For many, it’s financial issues that just never seem to go away, individual and family health challenges, dealing with the lunacy of bureaucracy and a sense of power from our homeowner’s association president and/or board, the quality of our municipal drinking water, or the fear of shark attacks while ocean swimming.
All completely reasonable concerns. Stress is life and life is stress. We have heard from members over the years who are dealing with the FAA on a mental health issue who assert that flying is what “grounds them” (not in the literal sense!) and helps them think through the circumstances and issues that contribute to their angst and sense of “unwell being.” I’m not saying that’s a good or bad thing, but we all have our built-in coping mechanisms developed over time and experience that hopefully allow us to level the playing field and respond with timely and appropriate actions or thoughts to get us through the crisis.
Post-traumatic stress disorder (PTSD) with its current clinical definition and identity came about in 1980 when the American Psychiatric Association added PTSD to the Diagnostic and Statistical Manual (DSM) third edition. Matthew J. Friedman, MD, PhD with the U.S. Department of Veterans Affairs wrote a thorough history and overview of PTSD geared toward military service members who were historically considered the most likely victims of combat-related psychiatric pathology. The disorder now is considered a “mainstream societal disorder,” for good reason, along with other psychiatric diagnoses such as depression and generalized anxiety disorder (GAD).
Not surprisingly, the FAA takes a cautious but open-minded regulatory approach to any behavioral health pathology that shows up on an airman’s medical application. A detailed, comprehensive medical history and psychiatric evaluation is part of the investigation that’s necessary for the issuance of any class medical. However, PTSD isn’t necessarily limited to the person directly affected by the incident.
Consider a quite recent incident at Denver International Airport (DIA) on May 8, 2026, involving a departing Frontier Airlines Airbus that struck a person who trespassed onto the runway. With 224 passengers, the flight crew, the cabin crew, the DIA tower controllers, the EMS responders, and anyone else who might have seen or heard the aftermath of that incident, PTSD to some degree may become an issue. Equally sad are the unknown circumstances that led that person to end his life in so drastic a way.
The obvious concerns from an FAA point of view include the possibilities of impaired concentration, quality and quantity of sleep, panic dissociation (flashbacks of the event that can recur often and indefinitely), associated depression, substance misuse to “dull the pain,” side effects from medication treatment, or even suicidal ideation, all of which are very real complications. Impaired pilot performance is not uncommon, despite our best coping mechanisms, and sometimes our brains just don’t respond to the compensatory strategies, and overall performance will likely be evident to others even if the pilot doesn’t notice the issues. FAA-required evaluations could take months to complete, and the pilot will likely be grounded, further compromising “well-being,” especially if you’re a working pilot whose primary or sole income is derived from flying. The good news is the FAA aeromedical docs work really hard to find a way to “yes.” It just takes time and patience.
Good health really is our most prized treasure!
