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Amidst a pandemic: an epidemic of anxiety

A combination of isolation, job insecurity and a potential health risk makes the current COVID-19 crisis also a threat to our mental well-being. With so many different stressors literally thrown at us at once, mental health professionals are preparing for an epidemic of anxiety after the pandemic. Peer Support Programmes (PSPs) for pilots are already reporting an increase in calls. That prompts us to look at the unique situation of pilots and share advice from psychologists on how to weather the storm – and when it might be time to look for help.  

The Captain is home

For the majority of pilots the pandemic means a complete stop of their normal work and daily routine. In March, life went from a full-throttle to full stop almost overnight. A lifestyle of intense traveling and prolonged periods away from home was swapped by a 24/7 confinement, at home, often with family around. To some people it provided much-needed break from the intense flying. But not to all.

Robert Bor, an aviation psychologist, one of the founders of the Centre for Aviation Psychology, cautions: “Let’s be real. We are not designed to stay at home for two months. Maybe some of us entered this period with a feeling of enthusiasm – they can take the time for all those things that they had to do at home. And spend time with family. Some mastered the art of looking after their home, enjoying better sleep. And some didn’t." 

Staying at home for such a prolonged period can be an opportunity for family comfort and bonding, or turn out to be exactly the opposite, adding another stressor in the mix. With the “Captain” suddenly home all the time, the routine and the roles of the entire family are challenged. “I’ve spoken to some pilots – the whole change of momentum for some spending time with family introduces more stress. Obviously, trips and work provided some kind of punctuation in the day and in the week.” But with almost no opportunity for commercial flying, pilots can no longer rely on this routine. Instead, Prof. Bor suggests something simple, to allow for a moment of being yourself: “Step out occasionally, go and do something on your own, go into a room on your own and just hide away from everyone.”

The stress of not working

Even as lockdown measures are gradually eased across Europe, aviation is not expected to bounce back completely anytime soon. The majority of pilots are now facing an unprecedented unemployment crisis across the industry. The lucky ones who get to keep their jobs may be facing severe pay cuts, increased duty hours and sweeping changes to their working conditions. Others have already seen a complete loss on income, prompting them to activate whatever plan B they had, or search for other jobs. While the financial impact of this is a big concern, the uncertainty about how long all of this will last and what is waiting for them on the other end of it, complicates the problem. “You need to find an emotional resource and a financial resource to keep going through the uncertainty,” says Bor. 

It is clear that the aviation industry as a whole will survive, but individual crew are facing very real uncertainty. In a publication, Prof. Bor and his colleagues give advice for pilots to cope better with such uncertainty, which can play havoc with our thinking. Sometimes to the extent that it is worse for our mental health than actually losing your job: “Uncertainty about job security and our thoughts can in fact create greater anxiety and take a greater toll on our mental and physical health than actually losing a job. Once we have an answer, we can act, see what happens, and stop living in anxious anticipation. It’s often the not-knowing that’s the worst,” says Laurie Ling, a pilot and a Peer Support Advisor.


Epidemic of anxiety

To work through this stress, the classic – routine, exercise, good sleep, good food – is a starting point. “In the face of uncertainty, routine is good, we’ve all heard that. Physical exercise should be no problem for pilots. Going out, doing a power walk. There are a few times in our careers that a good sleeping pattern is possible. Certainly, at the moment that is the case,” advises Bor. 

What may be even more important is our info diet: keeping an eye on the things we read and information we absorb. Whether it’s an expert analysis, an essay on wellbeing, or social media posts, pilots should be careful that the warnings about stress don’t add up to their stress…

“We read a lot of stuff online, all of which could be useful. But we need to be careful we don’t talk ourselves into a negative downward spiral. Secondly, remember your story is your story. Your circumstance is different than somebody else’s,” says Bor. What you are reading is a general advice to a group, which doesn’t factor in our age, family status or plans. 

The same counts for our social contacts. “Sometimes we can get into a negative mindset very quickly. We all worry, and worry escalates almost to an epidemic of anxiety. In a short period of time we can go from being a little bit worried about something to having proper anxiety attack. And this is also because we are accessing information that is simply feeding our anxiety,” says Bor. 

The question “Why me?” is on pilots’ minds. The only way to deal with all this is to take a more rational perspective.

But it is not just anxiety that could affect pilot’s wellbeing. Those who have already lost their jobs, may feel a sense of injustice about the situation. That could hit particularly hard if airlines had not handled the process of redundancies or communicated adequately with the pilots. The question “Why me?” is on pilots’ minds. “The only way to deal with all this is to take a more rational perspective. Most of these situations are random, they are down to the numbers, not the personality.” Depersonalising the misfortune – or accepting that the entire industry is in trouble – takes a bit of the pressure off the individual. 

But what if this is not enough?

If your pressure and stress is too much to cope with – and this can happen to anybody – there are Peer Support Programmes (PSPs). Such PSPs allow pilots to connect with fellow pilots, medical and psychological experts to deal with different kinds of work and life-related problems. PSPs are available even if you are not flying. In fact, in good times, a large part of the pilots who use Peer Support Programmes are not flying due to various reasons (e.g. temporary losing their medical license, performance or personal issues). The COVID pandemic and the pressure on mental health, could be a driver to make better use of this tool. “One of the basic things in peer support is that we don’t want seemingly small problems to escalate into bigger. That is a really bad scenario. Somebody who has been a little bit anxious, then three months later to have proper anxiety attacks because they were not helped by their peer or their doctor. We could have prevented this,” says Bor.

Signs of trouble

With the gradual return to flight operations, it will be vital for pilots to cope with the anxiety & stress before stepping into the cockpit. “Depression or anxiety in the workplace will interfere with flight safety and flying operations and distract us. And I’ve seen this already. No pilot should be afraid to put their hand up because they have depression or anxiety. They should be a little concerned if they are not doing anything about it, or they are in total denial. If you are crossing the fingers, hoping everything will be ok, you are more likely to get distracted when you’re doing your line flying,” says Prof. Bor.
 

No pilot should be afraid to put their hand up because they have depression or anxiety

For a proportion of people they would recognise the signs of depression themselves. Usually the telltale sign is when the stress or the anxiety is not going away or it is getting worse, or you find levels of disfunction. But usually it is when other people point it at us. When we hear comments “Hey, you used to be much happier. Now, you’re not sleeping” or “You’re sleeping too much”, we should consider it as a sign that we may need help. 

When no PSP available


But PSPs may not always be available. The legislation introduced after Germanwings 4U9525 requires European airlines to implement a Peer Support Programme by 14 August 2020 – but this deadline has now been pushed back, due to the COVID-19 crisis. Furthermore, some are lagging behind with their efforts to set up such programmes, leaving crew ill-equipped to deal with mental health issues. In addition, experts are still trying to break the stigma around mental health in aviation. Some pilots are worried about the confidentiality of the information they share – despite the fact that the EU legislation mandates such confidentiality – and this often is a barrier to seeking much-needed help. 

In addition, most of the Peer Support Programmes are not available for cadets, while they could be equally affected by the stress that the pandemic brought into aviation. Prof. Bor advises them to chat to a pilot, ideally a “not too cynical” one. “I suspect many of them will say “Be careful about changing direction unless you have a very good reason. Your flying qualification counts for much more than just the license. It’s a reflection about your discipline, capabilities.”

This provides a glimpse of hope for cadets. And may turn out to be a valuable lesson about the aviation industry and its volatility. Many of the experienced pilots today have worked through the Gulf War, 9/11, the economic downturn, the volcano eruption in Iceland, various airline bankruptcies, SARS, MERS... Resilience has become a key trait for pilots. But times are hard, rather than believing resilience on its own will pull us through, pilots need to be responsible and seek help, if needed: “I am going to strongly encourage people to make use of PSP at this time because it will prevent your problem from escalating. There is so much evidence for this. If we can get the message out: PSPs are operating. PSPs are appropriate to use,” concludes Prof. Bor says. 

 

EPPSI Pilot Peer Support logo

The European Pilot Peer Support Initiative has published a Guide on Peer Support that aims to assist organizations in setting up their Peer Support Programs according to a number of best practices. This guide will be updated regularly and EPPSI welcomes your comments and suggestions. For more information visit www.eppsi.eu