BY EIKO FRIED. In response to the Germanwings crash, media and politicians have construed depression as cause for the tragedy, and depressed individuals as hidden danger we need to protect ourselves from. This stigmatization is inappropriate and harmful—what we really need is a better understanding of a severe and very common disease.
On March 24rd, the Germanwings flight 9525 crashed in the French Alps, and 150 people lost their lives. It has been 3 weeks since, and we have had some time to reflect upon what happened. The catastrophe received unparalleled attention, especially in France and Germany, and the media created a vast amount of hypotheses and pseudo-news to fill hundreds of hours of live coverage. Most of this coverage happened in the first week, based on very little factual information.
While the desire to understand what happened, and why it happened, is understandable, wild speculations about the possible mental state of the co-pilot, private details about his life and his family, and pictures of grieving relatives and friends of the victims did certainly not provide clarity.
Responses to the tragedy are based on misconceptions of depression
What we know now is that the co-pilot had been diagnosed with severe depression in 2009, and that investigators discovered a letter in his apartment signed by a doctor declaring him unfit to work. Depression has been construed as cause for the crash, and it has been suggested that individuals with mental disorders should be forced to disclose their current diagnoses and disease history to their employer. There have also been requests that people with a depression diagnosis should be banned from working. These calls are hasty and based on four depression myths I would like to correct.
First, very few suicides committed by individuals diagnosed with depression cause physical harm to other people, and it is a notable exception when another person is killed. In the rare cases this happens, the victims are usually close relatives whom the depressed person does not want to leave behind. The plane crash does not resemble this pattern at all, and should in turn be interpreted as a very rare exception to a very rare exception.
About 1 in 5 individuals living today will, at some point in their lives, be diagnosed with depression.
Second, depression is the most common mental disorder in the world, and about 1 in 5 individuals living today will, at some point in their lives, be diagnosed with it. It is not a very picky disorder that only befalls people of a specific disposition, skin color, religion, or profession.
That a pilot was diagnosed with depression in 2009 is not unlikely, because so many people suffer from depression––doctors, bus drivers, athletes, and hairdressers. About half of all people diagnosed with depression will have multiple episodes that can last from weeks to months, whereas the other half will only exhibit a single episode in their lives. Therefore, a diagnosis of depression six years ago does not necessarily tell us much about how the person is doing today.
Third, there are many different reasons why people become depressed: adverse life events, biological predispositions, chronic stress, and early traumatic experiences, to name but a few. In most cases, several risk factors come together. Depression also has many different faces: some people feel strong negative emotions such as sadness and anger, while others are better characterized by an absence of positive emotions. Some depressed patients sleep very little and lose weight, others sleep 14 or more hours a day and eat more than usual. It is not surprising that depression is acknowledged as one of the most diverse and complex diseases in psychology and psychiatry.
Many articles called out his depression as cause for the crash, but depression didn’t crash the plane: the co-pilot did.
This implies that knowing about the co-pilot’s previous diagnosis is not very informative in the face of the variability of the disorder; in fact, the diagnosis tells us incredibly little about the specific problems he may have suffered from, and his possible motives for crashing the plane. Many articles called out his depression as cause for the crash, but depression didn’t crash the plane: the co-pilot did. And he did so because of very specific problems, in combination with a very specific personality profile, very specific life circumstances, and a very specific personal life history.
Finally, depression is a real problem deserving of a lot more than a knee-jerk reaction by politicians and press. It’s much more than just being utterly sad––it causes as much disability as other chronic medical conditions and severely compromises the capacity for self-care and independent living. This means that people suffering from depression, who often also have other conditions like anxiety disorders, need our attention and support just as much as people with cancer, HIV, or Alzheimer’s disease. Just because there is the word mental in mental disorder doesn’t make depression any less real, or any less a disability. This problem needs real attention and real solutions—not reactive measures that will hurt in the long run.
Stigmatization and violation of privacy rights do more harm than good
In addition to the fact that many responses to the tragedy have been based on wrong assumptions, they also seem inappropriate.
Putting a large group of people under general suspicion because of rare memorable situations like this plane crash is unjustified.
Demanding that patients should reveal previous diagnoses to employers is not only calling for the severe violation of privacy rights and medical confidentiality of millions of people—it is also highly unfitting, especially in the face of this one incident. People with mental disorders are much more often victims than perpetrators of crimes and deserve, if anything, special protection.
Putting a large group of people under general suspicion because of rare memorable situations like this plane crash is unjustified. Another major problem is that less than half of all people suffering from depression will seek help, often because they are afraid of disadvantages that could result from their diagnosis. The recent calls to force patients to disclose medical information to their employers foster the stigmatization of individuals with psychological problems, and will further decrease the willingness to look for help.
In sum, a terrible catastrophe happened, but we should carefully consider our options before we make rash decisions. People with mental disorders are as much individuals as people without, and there are large differences. Somebody with a specific phobia––for instance a fear of spiders or dogs––may be well suited to fly an airplane, whereas a patient suffering from sleep problems and severe fatigue after a traumatic experience may not.
And this variability exists not only across diagnoses, but also within: some individuals with depression may be able to do their jobs very well, depending on the particular symptoms, whereas others may not be able to do so. We need individualized solutions for individual people.