Depression and anxiety case-based scenario

James, a 35-year-old businessman, always promised himself that one day he would get his pilot's licence. James' father was a pilot in the Air Force and used to take James flying as a child.

James hadn’t found time to pursue his dream until recently. But he feared his history of mental illness might disqualify him from receiving a medical certificate.

After a messy divorce, James had began a spiral into depression.

Losing control

In part due to James’s long work hours and his lack of interest in home matters, James’ wife demanded a divorce. This came as a shock to James who began to have trouble sleeping. His general practitioner (GP) prescribed sleeping tablets, but they didn’t work. James eventually stopped seeing his family and friends.

Things came to a head one morning when James tested over the legal limit at a roadside breath test. The incident resulted in a suspension of James’ driving licence.

Seeking help

James’ GP diagnosed him with major depression. The GP recommended treatment with an antidepressant and referred James to a psychiatrist.

'I was reluctant to take medication at first,' James said. ‘Within a couple of months, I started to feel much better and could concentrate more at work. It surprised me how effective the antidepressant proved to be.’

In the 5 years after his divorce, James tried several times to wean himself off the medication under the supervision of his GP. Each time, James found his symptoms would return.

Cleared for flying

By the time James went for his pilot's licence, things were going well. The balance between his work and personal life had improved. He was also pursuing a range of recreational activities.

James met with his Designated Aviation Medical Examiner (DAME) for an assessment. ‘I was nervous when I met with the DAME for my first medical assessment,' James said. 'I didn't know how the doctor would react to my history of depression. I was afraid it would prevent me from getting my licence.'

The DAME questioned James in detail about his medical history and mental illness. The DAME explained that a diagnosis with depression would not necessarily disqualify James from flying.

Due to his history of driving under the influence, Aviation Medicine (AvMed) needed more supporting information before considering James’ application. This included:

  • reports from his treating GP and psychiatrist
  • a copy of his national police certificate
  • a blood test.

Once received, AvMed approved James’ application and he received a class 2 medical certificate. The approval came with conditions including that each year, James must:

  • provide a report from his treating doctor on the progress of his depression
  • ground himself and present to his DAME for review if his condition or treatment changes.
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