Many people have times when they feel sad or have low mood. When these problems become more persistent or impact a person’s everyday life, they might be diagnosed with depression.
CASA recognises that mental health conditions like depression vary in severity and impact. For aviation medical certification, CASA takes a case-by-case approach. We consider the type of depression, how well it’s managed, and whether the symptoms or treatment affect aviation safety.
You are not automatically disqualified from flying if you are living with depression. CASA and your designated aviation medical examiner (DAME) will consider your individual circumstances to help you stay safely involved in aviation.
The statistics
The Australian Bureau of Statistics has reported that more than 4 million Australians experience a mental health problem. Around 1 million of those people have a diagnosis of depression. One in every 6 people will experience depression in their lifetime.
About depression
Everyone’s experience of mental illness is unique to them. However, people who are diagnosed with depression usually have symptoms such as:
- loss of interest in their usual activities
- feeling down or sad
- trouble concentrating or thinking clearly
- having trouble doing their usual activities at work or at home
- feeling guilty
- feel irritable or frustrated.
Physical changes like low energy, tiredness, change in appetite and poor sleep are also common.
It’s important to know that these symptoms don’t always mean a person will be diagnosed with a mental illness or depression. In many cases the symptoms are relatively mild, and the person can recover with the help of counselling or informal support, without any diagnosis or medical treatment.
There is not always an obvious cause for someone to develop depression, but common causes of reduced mental wellbeing include relationship issues, financial problems or employment difficulties.
Aviation professionals often face unique challenges that can affect wellbeing. This can include time-zone changes, demanding workloads, and time away from loved ones. These factors can disrupt sleep, increase stress, and strain relationships.
Effects of depression on operators
Good mental wellbeing is essential for pilots and air traffic controllers. It helps to support clear thinking, effective communication, and sound decision-making. This is vital for aviation safety. Challenges to sleep and nutrition can affect performance, especially in high-pressure environments. That’s why early awareness, proactive support, and healthy lifestyle choices are so important.
Effects of treatment on operators
Most people with mild to moderate symptoms return to a healthy mental state once treated through a combination of lifestyle and behavioural changes, psychological therapy and/or medication. According to the Australian Institute of Health and Welfare, only about a third of people need medication as part of their treatment.
Most medications for depression have minor or temporary side effects. However, in some cases, side effects can be more significant, ongoing and safety relevant. This is especially the case when people start, stop or change medication.
To support safe aviation practices, CASA:
- approves medications with well-established safety profiles
- asks licence holders to self-ground and consult their DAME if they need to change their medications.
Approach to medical certification
Every case of depression is different. This is general guidance only.
Mild to moderate depression
You can continue to fly or control aircraft if you have well-managed mild to moderate depression and have been cleared by CASA or an authorised DAME.
In general, we may approve medical certification for mild to moderate depression if:
- your condition is stable with no current symptoms
- there are no safety-relevant side effects from your treatment
- you are under appropriate medical care
You are considered to have mild to moderate depression, for aeromedical purposes, when:
- don’t have any severe or high-risk symptoms (see below)
- are being treated with only one of the following medications:
- fluoxetine
- sertraline
- citalopram
- escitalopram
- venlafaxine (low-dose only)
- desvenlafaxine
- are responding well to treatment.
Your medical certificate will generally be suspended while you start treatment and work towards recovery. Once you are stabilised and symptoms have resolved, CASA or an authorised DAME can clear you to return to flying or controlling.
In some cases the medical certificate may have conditions relating to your aviation duties and operations, or may require extra reporting from your health care providers.
Severe or high-risk depression and other high-risk diagnoses
Some individuals experience more complex or severe forms of depression and mental illness, which may include:
- requiring treatment in hospital
- recent or ongoing thoughts or behaviours related to self-harm or suicide
- substance use
- using multiple medications to manage your symptoms
- diagnosis of bipolar disorder or schizophrenia
- presence of psychotic features.
These situations require careful management to ensure both personal wellbeing and aviation safety. In these situations, CASA takes a cautious and personalised approach to medical certification. This is because these conditions often carry a higher and less predictable risk of recurrence or impairment. In many cases individuals are may not be able to meet aviation medical certification standards due to the potential impact on aviation safety.
Seeking help
Your DAME or treating doctor can give advice and treatment options.
Peer support programs are also available across the aviation industry. These connect you with trained peers who understand the pressures of flying and aviation work.
Many employers, including airlines, also provide employee assistance programs. These offer free, confidential counselling for a wide range of personal and work issues.
If left untreated, mental health problems can affect aviation safety. Like physical illness, treatment may require time away from aviation duties. Most pilots and air traffic controllers with treated depression can return to their roles.
Seeking help protects safety. It also helps you feel and perform at your best.