We Asked an Aviation Psychiatry Expert Why Pilots Might Have Psychotic Breaks

The horrific crash of Germanwings flight 4U9525 became more of an enigma Thursday when it emerged the copilot, Andreas Lubitz, apparently crashed the plane into the French Alps on purpose, according to the authorities heading the investigation. Today prosecutors in Germany said that Lubitz was going through "an illness and corresponding treatment by doctors." A note from a doctor was found at his home in Düsseldorf excusing him from work on Tuesday, the day of the crash. Now, over the next few days, authorities are expected to try and piece together the psyche of a dead man.

According to his Facebook profile, Lubitz was into running and traveling. He listened to Schiller, David Guetta, and liked his neighborhood Burger King quite a bit. Superficially, he didn't appear to have the internet footprint of a mass murderer. He didn't seem like someone suffering from depression, let alone someone suicidal. An acquaintance named Klaus Radke told CNN that Lubitz "had a bright future. He made his hobby into his job. What more can you hope to achieve?"

Still, all indications are that Lubitz locked the pilot out of the cockpit when he went to the bathroom, and then he did something incomprehensible.

One breadcrumb in our search for answers: Aviation is a strange profession, and it comes with certain stressors. Pilots face an unusual set of circumstances several times a day. I talked to Dr. Joseph Westermeyer, former consultant to the FAA on the physical and mental health of pilots and air traffic controllers, to find out how being a pilot affects a person's psyche, and whether or not there's a lesson to be learned here.

VICE: Hi, Dr. Westermeyer. Will we get a satisfying answer about this guy's motive soon?
Dr. Joseph Westermeyer: Many of these major accidents, particularly in the United States—this one is outside the country—will eventually end up being reported in one of the aviation journals, and that's usually when there's a fair amount of information about it.

Are you concerned that people are going to start to mistrust pilots, or become overly worried about this stuff?
Well, as a passenger, I don't know the person who's flying. Am I going to be able to trust them to get me safely on the ground? I spent some time in Laos as a physician—two years in the middle of a war. There were several dozen of us flying regularly, and we were the flying public. We became very aware of who we wanted to trust our lives with. There were people who, if they were flying, I'd find something else to do. That was a blessing that the general public doesn't have.

How does the aviation world view mental illness in pilots?
They're expected to get medical care, and not fly until they're able to resume the duties of a pilot. That might involve the death of a child or spouse, parent or close friend. That might be the kind of thing where a pilot may not be able to fly for some weeks. And they would be expected to disqualify themselves.

Could the oxygen levels on a plane trigger psychosis?
In theory, hypoxia—or not having enough oxygen at a high altitude—can disable a pilot, and there are many cases of it. However, the altitudes tend to be so high that not only do they disable the pilot psychologically; they also disable the pilot physically. The pilot blacks out and dies. I don't personally know of any incident in which hypoxia has led to a pilot purposefully bringing down a plane. I would consider it, if I were investigating this crash, but it probably wouldn't be on the top of anybody's list.

What about a change in pressure?
Atmospheric pressure could be [a factor]. Sudden loss of pressure can cause lots of other physical problems. But again, the sudden onset of a psychiatric incapacitation in somebody who is on the edge, deciding they're going to kill the whole airplane? That's really a stretch.

Why might this have happened when it did?
Psychiatric conditions tend to be age-related. Young people, usually in their teens and twenties tend to have their first episodes of psychosis, psychotic depression, or even schizophrenia. But you can see late-onset paranoia. I've seen that in some pilots who have been mentally astute and gotten along with people, but they developed a paranoid condition in their 40s and 50s, and then that begins to manifest itself while in the cockpit.

Are their personality disorders that pilots tend to get more than other people?
Pilots apt to get all the disorders anyone can get. Pilots have had schizophrenia for example, bipolar illness, or they can already be pilots, and require something like brain trauma. Some of these conditions are pretty disqualifying. In other words, they're probably going to lose their licenses.

If you want to speculate about what was wrong with this guy, the floor is yours.
This may have been a normal person in a crisis, or a person with a personality problem. I just don't know.

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