endogenous. Reactive is what it means - Post traumatic stress if you prefer.
Endogenous depression is slow onset and is very common when people are involved in high-stress occupations for years. It has something to do with exhaustion of brain chemicals, specifically serotonin, and exposure to high stress situations on a routine basis.
johns... would you be so self-aware that you would know when you are impaired by endogenous depression? I doubt it. Most self-referrals have a common thread - they have had thier behaviour pointed out by others as having changed, and characteristially the terms used are "flat", "unconcerned" and "indifferent". This condition is very amenable to treatment. Based on statistics from other professions as much as 15% of staff over 40 years of age will be affected by this condition. If treated appropraitely almost all will return to work.
Depression in the main takes two forms ( there are exceptions) - reactive and endogenous. Reactive is what it means - Post traumatic stress if you prefer.
Endogenous depression is slow onset and is very common when people are involved in high-stress occupations for years. It has something to do with exhaustion of brain chemicals, specifically serotonin, and exposure to high stress situations on a routine basis.
johns... would you be so self-aware that you would know when you are impaired by endogenous depression? I doubt it. Most self-referrals have a common thread - they have had thier behaviour pointed out by others as having changed, and characteristially the terms used are "flat", "unconcerned" and "indifferent". This condition is very amenable to treatment. Based on statistics from other professions as much as 15% of staff over 40 years of age will be affected by this condition. If treated appropraitely almost all will return to work.
With CASA's approach, pilots are more inclined to seek treatment for depression. They lose six weeks of flying going on the drugs and six weeks when the dose is adjusted or ended.
Contrast that with the latest, greatest from the FAA where a pilot is taken off flying status for a year.
That leaves a major disincentive for a pilot to seek treatment for depression unless he has a really severe case, i.e. can't get himself out of bed to report to work.
In that situation many depressed pilots will continue to fly without treatment.
Contrast that with the latest, greatest from the FAA where a pilot is taken off flying status for a year.
That leaves a major disincentive for a pilot to seek treatment for depression unless he has a really severe case, i.e. can't get himself out of bed to report to work.
In that situation many depressed pilots will continue to fly without treatment.
Join Date: Jun 2008
Location: New Zealand , Wellington
Posts: 21
Likes: 0
Received 0 Likes
on
0 Posts
Treatment of depression is fixed by taking a step back and adjusting your life. Not taking a chemical expecting it to adjust it for you. It is a drug, which is being used everyday, and like every drug, you become immune over time, to the point it has little effect. Humans were not designed to take a chemical every day, why is it only in the last half century people have been fooled into taking this crap when real health has been mastered by the Chinese for over 3000 years.(Chi Qi-Gong) Get your energy channels flowing. It really does work.
Anti-depressants can often be looked at as the start of a long spiral down. Personally know people on using this stuff who all say it wears off over medium periods or time.
In terms of pilots flying using these pills, it needs to be a case by case basis in which each pilot is researched thoroughly as opposed to a single appointment.
Anti-depressants = sad reality of a not so uncommon modern life for some.
Anti-depressants can often be looked at as the start of a long spiral down. Personally know people on using this stuff who all say it wears off over medium periods or time.
In terms of pilots flying using these pills, it needs to be a case by case basis in which each pilot is researched thoroughly as opposed to a single appointment.
Anti-depressants = sad reality of a not so uncommon modern life for some.
I wonder how many pilots are out there flying suffering from depression yet still getting the job done. This is a good decision and I applaud the FAA for addressing the situation rather than just sweeping it under the carpet.
I have to believe they are taking a page out of the militaries play book of removing the stigma out of depression and addressing it as a treatable issue.
I have to believe they are taking a page out of the militaries play book of removing the stigma out of depression and addressing it as a treatable issue.
Join Date: May 2001
Posts: 52
Likes: 0
Received 0 Likes
on
0 Posts
Pattern is Full
But if you happen to be one of those pilots on a schedule with irregular hours or minimum turnarounds, you might find yourself hitting the wall while still in the cockpit. Just something to note.
Join Date: Jun 2008
Location: Brisbane
Age: 47
Posts: 24
Likes: 0
Received 0 Likes
on
0 Posts
Treatment of depression is fixed by taking a step back and adjusting your life. Not taking a chemical expecting it to adjust it for you.
I don't know how common it is for people to be on anti-depressants for extended periods of time but I would suspect that's the exception rather than the rule. Perhaps someone has statistics on that... although we are heading off-topic.
Jackdaw: Well, I wanted to leave the possibility open - however remote....
Psychology is complex - there are many levels of depression and different people react differently to the ailment or to the treatment. So there is room for a variety of approaches.
But for certain types of simple chemical depression, SSRIs are like topping up the oil on an engine. You don't counsel the engine on how to run without enough oil; you don't exhort it to "straighten up and fly right!" - you get out a quart and fill the blerry tank!
Psychology is complex - there are many levels of depression and different people react differently to the ailment or to the treatment. So there is room for a variety of approaches.
But for certain types of simple chemical depression, SSRIs are like topping up the oil on an engine. You don't counsel the engine on how to run without enough oil; you don't exhort it to "straighten up and fly right!" - you get out a quart and fill the blerry tank!
Treatment of depression is fixed by taking a step back and adjusting your life
You don't have control over everything that ails you.
Anybody here taken a look at the listed side effects of good old aspirin when taken with caffeine?
.. and I left out the more serious ones 
I would not worry too much about listed side effects here. The manufacturers must list them, for legal reasons, I suppose.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black stools; confusion; diarrhea; difficulty swallowing; excessive drowsiness; hearing loss; hoarseness; mood or mental changes; ringing in the ears; shortness of breath; sweating.
I would not worry too much about listed side effects here. The manufacturers must list them, for legal reasons, I suppose.
Join Date: May 2009
Location: A whole new world now!!
Posts: 227
Likes: 0
Received 0 Likes
on
0 Posts
Guys can I add my twopenneth here as someone who has once been refused a job in aviation purely because I had taken, not was taking, anti depressants.
I'm not a pilot but CC so have no where near the responsibilities you guys do. My potential responsibilities were quoted however as a reason for refusing me a position with a certain company.
I'm also a RN so have insight into the actions of SSRI's, tricyclic antidepressant's etc when treating patients but I am no expert. Having taken SSRI's yes I have had side effects whilst getting used to them.
Some people are pre-disposed to depression. I have a family history. My depression was post natal many years ago and since as a loss of job accompanied by bereavement. On both occasions I was treated successfully with drugs (small doses) and counselling.
Unfortunately even in this day and age depression is seemed as a stigma. Some people view sufferers unjustly as potentially suicidal maniacs and in the experience I had aviation was no exception.
I was offered a postion subject to reference and medical clearance so I'd passed all the airlines assesment criteria for CC. I declared I had previously suffered from depression on my med form. Without any further reference to my GP, any interview with me, any psychiatric opinion I was refused my position by the company DR.
I challenged this decision on the grounds of discrimination and lo and behold again without any of the above consults i was given a position!!!. If I was a risk to airline travel the company concerned would never have known either way.
As CC now I could travel with Pilots everyday who are depressed and not seeking treatment. I could also travel with those who have been there as have I and I would never know. Both catergories I'm sure would never admit to this for fear of jeopardising their careers as things seem to stand.
If the FAA are allowing Pilots to fly on anti depressants then good on them
..... providing these Pilots are closely monitored on both medication levels and a proper psychiatric evaluation regularly. Thank God a regualtory authority is recognising this as a treatable illness.
I believe (lurking on another Pilot thread) the CAA are almost there with Pilots as well. It takes a lot of courage however to put this to the test.
I'm not a pilot but CC so have no where near the responsibilities you guys do. My potential responsibilities were quoted however as a reason for refusing me a position with a certain company.
I'm also a RN so have insight into the actions of SSRI's, tricyclic antidepressant's etc when treating patients but I am no expert. Having taken SSRI's yes I have had side effects whilst getting used to them.
Some people are pre-disposed to depression. I have a family history. My depression was post natal many years ago and since as a loss of job accompanied by bereavement. On both occasions I was treated successfully with drugs (small doses) and counselling.
Unfortunately even in this day and age depression is seemed as a stigma. Some people view sufferers unjustly as potentially suicidal maniacs and in the experience I had aviation was no exception.
I was offered a postion subject to reference and medical clearance so I'd passed all the airlines assesment criteria for CC. I declared I had previously suffered from depression on my med form. Without any further reference to my GP, any interview with me, any psychiatric opinion I was refused my position by the company DR.
I challenged this decision on the grounds of discrimination and lo and behold again without any of the above consults i was given a position!!!. If I was a risk to airline travel the company concerned would never have known either way.
As CC now I could travel with Pilots everyday who are depressed and not seeking treatment. I could also travel with those who have been there as have I and I would never know. Both catergories I'm sure would never admit to this for fear of jeopardising their careers as things seem to stand.
If the FAA are allowing Pilots to fly on anti depressants then good on them
..... providing these Pilots are closely monitored on both medication levels and a proper psychiatric evaluation regularly. Thank God a regualtory authority is recognising this as a treatable illness.I believe (lurking on another Pilot thread) the CAA are almost there with Pilots as well. It takes a lot of courage however to put this to the test.
Nexialist
Join Date: Jul 2003
Location: Milton Keynes
Posts: 181
Likes: 0
Received 0 Likes
on
0 Posts
Just something to remember about listed side effects of any drug. They are reported effects that a sample group of patients experienced. Now if you are taking a drug to stop your knee turning green, but it doesn't work for you, your knee will be green. This would be reported as an effect.
Listed side effects are not always SIDE effects, sometimes just uncured symptoms.
Listed side effects are not always SIDE effects, sometimes just uncured symptoms.
Join Date: Aug 2005
Location: New Zealand
Age: 62
Posts: 56
Likes: 0
Received 0 Likes
on
0 Posts
Interesting Thread
Hi All,
Wow, do I have to add my 50c worth here! I was married to my (now ex) wife for 16 years. 10 years ago she was diagnosed with ASD (anxiety stress disorder). She went on Arapax, which was brilliant, but flat lined her emotions. She never had highs, and never had lows. And she never cried (most unusual for a woman). Great for me, but bad news for her. When I went back to long haul (5 years ago), the kids left home, she gave up work and went off her meds. She spiralled back down into depression, met someone on the 'net who had the same problem, and left me because she said "he understood her", and was home every night. He has the same affliction. I have to admit that after I found out she had an affair with him, I thought about antidepressants. But I realised that the only thing that really got me going, was going to work. LOL. Sad but true. But I now know so much about the second and third gen. antidepressants that I would be comfortable flying with someone who was using them.
Further to the above, my current g/f is on them as well (boy, can I pick'em), but for different reasons. Her Mum, brother and Dad died within 3 months of each other. The problem is, that once the emotional dependency is established, there is a general reluctance to come off the meds., and that is where the danger lies. But I am glad the FAA and CAS have seen the light. Divorce and house moving are generally the biggest causes of (temporary) depression. While it is normal for the majority of us "normal" ppl to criticise those who turn to medication to alleviate their problems, not everybody can cope on their own. They need our understanding. I would much rather fly with somebody who is honest about their condition than one who is hiding it.
Food for thought.
400R
Wow, do I have to add my 50c worth here! I was married to my (now ex) wife for 16 years. 10 years ago she was diagnosed with ASD (anxiety stress disorder). She went on Arapax, which was brilliant, but flat lined her emotions. She never had highs, and never had lows. And she never cried (most unusual for a woman). Great for me, but bad news for her. When I went back to long haul (5 years ago), the kids left home, she gave up work and went off her meds. She spiralled back down into depression, met someone on the 'net who had the same problem, and left me because she said "he understood her", and was home every night. He has the same affliction. I have to admit that after I found out she had an affair with him, I thought about antidepressants. But I realised that the only thing that really got me going, was going to work. LOL. Sad but true. But I now know so much about the second and third gen. antidepressants that I would be comfortable flying with someone who was using them.
Further to the above, my current g/f is on them as well (boy, can I pick'em), but for different reasons. Her Mum, brother and Dad died within 3 months of each other. The problem is, that once the emotional dependency is established, there is a general reluctance to come off the meds., and that is where the danger lies. But I am glad the FAA and CAS have seen the light. Divorce and house moving are generally the biggest causes of (temporary) depression. While it is normal for the majority of us "normal" ppl to criticise those who turn to medication to alleviate their problems, not everybody can cope on their own. They need our understanding. I would much rather fly with somebody who is honest about their condition than one who is hiding it.
Food for thought.
400R
None but a blockhead
Join Date: Nov 1999
Location: London, UK
Posts: 535
Likes: 0
Received 0 Likes
on
0 Posts
Mental illness has a special stigma. It's not so long ago in the West - still is, elsewhere - that it was seen as a sign of demonic possession, of moral degradation, of being an irretrievably unstable and untrustworthy person.
A lot of that is still washing around, even in our enlightened society. There has been a sea change in the last twenty years, on the back of better science, better medicine and social changes, and it's now possible to say that you've been clinically depressed (as I have) while expecting it to be seen as any other medical matter. The expectations aren't always met, but things have improved immeasurably.
And so it is possible, and preferable, to regulate employment along those lines. As with everything in aviation, it's risk/benefit analysis to the fore - and I find it very hard to argue against a regime where having depression is seen as no more of a career threat than any other monitorable, treatable and predictable condition. It will encourage honesty and effective management. It's also more humane.
The SSRI antidepressants are very well understood (to a certain extent, but certainly in practical use), and their use in conjunction with other therapies can be limited and safe. The recognition that the state of the art has advanced, together with a regulatory environment where sufferers feel supported, not at extra risk, is a good idea.
In terms of who I'd rather have driving my bones across the sky, I'd have someone with a history of properly treated clinical depression over the roster-fatigued, the hung-over and the work-stressed-to-the-limit, purely because I feel the latter factors are a greater risk - both when things go pear-shaped and when coping with the attention-sapping routine.
R
A lot of that is still washing around, even in our enlightened society. There has been a sea change in the last twenty years, on the back of better science, better medicine and social changes, and it's now possible to say that you've been clinically depressed (as I have) while expecting it to be seen as any other medical matter. The expectations aren't always met, but things have improved immeasurably.
And so it is possible, and preferable, to regulate employment along those lines. As with everything in aviation, it's risk/benefit analysis to the fore - and I find it very hard to argue against a regime where having depression is seen as no more of a career threat than any other monitorable, treatable and predictable condition. It will encourage honesty and effective management. It's also more humane.
The SSRI antidepressants are very well understood (to a certain extent, but certainly in practical use), and their use in conjunction with other therapies can be limited and safe. The recognition that the state of the art has advanced, together with a regulatory environment where sufferers feel supported, not at extra risk, is a good idea.
In terms of who I'd rather have driving my bones across the sky, I'd have someone with a history of properly treated clinical depression over the roster-fatigued, the hung-over and the work-stressed-to-the-limit, purely because I feel the latter factors are a greater risk - both when things go pear-shaped and when coping with the attention-sapping routine.
R
Join Date: Oct 2007
Location: San Francisco
Age: 52
Posts: 4
Likes: 0
Received 0 Likes
on
0 Posts
What year is it?
So I've been a reader on these forums for years and have never felt a need to verify my email so I could post until now, since I'm not a pilot and I generally don't feel I have anything of value to contribute -- which should give comfort to the only-professional-pilots-have-anything-worthwhile-to-say crowd (with whom I disagree, for the record).
As I've been reading this thread I've been stunned by the general lack of knowledge on the subject of antidepressants on display by what I generally consider a well-educated, rational group of professionals that are required by the rigors of their jobs to continually question situations and adapt to them as they change -- whether it be a sudden wind shear on approach, or the encroachment of silicone into more and more areas of the aircraft's systems.
So with an amazing capacity for adaption, why this incredible reluctance to re-examine a medical condition that has, over the past ten years, seen an amazing set of leaps both in our understanding of its mechanisms and of its treatment options?
There are a few here who have tried to point out the rational side by explaining how depression works and how the SSRIs treat it, and they've got the right of it in broad strokes, but if the pilot population as a whole is emotionally set against the idea of allowing SSRIs, explaining the mechanisms of depression is a bit like teaching a deaf person the differences between a major and a minor scale. Admirable, but perhaps not the best use of one's time.
Instead, I would ask that those who have a strong negative emotional reaction to this turn of events take a moment to ask themselves if their reactions are based in current facts.
Remember that aviation was once mysterious and unknown and that over a series of decades through the HARD work of pilots, technicians, scientists, mechanics, daredevils, accountants, dreamers, skeptics and many many more, we have come to understand aviation further, define its workings, discover the principles, master all sorts of aspects once considered practically magic. Are there still unknowns? Sure - what the hell did happen with AF in the ITCZ? But we all know that a huge number of people are working to nail down that mystery, and if not solved at least it will most-likely spur innovations that might help future flights (does any pilot out there seriously doubt that in the next twenty years they will not have instantly updated weather at all times in the cockpit -- damn the technical naysayers, I have it now on my $300 cellphone -- global coverage is a logistic, not a technical issue).
Think of the clinical understanding treatment for depression as following a similar course to aviation knowledge, just on a different timescale. The unknowns are being nailed down, just as Yeager proved there was no bogeyman past Mach 1, and millions of safe flights have proven the relative safety of FBW.
All this said, I appreciate the naysayers, for they are the ones who will keep the pioneers honest. They are needed and should be actively involved with any new endeavor. My hope is that the naysayers are as informed as possible, as that is when they are at their most-effective.
So before I go back to my next five years of silent reading of your fascinating forums, I'll tackle a smattering of what's been thrown out there, but really, my hope in writing this is not to answer any one individual voice, but more a call to the profession to shift the attitudes away from a strict rejection of an entire field of inquiry to a more helpful examination of the facts, befitting a group of quite-smart professionals.
Feel free to stop reading here if you are in a hurry.
jm
========
For the record, I'm not an aviator, nor a medical professional, just an ordinary guy with an unhealthy obsession about a few select topics, including aviation and mental health - so if you feel you must ignore or dismiss my points, you have every reason to that you'll ever need.
Well I won't shoot, but this is wrong. In terms of mind-alteration from a medical perspective, if Alcohol is 100 units of mind-alteration, cannabis is about 65-95 depending on who's research you want to believe and the SSRI class is about 10-30. Caffeine can be higher than SSRIs. Certain cold medications can be 150.
Frame of mind and depression are not related. Investigate it further. Common mistake since clinical depression uses the word depression. Most people have an intuitive sense of what depression is and therefore believe they understand it. Then again many people have an intuitive sense that adjusting the throttle should change the speed of the aircraft since that's what happens in their cars. However in truth it's much-more complex. Something about pitch comes into play if I've been following along correctly.
Agree re lack of emotion. Understand SSRIs do NOT inhibit emotion. They actually can increase one's ability to process emotion. I would guess your partner's colleague is either (a) a shiny happy person bordering on space cadet as her normal baseline or (b) not getting the desired results from her current treatment.
Hm. Not sure about this being a concerted effort to weaken a profession. Not familiar with the Delta crash, but as to people studying the effects of antidepressants under emergency/stressful situations there have been plenty of those and while not strictly in a cabin, there are considerable amounts of the world population at high-elevation cities taking these types of medications with no noted special problems.
This can happen, but I would argue that within a couple weeks of taking the medication any tendency for this to be a problem larger than any normal fatigue problem is minimal to non-existent. And certainly it is preferable to not getting enough sleep and then dealing with fatigue, which can be, as we all know, worse than a couple beers.
Interesting point. There are many drugs available OTC that are MUCH MUCH more powerful and concerning to me than an SSRI. The SSRI by design is administered at incredibly small dosages as the goal is to maintain a absolute minimum effective dosage; wheras many cold medications and painkillers that one would think of as perfectly innocuous work by administering massive doses of quite mind-altering substances as any bored teenager with access to a medicine cabinet can attest to.
This is a really happy story. However, I'd caution that this is not the case for all people. Think of it more along the lines of insulin for a diabetic. Some people require continued treatment with SSRIs and that is perfectly ok.
This is part of a big (happy) shift in medical thinking. It used to be that Western medicine used prescriptions to treat immediate problems in a massively quick way. Take yer' medicine, grit your teeth and you'll get better. Now, there is recognition that treating things more with more subtlety over a longer period of time might have a better outcome (shifting towards a more eastern philosophy). Hence there are a lot more long-term drugs out there - think of how many of you take meds long-term for cholesterol, cardio issues, etc. This is also explained by big pharma, sure, but there is a medical reason also.
I understand the gut reaction, but cannot agree with the logic behind it.
Situations aren't always as cut-and-dried as you might frame them here. Consider this - most people (and more men, statistically) will not acknowledge, even to themselves, that they suffer from anything like depression, even IF they are aware of it. It is estimated that from 20-40% of cases of depression in men go untreated and the great majority of these untreated cases use alcohol to help cope/avoid. It's even encouraged by most cultures, "have a drink boyo, that'll fix ya up." Unfortunately alcohol actually aggravates the problem. So it may not be a reflection on their professional integrity to not seek treatment -- they might just not know.
Finding some 'heart' doesn't seem like it's your cup o' tea, so instead think of self-preservation and hope the guy/gal sitting to your left or right isn't self-medicating a denied problem with alcohol and may not exactly be in his or her top form.
This is actually an oversimplification, but it's easy to understand how it comes about. The indifference is actually more likely in regards to things affecting onesself, not in regards to others. This is why you aren't reading headlines about suicidal people taking others to their deaths with great regularity, even though suicide is unfortunately common. The suicidal pilot is more likely to land the plane, go to a hotel room and OD on something than to take all the passengers down with them (sorry for the crudeness).
Very interesting point. Further to it, consider that piloting can be both boring, repetitive AND high stress and you have the perfect conditions for the triggers for clinically significant depression. Our ape bodies were designed to run around the Savannah, hunting and running in order to work off excess tension and systemic overloads of our fight or flight systems. When executing a tough crosswind on a slushy runway, those systems are hammered just as hard (or at least I hope to hell my pilot's are) but when the danger has passed, you still have to taxi to stand, perform rote drills, do paperwork and smile to the ungrateful ****s down the back who have no clue how close they all came to death that morning. If you don't exercise afterward and then eat a heavy meal/go to bed, how well is the body coping?
Got my American hackles up with that, but that's because there is quite a bit of truth in the statement. Touché, and a really interesting topic that could go on and on.
That said, the Freudians/Jungians/Chinese/Hindu/Whathaveyou all have a huge pile of data on the effectiveness of their approaches to treating depression and they all, with a few exceptions, have come around to accept that the physical causes of depression (neurons and such) are real and that treating them with medication has solved more problems and saved more lives and allowed more people to lead normal lives than any of their methods ever came close to doing.
Do Americans think as you outline above? Not all, just as not all Brits are polite tea-sippers, but there IS a tendency to look to the quick-fix. I would point out though, that SSRIs are not a quick-fix. They are long-term, require planning and strategy.
Now in terms of the economy, Christ, look to anyone but us. Our economy relies on constant growth. If we don't get another space race/cold war/tech revolution shot-in-the-economic arm, we're going down in flames and we're taking you all with us.
Agree. At least it's a step in the right direction.
Uff. The hard thing about responding to this is that you are partially right. It should often involve taking a step back and adjusting, but it CAN also include using the drug to help. The two are not mutually exclusive nor should they be set up that way. For some, the drug is the only thing that has ever worked for them.
But as to humans not designed to take a chemical everyday? Give me a break, there are plenty of chemicals you need everyday without which you would die. I'm sure you can name a few. Every food we eat is a chemical miracle that science is only now just starting to understand.
Chi Qi-Gong does work for some people and there is an effort to incorporate it into scientific studies. There are people studying it conjunction with drugs. Nothing should be dismissed out of hand until we know for sure. That's how we broke the sound barrier. Since exercise has been shown to be anywhere from 50-100% as effective as SSRIs in treating depression, it would not surprise me if Chi Qi-Gong is quite effective.
However, Chi Qi-Gong has not been around for 3K years unless I'm mistaken. It was accepted in the early 1990s in the Chinese Health system and a lot of traditional Chinese medicine practitioners view it with a great deal of skepticism. Some think the government only accepted it in order to control some ofshoots of the movement it found troublesome, WAY off topic, sorry.
[QUOTE]Anti-depressants can often be looked at as the start of a long spiral down. Personally know people on using this stuff who all say it wears off over medium periods or time.
</QUOTE]
Hm. Yes, they can wear off. It is subtle and can be addressed by the ever more-common dosage shifting and combination approaches. However, it is not the case for the majority of people that they wear off or that they are a spiral down. That said, we should wait another 20 years to really say anything concrete about this to get truly long-term data. Maybe you are right. I hope not for many people's sake.
Agree wholeheartedly.
It's becoming more common than not as the data show their efficacy and incredibly low-incidence of undesirable side effects.
Agree, but also brings up a larger point. For the most-part, people who suffer from long-term depression have the depression independent of any triggering event. It's endogenous as someone else pointed out. The genetic markers are placed there by your parents and it will manifest or not, usually by early adulthood. We still don't know why at this age, and we still don't know why some people can have the markers and have no problems and others will. Just like we don't yet fully understand how aspirin works or how to cure the common cold. But there are a lot of people hard-working open-minded people at work on these problems.
As I've been reading this thread I've been stunned by the general lack of knowledge on the subject of antidepressants on display by what I generally consider a well-educated, rational group of professionals that are required by the rigors of their jobs to continually question situations and adapt to them as they change -- whether it be a sudden wind shear on approach, or the encroachment of silicone into more and more areas of the aircraft's systems.
So with an amazing capacity for adaption, why this incredible reluctance to re-examine a medical condition that has, over the past ten years, seen an amazing set of leaps both in our understanding of its mechanisms and of its treatment options?
There are a few here who have tried to point out the rational side by explaining how depression works and how the SSRIs treat it, and they've got the right of it in broad strokes, but if the pilot population as a whole is emotionally set against the idea of allowing SSRIs, explaining the mechanisms of depression is a bit like teaching a deaf person the differences between a major and a minor scale. Admirable, but perhaps not the best use of one's time.
Instead, I would ask that those who have a strong negative emotional reaction to this turn of events take a moment to ask themselves if their reactions are based in current facts.
Remember that aviation was once mysterious and unknown and that over a series of decades through the HARD work of pilots, technicians, scientists, mechanics, daredevils, accountants, dreamers, skeptics and many many more, we have come to understand aviation further, define its workings, discover the principles, master all sorts of aspects once considered practically magic. Are there still unknowns? Sure - what the hell did happen with AF in the ITCZ? But we all know that a huge number of people are working to nail down that mystery, and if not solved at least it will most-likely spur innovations that might help future flights (does any pilot out there seriously doubt that in the next twenty years they will not have instantly updated weather at all times in the cockpit -- damn the technical naysayers, I have it now on my $300 cellphone -- global coverage is a logistic, not a technical issue).
Think of the clinical understanding treatment for depression as following a similar course to aviation knowledge, just on a different timescale. The unknowns are being nailed down, just as Yeager proved there was no bogeyman past Mach 1, and millions of safe flights have proven the relative safety of FBW.
All this said, I appreciate the naysayers, for they are the ones who will keep the pioneers honest. They are needed and should be actively involved with any new endeavor. My hope is that the naysayers are as informed as possible, as that is when they are at their most-effective.
So before I go back to my next five years of silent reading of your fascinating forums, I'll tackle a smattering of what's been thrown out there, but really, my hope in writing this is not to answer any one individual voice, but more a call to the profession to shift the attitudes away from a strict rejection of an entire field of inquiry to a more helpful examination of the facts, befitting a group of quite-smart professionals.
Feel free to stop reading here if you are in a hurry.
jm
========
For the record, I'm not an aviator, nor a medical professional, just an ordinary guy with an unhealthy obsession about a few select topics, including aviation and mental health - so if you feel you must ignore or dismiss my points, you have every reason to that you'll ever need.
Shoot me down if I am wrong or exaggerating , but isn't prozac just as much a mind altering substance as alcohol or cannabis ?
If your depression is severe enough to require use of a substance to alleviate the depression, are you really in the frame of mind to fly ?
A colleague of my partner is prescribed one of these wonder drugs, she is always a little bit "shiny happy people" bordering on "space cadet" at times.
Regretably humans get emotional for a good reason, sometimes it is adrenalin/emotion that pushes you to take the actions that keep you alive.
Lack of emotion isn't ALL good IMHO
Regretably humans get emotional for a good reason, sometimes it is adrenalin/emotion that pushes you to take the actions that keep you alive.
Lack of emotion isn't ALL good IMHO
so, the airlines have hundreds of guys with depression on their disability lists...paying out money in accordance with contracts
Voila, change the rules and put em back to work!
I think this is a huge mistake, just one more step to weaken the profession.
Does anyone remember the L1011/Delta at DFW that crashed in Microburst? wasn't the pilot taking a drug similiar to an anti depression drug?
And I don't think anyone has studied the side effects of prozac at a cabin altitude of 8000', or during a true emergency regardless of altitude.
Voila, change the rules and put em back to work!
I think this is a huge mistake, just one more step to weaken the profession.
Does anyone remember the L1011/Delta at DFW that crashed in Microburst? wasn't the pilot taking a drug similiar to an anti depression drug?
And I don't think anyone has studied the side effects of prozac at a cabin altitude of 8000', or during a true emergency regardless of altitude.
The downside is that after a good high-energy day thinking clearly, when the time to sleep comes, it comes on fast.
I think the new ruling sets a dangerous precedent as there are many modern non-prescription over-the-counter drugs which are marketed specifically to be "non-drowsy" as compared to their "drowsy" counterparts. Are we saying there ought to be an exemption for such drugs as well ?
After about 18 months I gave the SSRI up under the guidance of my GP, naturally. It needs to be looked at like a broken arm - it needs a "splint" for a while while it heals naturally, then back to normal. Just like me - for those who know me, no smart cracks, OK??
This is part of a big (happy) shift in medical thinking. It used to be that Western medicine used prescriptions to treat immediate problems in a massively quick way. Take yer' medicine, grit your teeth and you'll get better. Now, there is recognition that treating things more with more subtlety over a longer period of time might have a better outcome (shifting towards a more eastern philosophy). Hence there are a lot more long-term drugs out there - think of how many of you take meds long-term for cholesterol, cardio issues, etc. This is also explained by big pharma, sure, but there is a medical reason also.
Just what we need...suicidal pilots, now medicated, flying passengers around...
So we have gone from medicated, suicidal pilots, to unmedicated, suicidal pilots that have no sense of responsibility to their passengers, no sense of professional integrity....thus not seeking help...
I guess I am supposed to dredge up some compassion for these pilots, find some 'heart'?
I guess I am supposed to dredge up some compassion for these pilots, find some 'heart'?
Finding some 'heart' doesn't seem like it's your cup o' tea, so instead think of self-preservation and hope the guy/gal sitting to your left or right isn't self-medicating a denied problem with alcohol and may not exactly be in his or her top form.
BTW...thanks for clearing that up...I feel much better knowing my captain is 'indifferent to almost everything' and not 'suicidal'.
Endogenous depression is slow onset and is very common when people are involved in high-stress occupations for years. It has something to do with exhaustion of brain chemicals, specifically serotonin, and exposure to high stress situations on a routine basis.
Typically American problem solving; having trouble putting things into perspective, not setting priorities that make sense and only fighting the symptoms i.o. the root cause of a problem! (oh by the way, did anyone say airport security, terrorism and the economy...? )
A quick fix, some high speed tape in the shape of a pill to patch up a broken psyche and off we go again, waiting for the next problem to pop up!
The show must go on...
A quick fix, some high speed tape in the shape of a pill to patch up a broken psyche and off we go again, waiting for the next problem to pop up!
The show must go on...
That said, the Freudians/Jungians/Chinese/Hindu/Whathaveyou all have a huge pile of data on the effectiveness of their approaches to treating depression and they all, with a few exceptions, have come around to accept that the physical causes of depression (neurons and such) are real and that treating them with medication has solved more problems and saved more lives and allowed more people to lead normal lives than any of their methods ever came close to doing.
Do Americans think as you outline above? Not all, just as not all Brits are polite tea-sippers, but there IS a tendency to look to the quick-fix. I would point out though, that SSRIs are not a quick-fix. They are long-term, require planning and strategy.
Now in terms of the economy, Christ, look to anyone but us. Our economy relies on constant growth. If we don't get another space race/cold war/tech revolution shot-in-the-economic arm, we're going down in flames and we're taking you all with us.
With CASA's approach, pilots are more inclined to seek treatment for depression. They lose six weeks of flying going on the drugs and six weeks when the dose is adjusted or ended.
Contrast that with the latest, greatest from the FAA where a pilot is taken off flying status for a year.
That leaves a major disincentive for a pilot to seek treatment for depression unless he has a really severe case, i.e. can't get himself out of bed to report to work.
In that situation many depressed pilots will continue to fly without treatment.
Contrast that with the latest, greatest from the FAA where a pilot is taken off flying status for a year.
That leaves a major disincentive for a pilot to seek treatment for depression unless he has a really severe case, i.e. can't get himself out of bed to report to work.
In that situation many depressed pilots will continue to fly without treatment.
Treatment of depression is fixed by taking a step back and adjusting your life. Not taking a chemical expecting it to adjust it for you. It is a drug, which is being used everyday, and like every drug, you become immune over time, to the point it has little effect. Humans were not designed to take a chemical every day, why is it only in the last half century people have been fooled into taking this crap when real health has been mastered by the Chinese for over 3000 years.(Chi Qi-Gong) Get your energy channels flowing. It really does work.
But as to humans not designed to take a chemical everyday? Give me a break, there are plenty of chemicals you need everyday without which you would die. I'm sure you can name a few. Every food we eat is a chemical miracle that science is only now just starting to understand.
Chi Qi-Gong does work for some people and there is an effort to incorporate it into scientific studies. There are people studying it conjunction with drugs. Nothing should be dismissed out of hand until we know for sure. That's how we broke the sound barrier. Since exercise has been shown to be anywhere from 50-100% as effective as SSRIs in treating depression, it would not surprise me if Chi Qi-Gong is quite effective.
However, Chi Qi-Gong has not been around for 3K years unless I'm mistaken. It was accepted in the early 1990s in the Chinese Health system and a lot of traditional Chinese medicine practitioners view it with a great deal of skepticism. Some think the government only accepted it in order to control some ofshoots of the movement it found troublesome, WAY off topic, sorry.
[QUOTE]Anti-depressants can often be looked at as the start of a long spiral down. Personally know people on using this stuff who all say it wears off over medium periods or time.
</QUOTE]
Hm. Yes, they can wear off. It is subtle and can be addressed by the ever more-common dosage shifting and combination approaches. However, it is not the case for the majority of people that they wear off or that they are a spiral down. That said, we should wait another 20 years to really say anything concrete about this to get truly long-term data. Maybe you are right. I hope not for many people's sake.
In terms of pilots flying using these pills, it needs to be a case by case basis in which each pilot is researched thoroughly as opposed to a single appointment.
I don't know how common it is for people to be on anti-depressants for extended periods of time but I would suspect that's the exception rather than the rule. Perhaps someone has statistics on that... although we are heading off-topic.
A bit tougher when your life is adjusted for you. A divorce, a death in the family, losing one house, etc.
You don't have control over everything that ails you.
You don't have control over everything that ails you.
Join Date: Dec 2007
Location: Toulouse
Posts: 29
Likes: 0
Received 0 Likes
on
0 Posts
I wish you never having some events that puts you into depression.
Otherwise you'd had to face idiotic comments from ignorant guys about your ability to work while under treatment.
Part of the cure could be also resuming flying and enjoying a normal life again.
Pardon me if I'm wrong but you seems like a young unsensitive 'Know it all', and to me, it's far more dangerous than depressive people in a plane.
Otherwise you'd had to face idiotic comments from ignorant guys about your ability to work while under treatment.
Part of the cure could be also resuming flying and enjoying a normal life again.
Pardon me if I'm wrong but you seems like a young unsensitive 'Know it all', and to me, it's far more dangerous than depressive people in a plane.
Join Date: Jan 2008
Location: Germany
Age: 54
Posts: 7
Likes: 0
Received 0 Likes
on
0 Posts
First Hand experience here...
Long time reader, not a pilot (IT guy). Had a depressive episode in 1999, been treated, things were well again thereafter for 10 years. In fall last year I felt it started again. Some issues in life (related to money, work or relationship) you normally understand and solve rationally (or just ignore!) start to drag you down. It is as if your 747 is ballasted by 80 tons of lead, and put that either close to the nose gear or the aft bulkhead.
I have been on 20mg/d Citalopram (brand name Celexa) for a few months, and i am in the process of fading it out now. I can assure you that there are virtually no side effects. Modern SSRI's just get your weight and balance right again. You still have to fly (your life) yourself, and all systems work and have to work as before!
I have been on 20mg/d Citalopram (brand name Celexa) for a few months, and i am in the process of fading it out now. I can assure you that there are virtually no side effects. Modern SSRI's just get your weight and balance right again. You still have to fly (your life) yourself, and all systems work and have to work as before!
Last edited by b8361811; 12th Apr 2010 at 18:57. Reason: Small correction
Join Date: Aug 2007
Location: San Antonio, TX USA
Age: 62
Posts: 139
Likes: 0
Received 0 Likes
on
0 Posts
Although there appear to be many success stories relating to SSRIs, there are also a few horror stories (Columbine High School for one). Of course the brain is a very complex organ that we know relatively little about. What we know about the brain is equivalent to what could be gained from inventorying a pitch dark warehouse with a flashlight (most items would remain hidden). I feel it's way too soon to trust primitive medications in extreme high stress situations where multiple lives are in the balance. In flight is not the best place to discover a new side effect from SSRIs.
These drugs appear to ease chronic depression in most cases, it is the minority (like the Columbine shooters) that I'd prefer not seeing on the other side of the cockpit door. Until we can get a firmer grasp on precisely who those people are that occupy the minority, SSRIs should not be allowed.
These drugs appear to ease chronic depression in most cases, it is the minority (like the Columbine shooters) that I'd prefer not seeing on the other side of the cockpit door. Until we can get a firmer grasp on precisely who those people are that occupy the minority, SSRIs should not be allowed.