antidepressants

[rotorspeed]

anyone here have a medical with antidepressants approved

[CFR]

PM sent

[loopy]

I understand that the TC's policy isn't as droconian as it used to be and that certain drugs may be allowed. Be careful getting the prescription from a GP or a psychiatrist without consulting a CAME.

My personal belief, don't just get the drugs from a GP, CAME or shrink happy to write a script. Make sure that you see a therapist, preferably a licensed psychologist, and deal with the underlying problem, otherwise the antidepressants are just a band air. Most psychiatrists these days have poor therapy skills compared to psychologists. They get paid by how many patients they can see. They make more money by volume and writing scripts rather than real solid therapy. Psychiatrists a needed with, particularly when people are in crisis, the drugs can help get through that. A good psychologist can help with long term change. Don't be afraid to fire them if they don't work for you and try another one, as there are many different approaches out there.

Don't let you ego get in the way. There is no shame in asking for help. My guess in that you will be a better person for it coming out the other side.

Stepping off soap box now.

[Castorero]

Most psychiatrists these days have poor therapy skills compared to psychologists. They get paid by how many patients they can see. They make more money by volume and writing scripts rather than real solid therapy.

Loopy, you probably mean "most GP's" not Psychiatrists, right?

I agree with you that when your ability to fly can be affected by simply being on some antidepressants, you dont want any Tom, Dick, or Henri handing them out willynilly because they are too busy to provide alternate therapies.

Pilots, contrary to popular folklore, are just like other people. They will get sick, and some will develop anything from mild, to serious psychiatric illness.
I maintain that most pilots are certifiably crazy just for working under some of the conditions and poor pay that they do, but that's another story.

I worry about pilots that are suffering from some psychological ailment being afraid of seeking help for fear of losing their license. The fact is that most mild psychiatric ailments that affect us from time to time CAN be treated without medication, and will respond just as well to psychological therapy as medication. This is an irrefutable fact, confirmed by any of a number of clinical studies.

So, if you are a pilot that actually went to the GP for some help and he or she offered you drugs as a first option, you are either a lot sicker than you thought and you should be seeing a psychiatrist, or your GP is just a bit lazy, too busy or both.

I don't know how often this happens with pilots, because we tend to be paranoid about taking medications that will result in being grounded, but it is a common enough occurrence with the general population, to be of concern.

The time to find a good GP is when you are not sick, someone you can trust and have confidence in, someone that you feel will always have your best interests in mind. These people exist, you just have to root around for them amongst your friends and acquaintances.

TC is only interested in one thing, "does your condition or medication being taken for it, represent a threat to flight safety?" That's all.
Each case is assessed individually, but the fact is that if you are placed on mood altering drugs, your medical certification will be suspended until the circumstances of your case are reviewed.

This review may take a while and it will certainly involve feedback from a psychiatrist giving an opinion and recommendation as to whether the condition being treated and any medication side effects or lack of, represent a threat to flight safety.

So, you see how important it is that you don't get started on antidepressants willynilly, especially when other therapies could achieve the same results.

The problem for most pilots that know they could use some help, is the fear of losing their medical.
That fear is often unwarranted, and a visit to their trusted GP should be a first step to getting pointed in the right direction.

The short answer as to whether there are pilots flying while on antidepressants is a definite yes

The devil is always in the details....

[loopy]

Castorero, I did mean what I wrote, although it is my judgement and bias. It's not that there are not psychiatrists that are good at therapy, but in the last 20 years or so, they have become less focused on psychoanalysis and more on the chemical treatments. Thanks the drug manufacturers lobby for that. Again, my judgement. Psychologists spend a lot more time honing those therapy skills than psychiatrists do once they choose that specialty after med school.

[Castorero]

Loopy, You are quite right, generally, on all counts.

Medications in Psychiatry are a short cut to getting people feeling better faster, that's all.

Psychologists cannot prescribe medications, and that is a good thing, otherwise they too would fall victim to the shortcut approach.

A clinical depression, once underway, will last six months to two years, regardless of whether you are taking medication or not. Medication will get you functioning a lot sooner and faster, thus reducing your suffering time.

Psychiatrists have always had a penchant for a fast 'cure'. Remember the Montreal Clark Institute experiments with LSD? Someone had the bright idea that if they used LSD to induce hallucinations in alcoholics and then they "heard the voice of God" telling them that they had to change their ways, it would cut treatment time to a heartbeat. It worked for some, but it sure screwed up a lot of others.

Ever heard of ECT ? Now there was (is still) a most barbaric treatment...
I had the bright idea of volunteering at a psych hospital after high school, and what I saw there left a not so pleasant impression of psychiatry and its methods...
I should probably get some counseling for that, come to think of it.

I believe that most of the psychological suffering that affects pilots stems from the demands of the job and associated ramifications that bleed into our personal lives.
Stress is associated with all stages of a pilot's career, from the first bush job to being at the controls of the latest jetliner. The key is to learn how to handle this "stress without distress", as Hans Selye was fond of saying. Talking goes a long way to achieving that.

I am not sure that pilot culture is ready for that just yet, but it is long overdue.

I will cut my rambling short by again agreeing with your last statement,

Don't let you ego get in the way. There is no shame in asking for help. My guess in that you will be a better person for it coming out the other side.

[CpnCrunch]

I agree that antidepressants are really just a band-aid. I suffered from severe depression about 13 years ago, and managed to cure it myself by fixing the problems in my life that were causing it (didn't use antidepressants or therapy).

Another person I know used antidepressants, but they didn't really cure the depression. She tried a psychotherapist, but the therapist was useless. Eventually she got referred to an excellent CBT therapist (who is also an MD and surgeon), and he managed to help her fix the depression for good. If you're in southern Alberta and need a recommendation, PM me for details.

If you did into the research on anti-depressants you'll see that they are mostly (if not entirely) placebo.

Generally depression is caused by workplace/relationship stresses. Solution usually boils down to getting rid of the bad job/relationship, changing how you deal with stressful situations (CBT/therapy), or changing your life to have more purpose/motivation. As well as depression, chronic stress can lead to migraines, chronic fatigue, chronic pain, disrupted sleep, brain fog and other nasty symptoms that should lead you to avoid flying.

Depression is a big issue. Almost everyone I know has been affected by it at one time or another, and a few have tried/succeeded at suicide (which is a significant risk if severe depression is left untreated).

I don't know if any of the above applies to the original poster, but I'm just putting it out here in case anyone else is affected. Feel free to PM me.

[Changes in Latitudes]

Those are some excellent posts and insight. I really can't top that other than to add how much exercise can assist in the management of depression and anxiety. If you can find physical activity that you truly enjoy, it sure can bring some improvements. Sadly, many are often beyond those benefits.

I think that if we ever had the ability to compose a statistic of just how many pilots choose to suffer this problem in silence, the results would truly be staggering. I know a lot of people manage it in their own way without formal treatment, but it can topple the best of us on an off day and that's a big problem.

[RatherBeFlying]

The Australian CAA has for some time established protocols that allow pilots to fly with certain antidepressants -- but any change (including beginning or ending) in dosage requires going off flying status for some weeks.

TC is slooowly catching up -- have we heard this before. Give them a couple more decades.

If you are well and truly hammered with clinical depression, you should not be flying. Go see a psychologist first (note: no provincial coverage; so, maybe your employer plan will pay for a few visits). If the psychologist believes your current state requires antidepressants to get you over a bad spot, s/he will refer you to a psychiatrist or GP. Quite often you can get off them in a few weeks or couple months once the bad spot is over -- make that your goal. Bottom line is that going on and going off antidepressants takes you off flying status.

Sadly psychiatrists and GPs doing psychiatric practice are drug dependent and their patients often end up spending decades, if not the rest of the rest of their lives, on prescribed drugs -- at significantly reduced function.

[Castorero]

Captncrunch

You are a hero for sharing your personal experience. It will encourage others struggling with their own burden and it may help them to also realize that this is indeed a common problem and sharing it helps one to feel better and not feel than you are the only one.

This thread was at risk of sliding sideways into a discussion of treatment from the outset, so why dont we just recap what has been said before in other threads regarding treatment and coping strategies for depression and anxiety?

In order to treat anxiety/depression you need to know that is what you have and a visit to your family doc may help in sorting that out.

There are some general principles that play a significant role in maintaining our sanity.

The first is that we have a NEED to feel that we are not alone, that we belong to a community, so reconnecting with friends, joining a group or activity with other people on a regular basis is good.

The second is our need to work, or feel useful or active, so having something productive to do is essential

The third is our need to worship or believe in something that is greater than we are and over which we have no control. Call it god, Allah, or Big Moon, doesn't matter. Go to Church if all else fails.

These needs are like the three legs of our sanity stool, when one of them collapses we start to have mental stability issues.
Getting back on track and repairing this stool depends a lot on how broken the stool is.

Very often one needs help in reconnecting, finding work or finding some God because depression and anxiety rob you of the needed motivation to put the above plan into action and further slide you into isolation.
EXERCISE in any shape or form is a great way to fight both anxiety and depression and improve your motivation
DIET with fresh fruit/vegetables, and less coffee and alcohol definitely helps. Alcohol plays havoc with our sleep hygiene and not getting a good sleep makes everything worse.
SUNLIGHT makes us feel good and replenishes our stores of Vit D. I am not sure where in Canada one finds any useful sunshine between Oct and May, so if you can't move to Barbados for a couple of years to treat a depression or just get a good dose of Sun, then taking some Vit D during the winter as well as using a UV lamp will definitely be of value.

Finally, when it comes to Psychological treatment, CBT or Cognitive Behavioral Therapy is the hands down proven approach to the treatment of both anxiety and depression. Google it.
A psychologist trained in this therapy modality is needed, so a referral to one is essential.
This is not an overnight or week end seminar but a long term approach to healing that gives you control over your life.

Medication has a place in treating depression but that needs to be addressed by your trusted Doc, the one with the stethoscope...

We all deserve to be happy .

[CpnCrunch]

Castorero has given some very good advice here - I agree with pretty much all his points. The bottom line is the depression is very treatable, but only YOU (the patient) can treat yourself in the end. Doctors, psychiatrists, antidepressants and CBT are really only tools that help the patient help himself/herself.

[Lateralus]

Great thread guys, it is much appreciated.

[T.J.]

Off the seat for the last three months. On Zoloft. Will be meeting with the psychiatrist soon. Any advice will be helpful.

[CFR]

Off the seat for the last three months. On Zoloft. Will be meeting with the psychiatrist soon. Any advice will be helpful.

Here is a link to a thread on the subject. I submitted a post with a number of links in it that explains the current situation as far as TC is concerned.

One thing to stress is that determination of fitness to fly is a discretionary call on the part of the RAMO. Some RAMO's are more up to speed on current facts and treatment than others. At the end of the day if the illness is determined to be managable, it takes co-ordination between the individual, their physician, their CAME and the RAMO to make this work.

Depression is no longer an automatic ban on flying.

http://www.avcanada.ca/forums2/viewtopi ... 54&t=64161

[1000 HP]

Hey rotorspeed, good question.

I very recently lost a wonderful sister to depression. It can be a serious condition. I was headed down that way several years ago, and made some serious lifestyle changes. For one, I quit driving truck and went back to flying. Shortly after, I ended a long time bad marraige and got out of a destructive family. Times were tough for awhile, and I lost everything I had financially. But now, I really can't complain. Things are great. Although I have taken a holiday from flying full time, I have a great job, a great wife, and 4 wonderful kids. I feel better physically and mentally. I never was on any medication because I was able to improve all my troubles through lifestyle changes. It worked for me but each person is different. Get the help you need.

[rotorspeed]

I know tc is approving some people on antidepressants, I just didnt know how many are out there