A Fine Balance

Kreisha Ballantyne looks at how to balance life and aviation

I was at the peak of my career, being paid to fly high-performance single-engine aircraft and to share my joy and passion for flight, when it hit me. I was living my dream, travelling almost every week, commuting to Melbourne frequently, living in and out of hotels. My system of packing and unpacking my suitcase was worthy of a trademark; my frequent flyer status was Platinum and I was more comfortable in the Virgin lounge than my own living room at home.

Those who knew me could see it coming, but it knocked me for a six. One day, on my way to Melbourne to commence a demonstration of the latest aircraft, I was overcome by fear and dread. Tears streaming involuntarily down my face, shaking uncontrollably, with my heart pounding so loudly I could feel it in my ears, I took an Uber to the nearest hospital. I thought I was having a heart attack, or perhaps a stroke.

The diagnosis? A panic attack.

I was surprised and shocked. I was not a person who suffered from anxiety and although I am a classic over-thinker, I also considered myself a fine problem-solver who had relative emotional balance in her life. Turns out I didn’t know myself nearly as well as I thought.

The hospital referred me to my doctor—a wonderfully kind and patient professional—who, after formulating a mental-health care plan, referred me to a therapist. Over time, I came to understand that I had no strategy for managing stress; that if the small stresses of life are not dealt with, sooner or later they meld together to become one massive, unmanageable stress event that can often lead to health issues. Upon learning this, I quit my dream job and spent a year re-evaluating my life.

What does this have to do with aviation?

My first question to myself after being diagnosed with a panic attack was ‘what if this happened on short final? Or take off? Or indeed in any stage of flight in a single pilot operation?’

The more I began to understand that I had no management strategy for stress, the more I realised that I was unfit to fly. I made the cognitive decision to ground myself until I understood my issues more clearly. Half an hour on the internet was more than enough to highlight that I am not the first pilot to become incapacitated by stress. Furthermore, there are far too many examples of aviation disasters, where suicide (often of passengers alongside crew) has been the ultimate result of untreated mental health concerns (see resources).

What is stress?

Stress is the body’s reaction to harmful situations, whether they’re real or perceived. When you feel threatened, a chemical reaction occurs in your body that allows you to act in a way to prevent injury. This reaction is known as ‘fight-or-flight’, or the stress response. During stress response, your heart rate increases, breathing quickens, muscles tighten, and blood pressure rises. Your body is ready to act; it is how you protect yourself that is vital in managing stress.

Stress is a natural factor in life, and is a motivator for getting things done. Learning to fly, working in aviation and existence in general are stress-provoking events. Stress is largely managed by humans (and animals) every day. However, when life loses its balance, when a series of events cluster together and your brain and body experience overload, stress can lead to anxiety, depression and an inability to cope.

Identifying the symptoms

Symptoms are divided between physical, cognitive and emotional.

Physical symptoms of stress include:

• low energy
• headaches
• upset stomach, including diarrhoea, constipation, and nausea
• aches, pains, and tense muscles
• chest pain and rapid heartbeat
• insomnia
• frequent colds and infections
• loss of sexual desire and/or ability
• nervousness and shaking, ringing in the ear, cold or sweaty hands and feet
• dry mouth and difficulty swallowing
• clenched jaw and grinding teeth.

Cognitive symptoms of stress include:

• constant worrying
• racing thoughts
• forgetfulness and disorganisation
• inability to focus
• poor judgment
• being pessimistic or seeing only the negative side.

Emotional symptoms of stress include:

• becoming easily agitated, frustrated, and moody
• feeling overwhelmed, like you are losing control or need to take control
• having difficulty relaxing and quietening your mind
• feeling bad about yourself (low self-esteem), lonely, worthless, and depressed
• avoiding others.

Applying the symptoms to your situation

The first step in effective stress management is to train yourself to be able to recognise the symptoms that signal the onset of stress before stress levels get too high. From the list above, the most common signals of stress include:

• physical signs: cold, sweaty hands, headache, tension
• behavioural changes: irritability, anger, hurriedness, fixation
• speech patterns: fast, irregular, non-standard phrases, voice tone or loudness.

On presentation of these symptoms, it’s vital to recognise what’s happening and to break the circuit. Failure to do so can lead to anxiety and panic. With the onset of any of the signs above, take a step back. If you’re able to change your environment, do so: take a walk, call a friend, talk to a colleague. If you are unable to change your environment, change your breathing; a series of deep breaths will calm your body, and eventually your mind.

Understanding your symptoms

Much has been written about the stress load on pilots and aviation professionals in their work, and human factors is now an integral part of the aviation syllabus, but the general stresses of life: family, health, financial worries, personal issues, are not the focus of human factors specifically. We’re taught, as pilots, as air traffic controllers, as managers, to recognise work-load stress, but the broader stress factors of life are equally relevant and not nearly as often discussed.

Understanding and acknowledging life’s baggage is a key to stress management. The most basic elements of coping with stress issues are:

• Taking care of the physical causes of stress. These includes ensuring you get enough sleep, adequate nutrition and exercise. Hunger and fatigue are some of the most obvious stressors, and their effects are well-known. Climbing stairs is a very good way of eliminating excess toxins in the body, and swimming helps restore equilibrium to the nervous system. Find a technique that works for you and apply it when you feel the first physical onset of stress.
• Continuous professional training. Training ensures currency and competence in all standard and emergency operating procedures. If you feel out of depth at work, it’s vital you speak up and seek further training. Lack of, or loss of, confidence is a significant cause of stress.
• Social interaction. It is not prudent to allow personal problems and worries to build up. Communicating them with others is very important as it offers partial relief. Loneliness is a modern epidemic; human beings thrive on social interaction. Isolation may lead to depression and anxiety. Even if you are by nature an introvert, human contact is still vital. Ensure you have at least two people upon whom you can rely on to talk things over. If not, consider engaging a therapist, or joining a group of like-minded people for social interaction.
• Workload. Do not allow yourself to take on too many tasks and responsibilities (both work and non-work related) that can cause work overload. It is important to learn to say no when asked to do too many tasks.

Stress factors in everyday life

Mindfulness may well be the buzzword of the decade, but stress can be largely relieved by finding a balance in your life. As we are each unique individuals, awareness of our personal stress triggers is important. As well as the factors mentioned above, general life stress events can be split into the following categories:

Aviation stress situations. As mentioned, human factors cover a multitude of stress-provoking situations at work, from managing workloads to dealing with different personality types, as well as working in close confines with others, dealing with time zones and managing irregular shift patterns.

However, we are also subject to unique situations which cause individual stresses. For instance, I have no problem with written exams, but find practical aptitude tests (i.e. a flight review) incredibly stress-inducing. I have learned to manage this stress by being well prepared, by using visualisation techniques and by building a rapport with the testing instructor. I have a friend who loathes flying with family members, but enjoys taking the general public on joy flights. After realising that the specific family members were harbouring a fear of flying in light aircraft, he has avoided taking family members on board and thus relieved the stress.

Being aware of your individual aviation stress situations (i.e. crosswinds, flying in CTA, flying with a colleague you particularly dislike) will allow you to develop a strategy to cope. It may not relieve the tension of the situation completely, but it will allow a chance to flag the potential of stress and apply coping mechanisms.

Life’s baggage. Take a moment to evaluate your life. Do you like your job? How is your relationship with family members? How is your health? Do you have an adequate social life? To whom do you turn when you’re overburdened? Do you have overbearing financial issues?

Evaluate the main stress factors in your daily life. Some you may not be able to change; others you may be able to tweak to relieve the burden. We often become highly focused on the details of our lives, forgetting to take a step back. It’s common to feel that change is too hard, and that putting up with an untenable situation is the only option. Sometimes, looking at that situation from a different angle can provide a new light.

Underlying stress. Occasionally, the burden of stress can seem unsurmountable. When life is severely out of balance, finding a way back can be tricky. It may feel easier to give up, to bottle up the issues and soldier on. Often, the cause of a heavy burden is an underlying issue: grief, unresolved tension, loneliness and fear are examples that left unexamined can lead to depression or severe anxiety. Like physical medical issues, these problems require the aid of a health professional (see resources). An untreated underlying mental health issue is as dangerous as an untreated physical one. You wouldn’t put up with the pain of a toothache or broken bone; neither should you put up with the pain of grief, loss, loneliness or fear. Pilot incapacitation represents a serious potential threat to flight safety.

Pilots may feel reticent about raising emotional issues for fear of loss of their medical. However, depression is one of the leading causes of disability worldwide. Well-managed depression is compatible with medical certification. In cases that CASA assesses as ‘low risk’, treating doctor reports (GP or DAME) or psychologist reports may be accepted in lieu of a psychiatrist report. For more information on aviation and mental health, see Flight Safety Australia’s Aviation medicals—do I really have to report that? and Flying beyond the blue.

As for me, a year of psychotherapy has helped me navigate through some serious underlying issues. I have slowly reintroduced myself to flying, with an instructor at this stage, and look forward to returning to the skies with renewed vigour and a greater understanding of the importance of balance.

Resources

There are a number of excellent places to get information and support.

Beyondblue. Seeking help and getting support is essential in treating depression and anxiety. Last year, beyondblue had more than 78,000 calls from Australians about mental-health concerns or issues. They are available to talk and listen, 24 hours a day, seven days a week. Beyondblue’s website also contains useful resources (including people’s personal experiences of depression) and information on current initiatives. Phone 1300 22 4636.

Black Dog Institute. Visit the Institute’s website to find information on when and where to get help, support groups, personal stories and videos. The Institute also provides an interactive self-help service, myCompass, which aims to promote resilience and wellbeing for all Australians.

MensLine Australia. This national telephone and online support, information and referral service is for men to help them deal with relationship problems in a practical and effective way. Phone 1300 78 99 78.

CASA Aviation Medicine. See the Depression and anxiety safety fact sheet.

Cases of pilot suicide. See BBC news Six cases of suspected airline pilot suicides.