The Psychological and Mental Health of Pilots

A question was recently asked in a Pilot Wife Facebook Group:

"My pilot has his FAA medical, and is feeling anxious and a little depression over the state of the world, the airlines and the Pandemic situation, He's hesitant to seek counseling or any treatment, knowing that if he is reported for some reason, it might put his medical certificate at risk and keep him out of the flight deck. What options does he have?"

Joining me on today's call is Kora Kresin, the flight deck therapist. Her mission is to make mental health care accessible to pilots. She is specially trained to work with men, and has been in the field for almost 5 years. She founded Compass Counseling Center, located in Oregon. 

PLEASE NOTE: This is not medical advice or in anyway in lieu of seeking professional counseling. These are not my, Jackie Ulmer's, opinions, as I am not a licensed medical professional or therapist in any capacity. These are Kora's opinions and views based on her professional training and education. 

Kora holds a bachelor's and a master's degree, and is currently in school getting a second master's. She's worked predominantly with men, training under two colleagues; one that specializes in PTSD, autism and psychopathy. The other is more involved with social work. She has a medical doctor as a clinical supervisor, as well.

I asked her why she works primarily with men.

"Great question. It's twofold. I first started out working within the criminal justice system for folks that were convicted of person to person crimes.Those were my clients and mostly men. I saw there was a huge gap in research and practice, specifically geared towards men.  With a lot of the information geared and written by women; it doesn't always transfer over very well to men."

 We defined “Mental Health", because it’s a term that tends to have a stigma, and is a “no fly zone” for pilots, so to speak, because of a number of things, not the least of which is that stigma and the FAA and strict medical protocols.

 Kora shares:

"The first one being mental health, think of it as, like the rest of your body, sometimes we get a cold, take some days off and drink some soup, liquids like orange juice, and get the body up and running.

Maybe you had a death in the family, and you're a little shook up about it and it's going to take a little bit of time to process and heal.

But you're going to keep going.. You'll get over it just like a cold or the flu. If you treat it or even if you don't acknowledge it, it will go away.

Whereas a mental illness is something I like to compare to as like scoliosis or diabetes, where it's something you have to maintain. Mental illness might be something you would get a diagnosis for like anxiety or a mood disorder or something like that that; something you might have to address every day, or else it might push you, one way or the other."

Jackie: I personally think that is a beautiful definition, and it really opened my eyes; gave me that "Aha moment" of yes, makes total sense, I have a cold; I'm not healthy today. Two weeks late, I'm over it and totally fine.

With mental illness, I have a chronic disease.

We also cover:

What mental health conditions are reportable? Let’s talk about the specifics of the FAA mental health restrictions.

What is from the FAA regs? How would a pilot listening to this find this information?

Kora: "I want to preface that this information is what I gathered straight from the FAA website. I talked to multiple Colleagues, that are leaders in the ethical Community for mental health so based on that and the FAA, which is where i'm getting this information."

 Mandatory reporting laws? What are they? And why are they important in therapy?

Kora: "But what's tricky is mental health, through that lens it's really easy to get a mental illness diagnosis. It's much more rare for people to walk in and boom get a schizophrenia diagnosis, or something like that.

But something that doesn't always get talked about, and this is something I pulled from the FAA was this little phrase called a mood disorder. So just like I was saying, we get colds, generally, we can bounce back, but in the mental health world a mood disorder is measured by feeling any certain way, whether it's depression, anxiety, manic for more than two or three months. How long has this pandemic lasted?

I know my emotions have shifted and more than two or three months, and so, that is when it becomes really easy to get some of those diagnoses, especially when you are seeing a therapist that maybe doesn't see the gravity of writing that in your chart because it is easy, a lot of people get mood disorders, in fact, if you've ever heard of SAD, the sunlight thing it's Oregon.

So it's stuff like that that are mundane in like the mental health world but carry such weight if that same word as in like the FAA world, and so it took a lot of research to kind of like pair up what you know held more weight in each part I guess if that makes sense."

 Difference in mental health symptoms for men and women?

Kora: "Women are social creatures, that's how we communicate so generally we're really good at putting things into words. That's why we can say one color of blue looks like three different color names, but to a man, maybe it might just be blue.

Men think more in feelings and women think more in emotions, so let me talk a little bit about that. With feelings i'm talking about aches and pains, and maybe trouble sleeping and lack of appetite..

With men who could be going through these things, but their first instinct is to not label it as anxiety or to not label it as depression, whereas.

What I found with women is that we're quicker and we're quicker to throw words at our experiences and so it's easier to kind of start diving in there, so my first thing is that our brains just work different."

Because this is a podcast primary directed at women, and the wives and partners of pilots. So, we want to know the difference and what we should be looking for.

Kora: "For example, depression looks different and that's one of the first things i'd like to cover; depression looks different between men and women. What we find with men is they are going to address their depression iby being really grumpy and kind of mean. That's one of the signs  I hear a lot of.

Spouses come in and say 'he's just like very upset and angry and you know when you pair that with maybe low energy and lack of interest and things to me that screams you know depression, even though they're not coming out and saying I'm really sad and I don't feel like getting out of bed today they're asked them hey how are your muscles doing how's your neck, you know how's how's your stomach?

That would be a really good way if you ever have trouble of trying to figure out, you know what is, you know what's my partner feeling asked how their body is asking start there.

With women, they are more social so you're going to also see mental health impact them more socially, so you know depression, for example, more of a withdraw from socializing more than men.

Where they would just be kind of more in pain and then another one, for example, is when we're talking about attention deficit disorder.

I have ADD and people used to think I was kind of ditzy or dumb. But that's actually ADD, and that is different than ADHD which is more of hyperactivity and that's why you see it more in men it comes out in them like fidgeting with things.

That same lack of attention manifests in our mind going different places, and so you know if you've ever heard like "Oh, you know dummy" you might have ADD.

But that's one of those things that like no girls aren't dumb or did see they they it's just shows up differently in them, whereas you know boys or men they're going to be more physically active and that's how it's going to show itself."

 Kora share more on her mission to make mental health care accessible to pilots. 

 We cover ways we can all support pilot Mental Health reform?