AOPA Pilot Magazine - June 2022 - 30

FLIGHT MD
Flying and
depression
FAA's policies on mental health issues
are onerous and arcane
IT IS TIME for the FAA to get into the twenty-first century
regarding its approach to pilots with depression. A young pilot
committed suicide in an aircraft in 2021 rather than risk losing
his ability to fly because of arcane FAA mental health policies.
Everyone has felt depressed at one point or another, but
that does not mean they are mentally ill, nor does it mean they
are not fit to fly.
There are generally two types of depression. It is a complex
subject that I will try to put in very simple terms. There is
endogenous depression, which means " from within, " and exogenous
depression, which means " from without. " Exogenous
depression, also known as situational depression, is the type of
depression that occurs with a death of a relative or a friend. It is
usually short lived and resolves with time and sometimes counseling.
Endogenous depression is different in that it is really a
medical illness with psychological symptoms. It is related to
brain chemistry, usually inherited, which can cause a person
to be depressed even when everything in their life is going perfectly.
Endogenous depression is the type that is most amenable
to drug treatment.
Many times, these types of depression are mixed. A person
who is endogenously depressed may not do well in a marriage
that ends in a divorce, which then causes an exogenous depression
as well. Although we do not understand exactly why, a
person who is exogenously depressed for a longer period may
also become endogenously depressed as well. These people
may benefit from medication in addition to counseling.
The FAA's greatest fear is a disaster such as the 2015
Germanwings mass murder/suicide. In that case, the airline
had multiple warnings about the pilot's depressive episodes
and, essentially, hid them. Even if the offending pilot was flying
under a U.S. FAA medical, that disaster still could have happened.
The FAA has responded to the German crash by being overly and
unduly cautious, even though strict criteria would not have had
any effect in this setting because red flags were ignored.
Unfortunately, the process that is required for a person
who reports to the FAA depression or any other mental health
encounter (e.g., counseling during a divorce) is onerous and
arcane. If the pilot or student is on medication, the flow sheet
for certification is five pages long and includes requirements for
30
AOPA PILOT / June 2022
BY DR. BRENT BLUE
an evaluation by a board-certified psychiatrist and a CogScreen,
which is a proprietary test that has no significant value in this
setting. Many of the requirements also are from the last century
since only one of four antidepressant medications can be
used, even though there are many, and no two medications can
be taken at the same time. Even more discouraging, the FAA has
placed the evaluation of pilots on depressant medications under
the same section as pilots with drug and/or alcohol problems
(the HIMS program), which I assume is related to funding and
is totally inappropriate.
Not only is this process expensive and unnecessary but has
no scientific testing against pilots who are depressed and have
not undergone this process (e.g., no control group). Even if the
pilot passes everything with flying colors, it may take up to a
year to get a final response from the FAA.
Years ago, I posted a request on the original online bulletin
board AVSIG on CompuServe (yes, that long ago) asking anyone
who was or had taken an antidepressant and flown to send me
a postcard with nothing on it but " yes. " I got lots of postcards.
Here is the modern version of the same survey. It is completely
anonymous. Please take it (surveymonkey.com/r/KDCGZ5K).
I will post the results in a future issue.
If you are suffering from a mental health issue, get help.
Flying is one thing; your personal health is another. The suicide
prevention hot line is 1-800-273-8255 and is confidential.
One other small warning, if you are going through a bit of
depression like a divorce and your doctor says, " Here, try this.
It might help, " consider it carefully. Anti-depressants and other
mental health medications may not be the best first course of treatment
for situational depression and will adversely affect your FAA
medical flying status. A longer conversation with your doctor is in
order to find the right treatment path for you.
Answer this question
for yourself next time you
get on a commercial flight:
" Would it be better if your
pilot is hiding depression off
medications or for him to be
treated on medications? "
brentblue@wyoming.com
DR. BRENT BLUE is a
senior AME who flies a
Noorduyn Norseman and a
Cessna 185 out of Driggs,
Idaho. He also is a HIMS
AME and works with special
issuance pilots.
http://www.surveymonkey.com/r/KDCGZ5K

AOPA Pilot Magazine - June 2022

Table of Contents for the Digital Edition of AOPA Pilot Magazine - June 2022

Contents
AOPA Pilot Magazine - June 2022 - Intro
AOPA Pilot Magazine - June 2022 - Cover1
AOPA Pilot Magazine - June 2022 - Cover2
AOPA Pilot Magazine - June 2022 - 1
AOPA Pilot Magazine - June 2022 - Contents
AOPA Pilot Magazine - June 2022 - 3
AOPA Pilot Magazine - June 2022 - 4
AOPA Pilot Magazine - June 2022 - 5
AOPA Pilot Magazine - June 2022 - 6
AOPA Pilot Magazine - June 2022 - 7
AOPA Pilot Magazine - June 2022 - 8
AOPA Pilot Magazine - June 2022 - 9
AOPA Pilot Magazine - June 2022 - 10
AOPA Pilot Magazine - June 2022 - 11
AOPA Pilot Magazine - June 2022 - 12
AOPA Pilot Magazine - June 2022 - 13
AOPA Pilot Magazine - June 2022 - 14
AOPA Pilot Magazine - June 2022 - 15
AOPA Pilot Magazine - June 2022 - 16
AOPA Pilot Magazine - June 2022 - 17
AOPA Pilot Magazine - June 2022 - 18
AOPA Pilot Magazine - June 2022 - 19
AOPA Pilot Magazine - June 2022 - 20
AOPA Pilot Magazine - June 2022 - 21
AOPA Pilot Magazine - June 2022 - 22
AOPA Pilot Magazine - June 2022 - 23
AOPA Pilot Magazine - June 2022 - 24
AOPA Pilot Magazine - June 2022 - 25
AOPA Pilot Magazine - June 2022 - 26
AOPA Pilot Magazine - June 2022 - 27
AOPA Pilot Magazine - June 2022 - 28
AOPA Pilot Magazine - June 2022 - 29
AOPA Pilot Magazine - June 2022 - 30
AOPA Pilot Magazine - June 2022 - 31
AOPA Pilot Magazine - June 2022 - 32
AOPA Pilot Magazine - June 2022 - 33
AOPA Pilot Magazine - June 2022 - 34
AOPA Pilot Magazine - June 2022 - 35
AOPA Pilot Magazine - June 2022 - 36
AOPA Pilot Magazine - June 2022 - 37
AOPA Pilot Magazine - June 2022 - 38
AOPA Pilot Magazine - June 2022 - 39
AOPA Pilot Magazine - June 2022 - 40
AOPA Pilot Magazine - June 2022 - 41
AOPA Pilot Magazine - June 2022 - 42
AOPA Pilot Magazine - June 2022 - 43
AOPA Pilot Magazine - June 2022 - 44
AOPA Pilot Magazine - June 2022 - 45
AOPA Pilot Magazine - June 2022 - 46
AOPA Pilot Magazine - June 2022 - 47
AOPA Pilot Magazine - June 2022 - 48
AOPA Pilot Magazine - June 2022 - R-1
AOPA Pilot Magazine - June 2022 - R-2
AOPA Pilot Magazine - June 2022 - R-3
AOPA Pilot Magazine - June 2022 - R-4
AOPA Pilot Magazine - June 2022 - 49
AOPA Pilot Magazine - June 2022 - 50
AOPA Pilot Magazine - June 2022 - 51
AOPA Pilot Magazine - June 2022 - 52
AOPA Pilot Magazine - June 2022 - 53
AOPA Pilot Magazine - June 2022 - 54
AOPA Pilot Magazine - June 2022 - 55
AOPA Pilot Magazine - June 2022 - 56
AOPA Pilot Magazine - June 2022 - 57
AOPA Pilot Magazine - June 2022 - 58
AOPA Pilot Magazine - June 2022 - 59
AOPA Pilot Magazine - June 2022 - 60
AOPA Pilot Magazine - June 2022 - 61
AOPA Pilot Magazine - June 2022 - 62
AOPA Pilot Magazine - June 2022 - 63
AOPA Pilot Magazine - June 2022 - 64
AOPA Pilot Magazine - June 2022 - 65
AOPA Pilot Magazine - June 2022 - 66
AOPA Pilot Magazine - June 2022 - 67
AOPA Pilot Magazine - June 2022 - 68
AOPA Pilot Magazine - June 2022 - 69
AOPA Pilot Magazine - June 2022 - 70
AOPA Pilot Magazine - June 2022 - 71
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AOPA Pilot Magazine - June 2022 - 73
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AOPA Pilot Magazine - June 2022 - 76
AOPA Pilot Magazine - June 2022 - 77
AOPA Pilot Magazine - June 2022 - 78
AOPA Pilot Magazine - June 2022 - 79
AOPA Pilot Magazine - June 2022 - 80
AOPA Pilot Magazine - June 2022 - 81
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AOPA Pilot Magazine - June 2022 - 86
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AOPA Pilot Magazine - June 2022 - 88
AOPA Pilot Magazine - June 2022 - 89
AOPA Pilot Magazine - June 2022 - 90
AOPA Pilot Magazine - June 2022 - 91
AOPA Pilot Magazine - June 2022 - 92
AOPA Pilot Magazine - June 2022 - 93
AOPA Pilot Magazine - June 2022 - 94
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AOPA Pilot Magazine - June 2022 - 96
AOPA Pilot Magazine - June 2022 - 97
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AOPA Pilot Magazine - June 2022 - 99
AOPA Pilot Magazine - June 2022 - 100
AOPA Pilot Magazine - June 2022 - 101
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AOPA Pilot Magazine - June 2022 - 103
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AOPA Pilot Magazine - June 2022 - 111
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AOPA Pilot Magazine - June 2022 - Cover3
AOPA Pilot Magazine - June 2022 - Cover4
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