Airline Pilots with Anxiety: FAA Medical Certification Guide

The FAA does not categorically disqualify anxiety disorders. Certification depends on stability, control, and functional capacity.

Requirements

• Condition well-controlled on stable regimen ≥6 months (usually).
• No aeromedically significant side effects (sedation, cognitive impairment, orthostasis).
• No history of psychosis, bipolar disorder, suicide attempt, or substance dependence.
• Psychiatric evaluation by FAA-trained HIMS psychiatrist often required.
• Medications: Only certain SSRIs (fluoxetine, sertraline, citalopram, escitalopram) allowed with special issuance; benzodiazepines generally disqualifying.

Process

1. Report condition on MedXPress (Form 8500-8).
2. AME defers to FAA Aerospace Medical Certification Division.
3. Submit records, psychiatrist report, status report.
4. FAA grants Special Issuance (Authorization) with follow-up requirements.

Self-Management for Pilots

• Strict medication adherence; no dose changes without flight surgeon.
• CBT, stress management, sleep hygiene.
• Monitor for breakthrough symptoms; self-ground if impaired.
• Annual/renewal evaluations per SI conditions.

Many pilots fly safely with treated anxiety. Transparency and compliance are essential.