You can be a pilot if you have depression. But the Federal Aviation Administration (FAA) has strict regulations that can make some aspects tricky.
The Federal Aviation Administration (FAA) strictly regulates a pilot’s physical and mental status to protect the safety of the pilot and their passengers.
But the regulations reflect some deep societal misunderstandings, and sometimes discrimination, that still surround mental health conditions.
In this context, pilots who have depression may feel the need to either hide their condition or forgo treatment to keep their jobs. The regulations are strict, yes, and make maintaining flight status a challenge. But they don’t preclude someone with a mental health condition from flying.
You can be a pilot if you have depression. Treatment options and growing awareness about mental health in the workplace provide hope.
To fly, pilots must have a medical certificate approved by an FAA aviation medical examiner (AME).
Under the current guidelines, depression, anxiety, and similarly categorized psychological conditions don’t lead to automatic disqualification.
The AME must determine whether the mental health condition is a safety concern. Their goal is to identify mental health conditions that affect:
- emotional control, or
- mental capacity with loss of behavioral control
Specific mental health conditions require an FAA decision to grant automatic denial or deferment. Some of these conditions are:
- attention deficit hyperactivity disorder (ADHD)
- bipolar disorder
- personality disorder
- substance use
- substance dependence
- suicide attempts
Other mental health conditions, as in the case of depression, are left to the discretion of the AME. However, seeking treatment of any kind for depression can cause a loss of flight status until the AME determines that the pilot is deemed clinically stable for 6 months.
A pilot who decides to take selective serotonin reuptake inhibitors (SSRIs), a common category of antidepressant, can take only one of four approved medications:
“Even the four ‘approved’ SSRI medications are technically disqualifying medications,” says Anthony G. Ison, Esq., of The Ison Law Firm, which specializes in aviation law in West Liberty, Kentucky.
The FAA allows a pilot’s use of these medications on a case-by-case basis and requires a special issuance medical certificate.
If the pilot continues to take the SSRI, they would have to go through additional examinations to maintain their flight status, Ison says.
The FAA further stipulates that the pilot:
- can’t take concurrent SSRIs or psychotropic drugs
- can’t have a history of suicidal thoughts
- can’t have a history of psychosis
- can’t undergo electroconvulsive therapy
“The FAA’s standards regarding mental health conditions and medication use is largely in place to meet the European Union’s response to… the 2015 Germanwings accident, wherein the cause of the accident was ruled to be suicide by the pilot,” Ison says.
Ison has worked with pilots who have depression. He’s found that most decide against taking an SSRI to remove any current or future roadblocks to their medical certification.
The FAA regulations miss the nuances of how mental illness manifests and the best way to treat it, medical experts told Psych Central.
“With anxiety and depression on the rise, the FAA needs to do more to remove the stigma surrounding mental illness in the aviation industry so pilots are more likely to report, seek treatment, and take time off work, if needed,” says Yalda Safai, MD, MPH, a psychiatrist in New York City.
Regulations are in place to protect passengers. There’s a concern for issues with concentration, lack of sleep, and fatigue that could affect the pilot’s ability to fly. It was suicide by airplane, however, the precursor to current regulations surrounding depression, as Ison points out.
But a 2016 study that reviewed 65 cases of pilot suicide involving an airplane found that “both suicide and homicide-suicide involving aircraft are extremely rare events.”
Besides mental health conditions, there are other factors at play in these cases, such as legal and financial crisis, problems at work, and relationship issues, according to the study.
“The guidelines paint depression as a mental health condition that affects everyone in the same way,” says Ernesto Lira de la Rosa, PhD, a licensed clinical psychologist with the Media Advisory Group for Depression Research.
“If a pilot experiences sleep difficulties, lack of concentration, and fatigue this may be more concerning than someone who experiences feelings of worthlessness and guilt,” he says.
Treatment and stigma
Safai points out that “seeking mental health support at any point in a pilot’s life has the potential to taint their career for years.”
A culture where honesty can have career-ending consequences is extremely dangerous to the safety of pilots and passengers, she says. Pilots may go years without treatment.
Lira de la Rosa agrees. “The guidelines may mislead the public… about what constitutes effective treatment for depression,” he says.
Other effective treatments, such as talk therapy, can help but currently require a special issuance medical certificate. Overall, the regulations discourage pilots to report depression in the first place and may make them hesitate to seek treatment.
Safai also says that other mental health diagnoses, such as bipolar disorder, shouldn’t disqualify a pilot. There are treatments that allow people with mental health conditions to “have healthy, productive lives with no danger to the safety of anyone else.”
If you ask: Can I be a pilot if I have depression? The answer is yes. Depression doesn’t have to keep you from the skies.
The public is much more accepting and aware of mental health conditions than it once was. But the FAA hasn’t quite caught up.
Ison, the attorney who specializes in aviation law, recommends the public encourage the Federal Air Surgeon to review the regulations alongside the growing body of research on depression and treatment options. A culture that supports treatment makes everyone safe.
For those with depression considering flying as a career, you’ll want to put your mental health first and seek treatment through a licensed medical professional.
You can also take steps to care for your mental health by eating a balanced diet, exercising, and getting enough rest.
Confiding in the supportive people in your life can be valuable. You can be an advocate for changes to FAA regulations that more accurately mirror the current knowledge on depression.