This post explores FAA policy guidelines on ADHD. Specifically, being a commercial pilot while having ADHD and taking medications to treat ADHD symptoms.
Originally published in 2012 and updated February 2022, it’s one of my most perennially popular posts. I try to keep it updated. So if you have new information, please share in a comment. At the end, I’ll share a January 2022 FAA Safety Briefing article.
This Post Covers Five Related Topics:
- The two common themes in e-mail questions I receive
- Basic FFA highlights on ADHD and piloting
- Current FFA Guidelines: Summary
- FAA Medical Examinations
- A link to a January 2022 article written by two FAA psychologists on ADHD policy
Two Themes of Common Questions
It’s common lore that folks with ADHD gravitate to flying planes. I’ve seen no scientific research. But I have fielded enough questions to suspect it! There are two common themes in these e-mails:
- Does the FAA prohibit pilots diagnosed with ADHD from taking medication?
- You’re kidding me? This is discriminatory.
Let’s consider an example of each theme.
1. Diagnosis Is Clear, Stimulants Forbidden?
This common question came from the spouse of a commercial airline pilot. Her husband has an ADHD diagnosis. From her report, symptoms manifest strongly at home. This is increasingly true with age. (He’s in his 40s.) She says he forgets tasks, loses track mid-task, and forgets conversations. His temper flares up a lot these days.
Perhaps most disturbingly to her, given poor sleep’s known negative impacts on cognition, his sleep was erratic and typically too short in length. She worries.
She asked, “Do FAA guidelines truly prohibit him from taking medication for it?” The answer is: Yes, truly.
2. Isn’t This Discriminatory?
Another common example comes from a young man, age 23. He was diagnosed two years ago. Becoming a pilot is his lifelong dream. He rails against this prohibition as absolutely unfair. Seeing the clear disappointment on his face is heartbreaking.
Yet, I also saw how impaired he was before beginning stimulant medication:
- Repeatedly asked the same questions of the support group
- Always arrived very late to the meeting and seemed bewildered about how to change that or if he could change that
- Reporting struggles with schoolwork and getting sufficient sleep
With medication, he became sharper and more alert. His working memory became much-improved. working memory. The difference truly was night and day. Did he realize how differently he appeared, compared to the somewhat stoned-looking presentation earlier?
If he stopped taking medication, would being in the cockpit somehow “stimulate” him into higher functioning? I’m unlikely to bet my life—or his—on it. The much-ballyhooed ADHD Hyperfocus? Not all it’s cracked up to be. Moreover, it’s certainly not reliable. In fact, hyperfocus is a clinical term. It means dysregulated focus.
Let’s remember: ADHD is a highly variable syndrome. Moreover, it affects individuals. Many also have ADHD-related sleep disorders that impair cognition all on their own. There are no cookie-cutter descriptions, answers, or strategies. So, if you think hyperfocus is your superpower, good for you. But please know, people with ADHD are not clones.
This young man received his diagnosis as an adult, after a thorough and professional evaluation. What about potential pilots whose diagnosis as children was more informal? It might be worth re-visiting.
Basic FAA Highlights on ADHD and Piloting
As best I can make out, this is the bottom line for potential pilots with ADHD:
- ADHD itself is not a disqualifying condition.
- The FAA acknowledges that sometimes that the ADHD diagnosis in the past was in error.
- If you have a formal diagnosis of ADD or ADHD, you may need to undergo additional testing in order to receive a medical certificate.
- Most medications used to treat ADHD are disqualifying (stimulants and non-stimulant Strattera).
- Requires a 90-day period of taking no medication before evaluation.
- The FAA requires its own extensive evaluation for ADHD.
Current FAA Guidelines: Summary
Consider these points from this FAA webpage concerning ADHD (Guide for Aviation Medical Examiners: Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder)
- The FAA requires an extensive evaluation if an applicant for medical certification has been diagnosed with or is currently taking one of the medications used to treat this condition.
- If medications are being taken, they must be discontinued for at least 90 days and you will be asked to undergo a neuropsychological evaluation with a clinical psychologist or neuropsychologist
- The testing is very familiar to the psychology world. It consists of a battery of different tests that measure various areas of neurocognitive functioning. The evaluation is quite comprehensive. It generally takes six or more exhausting hours to perform.
- The complement of tests provides an objective way for the clinical psychologist to test for ADHD and any other underlying pathology that affects one’s short and long-term memory, ability to multitask, and to understand and comply with instructions, and many other “executive” tasks. The psychologist can compare one’s scores to “normal” functioning individuals, rather than against the applicants’ own baseline scores since there is no baseline testing to compare to! This is one of the objections that opponents have for this type of evaluation process.
- Many young folks are placed on these medications without ever being tested. They are prescribed the meds based on parental or personal concerns. Perhaps there was perceived inattentiveness to tasks such as job or school performance or other demonstrated history. In many cases, people who are treated for apparent symptoms don’t really have ADHD. But in order to rule it out, a formal clinical evaluation should be done.
FAA Medical Examinations:
From the FAA’s Guide for Aviation Medical Examiners (AME); Decision Considerations Disease Protocols – Attention-Deficit/Hyperactivity Disorder
Q: Why a required neuropsychological evaluation?
Attention-Deficit/Hyperactivity Disorder (ADHD), formerly called Attention Deficit Disorder (ADD), and medications used for treatment may result in cognitive deficits that would make an airman unsafe to perform pilot duties.
Q: What is the required testing?
There are two test batteries:
INITIAL BATTERY – performed on everyone; and
SUPPLEMENTAL BATTERY – performed when the Initial Battery indicates a potential problem.
Q: Why require a CogScreen-Aeromedical Edition (CogScreen-AE)?
CogScreen-AE is a neurocognitive test developed to assist the FAA in the evaluation of the domains of neurocognitive performance most important for safety of flight.
Q: Who may perform a neuropsychological evaluation?
Neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics. The following link contains a list of neuropsychologists who meet all FAA quality criteria. See FAA Neuropsychologist List (PDF).
January 2022 FAA Safety Briefing on ADHD
A recent Medium article on this topic comes from two psychologists with the FAA Office of Aerospace Medicine, Drs. Chris M. Front and Randy J. Georgemiller
It’s entitled: Pilots With Attention Deficit/Hyperactivity Disorder (ADHD) — FAA Safety Briefing
Safety experts agree that at least 70% of aviation accidents are attributable to the pilot. NASA scientists report that most accidents result from some failure in the pilot’s cognitive performance, with distractions and errors in aeronautical decision making (ADM) most prominent….
…The likelihood of an accident rooted in distraction or poor ADM is heightened when the pilot has a condition that negatively affects such skills….
NTSB investigations of fatal accidents attributed to ADHD have documented that pilots with ADHD:
- failed to adequately prepare for flight (e.g., did not check the weather),
- continued flight when it was ill-advised (e.g., due to deteriorating weather),
- engaged in hazardous actions (e.g., low-level maneuvering to show off),
- and became distracted and made critical errors (e.g., failed to maintain airspeed, stalled, and spun while circling a friend’s home at low altitude).
Due to the risks to flight safety posed by ADHD, regulatory authorities worldwide consider ADHD a disqualifying condition for pilots.
“Disclosure” After the Fact
One more excerpt from that article:
Unfortunately, pilots sometimes fail to disclose ADHD to their Aviation Medical Examiner (AME).
The result is that the FAA learns about the condition after a fatal accident when the toxicology results reveal the presence of medication used to treat ADHD. Notably, pharmacological treatments for ADHD are not approved for flying because they can cause harmful effects on perceptual, motor, and cognitive functions and impair the recognition of fatigue.
Additionally, their effectiveness is time-limited, a particular concern if a dose is missed or flight time exceeds the therapeutic impact of the drug.
ADHD and Driving On the Road
One area of research that clearly demonstrates ADHD-related impairments — and the effectiveness of stimulant medication? Driving.
This post explores that topic: Driving While Distracted: Adult ADHD Hits the Road
If you have personal experience or something else to share on this topic, please leave a comment.
77 thoughts on “FAA Guidelines on ADHD — No Rx for Commercial Airline Pilots?”
It’s unfortunate that the FAA is very “one size fits all” on this topic, requiring costly screening even for those that have successful lives without being treated in 25+ years. Assuming that the student pilot is not on any prohibited medication, you would think they could trust the decision of whether they are qualified to pilot a plane to the flight instructor, medical examiner, and checkride examiner. In my case, both my CFI and my AME believe I am more than capable of completing my training and are doing everything they can to help, but it is still going to be a 6+ month process filled with invasive paperwork before I am able to solo.
I’m all for safety, and I’m sure there are individuals with adult ADHD that should not pilot a plane, but I would like to see some real statistics; the best I can find is an anecdotal “ADHD meds were found in tox screens postmortem in some pilots”.
Another thing I am curious about is that all stimulant-based and Strattera are on the list of prohibited medications, but I have yet to see any mention of Qelbree (viloxazine) on the list of non-approved medications. It could be easier to make an argument for permitting this medication as it’s extended release, and one of the FAA’s arguments for prohibiting ADHD medication is that it is limited duration and a missed dose could cause issues. I’d love to see an approved treatment that opened the skies up to more people in a safe manner. What do you think?
I appreciate your frustration.
You ask what I think about Qelbree not being on the prohibited list? It might be that Qelbree is rather new and hasn’t yet been reviewed.
As for the rest, I think this is one more type of fallout that comes from viewing ADHD monolithically.
ADHD is a highly variable syndrome. It affects individuals, not clones. The genetic factors are potentially in the hundreds, each making small contributions.
Yet, to understand diagnosable ADHD, we do need to understand the risks that it can bring.
When it comes to ADHD research, perhaps no other “domain of life” has been studied more than driving. And that is probably the foundation of the FAA’s guidelines. We know that ADHD is associated with very real impairments to driving — inattention, impulsivity, distractibility, etc.. Higher rates of traffic citations and accidents — and more severe accidents.
Also think about the other risks to untreated ADHD — higher rates of substance use, sleep disorders, health conditions such as diabetes, all of which can impair cognition.
But again, this is the body of research done on huge numbers of individuals with ADHD. It shows elevated risk over all. But it cannot indicate any one individual’s risk.
I have absolutely no knowledge of what it takes to be a pilot. But it only seems fair to me to apply the same scrutiny and screening to all potential pilots. Because, geez, many people have ADHD but don’t know it. Or they might have other issues.
That said, many people with ADHD tell me they “kill the interview, aren’t so great in the job.” In other words, the stimulation of “winning” the job can motivate them to excel in the interview. But carrying on the day to day tasks that job requires…not so much. When ADHD goes untreated, anyway.
Even with treatment, it’s true that it won’t always be accessible. There could be emergencies. And many people with ADHD are more vulnerable to sleep disorders, including Circadian Rhythm disorders — obviously not helped by buzzing across time zones every day. So many potential factors.
I wish you all the best!
Son was tested in college and was diagnosed with ADHD. Prescribed very low dose and didn’t take it ver long because he didn’t like the feeling. He experienced a very traumatic incident at the beginning of college and honestly I think he was miss diagnosed and it was a crutch that the school allowed / pushed for students to excel. Since he graduated college he has been working and hasn’t been on prescription for around 6 months. He’s really wanting to start flying but a little nervous because most of what you read says it a STOP. Even if he could get through the testing and cleared, what do airline employers say about this on one’s record? I know it’s a touchy subject but do they stay away from the possible known risk?
Good question, Danny. Maybe someone else can answer.
I would only point out that your belief that your son was misdiagnosed, your viewing ADHD as a “crutch” demanded by the school to excel, that’s what keeps many people with ADHD from getting the treatment they deserve.
Unfortunately, “not liking the feeling” of the medication is not a reason to quit, if the diagnosis is accurate. It often takes several tries, different types of stimulants and addressing sleep challenges, to find the right fit. Often, a parent or other loved one or friend helps because we unfortunately cannot leave it to most MDs.
Hello I am currently a student pilot and my therapist recently brought up the possibility of an ADHD diagnosis with me. She said she won’t do the testing if it will put my career at risk but I don’t want to keep flying if my possible disorder could make me a bad pilot. If I do get diagnosed and never take medication will I still have to get the testing done?
That’s a key question. I’m afraid I can’t answer it.
I encourage you to read the information in the link I shared closely.
Also know: Electronic medical records means that once something goes in a database somewhere, it stays there and is easy to access.
There are no cookie-cutter answers here, as you can tell from reading the stories of others in the post. Including the recent one from S, a pilot who does well on the job but struggles in the rest of life.
One thing I have noticed, some folks with unrecognized ADHD pin their hopes on being a pilot. Once diagnosed and pursuing treatment, that burning desire might change. They might suddenly see more options (with education and profession). They might no longer need the “thrill” of flying.
For others, of course, the desire won’t change. It’s what they love to do.
It really requires some personal soul-searching, it seems, about what you want out of life and why you want to be a pilot.
I’m an aspiring pilot about to start flight school who had adhd and took Adderall for about a month and stopped talking it because my parents didn’t notice an improvement all that happened was my appetite was suppressed. After a passed initial battery cognitive test I was able to get my third class medical just wondering when I will be able to get my first class medical.
I wish I could help you. But I don’t work for the FAA. 🙂
If you read the information at the links, you might find the details you need.
I am glad to learn this valuable information.
This seems wildly unfair, but I wanted to comment on one part of this article that was misrepresented.
The part where you say that there are many people put on meds but not diagnosed, then suggest that they don’t have ADHD. Apparently you are not aware of the fact that stimulants affect individuals with ADHD brains very differently than neurotypical ones. Stimulants do not stimulate us!! They help us focus. Therefore, if a person without an ADHD brain is put on stimulants they will be STIMULATED and act like such. A VAST difference. There’s no way that tons of people are being put on these drugs and thought ADHD that aren’t. They would be acting DRUGGED because it affects their brains VERY differently!!
I even asked this of the psychologist (with decades of experience focusing on diagnosing and treating ADHD) if this were true and he confirmed it.
So this idea of all these people being treated with stimulants without actually having ADHD is ridiculous! They would all be bouncing off the walls!!
Please keep in mind: This blog is the very first website on Adult ADHD, established in 2008. Much of what you know to be true about Adult ADHD….was first publicized by me.
If you read my “about” page, you’ll see that I am an internationally recognized expert on Adult ADHD.
I’ve been tackling myths such as you point out since 2002!
So, before you come in attacking someone, it’s really best to know who and what you are attacking.
For example, you claim that my article said, “Tons of people are being put on these drugs and thought ADHD that aren’t.” Please, where did I say that?
I encourage you to re-read the article, this time trying to understand my actual point instead of going in for the kill.
For one thing, I was quoting the FAA page. Believe it or not, ADHD is often misdiagnosed and medication taken, with poor results.
For another, there just might be some nuances around ADHD that are not yet familiar to you.
Thanks for your comment.
Many ADD drugs are performance enhancing even for “normal” non ADD individuals. Therefore your statements about individuals being treated bouncing off the walls or being drugged up is inaccurate. It is all about the dosage and individuals metabolism as to how the drug affects them. Similar example…. A patient who is not asthmatic is given an asthmatic drug and is able to perform better. The bronchodilator effect of albuterol improves the performance of even an individual who does not have asthma
Like many other children of the time, my nephew, Johnny, was advised to take Ritalin in 2nd grade for ADHD; he was off the drug by 6th grade. There was never a formal diagnosis by the primary school — only that they thought he would do better. Does this automatically disqualify him from becoming a pilot? Johnny’s in his 20’s now. Is testing by a FAA neuropsychoanalysist now required or can he just take a regular pilot’s exam?
I can’t speak for FAA regulations. From what you write, though—that he was never formally diagnosed and he has not taken medication since 6th grade— it seems that’s not a dis-qualifying issue.
But you should read the guidelines closely.
Someone with ADHD can totally concentrate on a video game for hours on end. If they are given something that is not stimulating they tend to “zone out.” Ritalin, Adderall, and Strattera stimulate the brain to help it to focus better. It would be interesting to see if someone, who had stopped ADHD meds for 90 days, started playing video games the day right before they had the neuro testing, whether there would be a carry over of the higher effect in concentration when taking those tests (and possible passing them).
My hunch tells me they might do worse on the tests, which are more tedious than videogames, than if they hadn’t played the videogames.
With the various “brain training” software, there might be higher scores within the system — indicating improvement — but they typically don’t carry over into real life. And that’s the problem.
thanks for your comment,
Hi all, newly winged USAF C-5 pilot here. Like many who have commented, I had ADD/ADHD throughout my childhood.
My case was severely disruptive academic and social/behavioral side. I was put on Ritalin and adderall as a young kid and transitioned to vyvanse, wellbutrin, and tenex later on.
After my 8th grade year, a seed was planted that I COULD potentially become a pilot if I wanted to. One of the biggest agents in that planted seed was my mother, (who had no faith in me or my future, but full belief in my diagnosis) genuinely seeing that specific potential in me.
Gina, you are spot on with the Monofocus comment. I had never been so vehemently driven in my life as I was chasing down this newfound goal. It was personal. Up until 8th grade I had never received a single A or B (with meds). After my catharsis that summer, I finished my freshman year of high school with a 3.35. Almost makes me question the validity of my diagnosis, and the confidence-draining aura that came along with it. This is a discussion for another day. Today, I will say it was imperative that I came off meds freshman year of high school.
I got my Class 3 medical 2 years later and that was a fight, but it wouldn’t have happened if I had been later on my official medication withdrawal. Got my PPL shortly after before starting college, and never had any academic or behavioral issues since coming off meds in 9th grade. I finished my B.S. in Business Management with a 3.8, AFROTC Scholarship, and packed my bags for Air Force UPT. If you have a son or a daughter with genuine aspirations to fly, my advice is to believe in them and do your best to drop the “but you have a disability” case. That in itself destroys the one thing that can get us there, confidence. If they really want to do it, and you believe in them, the change will occur and you’ll see a vehement drive leading to something great.
At that point, let them take the wheel. Opinion: get them off the meds summer before high school (clear and defined life transition) and believe in them. Also, the Air Force and FAA doctors took issue with my Wellbutrin usage (normally prescribed as an anti-depressant) make sure they know, and have in writing from the psychiatrist, it was used purely for the treatment of ADHD, not depression. Diagnosed depression is a kill shot for a flying career. There is no getting around that one.
First, congratulations! Wow…flying a C-5. Well done!
Second, thank you for sharing your insightful story.
I did not know that about depression. And that’s too bad. Maybe unfair.
But there’s a highly publicized case of a few years ago, in Germany, I believe (or a German pilot), where he was allegedly diagnosed with/treated for depression….before crashing his plane, apparently intentionally. Perhaps that drives the rule.
We will never know the truth of that. But I remember reading what I could of his medical story. And I couldn’t help but wonder….bad prescribing strikes again.
At any rate, I’m glad you persevered in pursuing your dream.
People with ADHD aren’t clones, unfortunately. It’s a highly variable syndrome, with all the rest of personality to consider.
Some could follow your path and come out victorious — and some deeply disappointed.
But your lessons surely ring true for everyone — believe in your dreams, work hard for them, focus on rewards and accomplishment and less on “but you have a disability.”
“Diagnosed depression is a kill shot for a flying career. There is no getting around that one.”
I’m pretty sure that changed since the crash in the Alps. I’d rather have a medicated pilot than one non-medicated…
I’d be interested to know. Maybe I’m remembering a different incident (pilot suicide by crash), but I recall wondering if he had been misdiagnosed with “depression”.
It’s astounding how many times psychiatrists and other MDs diagnosed based on how a person “looks” or “feels.”
The risk is misdiagnosing bipolar disorder, ADHD, etc. as “depression” and taking an SSRI.
I would not be surprised if that pilot was taking an anti-depressant — prescribed or otherwise procured.
I’m diagnosed with adhd and use medication on as needed basis.
I could certainly be without medication for 90days if there was a need for it.
I fare far better in flight simulators than synthetic attention tests.
In Sweden simulators are used to evaluate the ability of a person to drive a car so why couldn’t it also be used as a complement to neuropychological assesments in both Sweden and USA?
In the EU rules on adhd and flying would be governed by a common eu directive, making the rules for flying and adhd fairly similiar in most europena contirues.
I’m also diagnosed with aspergergs that for me personally that would not pose a problem when working with people or flying since I’ve among others things worked with teaching.
Then what prejudices doctors might have on this condition i would mostly certainly be able to work together with a flying instructor to learn fly and being able to communicate clearly with an air traffic controller.
Acutally Sweidsh Transportation Authorities tried to suspend an engine dirver with Aspergers’s syndrome but the court ruled his Aspergers’ wouldn’t be a problem when communicating with the rail traffic control.
It definitely seems there should be a battery of objective tests and simulators.
People with ADHD and/or ASD aren’t clones. There is infinite variety among individuals.
Thanks for your comment. We are fighting for my 15 year old daughters dream right now. In fact driving to an appointment with the diagnosing doctor At the moment. She has never been on meds so we are hoping she isn’t denied.
You are right: There is no evidence that essential oils are in any way useful in treating ADHD. And I doubt there will be research unless it is by the company selling the oils. Because there is no reasonable hypothesis that these would have any effect on ADHD.
It seems to me that a high school junior is very young to be making such a decision. Many males with ADHD are particularly drawn to aviation. Granted, it has its obvious appeal. But I think there’s something of a “self-medicating” aspect to flying for many of these young men. It becomes their mono-focus. And sometimes I wonder if it because how they feel in the cockpit: stimulated, clear (due to the stimulation and noise, etc.), and focused (let’s hope so anyway).
It might be wiser if he were to pursue traditional education now and then see how he feels later. His brain is still so young (generally, what we think of as brain maturity doesn’t happen until around 25 – and even later for many).
I would worry about a person with ADHD who needs medication to function adequately becoming a pilot who does not/cannot take medication.
But I am the cautious sort who sees potential consequences very clearly.
Hey so if someone receives a first class medical and then is diagnosed with ADHD/ADD later on several months after the medical is recieved, how would the FAA know? Would the pilot be in legal trouble if he doesn’t know ADHD is disqualifying?
Sorry, I’m not an FAA legal expert!
I found this paper on the subject, but it’s from 2013: https://scholar.smu.edu/cgi/viewcontent.cgi?article=1317&context=jalc
You might also check this site: https://pilot-protection-services.aopa.org/news/2018/february/01/adhd-and-the-faa
My bottom-line understanding is this:
If you were to be diagnosed after you were certified and you were to take medication, there is the risk of routine drug-testing that would indicate you are taking a stimulant (and maybe even a non-stimulant..I don’t know).
If you were only diagnosed but did not pursue treatment, that’s a different question, it seems.
Good luck finding more answers!
Having been in the aviation industry for over 40 yrs, I’m convinced at least 20% of professional pilots would qualify as having an undiagnosed attention or hyperactivity “disorder.” I would be one of those. Flying airplanes seems to be an attraction, probably because of the intense and varied stimuli it provides.
Yes, for many years the FAA would disqualify any medical applicant that reported past diagnosis or treatment for ADD/ADHD. Many applicants were able to get around this by claiming a misdiagnosis or a diagnosis was made by a non-medical person. When the school nurse recommended little Johnny go on Ritalin, it could have a lifetime of consequences. To get such a diagnosis reversed is an expensive and time consuming process. Now it seems the FAA has softened a bit on that hard line but a previous diagnosis of ADD/ADHD will still put a number of obstacles in a professional pilot’s career path.
For a non-professional pilot, ADD/ADHD should not be an issue as long as one applies only for a basic medical certificate called ‘BasicMed’ or elects to exercise only Sport Pilot privileges which require no formal FAA medical screening process.
Interestingly (and conversely), it seems having ADD/ADHD is an asset in airline management. David Neelman, founder of JetBlue airlines has often spoken and written books about having ADD/ADHD and how it has helped him in his airline successes.
One day this will be undoubtedly be recognized as an overreach/overreaction by the FAA. Perhaps a severe form of ADD/ADHD would be grounds for medical denial but milder forms of this “disorder” seems to make the best pilots and no I’m not referring to the ability to “hyperfocus.” The other symptoms, failed personal relationships, messiness or poor organizational skills, anxiety, boredom, depression, alcohol (and substance) abuse are all readily apparent.
Thanks so much for sharing this information.
Thank you, M.M. you have given me hope! I just walked out of my flight physical for a class 3 med clearance and was told that she would not clear me because of my ADHD diagnosis and current prescribed medication treatment. I was diagnosed for ADHD when I was in the 5th grade which would have been around 1996 and to learn today that I am ineligible for flight clearance due to a diagnosis which occurred over nearly two decades ago is ridiculous. I have always had a deep appreciation and love for aviation and all that it entails since I was five years old-ask anyone I know! I’m deeply dissapointed and upset with how I’m viewed as “unfit” to fly both by the FAA and civilization, and in order to do so, will in fact need to spend more money than those not diagnosed with ADHD in order to receive a license. I agree that having ADHD in fact makes me more aware, alert and likely to address a concern, irregularity or something out of place after having been conditioned to fully learn and comprehend every situation which would present itself out of the “norm” during a flight.
As a female airline pilot (upgraded to captain and TRI at a young age) recently diagnosed with ADHD and not being able to try treatment with medication … both me and my psychiatrist agree that a great amount of pilots show clear signs of this disorder.
I thrive at my job because of nature of it: novelty, excitement, regulations, problem solving, multitasking, possible risks if anything is done wrong -, but I’m having so much trouble at home with things like cleaning, getting anything done, relations with family, (spending) money, food. I can just be glad that I have this knowledge now and it explains all my troubles I have had in my past. I’ve managed to achieve this much in my career because of relatively high intelligence coupled with ADHD, but I do struggle a lot on my off days at home.
Thanks for bringing the voice of seasoned experience, S.
Sports light pilot certificstion is a possible work around. The way I read it disqualifying meds do not apply to sport light and there is no medical.
I know nothing about this. But I think this piece needs updating. I will soon.
My son has had adhd since he was small. He is in college now and still dreams of flying. We researched and made many phone calls to discover he must be off meds and take the battery of testing before applying for the PPL. He hasn’t taken meds for 3 years and his grades suffer but he had side effects on the meds so I am not sure what is worse. He wants to take the testing next month over spring break but it’s over $2k! We live in SC. Do you think there’s hope for him or are we just wasting money?
It seems your son has a very important decision to make:
1. Pursue ADHD treatment, with medication if he needs it: Side effects can be managed; someone will need to be more pro-active about treatment. Most prescribers are doing a poor job of it.
2. Risk having his untreated ADHD symptoms affect his would-be flying career.
Of course I cannot tell you. I don’t know your son, his aptitude for a career as a pilot, whether his poor grades are the result of his lack of interest or ADHD-related cognitive problems, and all the rest.
But it’s something to consider very carefully. Sometimes the “reward” can be very enticing to folks with ADHD, most especially when it seems out of reach. That can provide a drive that might diminish after the reward is achieved.
Good luck to you both.
There’s hope! I have a similar story. I dealt with ADHD throughout my childhood, finally being diagnosed when I was 13. I stayed on medication for 6 years. I stopped taking medication about 6 months before taking the battery of tests, and I passed. My grades and performance in college suffered some, but I’m now a commercial pilot. Totally worth it! (I drank coffee throughout the testing, and that helped a lot)
Thanks for chiming in, Katie. Congratulations!
Just to clarify my comment, if you have taken medication for add or ADHD within the past 5 years you have to wait 5 years since you took the medication to apply for a class 4 or higher medical and then go through 28 different tests which have to be done by an AME and are not insured by most insurance companies and then wait a year and go through all the tests again before you can actually get the medical
Oh, thanks for the details, Zachary. Do you have a source that I can link to, for readers?
Where can I find the source of this information?
Could you please be more specific? What is “this information”?
Do you mean my blog post? If so, I provided the source when I introduced the excerpted information:
Is this true for a first time PPL? My son has been off meds for 3 yrs. and wants to do the testing next month. Are we wasting money? I had not heard 5 years waiting.
In Canada and in the United States by January 15 2017 having ADD or ADHD is an immediate denial of flight privileges
Wow, thanks for the update.
Canada contemplated a similar law, but for driver’s licenses. They abandoned it, based on the assumption that such a law would just discourage people from seeking a diagnosis and treatment.
I have been diagnosed with ADD since I was 12 and I was prescribed to Adderall ( 25mg) by my doctor. I’m 16 and take the Adderall daily, I have a GPA 0f 3.8 unweighted and take all advanced and AP classes. Unlike lot’s of people with ADD I don’t struggle in the least bit in school and have a high aptitude for learning. When I’m off of medicine there’s definitely a difference in me (No academic performance is lost though), I become a little less impatient and tend to be a little “Amped Up.” But I have started to learn to cope with it on the days that I’m without it.
To get to the point, I have aspirations to become a pilot in the Air Force and eventually move onto commercial as both of my parents are commercial cargo pilots and certified flight instructors. But in order to achieve my goals I have to get off of the Adderall. I’m still young but I wanted to know if I should start to get off of it now to make the transition easier when I’m older, or wait to get off of the Adderall right before I start flight school like “Katie” said earlier in this chat.
I can only offer you my opinion, as I don’t know how the military views such situations. (All branches are difference, of course, and who knows what the criteria will be by the time you’re of age for it to matter.)
So, here are my thoughts:
1. Continue ADHD medical treatment. Your grades might not suffer (at least for now) when you don’t take the medication. But it sounds like your mood and temper do. That can affect your relationships, including relationships with teachers. I would imagine that having “good conduct reports” throughout your education are important when seeking to be an Air Force pilot. Moreover, as coursework gets more complex, you might not be able to perform at the level you desire without medication.
2. Optimize other strategies. ADHD is highly variable. Some people can adopt environmental strategies to offset symptoms, thus eliminating the need for medication.
These strategies might include organizational systems, if that’s where one’s symptoms primarily cause problems.
But such strategies can also include getting regular aerobic exercise (in the morning is best, apparently), getting sufficient sleep, and eating a healthy diet. The latter also might include experimenting with excluding certain foods that might cause adverse effects, cognition-wise. For example, many people with ADHD are sensitive to gluten and dairy; others do best with a diet that maintains steady insulin instead of one that creates spikes from simple carbs.
Of course you can and should do all this while still taking the medication. But the more you optimize healthy habits, the less medication you might need.
I hope this helps.
Best of luck to you in reaching your goal!
I was diagnosed with ADHD when I was 13 and was prescribed Ritalin. I was on Ritalin until I was 19, which is when I began my flight training. Since I had the full childhood diagnosis, I had to wait 90 days off medication, then take the battery of cognitive tests. As an aside, the FAA was not at all forthcoming about what I needed to do to obtain a medical certificate. I really had to wrench it out of them.
Fortunately I passed the evaluations, and I obtained a 1st class medical, and I’m now working on getting all of my certificates to fly commercially. However, I’m not allowed to take stimulants again if I want to keep my certification. I’m doing my flight training at Embry-Riddle Aeronautical University, and I have several peers who definitely have some form of ADHD. The unfortunate thing about the way the FAA deals with this is that is doesn’t actually prevent people with ADHD from flying, it just prevents them from getting help.
Thank you so much for relating your experience with getting your flight certificate while disclosing ADHD.
You are so right….there are MANY untreated folks with ADHD in our skies, and it raises the risk for both them and others.
Congratulations on becoming certified!
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I have been diagnosed with ADHD. Well, sort of; my doctor just kind of prescribed me Vyvanse but I havent seen any official documentation, and I managed to get my Cat. 1 in Canada.
I am currently pursuing my CPL after recently just getting my PPL through school. However, I don’t normally take medication when i fly, only when I study. I find that my “condition” actually benefits me in the sky…I’m really good at thinking of more than one thing at a time, which allows me to attend to proper instruments for certain situations (ex. Climbing and monitoring the fuel pressure, ASI, and heading while primarily looking at attitude/outside). My anxiousness has me thoroughly checking my systems to make sure all is running well.
Perhaps I’m misdiagnosed (could be a minor case of GAD), but the key for me is exercise. When I’m in the sky after a run, it helps me focus on attending to the right things in the environment, and avoids a “racey” mind. I tend to be more worried and stressed than the people around me, but working out tends to help bring me to the optimal arousal for performance, and really allows me to get the job done.
When Im not on meds, I’m not thinking about random things. Rather, it’s me constantly worrying about if Im doing the right things at the right time, and worried about all the things I need to do at once to a point where I tend to be avoidant of organizing myself because it scares me.
I dont know! I notice other people with ADHD around me are somewhat different, in a sense that they dont really care about what they have to do. With me, I tend to care a little too much about the little things and tend to miss the bigger picture.
Moral of the story = I find that when using natural remedies (exercise) for calming my thoughts, I tend to perform in-flight the way I should, but I still never feel satisfied with how I do afterward haha.
Next stop: Mindfulness
From what you describe, there are more clues to anxiety than ADHD. But there could well be both.
Sometimes the people with ADHD who have co-existing anxiety are higher performing, because they worry themselves constantly over what they might be forgetting. This worry, however, takes its toll.
I encourage you to keep reading about ADHD and see if the diagnosis resonates for you in other ways.
Ron, Charlene, and any others,
I know that my response is late but better late than never. The clinic was Psych Recovery Inc. in St. Paul, MN. I think that my follow up appointment ended up around $250 / $300 too so it cost around $1200 by the time it was all said and done.
I successfully completed my PPL training in February 2014 so there is hope.
Hi J – thanks for checking in with that info! And congrats!
Hey Justin, Do you know which provider you used at Psych Recovery. I am needing to do the testing but I too was quoted over $2000. I’ve been told to be careful about who I use as the FAA is very specific about how they want the tests completed and presented to them. Obviously the person you met knew exactly how to process the materials and submit to the FAA?
I was diagnosed with ADD in 2006. I am now a commercial pilot and not being able to take my meds has made life extremely difficult. Any idea why this regulation exists???
I don’t know, but it’s probably the same as in the military. They want to be sure pilots can function without medication, if it came to that. Or so that’s how it’s been explained to me.
Gina–I loved your book. I listened to it on the CDs. My husband finally saw a doctor yesterday. however, he is a commercial pilot so i see no immediate help –and I am exhausted. Do you know of any support groups in Maryland? Thanks
So glad you found benefit in my book. Yes, there is a strong CHADD chapter in Maryland.
You can also join my online support group:
And there is much your husband can do, short of medication (if that’s for sure not allowed at this point). Changes in diet and exercise, and maybe sleep. Also some amino-acid supports.
This all sounds pretty discouraging. I’m a Marine veteran and just got out in 2010. I was aiming for veterinary school and have slowly been decreasing that goal since then. I’ve always love flight and have just decided to start pursuing it. It’s the only thing left that I can see myself doing for the rest of my life. Once I got into school again, I also got the Dx for ADD, not ADHD and my prescription to the dextroamphetamine is pretty small compared to many other people. Most of it comes from having trouble tuning people out that are around me and having a need-to-know of people coming in and out of the lecture halls. That I can surely thank my military service for, but it adds to the minor case of ADD I have. I wonder how many pilots out there have been able to pull this off. I function just fine without the medication but it helps a ton when I am in situations like that and can’t shut off my trained instincts. It’s heightened situation awareness, basically. Does it sound like I have a good chance of gaining waivers? I was going to try to get into an aviation major starting this fall and was considering becoming a UAV pilot for the National Guard. It’s frustrating to see that this could keep me grounded! I thought I finally settled on that career that will make me happy.
“Love what you do and you won’t work a single day in your life.” Or something like that. I would love to hear some more advice and/or thoughts on this topic. I’m nervous about the battery of tests, though. Thanks!
I wish I had some answers for you, Justin. The most useful advice I can think of is to maximize all the non-Rx strategies you can.
First, I’d recommend reading Dr. Parker’s book:
Then, I would suggest looking into
–amino-acid supplements (such as tyrosine in the am, on an empty stomach)
–optimizing your diet (protein in the morning, eliminating simple sugars and carbs, etc.)
–incorporating brain-boosting exercise (aerobic in am with “coordinated” exercise, meaning not just running or some other “rote” activity but one that requires coordination and varied movements)
–making sure you’re getting good sleep
I hope this helps.
I would like to comment and say that I have been going through the problem of being denied my 3rd class medical because I was on Adderall.
I was diagnosed as an adult and had been on the medication for 2 years when I started work on my private pilot license in January. The first step was being denied my medical. The second step was a letter from the FAA stating that I could not fly with ADHD and while taking Adderall, but if I was off the medication for 90 days and could pass a battery of tests (including a UA) I could obtain my medical. September 6th marked my 90th day off Adderall and next Monday I am taking the day off work to complete the testing. I hope that I can pass. This has been a very difficult path to take as I find that my symptoms are worse now than when I started taking the medication. I would encourage shopping around for testing resources as my initial contacts quoted around $2,000 but I was able to find a doctor to do the tests for $750.
That’s a lot of dedication on your part!
There are many things you can do to improve your brain function in the meantime — get exercise in the morning, get enough sleep (not always easy for some people with ADHD, I know!), eat a protein breakfast in the morning.
I wonder if it’s just Adderall (and any other amphetamine stimulant) or if the methylphenidate class is prohibited as well. Same for Strattera, which is not a stimulant (but in my experience is not entirely effective as a standalone treatment for ADHD).
I can see the reasoning. Many people with ADHD don’t take their medication consistently. Or it’s not the most effective medication at the best dosage. So, the testing makes sure that you can function well without your medication (in case you don’t take it!).
Still, it does seem to penalize people who are responsible about being diagnosed and taking medication responsibly.
I was wondering if you could give me the name of the Dr. that you were able to see for the ADHD testing for the $750? What state are you in? I am in Colorado and I got quoted $4000 for all the required tests so definitely want to find someone that can do it for cheaper. How did all your testing go?
Justin I would greatly appreciate the contact info on dr you used also.
Sorry, I see now that the blog you put a link to is all about relationships!
Yes, Marni. I also wrote a book that covers many of the questions you ask: Is It You, Me, or Adult A.D.D.?
It’s available as a paperback, a Kindle and Nook book, and as an audiobook.
Thanks for your response!
I requested this book from the library, thanks for the recommendation.
This is something I am interested because of my significant other. Reading the comments on your Meetup page made me curious about common experiences with ADD in relationships. The comments seemed to be more focused on functionality in the world and coping with things like depression.
One question, for example, is how can ADD affect relationships and how can it be worked with. Mood seems to be a huge factor but my inquiry is more about issues like not being able to contain troughs and set internal boundaries with a significant other. The closer someone is emotionally, the more issues there are of course. I’m sure there are many other factors, so the inquiry is endless.
But you gave me a resource to look into and I appreciated it!
I mis-read this as “Meditation and ADD”. Took me a while to figure out it was NOT about that. I was so hopeful that there was some info about how meditation can ever be done by someone with ADD. (significant other) Oh well 🙂
Actually, I just hosted a lecture here in Palo Alto with Dr. Lidia Zylowska, author of “The Mindfulness Prescription for Adult ADHD.” Look for the book on Amazon. There is a CD in the back with guided meditations.
It’s true, though, that some people with ADHD will have a hard time with any meditation practice until they take medication. The two together can be quite powerful. Some people with ADHD, depending on severity of symptoms and life situations, will be able to practice the techniques in the book without medication. It just depends on the person.
On the blog I write for CHADD, you can read a guest post by another physician who teachers Mindfulness Meditation for the ADHD community, Dr. Mark Bertin: http://adultadhdrelationships.blogspot.com/2012/06/communicating-mindfully.html
The restrictions also apply when pursuing a private pilot’s license for recreation purposes.
Oh, okay. Thanks, Gary.
The Air Force regularly dispenses “Go Pills” (dexedrine) to its pilots in combat. Military pilots in 2003 were regularly exceeding their dosages in Iraq yet my Vyvanse which is not as easily abused would disqualify me???
I was undiagnosed for 14 years as a police officer, detective and FBI certified computer forensics examiner. It wasn’t until I gave up the adrenaline that certain difficulties emerged. So I can carry a gun, take on great responsibility that affect peoples liberties but can’t pursue a hobby that just may allow me to be just as effective off medication and that much more effective on medication given the Air Force’s reasoning. That’s just not right.
Yes, on the face of it, there is little sense here.
What hobby do you mean?
Crazy isn’t it? There’s a good chance that a large majority of enlisted men/women have ADHD, did poorly in school because of it, and therefore enlisted in the military because college was not a viable option. Yet these military personnel get to fly jets and carry guns. My son was diagnosed at 12 with ADHD and has been successful due to the fact that he takes medication. He recently graduated from a prestigious university with an engineering degree and would love to become a pilot, but cannot due to his ADHD. His comment about it related to how insane it is to think that an ADHD pilot without medication would be a safer pilot. Not!
Yes, crazy. That’s what it is, Jane.
This kind of “don’t ask, don’t tell” policy does nothing for public safety and penalizes those responsible folks with ADHD who know when they need medication — and take it.
Congrats on your son’s graduation!
I was diagnosed with ADHD as a teenager. I outgrew/manage the condition well as an adult. Recently I attempted to get a pilot’s license. I can tell you for certain that any use of stimulant meds is a categorical disqualifier for your medical (required for a pilot’s license). Any pilot that takes them and reports it will lose their license. The Catch-22 is that if you are diagnosed with ADHD, you are disqualified because of the condition, and if you take medication to manage the condition, you are disqualified for taking a prohibited drug. The only way I have found to get/keep your license with an ADHD diagnosis is to (1) be off meds for more than a year, and (2) pass a huge battery of outdated psychological tests (such as WAIS-R, and MMPI-2, costing north of $2k) to prove you are not impaired by your condition when off meds, including a drug test for any stimulants — no easy task. You are then never allowed to go back on any stimulant medication.
Thanks for sharing that info. The policy sounds similar to that of the military, where it causes many problems.
I hope that some day we find ways to make it possible for people with ADHD to both be pilots and serve in the military while still benefiting from medical treatment.