Feeling low, or depressed, may be a response to the prevailing life-stressors due to COVID-19, particularly the uncertainties about one’s employment as an effect of the downturn in the aviation industry, in turn our financial status. The stress may seem overwhelming at times, while at other times it may seem to linger in the back of our minds, leaving us feeling blue. The question is when to seek help: when we perceive stress or when it becomes overwhelming?
Remember 9/11! The impact of the attack on the World Trade Centre and the Pentagon in the USA on 11 September 2001 was unthinkable and unprecedented with major loss of lives. A telephonic survey, about 1 to 2 months after this catastrophe, among those living in Manhattan, where the World Trade Centre was located, revealed that 7.5% and 9.7% people reported symptoms suggestive of post-traumatic stress disorder (PTSD) or depression, respectively. These incidences were nearly twice that of the reported prevalence of PTSD and depression among the North Americans.  Another study 6 months later found that there was a significant level of distress among people, even though 38% participants in this study did not have direct or first hand exposure to the attacks. As is natural, everyone has different coping strategies and yet it is the coping strategies of those surveyed that determined their perceived level of distress. Among those who used positive coping strategies like active coping, positive reframing, planning, humour, acceptance, or religion were reported to have lower levels of stress. 
COVID-19, though not an instant event like 9/11, has placed us in a similar predicament wherein each of us are affected in various degrees at personal and professional levels. As humans, being differently wired, our emotional, cognitive, and behavioural responses tend to vary, with some of us being more hard-wired while others feeling so vulnerable as if on the verge of cracking. However, this is a normal human response where we, like a rainbow, have different hues and shades, not just in our physical appearances but also in terms of our psychological make-up. We tend to respond to any stress in a different manner: while some may seem to remain unaffected, others appear nonchalant and still others left feeling low, anxious or lie awake at night.
Those among us who are feeling depressed, have anxiety or loss of sleep (find it difficult to fall off asleep or wake up earlier than usual) – please remember this could be a normal response when faced with a stressful situation. This could our response to the uncertainty about the future, related to our job or some other personal matter. It could even be said that such feelings could be an expected human response to a novel stress induced by COVID-19 since its impact is beyond our individual control, without any visible end to the pandemic yet.
When feeling blue, the important question to ask ourselves–pilots, cabin crew, air traffic controllers, or the ground staff–is whether our individual emotional response, to the prevailing conditions in aviation industry impacting our employment, impairs us functionally or has a potential to affect us to perform to our optimal capabilities. Put another way, would our emotional state adversely affect performance of our professional role, considering the safety sensitive activities that we perform? Specifically, is our present state likely to result in loss of concentration, focus and task persistence when performing our assigned duty/professional activity?  If the answer is yes, we need to seek help. It could be a phone call away in case an employee assistance program is offered by your employer, or one may need to seek help from a counsellor or one’s family doctor / Aviation Medical Examiner (AME).
Those who answer in a negative, remember that even in such a state we cannot let our guards down by thinking that ‘it can’t happen to me’. Instead, one must stay focused on our coping strategies living each day meaningfully. Feeling low at times is not a reflection on our mettle, instead it is a reminder that we are human, and thus vulnerable.
1. Galea S, Ahern J, Resnick H. et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med 2002;346:982 987.
2. Silver RC, Holman A, McIntosh DN. Nationwide Longitudinal Study of Psychological Responses to September 11. JAMA. 2002;288(10):1235-1244.
3. Gitlow S. Pscyhiatry. In: Rayman RB , Davenport ED, Dominguez-Mompell R, Gitlow S, Hastings JD, eds. Rayman’s Clinical Aviation Medicine Chapter 12. 5thedition. CITY: Castle Connolly Medical; 2013: 309-321