The stigma surrounding mental health issues among pilots seems to be a current topic in aviation, yet being open and honest is seen as a weakness, rather than a strength. Pilots especially are perceived as made of “the right stuff”. It sort of comes with the job, that you are capable of performing anytime, anywhere.

A few years back I attended my annual CRM recurrent training. At one point we were informed about the high numbers of cabin crew being sick due to stress. I asked: “How big a problem is stress among the pilots?” The instructor looked at me with surprise and replied: “We do not have any reports from the cockpit, you are the one who is supposed to take care of the cabin crew”. Nobody commented further on that subject.

Though I do believe that we have made some progress, the stigma still exists.

What are we aiming for, when we talk about mental health?

In 2011, I went on leave from the pilot job and came back 3 years later. I remember being astonished when talking to my colleagues. Though their passion or flying was still intact, they were exhausted to a point I had not seen before.

One told me how he was on the edge of crying due to exhaustion when the alarm went off at 4:30 am, on the fourth day in a row. Knowing that 6 sectors in winter conditions in Norway was facing him.

Another one told me, how he spontaneously fell asleep the moment he sat on the couch to be with his family. Having no time with his children, he packed the suitcase and went off to work again.

Flying short-haul myself, I remember those days feeling like running all the time. Trying to meet the unrealistic planning, only to be met by Operations with the argument “you can still extend with Commanders discretion” when we were reaching the limit of duty.

So why not just report feeling unfit or fatigued?

I think the explanation is partly the stress caused by the nagging thoughts in the back of your head, circling around job security. Everybody today has an increased awareness of how fragile job security can be. A lot of us have experienced our airline going bankrupt, and some have even experienced several bankruptcies.

This awareness has a side effect on the job. You go the extra mile, in order to keep your job alive. You do not want to create a hassle; you just want to keep your job. Meanwhile, you might experience the nagging thoughts growing in your mind and combined with feeling exhausted, you are experiencing a dangerous cocktail - fatigue and stress. You are no longer in a state of well-being you are in “Fight - Flight” mode.

The stress response is a fantastic mechanism that guarantees our survival, and in small doses, it will help you increase your performance and being alert for the threat lying ahead.

However a lot of the stress today is not fighting or fleeing the animal on the savanna. It is fighting or trying to flee the perceived threats in your mind, created by you. The problem is, that the stress response was “designed” for you to meet a physical threat, deal with it, and then restitute. By fighting the animal or in the restitution afterward the stress hormones Adrenalin and Cortisol would get back to a normal level.

Today, the nagging thoughts in our minds, create the same stress response and release of hormones, not just once but multiple times a day. However, we are not physically fighting anything and honestly, how good are we at restituting? This leaves our body and mind pumped up with Cortisol, and that literally messes with our brain. The amygdala in the Limbic system associated with fear is working overtime; at the same time the hippocampus associated with memory can be damaged by the high level of Cortisol.