Many people, including pilots, will struggle with mental health at some point in their lives. Approximately 8.4% of the population will experience depression during their lifetime, and 5% are affected by it at any given time. Anxiety often accompanies depression, and the FAA treats both conditions similarly when it comes to medical certification.
Financial difficulties, career setbacks, divorce, or personal tragedies can lead to decreased energy, sadness, and other symptoms associated with depression. The FAA recognizes this and has adopted a more flexible approach to mental health issues for pilots. If a pilot has recovered from a past episode of depression or has an active diagnosis that is well controlled, they can still qualify for any class of medical certification.
Protecting Public Safety While Addressing Mental Health
Though the FAA has softened its stance on depression and anxiety, it still takes these diagnoses seriously. Statistics show that about 90% of individuals who commit suicide have a mental health condition, with depression being one of the most common. Moreover, those diagnosed with anxiety or depression have a higher mortality rate—nearly 50% higher than the general population.
Mental health diagnoses account for five of the 15 conditions considered disqualifying by the FAA, highlighting their significance in aviation safety. Unlike physical ailments, mental health conditions are more challenging to assess, and their impact on safety can be difficult to predict.
Changes in FAA Standards
Qualifying for a medical certificate with a history of mental health conditions used to be much more challenging. However, times are changing. Since 2010, the FAA has certified pilots who are actively treated with antidepressants, and recent updates in the FAA’s Aviation Medical Examiner (AME) Guide have made the process easier.
The FAA now allows pilots with up to two mental health diagnoses, treated with medication or psychotherapy two or more years prior, to receive certification without requiring a deferral to the FAA for review. These changes reflect the growing data showing that those seeking treatment for depression or anxiety do not pose a significantly increased safety risk.
Understanding the FAA’s Evaluation Process
Despite these changes, pilots with mental health conditions still receive closer scrutiny. The FAA’s recent revisions list specific conditions that can be cleared without deferral, including generalized anxiety disorder, postpartum depression, and situational depression or anxiety. If symptoms are well-managed and have not recurred in two or more years, pilots can receive certification without needing additional evaluations from a board-certified psychiatrist.
However, certain conditions—like bipolar disorder, psychosis, and substance misuse—still require automatic deferral to the FAA. These conditions are often disqualifying, especially if they significantly impair judgment or functioning. Additionally, any history of self-harm, suicidal ideation, or serious mental health treatments, such as electroconvulsive therapy, necessitates deferral.
Medication Use and Mental Health Certification
Medication plays a significant role in how the FAA evaluates mental health conditions. Pilots taking antidepressants must apply through a HIMS AME, and only specific medications like Fluoxetine, Sertraline, Citalopram, and Escitalopram are allowed. If a pilot has discontinued medication, the FAA carefully reviews the reasons for the prescription and the pilot’s mental health history.
Even if a pilot no longer takes medication, they may still need to provide well-written treatment notes from their physician. For conditions lasting longer than six months or involving multiple episodes, the FAA requires additional documentation, including a current psychiatric evaluation.
Stricter Guidelines for Certain Conditions
The FAA has maintained strict guidelines for many mental health conditions. Bipolar disorder, major depressive disorder, and personality disorders can impair judgment and behavior, leading to automatic deferrals. These conditions often require ongoing monitoring or treatment to ensure the individual can safely operate an aircraft.
The FAA remains vigilant in balancing mental health support with public safety. While adjustments have been made to reduce stigma and encourage pilots to seek help, safety remains the top priority. As part of the ongoing effort to support mental health in aviation, the FAA has introduced a new questionnaire tool for AMEs to determine whether a case should be deferred for review. If any concerning mental health history or symptoms are flagged, deferral is mandatory.
Obtaining a VA Disability Rating Shouldn’t Be a Barrier
It’s important to note that having a mental health condition such as depression or anxiety should not scare a pilot away from seeking a VA Disability rating. Many veterans struggle with these conditions as a result of their service, and obtaining compensation through the VA is not only a right but can also help provide the necessary resources to manage their health.
Having a VA Disability rating does not automatically disqualify someone from receiving FAA medical certification. While the FAA will closely review the history and treatment of mental health conditions, pilots can still obtain a medical certificate if their symptoms are well-controlled and they meet FAA criteria. Pilots should not avoid seeking VA benefits out of fear that it will interfere with their flying career—seeking proper care and compensation can improve their overall well-being and their ability to continue flying safely.
Ongoing Adaptations in Medical Requirements
In addition to mental health, the FAA continuously updates its guidelines for other medical conditions. For example, the recent revision of protocols for cardiac issues removed the requirement for fasting blood sugar testing and an exercise stress test for certain cardiac conditions. The FAA also now mandates full 12-lead ECG testing for cardiac assessments.
Conclusion: A More Inclusive but Vigilant Approach
The FAA’s evolving stance on mental health represents a positive shift, allowing more pilots to qualify for medical certificates while still maintaining stringent safety measures. Pilots experiencing depression, anxiety, or other mental health concerns are encouraged to seek treatment and focus on recovery. With proper care and documentation, many can return to flying safely.
By continually adapting its policies to better address the realities of mental health, the FAA ensures that pilots can receive the support they need without compromising aviation safety. Additionally, veterans seeking VA Disability ratings should feel empowered to obtain the benefits they deserve without the fear of it jeopardizing their medical certification.
