Post-Traumatic Stree Disorder

I saw my share of Post-Traumatic Stress Disorder (PTSD)

serving in the Navy Medical Corps. Unfortunately, it’s seen

not only in those who have served but also in civilian life.

Our society can be violent. Bad things happen to good

people. The psychological consequences of these incidents

can linger for years. The National Institute of Mental

Health states,

“About one half of all U.S. adults will experience at least one

traumatic event in their lives, but most do not develop PTSD.

People who experience PTSD may have persistent, frightening

thoughts and memories of the event(s), experience sleep

problems, feel detached or numb, or may be easily startled.

In severe forms, PTSD can significantly impair a person’s

ability to function at work, at home, and socially.”

Almost 4% of the population develops PTSD per annum.

Overall a bit less than 7% of folks have active PTSD. The FAA

recognizes this and has developed certification guidelines.

These help Aviation Medical Examiners (AMEs) and pilots

deal with these issues during a flight physical. If you have

or have had PTSD there will be a number of things with

which the AME will be concerned. She’ll want to know what

triggers elicit a PTSD episode. Triggers can be varied. Smells

or loud noises sometimes can do this. Of especial importance

is the likelihood of the triggers being encountered

when flying. If there is any concern about an episode being

set off in the cockpit, you will be deferred for further evaluation.

On the other side of the coin, the FAA has recently

released a “Post-Traumatic Stress Disorder (PTSD) Decision

Tool for the AME” which allows us to issue a medical certificate

if seven criteria are met. Specifically, to issue without

further psychiatric screening we have to answer “no” to

the following:

1. Are there any other mental health problems such as

depression, anxiety, ADHD or substance use/abuse?

2. Has the airman ever had suicidal or homicidal thoughts

or attempts?

3. Have there been any symptoms of PTSD within the past

two years?

4. Has the airman required medications or psychotherapy

for PTSD within the past two years?

5. Has the airman had trouble functioning in his job due

to PTSD (aviation related or not)?

6. Is there anything in the airman’s history that would

make one wonder if the PTSD is in full remission?

7. Are there ANY concerns regarding this airman or is the

AME unable to obtain a complete history?

If the answer to all of these questions is “no,” your AME can

issue a medical certificate on the spot. If not, you will have

to be deferred. What this means is you‘ll get a letter from

the Civil Aeromedical Institute (CAMI), the FAA’s medical

branch, asking you to obtain some additional studies.

Among other things, they will ask you to provide a personal

statement discussing the incident(s) which lead to the

development of PTSD, the triggers, the impact it has had on

your life, the modifications you have had to make to your

living and working to lessen its impact, and the medications

and counseling you have received for the problem. They will

want a report from your treating psychiatrist or psychologist

as well as a list of current medications. If you’ve had

any PTSD screening tests or other psychological testing

they’ll want copies of that as well as any previous hospital/

clinical records, VA included.

This may seem like a lot, but stick with it! If your symptoms

are well controlled and the psychologists at the FAA feel that

you can safely conduct flight operations, you’ll get your

medical certificate.

Fly wisely. See you next month!