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Pilot mental health

Old 2nd Feb 2023, 03:26
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Pilot mental health

Hi all,

I was just hoping for a bit of anonymous advice. As a current airline pilot I need to now accept that I really am not OK. I suffer many symptoms of a mental health condition and have to accept that itís now affecting my personal life (not my professional). Iíve been to my GP who has suggested a course of medication to help my mental health. I am aware that by taking this mediation (SSRI) would temporarily lose my class 1 medical.

I am very worried about the future. Does anyone have any experience with this? If I talk to my AME, what happens next? If you lose your medial due to mental health, how do you get it back? Does anyone have any prior experience of this that they are willing to share?

Kind Regards,

A very worried pilot
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Old 2nd Feb 2023, 14:33
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Hi. Iím not an AME but have some experience of colleagues going through a similar situation.

Firstly - try not to worry (easy to say, I know!). In the UK and I believe also in EASA (as the process used to be the same for both) then you can fly on a Class 1 while undergoing treatment and taking SSRI. You will be made unfit initially until the dose of SSRI and treatment plan is approved but as long as they are working out for you then you can get a Class 1 re-instated with OML restrictions.

If you are in the UK then the CAA have a specific treatment pathway that they will follow. It can be found here -

with more information available on the CAA website. Iím not sure about EASA but imagine that it will be similar.

Key points to note are that only specific SSRI meds are approved for ongoing use ď SSRI's: only CITALOPRAM, SERTRALINE or ESCITALOPRAM within normal BNF dose range are acceptable as maintenance therapy.Ē

You can only be made fit 1 month after resolution of symptoms; assuming the treatment plan is working then ongoing treatment (CBT/SSRI) is normally ok. Also, any change in dose will make you unfit again for 1 month.

So in reality you are looking at 2-3 months unfit as a minimum, depending how your treatment goes. To be assessed as fit, you will need reports from your GP or AME and also you will need to see a CAA psychiatrist for a final assessment. It is likely the CAA will also require 3 or 6 monthly visits to their psychiatrist during treatment.

Hope this helps. As I said it is UK specific and only a summary of similar cases. Every case is different so be guided by your AME.

The best thing you have done though is to recognise the issue and start to get treatment. It seems like a mountain to climb but you will get there. Good luck.
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Old 2nd Feb 2023, 18:08
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Today is Time to Talk Day
The only advice I can give is to keep talking. To friends, family, cab drivers, work mates, total strangers. Just keep talking. You're never alone.
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Old 2nd Feb 2023, 18:12
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Most likely your union has support programs available.
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Old 3rd Feb 2023, 20:46
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Have you tried to find what the root cause of your condition is? Airline flying in many cultures relies on a can-do attitude and having to deal with many crises to keep the operation going. At the same time the lifestyle of uncertainty over employment, irregular shift work, poor sleep and eating crap food at stupid times undermines the bodies natural mechanisms to cope and your own resilience ebbs away un-noticed by the self.This is without any personal pressures from home life interfering into the professional. Eventually this leads to a personal crisis or mental health problem. At least you have recognised in yourself that there is a problem but for most of us a temporary or long term break is going to add to the pressures in our life because of the financial consequences of not being employed. If you have a sympathetic employer they will give you time to make some changes and also allow changes to the terms of employment. Sometimes a break can help reset the situation and you can go back with a fresh outlook or you look again and decide that airline flying is not for you. I would certainly look at the causes before resorting to medication.Personally I found that after over a decade of trying to fire fight many major crises in all aspects of my life and worn down by decades of airline flying I had nothing left so I left the industry. Having now had over a year of great sleep and decent nutrition I am glad I left.
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Old 3rd Feb 2023, 22:43
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I think Tubby's words have great value. I you do end up losing your medical and job, its not going to help your state of mind either, unless its the job that is the problem! You recognise your condition so hopefully can identify the area in your life that needs attention. Call in favours, take all the help that's out there and speak to management if they can change things to help. There will be a time when you can repay favours, we all need a hand at some time in life. I loved my time in the airlines but it is demanding. Sad to say, but I dont feel much better in retirement, the main benefit has been ditching long road commutes. Hope things improve.
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Old 4th Feb 2023, 09:28
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SSRIs have recently been found not to work - the mechanism they were thought to act on and "cure" has been misunderstood. SSRIs actually work through the placebo effect.

This suggests that you can do a lot to cure yourself, without drugs. The brain is the most complex system in the universe, and nobody truly understands how it all works. Selectively meddling with one of the many chemicals in the brain without 100% understanding how the brain works is very questionable.

The placebo effect is very real, it works and has been proven in many double blind tests.

I would suggest that your airline lifestyle probably is the cause of your problems. My first marriage did not survive it and I once went to my GP with a mild question about why I almost failed a recurrent Sim, which was very out of character. I was very surprised when he told me I was stressed and he signed me off work for 2 weeks there and then, with a review after that. I didn't feel remotely stressed at all, but I actually was very stresssed.

Physical exercise is very good for stress busting. I just go jogging through the woods, along the river, even along the pavements in my neighbourhood. No gyms, no booking, no problem. Whenever I want to exercise I just put on my runners and go for a run. It clears the mind, it takes away your stress. It is easy and cheap and can be done anytime, anywhere. I do 5-10kms a week, which is easy. I don't use any Apps by the way; don't set yourself targets or anything, just jog at your own speed and enjoy the surroundings.

I would not get into the trap of the drug treatment treadmill. Most drugs try to treat the symptoms, not the cause. You are probably highly stressed, with an airline job and bringing up a family. You simply need to remove the causes of the stress and do physical exercise to bust any stress that is left.

If that means going part time or moving to another airline or even leaving your job, I would do so - your health is far more important.

Good luck, you will get through it.
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Old 5th Feb 2023, 07:14
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My source from Science Daily online:

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Old 5th Feb 2023, 10:45
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That is interesting.
To the OP, well done for admitting something's not quite right. As others have said, find some work support and your doc might be able to assist in finding a psychologist. Do you have a CISM contact?
Depending on how severe your mental health is, you may be able to manage it without medication. Appropriate talk therapies and exercise have been found to be more beneficial in many cases.
Reasons? You're not being numbed by the medication (depending), you retake control by engaging in something that is good for you. Rhythmic non competitive cardio (cycling, swimming, walking etc) plus a resistance workout has had many positive outcomes.
Your health and future happiness is priority now, your career might have to wait a bit.
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Old 14th Feb 2023, 20:04
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I know it is a not what you want to hear probably , but the most important thing here is definitely your health.
Canadian Pharmacy Online website has a lot information about possible treatments and they also have a great customer services which works 24/7
The career comes after that. Wish you all the best.

Last edited by liamricci; 26th Feb 2023 at 19:26.
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