Healthy Pilot #11 – Mental Disorders

Item 18M on the BasicMed checklist has to do with depression, anxiety and other mental disorders. And were not just talking about stress and emotion in the IMSAFE mnemonic most pilots are already familiar with.


It’s only within the last 20 years that scientists have identified depression as the precursor to a host of physical ailments—from heart disease to sensitive gut. Whether depression is the cause or depression is the consequence, there is no doubt that feeling low impacts health in negative ways.

For BasicMed, the FAA bundles depression, anxiety, stress and other “mental disorders” into one silo. The philosophy behind BasicMed is honest assessment, and if you and your primary care physician suspect your mood is more than just the standard “bummer,” you might need additional help. Our friends at University Health News have a great checklist, below.


The FAA will get involved if your depression is serious enough to require medication. In fact, an FAA decision to grant a special issuance that allows you to fly is required in most instances of a diagnosed mental disorder if you and your physician decide you require drugs to stabilize your condition.

Take heart. There are instances where a mental condition might be met with a favorable FAA outcome: Taking anti-psychotic meds for a limited period for smoking cessation, for example, or for short-term depression caused by bereavement. In instances such as these, medications must not have been prescribed for more than six months, and need to have been discontinued for at least three months.

FAA Senior AME Glen R. Stoutt Jr., MD has an excellent treatise on the subject of depression here.

In addition, according to the FAA circular on anti-depressants, an individual may be considered for an FAA Authorization of a Special Issuance (SI) or Special Consideration (SC) if the applicant has one of the following diagnoses:

  • Major depressive disorder (mild to moderate) either single episode or recurrent episode
  • Dysthymic disorder
  • Adjustment disorder with depressed mood
  • Any non-depression related condition for which the SSRI is used

For a minimum of 6 continuous months prior, the applicant has been clinically stable as well as on a stable dose of medication without any aeromedically significant side effects and/or an increase in symptoms. If the applicant has been on the medication under 6 months, the Examiner must advise that 6 months of continuous use is required before SI/SC.

The SSRI used is one the following (single use only):

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)

If the applicant is on a SSRI that is not listed above, the Examiner must advise that the medication is not acceptable for SI/SC and the applicant DOES NOT have symptoms or history of:

  • Psychosis
  • Suicidal ideation
  • Electro convulsive therapy
  • Treatment with multiple SSRIs concurrently
  • Multi-agent drug protocol use (prior use of other psychiatric drugs in conjunction with SSRIs.)

Diagnosis and Treatment

If you think you or a loved one might be slipping into depression, stress, or anxiety. UHN offers an exceptional downloadable free guide on the subject, Am I Depressed?

If you think you (or a loved one) might be experiencing a mental breakdown, you can also consult the symptom list found here.

You can find out about the different types of the disorder by consulting this UHN post. If you think stress, panic attacks or general anxiety might be an issue, these posts offer helpful general guides.

If you are concerned about taking drugs for stress or anxiety, there are natural depression relievers to consider.