Lonely at sea

The most commonly reported mental illness among seafarers is depression. This is not surprising, given their particular work situation: they spend six months at sea, far away from their loved ones. Loneliness is a natural reaction. But when does loneliness worsen into something more serious?

According to Dr. Romel Papa, chief of the Behavioral Science Division (BSD) of the National Bureau of Investigation, there are tell-tale symptoms and behavioral changes that would signal a change from ordinary loneliness into a clinical depression; in the second case, medical attention is necessary. Apart from his duties at the NBI, Dr. Papa also works with the AMOSUP (Associated Marine Officers and Seamen’s Union of the Philippines) Seamen’s Hospital in Manila, to help seamen suffering from depression and other mental illnesses.

“All of us become lonely or depressed at some point in our lives. It’s a natural reaction to certain circumstances. Now, how do we know when it’s already depression? Well, first, we look at the person’s level of functioning. If a person is no longer behaving or functioning normally at work or at home, then that’s when intervention is needed,” he says.

Signs of clinical depression

Among the signs of depression are:

a) feelings of sadness or unhappiness;

b) loss of interest or pleasure in activities that a person usually enjoys;

c) hopelessness; and

d) withdrawal from work and social situations.

Dr. Papa says that if these symptoms last for two weeks and beyond, the person must receive medical attention for clinical depression.

“For example, if a person reaches a point where he or she is unable to go to work because of the depression, or if that person just prefers to stay in his room all the time, those are signs that the person is already overwhelmed by the symptoms of depression and can no longer effectively cope with the symptoms,” he explains.

Dr. Papa also points out that in most cases, a person with depression is able to find means to help him get over it. These are known as “coping mechanisms”—both healthy and unhealthy ones. In the case of seafarers, not all of the coping mechanisms available to them are healthy. This makes depression particularly challenging for seamen to cope with.

Coping mechanisms

“Instinctively,” Dr. Papa says, “we can find ways to cope with our depression. The principle is obvious: when we feel unhappy, we find things or engage in activities that make us happy, so we can overcome the unhappy feelings.”

Going to the mall, watching a movie, hanging out with friends—these are all very good ways to counter feelings of depression or loneliness in the case of most people. If
 a person is experiencing difficulties at work or with his or her personal life, he or she can find a relative or a friend to talk things out with. This relieves the stress, anxiety, loneliness, and other negative feelings that person may be having.

The problem for seafarers, however, 
is that most of these regular coping mechanisms are not available to them when they’re out in the middle of the ocean; there’s nowhere to go and one’s loved ones are far away.

Unfortunately, the coping mechanisms that are available to a seaman who is out at sea or who has disembarked to a port of call are not exactly healthy ones. Dr. Papa says that these coping mechanisms would include alcohol, gambling, drugs
 and women.

“Alcohol, for example,” he says, “provides a temporary solution to loneliness and depression. It makes the bad feelings go away. But there are consequences. If
 you drink alcohol too often, you can become an alcoholic. It’s the same with drugs and gambling, which could become addictions.”

And having relations with different women at the ports of call, of course, also present the risk of STDs.

Intervention and treatment

There are several ways to prevent an onset of depression or to help give support to a seafarer with clinical depression so that he can get well. Clinical depression is a real illness that can be serious or even fatal—the worst outcome of clinical depression
 is suicide.

Dr. Papa suggests several ways to deal with clinical depression among seafarers. These include:

Providing access to telecoms. Thanks to advanced telecoms technology, seafarers are now able to communicate with loved ones even if they’re overseas. Using their cellular phones or computers to link with the Internet, they can now exchange e-mails, or even chat, with their families.

“The availability of today’s telecoms technologies puts our seafarers in touch with their families, and that’s a major way of easing their loneliness,” he says.

Banning drugs and alcohol from ships.

Employers and ship officers can ensure that their seamen don’t have access to these potentially addictive substances on board their ships. Seamen who are going through a depression are more likely to use these substances to cope with their condition, which could result in an even greater problem as mentioned earlier: drug addiction or alcoholism.

Depression alert system.

Dr. Papa says that it would be good if ship owners and shipping officials put in place a system on board their ships where abnormal behavior among seamen are observed and noted. This would enable them to spot potential or existing cases of depression and make a timely intervention. “There should be people on the ship who are trained to spot warning behaviors and act
 upon them.”

Medical intervention at work.

The availability, safety and effectiveness of today’s anti-depressants make it possible to treat a seaman for depression even while he’s working on board a ship.

“Anti-depressants do not reduce alertness and they may be taken 
during the seaman’s tour of duty. In
fact, seamen who have taken anti-depressants report that they actually help them become more focused and help them become more productive,” Dr. Papa says.

The administration of anti-depressants to a working seafarer is of course, something that an employer would have to approve. There are employers who are fine with the idea, while others prefer that a seaman take time off work, get well, and come back to work when he’s recovered.

Family education and support.

A seaman who is clinically depressed has a greater chance of recovery if he is receiving support from his family.

“First of all, we have to involve the family in the treatment of a seafarer who is diagnosed with clinical depression. The family is always part of the treatment process. This means that we have to educate the seafarer’s family on what depression is and how they can deal with it best,” says Dr. Papa.

Sometimes, however, it’s the seafarer’s family itself that presents additional stressors that worsen the depression.

“There are seafarers who get worried that their wives are having affairs—and there are cases where their worst fears turn out to be true. Or, their children are entering a rebellious stage and causing problems for the entire family. All these family problems are stressors that aggravate a seafarer’s depression,” he explains.

Previously published in Seafarer Asia, 2012 The Health issue. Story by Ramil Digal Gulle.