Troy Merritt, a pilot for a major U.S. airline, returned from his 30th birthday trip in Croatia in October 2022 — sailing on a catamaran, eating great food, socializing with friends — and cried. This wasn’t back-to-work blues but collapsed-on-the-floor, full-body-shaking misery. When he wasn’t crying, he slept.

“I’ve got to find a therapist,” he told himself. And he did, quickly. If that therapist didn’t write down “depression,” Merritt would be OK. He could still fly planes, keep his job — as long as he wasn’t diagnosed with a mental illness.

After several sessions, the therapist gently suggested that he might need medication. Merritt adamantly refused; the therapist never raised the subject again.

Merritt’s husband, also an airline pilot, hoped he would break out of this funk. “Let’s go for a hike,” he would say. “We live in California, it’s a gorgeous day!” But Merritt wouldn’t get up off the floor. “I don’t know what to do,” Merritt sometimes mumbled. Other times, it seemed as if he were in a coma. His husband worried about going to work and leaving Merritt alone at home.

But when Merritt was at work, flying planes, he was much better, focused on the tasks in front of him. It was when he reached his destination city and tried to settle into a strange hotel room that loneliness and sadness crept over him again. Co-workers didn’t seem to notice because he was often flying with different crews.