Dr. Henry Paul, MD

Psychiatrist, Author and Educator

ABOUT THAT PILOT

April 7th, 2015

Most of the news coverage of the recent airplane crash has described the co-pilot, Andreas Lubitz, as a depressed person; one with suicidal tendencies who had recently researched suicide and cockpit security on his computer. He apparently sought medical help for an undisclosed mental health issue. It is also suggested by the news media and law enforcement that the co-pilot might have been on medication recently for a mental health issue.

25869324_sAlthough suicide does happen more frequently in the depressed population, we should remember that it is not that common, and violence is rare. To understand this co-pilot you have to go beyond the criteria for diagnosing the usual major depressive episode and consider that some people become so depressed that they develop psychotic depression sometimes with delusions. Delusions can convert a person’s perception of the world so dramatically that it becomes a very bad place, even a place that one should leave. Sometimes taking others with you is not perceived as a murderous act but as one of saving them from suffering in such a terrible world. On occasion, you will see this in suicide notes left by parents who kill their children and then commit suicide so that everyone is “safe and together” in a better place. As bizarre as all this might sound it might explain what happened in this horrendously destructive act and decrease our perplexity to a degree.

It would not be the first time that the mental health of a pilot has been called into question. Alpo Vuorio, MD, PhD, an aviation specialist in occupational medicine at the Mehiläinen Airport Health Centre in Finland, led a study in 2014 that had researchers looking at the last 20 years of data for “aircraft assisted suicide”. What they discovered was reported in the Journal of Aviation, Space and Environmental Medicine. The study found that from 1993-2012, 24 of 7,244 plane crashes were thought to be deliberately caused by a pilot.

In TIME magazine last month, Vuorio said in response to the study, “I really wish that we had some kind of deeper thinking about this issue, because it’s one of the most difficult in aviation medicine.”

Screening pilots and cabin crew of commercial airlines for mental health issues is tricky. I just wrote last week about the fear of disclosing a mental illness to your employer. In this particular case, declaring that you have a mental illness, however temporary, could be a career-ender for a pilot. Disclosing your disorder to your employer raises questions not only about pilots disclosing their mental health issues but also how do you treat them and what is the criteria for deciding if they are capable of flying. Many people in many high-profile professions work while being treated for their mental illness. There certainly is a lot to consider here. The good thing is that the dialogue has started, and the discussion needs to include all professions and not just airline pilots. So let’s remember, this case of possible depression should not warrant any great worry that suicide and homicide are frequent outcomes of this disorder. The majority of depressed people can receive treatment and recover without tragedy.

Disclaimer
This blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

SHOULD I TALK ABOUT MY DEPRESSION AT WORK?

November 21st, 2014

Many people with depression or another mental disorder are overwhelmed enough just dealing with their diagnosis and their focus on getting better, so it is no wonder that they do not want the added stress of having to tell family, friends, co-workers and bosses about their mental health.

Last Friday, a New York Times article, Deciding Whether to Disclose Mental Disorders to the Boss analyzed the decision that Patrick Ross, a deputy director of communications for the U.S. Patent and Trademark Office, made when he decided to tell his boss he had bi-polar disorder.

There is no right or wrong answer about telling your boss or others that you have a mental disorder, but if suddenly you are unreliable, your work drops off, and you no longer are the team player you used to be, then your boss will notice.

At work, you have two options: tell your boss and hope s/he will understand or do not saying anything and hope it goes unnoticed (if it isn’t too severe).

In the NY Times article, Sarah von Schrader, a senior research associate at Cornell University’s Employment and Disability Institute, said, “In one recent study of 600 people with disabilities, roughly half involving mental health, about a quarter of the respondents said they received negative responses to revealing their problems — such as not being promoted, being treated differently or being bullied.”

For Ross, who recently published a book on the subject, “Committed: A Memoir of the Artist’s Road,” he said that telling his boss was more difficult than he had expected. Since he told his boss, Ross says the support from his boss has been positive and even helpful. Ross still wonders how telling might affect his overall career, though, since his job is a political appointment. Only time will tell.

The World Health Organization predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease. Right now major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institute of Mental Health, and the direct cost of depression to the United States in terms of lost time at work is estimated at 172 million days yearly.

I want to see a national dialog about mental health that helps employers to understand the importance of having an employee who is both physically and mentally well. Sadly, it is still a reality in America in 2014 that people with mental illness are somehow labeled or looked upon differently. I am proud to say that we are making strides in this country to change stereotypes like these. I only wish it could happen faster. Putting mental-health problems on an equal footing with physical illnesses will only help more people make the disclosure. In the end, all will benefit. An employee at the top of his/her game is much more productive!

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.