The crash of Germanwings flight 4U 9525 - mental health assessment for airline pilots

The crash of germanwings flight 4U 9525 has left Europe and the rest of the world heartbroken, especially since the revelation that co-pilot Andreas Lubitz appears to have crashed the flight deliberately. For me personally this tragedy feels and is very close to home, as I'm a spanish born, living in Germany and someone very dear to me took the very  same flight just one day before the crash. Most likely it was the same plane, maybe even flown by Andreas Lubitz.

In the last few days we have learnt many things about the crash, among others the co-pilot had a known history of depression. This has raised the question, whether  regular psychological tests for pilots should be mandatory. Personally I was shocked that this wasn't mandatory worldwide already and so far has only been implemented in some countries such as the US. 

Being an advocate to end the stigma of mental illness and someone who has suffered from depression herself I can't help but feeling anger at this situation, because in many ways it means that again society has failed. There are many speculations about the reasons why Mr. Lubitz has done what he did, but one thing we know for fact: He was in no way fit to fly a plane full of people. 

It is known that he had a sick note for the day of the crash and had been in treatment for an undiclosed illness. He had interrupted his initial training to be treated for depression and supposedly it was recommended that he should undergo regular psychological checks. Why hasn't this happened? How can it be that nobody saw what was going on? The answers to these questions are hard to find but we need to face the reality. 

Mental illness is still a taboo because it bears a stigma. Here in Germany one of the first things that you are told when you start a therapy is not to inform your employer because it could lead to respercussions at work. In a situation where you are supposed to find help secrecy is again encouraged, which results in the patient leading a double life. One where you try to seek help and fight a disease and one where you pretend that everything is in order. This also leads involuntarily to the feeling that a mental illness is something to be ashamed of, which in turn leads to isolation in my own experience.

In Germany you can have up to a waiting time of 3 years to get a therapy spot through the standard health insurance. This means three years during which a mental illness goes untreated. If you make a therapy through standard health insurance there is a "record" of it, but you can choose to private therapist and pay yourself. Then there is no official record, which is said to have been done by the co-pilot. If he did that to hide his illness or simply because he didn't get a therapy spot we will never know.

Many mental health organizations have raised concerns that the present media coverage might increase the stigma and that many pilots fly safely despite having fought mental illness in the past.  This is true but in my opinion this incident shows that we have to rethink the past regulations, since one deliberately caused confirmed crash is one too many.

There are many physical illnesses such as epilepsy which keep people from becoming a commercial pilot, why not setting similar standards for mental illnesses? It has been proven that around 50 % of the people who at one point in their life suffered from depression will suffer a relapse. After a second episode the likelyhood of a third episode happening is even higher.

Of course many people don't suffer a second episode and aren't suicidal but in a situation where hundreds of people's lives depend on one person there should be a zero tolerance. This may sound drastic but what many people forget is that stress is a common trigger for a mental illness and being responsible for so many lives certainly is a huge stress factor. 

In this respect the regulations also failed Andreas Lubitz. Of course he has committed a terrible action but condemning him as a mass murderer is certainly the easy way of handling this. The fact is that he was a man with a known past of mental health problems and he was in treatment for an undisclosed illness. How could it be allowed that he was put in a stressful situation where he was responsible for so many lives? He was a sick man that should not have  been in the pilot seat in the first place, even if this would have meant crushing his dream. Sometimes people have to be protected from their own, especially since a mental illness affects your view of the world and you don't see things clearly.

Personally I believe that someone with a known past of mental illness should be banned from flying commercial flights indefinetely and that pilots should have to undergo regular intense, psychological checks, so that it is impossible for them to hide an illness. Also when a patient is responsible for other people's lives due to their job e.g. pilots, bus drivers, doctors etc. and he or she suffers from any medical condition that could endanger other people, the employer should be informed without delay. This might have an effect on many people but as stated before in these cases a zero tolerance policy should be the rule.

The Challenge of Being Yourself

Recently I have read the my generation (Born in the 70ies or 80ies) is considered the generation of expectations and I think that might be true. We were the first generation in the western world, in which the majority of people grew up in decent financial circumstances and the most urgent needs were fullfilled. Universities were no longer just open to the upper classes and we could choose freely, who we wanted to be and everything seemed possible.

You might say: But these are good things and you are right. But this luxury came with a price, the price of unfilled dreams and inattainable expectations. Seeing all the options laid out in front of us, we all started dreaming and pushing us further than we might be able to reach,while sometimes our true goal lies right in front of us. Why should you try to be a world class scientist just because you can, while you would be much happier being a hairdresser? The questions asked shouldn't be: What can I... but rather what do I want....

Our generation lost the focus for what they really want in favour of the highest achievable goal, because we are sold the concept that the more the better. But what is wrong with the simple life? Why should we choose the higher goal, just because we can?

In my personal opinion this is also responsible for many mental illnesses. One could argue that years ago people would not speak up about it. This is most likely true but I believe that also modern lifestyle has led to an increase of mental illnesses like OCD, depression and burn-out syndrome, as we live lives that are  opposed to our nature.

This is also becoming a problem for society. Here in Germany companies that train young people for manual jobs like mecanics, hair dressers, bakers and many more are having problems to cover all apprentice positions and one can only wonder why this might be. Have all young people lost interest in manual jobs? Maybe their appeal has indeed dimished or people have decided to follow societies pressure rather than their own wishes. 

But this problem can not only be seen in the career choice: How about fashion? Instead of choosing to wear what we actually like, we run into stores and buy something we are told by some people is hip. Imagine how interesting the world would look, if people would wear what the really like. People wearing outfits composed of stuff from different decades and wearing original make-up. Wouldn't that be amazing?

In general we are told to follow a certain pattern with our life or better we are expected to. This is great for some or maybe even most people for some it is not. 

In any case it is getting more difficult to be ourselves these days, because we are bombarded with so many options and things, that we overhear the voice of our subconsciousness. And even if we do hear it, it is sometimes hard to follow it due to the overwhelming reaction by your surroundings. Just try to wear something a little more extravagant than your usual style. It will cause interesting reactions. Some people will love it, others will tell you that they prefer you usual style but most people will frown upon it.

The point is not be put off by that, because sooner or later people get used to it and admire you individuality and that you dare being yourself. New people you meet will also react in a more positive way, because they perceive you as authentic.

Start with little stuff and you will see how liberating it is to be your true self. Yes, some people will turn their back on you. But are those people the sort of people you want to have in your life?

Maybe the key to all this is to redefine "success". These days success is usually messured by economic status and social standing. Perhaps we should consider a success to be who we really are. Sometimes a simpler life is more rewarding than a life on the fast lane. 

Living with depression

The recent, tragic passing of Robin Williams, whose protrayal of John Keating in "Dead Poets Society" is partly responsible for me becoming a writer, has made me painfully aware about many misconceptions that still exist, when it comes to depression. So I have decided to write about my personal experience in an attempt to help people understand this disease. 

I am not a psychologist, so I won't be throwing around medical terms but I have been diagnosed on three separate occasions with depression. I am presently going through my second cycle of therapy and have been on three different medications (Thank god, I am managing without since 2011!). 

Why am I sharing this with you? Because I think it is time. Not only for me but for everybody. Depression is sadly a common thing and most people don't dare speaking about it and therefore are not getting the help they need. 

I was thinking of how I could explain to a person whom has never suffered from depression how this feels, because depression is so much more then "being sad". So I came up with the following exercise: 

First I want you to think of the state you are e.g. on a sunday morning. You get up, feel relaxed, just have a shower and do some small errands, nothing out of the ordinary. Basically the state, were you are in a balanced mood, neither sad nor happy, neither mad nor frustrated. I would like to call this "neutral mood". 

Then I want you to think of the worst moment of your life. It doesn't matter if it was after a bad break-up, loosing a loved one or loosing your job. I mean one of those moments, where you wouldn't eat, shower or if it were up to you even leave the bed. I know this is hard, but I want you to remember that feeling, in every detail. I want you to remember how hard it was to do even the simplest tasks. 

Now I want you to imagine how it feels, to take this feeling and think of it as your "neutral mood". Imagine when you wake up in the morning you feel this numbing emotional pain, although nothing has happened yet in your day. Besides all this, there is no rational reason, for feeling like this and you are very well aware of that. You know that there is no sense to you feeling like this, but you cannot help it. So on top of this feeling, you start being mad at yourself and frustrated because you feel stupid, for being so upset without any apparant reason. Imagine this going on for months, sometimes even years. I think this gives you an idea about what depression really means. 

People who have never gone through depression don't understand the strength it takes to even do the smallest things, like getting up in the morning or leaving the house. 

Most people think that depressed people are weak, when in reality they are strong because living with this disease is an effort beyond words especially if you are functioning, which means that you continue to do your job and duties, without allowing the depression take over. 

When I was going through my worst depression, to the outside world I was in the best moment of my life. I was successful in my job and managed to always smile. People in fact thought I was an extremely happy person. 

The problem is that in today's society people think of you as a weakling if you admit to depression, so you do everything to hide it and if you do it for years, you get good at hiding it and therefore you don't talk about it and nobody suspects it. 

I remember when I first talked about it to a person, he laughed and basically said: "Depressed? You? Nice joke!" We really need to listen to people again and also watch them. Show them how much you actually care. 

Something that makes living with depression or better dealing with it even more difficult is that constantly being upset and angry at yourself starts messing with your view of the world. You become sort of paranoid and even start doubting the affection of family and friends. You often think, that their affection is more like masked pity. In a weird sense it makes sense to yourself, because you feel like a fool, after all you are upset for months without any  "real" reason. That is what makes it a disease and not just bad mood. Bad mood has a reason, while depression has not. It is a flaw in the system if you want to put it like that. 

If things get worse then a lot of people start becoming suicidal. It starts sneaky, that sort of thought were you think before going to bed: Maybe if I am lucky, I won't wake tomorrow. 

This is the point, where this disease starts getting really dangerous. If you ever have felt like this:

Please, look for help!

Talk to someone close to you and tell them how you feel. Ask for help and don't allow the most precious thing you have, your life, to be ruined by a flaw in your system. This is a disease! You haven't done anything wrong and there are people than can help you!

Suicide isn't a solution. Because life isn't a computer game, where you can start from the beginning (At least as far as we know!). Please seek help, because there is and maybe in your darkest hours, it will help you to think of all the things you'd miss if all was to end at that moment: 

The first female US president, the ending of "Game of Thrones" (We all want to know about Jon Snow's true heritage, right?), the smile of your first grand child, the next sunrise, the first man on Mars, the next sort of Oreo cookies, the kiss from someone you truely love and who loves you back.... 

There are many beautiful things ahead of you, don't miss out on them!

Writing this, I have to admit, took an incredible effort. I had to revisit the darkest times in my life and this has affected me. It took me several days to write this post. Still, I don't regret writing this, because I think depressions are an important topic we all need to talk about. It might have been caused by modern society, but this doesn't make it any less real. 

I hope this helps non-afflicted people to better understand people who suffer from this illness. 

Mental Illness in Society

This is still a very sensible topic and in many ways admitting to have a mental illness is still a big stigma. In my opinion even more of stigma than admitting to having AIDS or any other transmitted disease. The question is why?

I am certain there might be a lot of different ways to approach that question or better the answer to that question, but I have my very own theory.

First of all with a mental illness you don't really see the symptoms. Most people perceive only things they can grasp. With most "physical" illnesses this can include visual things e.g. a rash or an injury or things you can measure with blood tests etc. In most of the cases with mental illnesses you don't have hardly any of these options for testing. So everything people can see is the patient's behavior and that is part of the problem. At least it seems you can only see the behavior, since mental diseases are sometimes caused by a chemical imbalance in the brain, but that is a different matter.

As children we were taught: You can control your own behavior! If we assume that is right, then the consequence is to wonder, why people with mental diseases don't simply  pull themselves together and that is where the most common misconception happens. When you have a mental illness no matter if it is depression or something else you cannot control your behavior, which is why it is an illness.

Take depression as an example. People not understanding the background of the illness say things like: "So you are sad, what about it? We all are from time to time, just pull yourself together!" This sounds cruel, but trust me I have heard people following this line of argument and worse often enough. They just don't understand that you cannot pull yourself together. There is no way, if you are suffering from depression. People suffering from this kind of illness are sad without a reason and sometimes even feel like crying and don't even understand why. If you are just sad, there is a reason, because something has upset you, but with depression there is none, at least no emotional reason, the sadness is just there. So the question has to be: How do you cheer yourself up, if the sadness has no apparent reason? The answer is: You can't! Having suffered from depressions myself I can assure you that it is one of the toughest things you can experience, because of how helpless you are, when fighting something you cannot understand without help. Of course you learn how to deal with it, through therapy and on short term medication can help, but you need help, one way or the other. 

What people have to understand is that your behavior is usually more of a reaction than a mere action. Usually you get angry, when someone teases you and you get happy when something good happens. So if you want to avoid getting angry you can avoid people who tease you and usually this is the end of the story. But if your reaction happens without a trigger than there is no way you can control your reaction, because you cannot avoid the trigger.  

A very different illness is OCD, obsessive compulsive disorder. I think this is probably one of the worst things that can happen to you, because of the way it is often portrayed in the media and by ignorant people. Often enough people suffering from this disease are ridiculed for cheap laughs on TV or in the movies. To be honest seeing that sort of things makes me sick, as people suffering from OCD have enough of a hard time battling the condition, without having to worry about what other people might say or think if they find out. 

We all have cravings and urges and should understand that sometimes fighting them is beyond our strength. Take a simple example: Have you ever suffered from chicken pox? Then you know it itches gravely and you are not supposed to scratch. I remember when I had chicken pox that suppressing the urge to scratch was almost impossible. Now imagine having a much stronger urge to, let's say wash your hands. While you know the chicken pox does eventually go away an OCD doesn't simply go away. The people with this condition hardly cannot surpress their urges, although those urges are sometimes even destructive, for instance some people feel the need to wash their hands with bleach to keep them REALLY clean. 

There are many mental diseases, some of them graver than others. While some can be managed in daily life, others require institutionalization. Of course I am no doctor and this is merely scratching the topic but my point is that mental illnesses are very real and that people literally suffer from them. Having a mental illness doesn't have anything to do with being weak or undisciplined; often enough people suffering from mental illnesses are among the strongest people. So people with mental conditions don't deserve our reproach or ridicule, they deserve our help and our compassion, to give them the strength to fight their condition.