How does nine months at sea impact your mental health?

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1:04For more than 9 months, thousands of American sailors have been living aboard a giant grey warship, the USS Abraham Lincoln. It was at sea because of the US-Israel war with Iran. Half of the crew are under 24 and they've been at sea since late last year. This included a record stretch, more than 250 consecutive days without a break. Now, life on a ship like this can be intense. It's noisy, it's cramped, you're far from friends and family. And there have also been loads of media reports of broken toilets, food shortages, worries about morale and mental health. Although the US Navy says there haven't been severe problems on board. So how does spending months at sea impact a sailor's mental health? That's what we're going to get into today. I'm Hannah and this is What in the World from the BBC World Service. I'm speaking to Dr Harold Cudler, who is a psychiatrist in the US and he used to oversee mental health policy for the US Department of Veteran Affairs.

2:07That's the agency that provides lifelong support for American veterans. Dr Cudler, thank you so much for joining us. My pleasure. So being at sea for nine months is a really long time. What are some of the main challenges that the crew members would have been feeling in terms of their mental health? Well, the fact is that being on a warship and especially on an aircraft carrier, there are special stresses and strains that most people don't think about. There are 5,000 human beings on a modern aircraft carrier. So there are a lot of people doing a lot of jobs living in very tight quarters. Some people just about never getting above decks to see the sun, but working in engine rooms, working in communications, repair and equipment. And doing that for perhaps in this case more than 250 days is an unusual strain on any human being. And you said there were about 5,000 people on a ship like this.

3:11And yet it can still feel like a really isolating, like a really lonely experience, can't it? Well, yes, for several reasons. Number one, you're not seeing all your your buddies every day. You're working in a compact space with a fairly small group of friends, which can both be very supportive. But in the course of 250 days, there could be times when conflict will arise within that small group. And that would be pretty normal. And remember, you're not just there on a cruise. You're there under conditions of war on high alert. It's a very intense and compact atmosphere. There's a problem of being at war called nostalgia. And nostalgia is a kind of pathological homesickness. Now we consider both anxiety and depression, natural fear, which would be normal in a combat area, combining during these long periods of nothing to do.

4:12And nostalgia was one of the main causes of casualties in earlier wars. And when we think about the situation of thousands of people packed in in different segments of the most powerful weapon, the most powerful engine of war, that's probably ever been built on alert, but without an endpoint and frankly without a clear mission, you could imagine how that becomes a pressure cooker in which something like nostalgia could take over what we're hearing are people saying severe loss of weight, severe anxiety, thoughts about suicide, the very graphic idea of people even thinking about jumping off the flight deck and we're talking about a very long way down to the water that follows up could be lethal. But also no understanding of what they're doing there or when it's going to end.

5:15Some of the challenges that Dr. Kudler mentioned are specific to living on a warship, but living and working on any type of ship for an extended period of time does bring its challenges. And I want to play you this voice note we got from Joe Franta. He documents his experiences working on cargo ships on his YouTube channel and he sent us this from off the coast of Mexico. Back on the vessel for too long it really starts to take a toll on you mentally and physically. Personally for me I find that after 90 days on board a vessel you really start to lose it.

6:19I mean keep in mind you're working seven days a week, 12 hours a day, some nights you're not getting your full six or eight hours of sleep. Not to mention you're working next to the same people every day all day. So if there's somebody that you don't get along with, well there's no escaping that person you just got to learn a deal with them. Let's say the Galley department and the cook they're not very good or we ran out of food because we've been out to sea for too long or you don't want to eat because the food's lousy. So now you're malnourished also the constant noise on a ship it's always humming or buzzing and probably the biggest thing is just the feeling of isolation that you get from working a board a ship. I mean you're literally days away from anybody else so mentally that definitely takes a toll. And on top of all this you could be dealing with problems back home whether that be in a relationship or something happened to a family member which that's constantly on your mind and all you're

7:20thinking about is how much you want to get off which makes everything 10 times worse. Like I said I love this job but being on for too long it basically turns the ship into a prison and it can really weigh on you. Doctor Kudler I mentioned that around half the crew on board the USS Abraham Lincoln are under 24. Do you think it would have been particularly hard for younger crew members in this environment? Well I think particularly people who have never been on these kind of long deployments before might not have known how to pace themselves and this isn't what they expected. Sometimes younger people to join the military for lots of very good reasons including patriotism don't understand exactly what it is they're going to be doing until they get there and so they use up a lot of their adrenaline at the beginning and then they're kind of worn out and overwhelmed and exhausted. I think younger people are vulnerable it's interesting in preparation for our conversation. I went back and I read some stuff about nostalgia and it turns out that physicians a hundred years

8:25ago were saying that younger people were more subject to this and then in fact weight loss, anxiety, depression were parts of that clinical picture. What kind of support is available for people on board these ships to try and help them through this? Well an aircraft carrier is part of a group of vessels that deploy together and they have an assigned embedded mental health support system both mental health professionals, psychologists usually maybe psychiatrists. They also have Korman who are not mental health professionals but have had special training in dealing with mental health issues and they're particularly valuable because they provide peer level support. You're talking to somebody who looks like you is about your age as opposed to talking to say an officer who's a psychologist or psychiatrist. There's a concern though about talking about your problems even with a peer and that is that what if I am looked upon by my friends as maybe not reliable? What if they think

9:31that I'm too upset, too nervous, too depressed to do my job well so they won't bring these problems forward and as we all know if you have a problem that you can't talk about it usually gets worse. Dr. Kudlow thank you so much for speaking to us. Open my pleasure Hannah thank you. Now just before we go a big shout out to everyone who left us comments on our YouTube episode about what you should call your boss. Fatima said that in Asia in most workplaces even in startups you can't call your senior by their first name. Please do keep your comments coming but for now that's it from us. I'm Hannah this is What's in the World from the BBC World Service and we'll see you next time. One of the most notorious gangs of hackers that ever existed. All of your files were encrypted with military grade algorithms making our outrageous demands. Let them pay millions. I'm Jeff White and I'll

10:31take you inside a business like no other where cyber criminals piled up the cash until divisions grew and somebody took revenge. Cyber hack season four the county files all episodes available now wherever you get your BBC podcasts. Premium on Apple podcasts. You can also enjoy a range of our podcasts add free with an Amazon music subscription.