Download Committee Updates and Articles - Committees

3/31/2016
by Chris McCleskey
BOS ALPA Aeromedical Representative
Feeling Low?
Mental health is an issue rarely discussed by aviators. Most of us would rather take
a check ride at 2 a.m. than visit the doctor for any reason, especially for a possible
mental health concern. In the past, mental health issues were often considered a
career killer. However, the FAA has modified its approach to addressing mental
health needs in the last decade and is now focused on helping pilots who face a
variety of health concerns, including those related to mental health. The FAA wants
pilots who need help to get help. The sooner a depressed pilot gets help, the less
time he or she will be out of the flight deck. More importantly, getting help early
can shorten the length and severity of any mental health conditions.
There are many types of depression; I will cover three in this update. The first one
is the mood disorder, dysthymic disorder. While dysthymic disorder is not
technically depression, those with the disorder can be at a higher risk for
developing depression. Experts describe the symptoms of this disorder as persistent
melancholy. The patient with dysthymic disorder may not recognize these
symptoms—even his or her family members may not notice. Individuals suffering
from this type of mood disorder are often subject to an increased risk of developing
exogenous depression.
Exogenous (caused by outside factors) depression arises when someone encounters
an event such as the loss of a family member, problems at work, a troubled or
unhappy marriage, divorce, alcoholism, drug abuse, financial problems, job loss,
etc. By no means is this a comprehensive list of the causative factors in developing
exogenous depression. It is often labeled an adjustment disorder with depressed
mood.
The final type of depression I will touch on is endogenous depression, also termed
major depressive disorder, which may be inherited and chemical in nature.
Endogenous depression may also develop at any time without an apparent reason.
Think of it as a glitch that shows up in a computer that has been working fine for
years.
Some of the signs and symptoms of depression are:













Feeling depressed all day long
Loss of interest in activities that you usually enjoy
Social withdrawal
Fatigue
Tearfulness
A pervasive feelings of sadness, grief, or helplessness
Changes in appetite
Irritability
Feelings of guilt, worthlessness, or sinfulness
Inability to concentrate or think clearly
Illogical thought patterns
Agitation
Physical symptoms such as stomachaches, headaches, and
backaches
The good news is that there are options for anyone needing help that generally do
not require notification to the FAA:
 Give up alcohol consumption, it will always make depression worse.
 Start exercising or exercise more, it releases endorphins and can release
pent-up feelings of frustration, anger, or hostility.
 Forgive yourself and forgive others. Remember no one is perfect—do not
expect it from yourself or others.
 Open up more. Most of us are not “touchy feely” by nature, but in this case,
talking to your spouse, significant other, or a close friend may help.
The next rung on the ladder is talking to a professional. (Slow down, breathe, no
one mentioned a psychologist or psychiatrist.) Talk to a member of your clergy or
someone referred through an Employee Assistance Program (EAP). (JetBlue’s EAP is
administered through Life Solutions, username Blue) Under most circumstances
EAP representatives have no requirements to report to the FAA and they may be
beneficial in righting the ship before the next rung is required.
Finally, we reach the medical professional level. Psychologists and masters-level
mental-health professional visits are required to be reported, with a few exceptions
such as marriage counseling, family counseling, counseling for a family member’s
drug or alcohol addiction, or other family issues. Many times receiving counseling
may prevent the condition being treated from affecting the status of your medical
certificate.
Now for the psychiatrist, the professional who may prescribe medicine to help
combat depression. While many medications may be used to counter depression,
the FAA will only consider issuing a special issuance for those taking one of four
allowed SSRIs (selective serotonin reuptake inhibitors) while being treated. There is
the requirement to be on a stable dose and symptom-free for six months, as well as
neurocognitive testing the FAA will require. The FAA may also issue a medical after
the successful treatment and discontinuation of other antidepressants, again with a
six-month stable period. I know that a special-issuance medical certificate concerns
many pilots, don’t let it. Any time a pilot seeks a special issuance of a medical it is
on a case-by-case basis, regardless of the medication or the condition being
treated. In many cases, after the initial approval from Oklahoma City, the regional
flight surgeon will be able to issue subsequent medical certificates. (Note—this is
not true for pilots taking SSRIs; all special issuances in these cases must go to FAA
HQ in Washington, D.C.)
Don’t let the fear of being temporarily grounded keep you or someone you know
from seeking help. It is far better to lose six months or a year in the air than to be
permanently grounded. Depression can be successfully treated with over an 85
percent success rate. Getting treatment if you suffer from depression no longer
means trading in your wings for another profession.
The bottom line is that if you feel that you are too far below the glide
slope, get help.
Questions can be directed to your Aeromedical Committee or by calling ALPA’s
Aeromedical professionals (AMAS) at 303-341-4435.
Resources:
ALPA Aeromedical AMAS
FAA specifications for neuropsychological evaluations for treatment with SSRI
medications
FAA Guide for Aviation Medical Examiners