Many truck drivers suffer from mental health issues but are reluctant to seek help, often because they fear losing their jobs.

"Men don’t seek care, especially mental health care, as readily as women. This is amplified by an industry that’s primarily men and a hyper-masculine industry at that.  You have DOT regulations that make it difficult, if not impossible, for medications that could really help,” says Mona Shattell, Professor & Chairperson, Community Systems and Mental Health Nursing at Rush University's College of Nursing.

The ability to drive with mental health problems, such as anxiety or depression - with or without medications – is a judgment call by the medical examiner. Drivers are reluctant to admit to these health issues to physicians or their managers and get the help they need because they risk losing their medical certification.

"Managers need to be aware that it’s a problem, be aware that people aren’t going to necessarily say 'I’m having some issues. I’m depressed, I don’t want to eat, I don’t have any enjoyment in life. I’m working, but I’m barely making it through. I have a really short fuse, I have a bad temper and I’m getting into fights or I’m drinking too much, I'm using drugs.' Drivers in general are not open about these issues."

Mental health challenges come with the job, and, as every driver knows, many are related to the everyday stresses of the job. "Certainly the work environment is stressful; they have to deliver on time, have to meet the HOS rules. Sometimes there’s double bookkeeping. Drivers have to decide which rule they are going to break," says Shattell, who recently has written general articles on drivers and mental health for the New York Times and The Atlantic. She and colleagues also published in Issues in Mental Health Nursing, a peer-reviewed article titled Occupational Stressors and the Mental Health of Truckers in 2010.

In this article she notes: "Findings from the current study show that truckers face many occupational stressors including constant time pressures, social isolation, disrespectful treatment from others, driving hazards such as weather changes, traffic, and road conditions, and violence or fear of violence. Facing such stressors may be a factor in the prevalence of risky behaviors including drug use and paying for sex. Therefore, mental health promotion and treatment for truckers is an important area of concern and must be examined within the broader context of the transportation environment."