While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time. It can last weeks, months or even years and sometimes without any apparent reason.
Depression is more than just a low mood: it's a serious illness that has an impact on both physical and mental health.
Research suggests continuing difficulties are more likely to cause depression than recent life stresses. These difficulties could include:
- long-term unemployment
- living in an abusive or uncaring relationship
- long-term isolation or loneliness
- prolonged exposure to stress at work.
Recent stressful or traumatic events, such as losing a job, or a combination of events can trigger depression in people who are already at risk. This may be because of past bad experiences or other personal factors.
Depression affects how people feel about themselves. They may lose interest in work, hobbies and doing things they normally enjoy. They may lack energy, have difficulty sleeping or sleep more than usual. Some people feel irritable and some find it hard to concentrate. Depression makes life more difficult to manage from day to day.
On average, 1 in 6 people (1 in 5 women and 1 in 8 men) will experience depression at some stage of their lives. There are different types of depression. Symptoms can range from minor but still disabling through to severe.
The following guidance is relevant for applicants treated for:
- a major depressive disorder
- adjustment disorder with depressed mood
- or dysthymia (a mild but chronic form of depression).
Effects of flying on depression
Some conditions associated with aviation can exacerbate the symptoms of people suffering from, or with a history of, depression or anxiety. These include:
- fatigue
- sleep deprivation
- time zone changes
- stressful events
- social isolation
- irregular access to medical care and surveillance
- remote locations.
Effects of depression on operators
Depressive episodes during a flight can lead to either overt or subtle incapacitation. They include:
Overt incapacitation
- Suicidality
- Psychosis of major depression
- Development of other chronic diseases or conditions like anxiety and substance use
Subtle incapacitation
- Reduced concentration and memory
- Impaired cognition
Effects of treatment on operators
Some medications used to treat depression and anxiety can impair aviation by causing:
- Impaired cognition
- Sedation
- Nausea
- Disequilibrium (lack of balance)
- Impaired sleep
Approach to medical certification
Depression is one of the leading causes of disability worldwide. Well-managed depression is compatible with medical certification.
If you relapse in depressive symptoms, you must report them to the Designated Aviation Medical Examiner (DAME).
You must tell your DAME about any changes to your medication and will require grounding for 2 to 4 weeks. This includes starting, stopping or changing drugs or doses. We may require additional information from family, treating doctors and flying colleagues.
In cases we assess you as 'low risk', we may accept reports from your treating doctor (GP or DAME) or your psychologist in lieu of a psychiatrist report.
More likely to gain certification
You are more likely to gain certification if:
- your doctor has confirmed a diagnosis of unipolar depression and excluded other conditions
- you are taking only one medication
- you are being treated with one of the following:
- fluoxetine
- sertraline
- citalopram
- escitalopram
- venlafaxine (low-dose only)
- desvenlafaxine.
Less likely to gain certification
You are less likely to gain certification if you:
- have alternative diagnoses including BPAD, schizophrenia, psychotic disorders
- are receiving therapy involving a multiple drug regime
- are taking lithium, anti-psychotics, agomelatine, quetiapine, tricyclic antidepressants or monoamine oxidase inhibitors.
You are unique
Every case of depression is different. We make aeromedical decisions on a case-by-case basis. We make aeromedical decisions on a case-by-case basis. We base a particular assessment decision on the individual circumstances of the applicant under consideration.
Further information
For further information see Beyond Blue.