FAA Fast Track for Anxiety and Depression: How to Avoid a Deferral

Introduction

In the past, a history of anxiety or depression almost always meant a long FAA review and a deferral at the first medical exam. That has started to change. The FAA now offers a Fast Track pathway for certain cases of anxiety, depression, and related conditions. If you meet the criteria and prepare correctly, your Aviation Medical Examiner (AME) may be able to issue your medical certificate at the appointment instead of sending it to Oklahoma City for review. Applicants with ADHD follow a different process called the ADHD Fast Track.

Who qualifies

The Fast Track pathway applies to specific diagnoses such as generalized anxiety disorder, situational anxiety or adjustment disorder with anxiety, social anxiety disorder, postpartum depression, situational depression, adjustment disorder with mixed anxiety and depressed mood, uncomplicated bereavement, relationship distress, parent-child problems, and other normal life transition stresses. The condition must be limited in severity, stable, and uncomplicated.

You can see the FAA’s own Anxiety and Depression Fast Track Pathway form here (PDF). This is the exact checklist your AME uses.

Medications and treatment

You may qualify if you are currently stable on a single approved antidepressant or if you used one in the past and have been off it for at least two years. The FAA’s accepted list includes:

• SSRIs: citalopram, escitalopram, fluoxetine, sertraline

• SNRIs: desvenlafaxine, duloxetine, venlafaxine

• NDRIs: bupropion (sustained or extended release)

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You will not qualify if you needed multiple antidepressants at once, or if you have ever required treatment with antipsychotics, benzodiazepines, lithium, or other mood stabilizers.

Disqualifying history

The AME cannot issue a certificate under Fast Track if you have a history of major depressive disorder, dysthymia, seasonal affective disorder, bipolar disorder, psychosis, autism spectrum disorder, substance misuse, or eating disorders. A history of psychiatric hospitalization, suicidal behavior, involuntary evaluations, or treatments such as ECT, TMS, ketamine, or psychedelics also excludes you.

If you fall into one of these categories, the FAA will likely defer your case. The FAA may then send you a letter requiring additional documentation or a full neuropsychological evaluation with a HIMS neuropsychologist or a psychologist who specializes in aviation evaluations. That is a much more extensive process than Fast Track.

What the AME looks for

The AME uses a structured decision tool. For you to qualify, every answer must be “no.” If even one answer is “yes,” the AME must defer your application.

You can review the FAA’s official Anxiety/Depression Decision Tool (PDF), which outlines exactly what AMEs check. For situational depression, there is a separate Situational Depression Decision Tool (PDF).

It is important not to minimize your history or try to game the system. AMEs are trained to recognize incomplete or inconsistent stories. A deferral caused by hiding information is almost always worse than being transparent from the beginning.

Documentation to prepare

You will need to bring thorough records to your AME visit, including:

• A treatment summary from your clinician that lists diagnosis, treatment dates, and your current status.

• A medication history with names, doses, start and stop dates, and your response.

• Therapy records or discharge notes, if available.

• Any hospital or urgent care records related to your condition.

• A personal statement explaining your experience and current stability.

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Arriving without complete documentation is one of the most common reasons Fast Track applicants get deferred.

Situational depression

If your diagnosis was situational depression that resolved within six months of the stressor and has not recurred, you may qualify. If it lasted longer than six months, required extended treatment, or recurred, the AME must defer.

You can see the FAA’s Situational Depression guidance here (PDF).

Takeaway

The FAA’s Fast Track for anxiety and depression is not about seeing a psychologist or completing neuropsychological testing. It is an option your AME can use if you meet the FAA’s specific criteria and provide complete documentation. Preparation and honesty are the key factors. If you qualify, the AME may be able to issue your certificate immediately, saving you months of delay.

If you do not qualify, expect the FAA to defer your case. In that situation, you may receive a letter requiring a full neuropsychological evaluation by a HIMS neuropsychologist or another specialist with aviation experience. That process is much more detailed and can take months to complete.