Why airline pilots hide mental-health struggles despite stress at work

Despite growing stress and burnout, many pilots avoid reporting mental-health concerns due to lengthy medical reviews and career repercussions

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Commercial airline pilots around the world are increasingly concealing mental-health challenges, even treatable ones such as depression or anxiety, for fear of jeopardising their careers, according to a recent report by Reuters. The consequences can be tragic, and the reluctance to seek help raises serious concerns for both individual well-being and aviation safety.

 

The human cost behind pilots’ struggles

 

The growing scrutiny over pilot mental health is highlighted by cases that reveal how stigma and regulatory hurdles can keep aviators from seeking timely care.

 

Brian Wittke, a 41-year-old Delta Air Lines pilot and father of three, struggled with depression during the Covid-era downturn. Fearful that reporting his symptoms might jeopardise his flying career, he avoided formal treatment. His death by suicide in 2022 prompted calls for clearer, safer pathways for pilots to seek help.

 

“Real people have real problems,” his mother Annie Vargas told Reuters. “And they shouldn’t be penalised for dealing with it,” she said, as cited in the Reuters report.

 

Commercial airline pilot Elizabeth Carll, 36, offers another window into why change feels urgent. After disclosing a low-dose anti-anxiety medication during training in 2021, she was grounded, waited months for specialist clearance, and then faced over a year of regulatory review, only for authorities to demand updated assessments.

 

“The joke is you just ignore it,” she told Reuters, “because people are afraid their livelihoods will be taken away.”

 

A day after the Air India Boeing 787-8 tragedy in Ahmedabad this year, the captain of an Air India Delhi–Frankfurt service suffered a panic attack while lining up the same aircraft type for departure. He informed air traffic control that a crew member was unwell and taxied back to the gate.

 

Days later, a young First Officer scheduled to fly another Boeing 787 reported sick, saying he had barely slept as his mind kept replaying what the cockpit may have looked like in the moments before the country’s worst air disaster in three decades. “I was spiralling,” he told The Hindu.

 

Why pilots are reluctant to open up

 

In most professions, people can seek medical or psychological care without alerting employers or regulators. Aviation is different.

 

In the US, pilots must meet strict physical and psychological standards to maintain their medical certification from the Federal Aviation Administration (FAA), with some required to undergo exams every six months. Reporting anxiety, depression or the use of certain medications can result in being grounded. While mild conditions may be cleared quickly, more serious cases undergo an extensive FAA review that can stretch for a year or longer.

 

The Directorate General of Civil Aviation (DGCA) in India, much like the FAA, requires both physical and psychological fitness checks for pilots and has recently stepped up its focus on mental health. In 2023, the regulator issued a circular on 'mental health promotion' for flight crew and air-traffic controllers, recommending regular mental-health assessments, peer-support programmes (PSPs) and pre-employment screening.

 

Yet, many pilots remain hesitant to come forward or enrol. “Signing up means being grounded without pay,” a pilot told The Indian Express.

 

Interviews with more than two dozen pilots across US and international airlines reveal a pervasive fear that seeking help could end their careers. Disclosing therapy, medication use or even minor symptoms often triggers a rigorous investigation, making the process lengthy, expensive and uncertain.

 

This fear is reflected in a 2023 study of more than 5,000 US and Canadian pilots, where over half said they avoided healthcare due to concerns about losing flying status, a pressure encapsulated in the community’s bleak maxim, “If you aren’t lying, you aren’t flying.”

 

The price pilots pay for speaking up

 

While some airlines offer confidential peer-support programmes and counselling, the barriers remain steep. Besides the stigma, the financial strain adds to the pressure, as pilots often exhaust their sick leave and are then placed on disability, which can sharply reduce their income.

 

Another pilot, Troy Merritt, said he spent nearly $11,000 out of pocket and remained grounded for 18 months before he was allowed to return to the cockpit. He believes pilots who respond well to treatment should not have to wait six months before reapplying for a medical certificate.

 

Reforming mental health policies in aviation

 

There is growing momentum among pilots, unions and safety advocates for reforms. Proposed changes include streamlining the process for pilots to return to duty after mental-health treatment, reducing the financial burden of medical reviews, and expanding confidentiality protections.

 

The European Union Aviation Safety Agency now requires airlines to run peer-support programmes for pilots and has tightened oversight of medical examiners, signalling a gradual shift toward more supportive mental-health frameworks.

 

In the US, the FAA has broadened the list of approved medications and signalled willingness to update its mental-health policies. Other regulators, such as Australia’s aviation authority, have adopted more flexible, case-by-case approaches.

 

In India, the DGCA’s newly revised Flight Duty Time Limitations (FDTL), which increase mandated rest hours, extend the definition of night duty and require annual fatigue-management training, also signal a shift towards more holistic pilot-wellbeing policies. Fatigue is closely intertwined with mood disorders, anxiety and impaired cognitive function. By strengthening rest norms and introducing structured fatigue-reporting systems, the DGCA is acknowledging that mental health and operational safety cannot be separated.

 

Yet many pilots say perceptions must shift too. In an industry where trust, composure and sharp judgement are the bedrock of safety, the mental-health of pilots cannot remain a taboo.