Pilot mental health
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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 it’s now affecting my personal life (not my professional). I’ve 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
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 it’s now affecting my personal life (not my professional). I’ve 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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Hi. I’m 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 -
https://www.caa.co.uk/media/00lbz5lx...flow-chart.pdf
with more information available on the CAA website. I’m 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 “ SSRI's: only CITALOPRAM, SERTRALINE or ESCITALOPRAM within normal BNF dose range are acceptable as maintenance therapy.”
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.
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 -
https://www.caa.co.uk/media/00lbz5lx...flow-chart.pdf
with more information available on the CAA website. I’m 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 “ SSRI's: only CITALOPRAM, SERTRALINE or ESCITALOPRAM within normal BNF dose range are acceptable as maintenance therapy.”
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.
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.
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.
Most likely your union has support programs available.
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.
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.
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.
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.
My source from Science Daily online:
PPRuNe Handmaiden
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.
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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Im going though a similar case
Before I write about my case , have you considered checking your Testosterone levels . I understand males don't have the tendency to check hormones ,but this thing is connected to so many mental health issues that you cant imagine?
I have been working as an expat FO for 4 years in A320 . Before that I was cabin crew for 8 years . Overall I am exposed to commercial aviation for about 16 years . I thrived in both professions and loved the job .
When everything seemed to go amazing with my life with a great future career , out of no where in beginning of 2023 I had a panic attack and this happened in flight .It was a very scary experience but I managed to hold up myself and not let the captain notice during the flight . I felt like I was gasping for air , trapped with no where to escape and like I was going to die . Tried to distract myself by drinking water and trying to open a topic to discus with captain. Meanwhile I was thinking to myself where is the nearest airport we can divert in case something happens to me. ...
This happened 3 weeks after I recovered from a second infection of Covid19....
As the days went by I started to get worried and more worried that it might happen again in flight and how I was going to handle with it . Started thinking that this will affect my work and I am going to lose my job because of this . I didn't seek help immediately because I thought this is just temporary and it will pass .
(Therefore I advice any colleagues please if you experience any mental health issue go seek for help immediately and don't delay , the more you delay the more damage it will do. However try to do it discretely and don't make the same mistake like I did ,to report the problem to your airline )
As the days went by , I started to develop fear of irrational fears to the point that by April I started to report sick to avoid flying . This thing was turning into a Phobia .
During this time I got a letter from the company that I was going to another fleet in A350 . If this transfer would have come one year ago , I was so ready and motivated to move to long and ultra long haul flying . But this time I had to accept the transfer with fear and worries on how will I deal with long haul flights , over the Atlantic or polar routes . I had no choice but to accept the transfer and sing a bond which placed on me more burden since I already have a loan and other financial responsibilities ...
Before May I reported sick for a lot of flights , I was only operating the short haul ones which gave me a sense of security and safety cuz you are busy in all the stages of flight and no time for irrational thoughts .
In may I went for the Type rating in A350 . Things were so bad that I couldn't focus on studies. Lost my motivation , my drive . Started feeling hopeless and started experiencing a bad insomnia . My mental health was deteriorating but i was pushing myself to complete the training . In the sim session I was performing up to standards but all the SOP I was referring to was from the A320 . Flows are quite similar ,with a difference to certain system and procedures ( A350 is a wonderful machine )
After completing LOFT and ZFTT was time to Line Flights . Its there where I broke down and told the company that I don't see myself fit to fly because I am having problems with sleep . Indeed I was worried about the safety of the passengers and the operations.
During May I reached a psychologist online and we started some CBT . He also suggested to check my Testosterone . When I checked it came out extremely low .
First thing to do I went to the AME , I thought it was the right thing to do and I didn't disclose the panic attack and the Anxiety Disorder I was going through as I am worried of loosing everything . I simply stated that I have trouble sleeping and I cant focus . He placed me on sick for the whole month of July and in 4 days time he arranged a visit with a Psychologist . They both didn't consider at all the testosterone levels and they diagnosed me with depression ( for which personally I don't think I have ) .
I'm still on sick for the whole month of August and I don't have anymore clue what is happening since every time I try to contact the AME and book for appointment for follow up , they say he is on leave and he is busy. I don't get payed anymore and still have a loan , rent and bills to pay , which is putting a lot of more stress anymore . I think I opened another cans of worms and I see no way out for now ...
Therefore I don't know how you are feeling now , but don't disclose your mental health to the Airline . I don't think Airlines have a proper plan to deal with mental health amongst pilots , maybe in EU and US they do , I am an expat is some other part of the world.
Of course Airlines are a business and they don't want you to be a liability but mental health can happen to anyone , we are people also....Please let me know how are you doing now . and yes talking to people helps , especially to colleagues having the same profession.
Wish you all the best .
I have been working as an expat FO for 4 years in A320 . Before that I was cabin crew for 8 years . Overall I am exposed to commercial aviation for about 16 years . I thrived in both professions and loved the job .
When everything seemed to go amazing with my life with a great future career , out of no where in beginning of 2023 I had a panic attack and this happened in flight .It was a very scary experience but I managed to hold up myself and not let the captain notice during the flight . I felt like I was gasping for air , trapped with no where to escape and like I was going to die . Tried to distract myself by drinking water and trying to open a topic to discus with captain. Meanwhile I was thinking to myself where is the nearest airport we can divert in case something happens to me. ...
This happened 3 weeks after I recovered from a second infection of Covid19....
As the days went by I started to get worried and more worried that it might happen again in flight and how I was going to handle with it . Started thinking that this will affect my work and I am going to lose my job because of this . I didn't seek help immediately because I thought this is just temporary and it will pass .
(Therefore I advice any colleagues please if you experience any mental health issue go seek for help immediately and don't delay , the more you delay the more damage it will do. However try to do it discretely and don't make the same mistake like I did ,to report the problem to your airline )
As the days went by , I started to develop fear of irrational fears to the point that by April I started to report sick to avoid flying . This thing was turning into a Phobia .
During this time I got a letter from the company that I was going to another fleet in A350 . If this transfer would have come one year ago , I was so ready and motivated to move to long and ultra long haul flying . But this time I had to accept the transfer with fear and worries on how will I deal with long haul flights , over the Atlantic or polar routes . I had no choice but to accept the transfer and sing a bond which placed on me more burden since I already have a loan and other financial responsibilities ...
Before May I reported sick for a lot of flights , I was only operating the short haul ones which gave me a sense of security and safety cuz you are busy in all the stages of flight and no time for irrational thoughts .
In may I went for the Type rating in A350 . Things were so bad that I couldn't focus on studies. Lost my motivation , my drive . Started feeling hopeless and started experiencing a bad insomnia . My mental health was deteriorating but i was pushing myself to complete the training . In the sim session I was performing up to standards but all the SOP I was referring to was from the A320 . Flows are quite similar ,with a difference to certain system and procedures ( A350 is a wonderful machine )
After completing LOFT and ZFTT was time to Line Flights . Its there where I broke down and told the company that I don't see myself fit to fly because I am having problems with sleep . Indeed I was worried about the safety of the passengers and the operations.
During May I reached a psychologist online and we started some CBT . He also suggested to check my Testosterone . When I checked it came out extremely low .
First thing to do I went to the AME , I thought it was the right thing to do and I didn't disclose the panic attack and the Anxiety Disorder I was going through as I am worried of loosing everything . I simply stated that I have trouble sleeping and I cant focus . He placed me on sick for the whole month of July and in 4 days time he arranged a visit with a Psychologist . They both didn't consider at all the testosterone levels and they diagnosed me with depression ( for which personally I don't think I have ) .
I'm still on sick for the whole month of August and I don't have anymore clue what is happening since every time I try to contact the AME and book for appointment for follow up , they say he is on leave and he is busy. I don't get payed anymore and still have a loan , rent and bills to pay , which is putting a lot of more stress anymore . I think I opened another cans of worms and I see no way out for now ...
Therefore I don't know how you are feeling now , but don't disclose your mental health to the Airline . I don't think Airlines have a proper plan to deal with mental health amongst pilots , maybe in EU and US they do , I am an expat is some other part of the world.
Of course Airlines are a business and they don't want you to be a liability but mental health can happen to anyone , we are people also....Please let me know how are you doing now . and yes talking to people helps , especially to colleagues having the same profession.
Wish you all the best .
You have my sympathy. Doctors often try to treat the symptoms when they should be treating the cause, although signing you off work is removing one cause.
Low testosterone is interesting. Physical exercise should boost or at least maintain testosterone, I would have thought? Men are "designed" to fight and be very physical, e.g. to run for miles in pursuit of prey, and I strongly suspect that maintaining physicality through suitable exercise must therefore have important health benefits.
Being in good physical condition also means your body "knows" that it could fight if need be, so your panic attacks should disappear, since your brain will know that if it came to it, you could fight and defend yourself.
To get strong and fit, you don't have to sign up to a gym and start lifting weights. Just do 30 press-ups and 50 sit-ups every morning, and go for a gentle 10km jog once a week, or a 5 km jog twice a week. Cut out all sugar, almost all salt, and eat healthily.
Good luck
Low testosterone is interesting. Physical exercise should boost or at least maintain testosterone, I would have thought? Men are "designed" to fight and be very physical, e.g. to run for miles in pursuit of prey, and I strongly suspect that maintaining physicality through suitable exercise must therefore have important health benefits.
Being in good physical condition also means your body "knows" that it could fight if need be, so your panic attacks should disappear, since your brain will know that if it came to it, you could fight and defend yourself.
To get strong and fit, you don't have to sign up to a gym and start lifting weights. Just do 30 press-ups and 50 sit-ups every morning, and go for a gentle 10km jog once a week, or a 5 km jog twice a week. Cut out all sugar, almost all salt, and eat healthily.
Good luck
Last edited by Uplinker; 21st Aug 2023 at 10:10. Reason: Typo
