(Commercial) Flight anxiety - see the flight doc?

[AOF_ATC]

I am an air traffic controller and therefore have a class II medical. I have two CONUS TDYs coming up where I will need to fly across the country. I know it is somewhat ironic but I get very nervous when I fly . I am considering asking the flight doc for something to take the edge off for these flights. I can be DNIC during the TDY as I won't be doing any controlling. I'm just afraid that even being a nervous flier might have some negative impact on my medical. I decided to post this issue here to hopefully get some insight from fliers and medical professionals before deciding to actually bring this up with the flight doc or not.

Thanks in advance for any info/opinions.

EDIT: BL I would like to bring this up with the doc because I know it works and is a common treatment in the non flyer world but I'm afraid of being labeled as someone with anxiety issues or a drug seeker when this is like a one time isolated situation. I hate having to sneak around with medical issues but I guess that's what you have to do when you are in flight Med.

Edited May 3, 2012 by AOF_ATC

[Toro]

I have two CONUS TDYs coming up where I will need to fly across the country...I am considering asking the flight doc for something to take the edge off for these flights. I can be DNIC during the TDY as I won't be doing any controlling.I'm just afraid that even being a nervous flier might have some negative impact on my medical.

A nervous flier is not the same thing as anxiety. That being said, if you go in asking to be diagnosed in order to get medication, they're probably going to have to document it. Whether that's leads to anything is something you'd have to ask a doc, but why bother?

My two cents - hit the bar after you check in for a couple rum and cokes, it should do the trick. If you're not the drinking type, pop a couple Tylenol PM when they start boarding. Just make sure you're outside of the self-medicating window for your return flight.

[spaceman]

My two cents - hit the bar after you check in for a couple rum and cokes, it should do the trick.

Best OTC medication you can get... And most airports are equipped with a few pharmacies that can hook you up!

[HerkFE]

I know that Benadryl and OTC sleep aids have the same active ingredient and Benadryl is cheaper....had a pharmacist point this out to me once. Of course this was before I knew anything about Ambien or Restoril....which would also work great but you would need a prescription for that. You wouldn't want to find someone who just happened to have a spare or two because that wouldn't be right. Anyway, back to the Benadryl. I think the active ingredient added to the Tylenol PM to make it "PM" is also the same as Benadryl. I know you didn't say anything about having a sleeping problem but I've never been nervous while I was asleep.

[guineapigfury]

Of course this was before I knew anything about Ambien or Restoril....which would also work great but you would need a prescription for that. You wouldn't want to find someone who just happened to have a spare or two because that wouldn't be right is illegal.

FIFY

I'll admit that I occasionally have an irrational "concern" when flying in the cabin (due to not being at the controls)

Good, I thought I was the only one. I'm always annoyed when they don't fly the approach and landing the way I would have.

[Techsan]

It depends on how much you value your job & just how anxious you get when flying. I always try to avoid the Flight Doc like the plague, if the plague was still around.

In lieu of seeing the Doc, I would:

1. Think positively (always helps me)

2. Have a couple drinks @ the airport prior to boarding

3. When in your seat, point your eyeball vent directly at you & make sure it's open all the way

4. After takeoff, watch a movie on your iPad/computer, preferably a comedy

5. When the drink cart comes along, have another drink.

6. After movie, listen to some classical music, while thinking about how sweet your TDY is going to be (or not be)

Good luck buddy, I'm sure you'll do alright. Be very cautious with the Flight Doc though, it's a crap shoot to which route they want to take to get to the bottom of your anxiety.

[Guest]

Section 6G— Medical Standards for Flying Duty

6.44.24.1.8. Anxiety Disorders. If the flight surgeon determines that the problem is due to a non-phobic fear of flying or (in a trainee) a manifestation of apprehension, then the disposition is considered administrative and not medical…

6.44.24.1.21. Current or history of anxiety disorder including, but not limited to, generalized anxiety disorder, phobic disorders, obsessive-compulsive disorder, posttraumatic stress disorder, and acute stress disorder…

Section 6I— Ground Based Aircraft Controller

…The medical conditions listed in Chapter 5, Section 6G and relevant Section 6K categories are cause to reject an examinee for initial controller duty or continued duty unless a waiver is granted. Acute medical problems, injuries, or their appropriate therapy are cause for withholding certification of initial training or temporarily restricting the individual from controller duties until the problem is resolved…

6.46.15.3. Anxiety disorders…

Aircrew Waiver Guide pp. 56-62

Generalized Anxiety Disorder:

Generalized anxiety disorder (GAD) is the most common anxiety disorder in primary care. The onset of GAD is usually before the age of 25 years and the life time prevalence is 5% with a female to male ratio of 2 to 1. GAD is characterized by excessive worry and anxiety that are difficult to control and cause significant distress and impairment out of proportion to the actual likelihood or impact of the feared situational stressors. It is chronic, with symptoms waxing and waning over time and in response to situational stressors. Also somatic symptoms (e.g. fatigue, muscle tension memory loss, insomnia, indigestion, cramping) are common. Major depression is the most common coexisting psychiatric illness, occurring in almost two-thirds of individuals with this disorder. Panic disorders occur in one fourth of individuals with generalized anxiety disorder and alcohol abuse in more than one-third. Other conditions that may be associated with stress (e.g., irritable bowel syndrome, headaches) may accompany generalized anxiety. Selective serotonin-reuptake inhibitors (SSRIs) and serotonin-norepinephrine-reuptake inhibitors (SNRIs) have largely replaced tricyclic antidepressants and benzodiazepines as first line pharmacologic treatment. Treatment duration is usually 6-12 months. Cognitive behavioral therapy is also used as treatment either alone or in combination with drug therapy…

Three terms that relate specifically to anxiety and flying, manifestations of apprehension (MOA), fear of flying (FOF), and phobic fear of flying (specific phobia in DSM-IV-TR) are used in aerospace medicine. MOA and FOF are used to denote a non-phobic fear based on uneasiness, lack of motivation, feelings of inadequacy, rational decision, life circumstance, etc.; MOA is used with student aviators and FOF for rated aviators. Both MOA and FOF are handled administratively by the commander (often in the context of a flying evaluation board or the SUPT/UNT equivalent). A mental health consultation is helpful to clarify the issues in MOA and FOF. An increasingly recognized problem in the ATC/GBC community is fear of controlling. These cases are almost always handled administratively just as is fear of flying…

For trained FCII, FC IIU, FIII, and ATC/GBC personnel, a diagnosis of anxiety is disqualifying for continued duty and would require a waiver to continue in their assigned duties. A waiver may be requested once the aviator has completed treatment successfully, and has remained asymptomatic without medications for six months…It is important to note that non-phobic fear of flying (trained aviator) and manifestations of apprehension (untrained aviator) are treated as an administrative rather than a medical matter.

Both of these reg.s are very open to interpretation to the individual medical authority. Also, it might get you tangled up with your commander and possible admin. action.

PROTIP: Don’t let yourself get mixed up in all of this.

I think you have two options:

1. Enjoy a few drinks when traveling because you get to spend some time away from work on a fun TDY. Have a good flight and mini-celebration with some of your best buddies from the bottle, Jack, Jim, Johnnie, and Jose.

2. You are concerned that you won’t be able to focus with the major time zone change after flying and you need to be able to concentrate on the important information at this TDY. You sometimes have major jet lag and really want to get the most out professional development of the trip. See the Flight Doc for a possible prescription of Ambien to help re-adjust your circadian rhythm, and take the medication as needed.

Final note: NEVER take medication prescribed to other people. That’s one great conversation starter to have at your job interviews in the civilian world.

Edited May 5, 2012 by deaddebate

[Learjetter]

You may also check out the Tricare mental health benefit--I believe every member and dependent gets something like six visits to a mental health professional, covered by Tricare, and maybe even unreportable to the flight doc. You may want to make inquiries on this to the local on-base mental health folks...they could give you some good anxiety coping techniques....but call only, or go in in civvies, and don't give them your name until your sure they will talk to you w/o reporting you to the Flt doc or your CC.

Go see the chaplain--he/she is absolutely trustworthy to not narc on you about anxiety--regardless of your religious affiliation, I've found them to be very good counselors over the years when I needed to renew my mental armor.

Or, you could see Dr. Google for anxiety coping techniques and never set foot in the clinic--Dr. Google may even give you better advice...

Good luck.

[magnetfreezer]

You may also check out the Tricare mental health benefit--I believe every member and dependent gets something like six visits to a mental health professional, covered by Tricare, and maybe even unreportable to the flight doc. You may want to make inquiries on this to the local on-base mental health folks...they could give you some good anxiety coping techniques....but call only, or go in in civvies, and don't give them your name until your sure they will talk to you w/o reporting you to the Flt doc or your CC.

Go see the chaplain--he/she is absolutely trustworthy to not narc on you about anxiety--regardless of your religious affiliation, I've found them to be very good counselors over the years when I needed to renew my mental armor.

Or, you could see Dr. Google for anxiety coping techniques and never set foot in the clinic--Dr. Google may even give you better advice...

Good luck.

2. In the course of researching various base options to help people in the unit with issues, the chaplain was the only confidential option (for all the vaunted AF talk about how seeking mental health assistance will not affect your career). Most bases should have a Military Family Life Consultant that is not bound by the chaplain's ironclad restriction, but will meet with you a certain number of times and help with counseling/etc without asking for data/building a file on you. Anything beyond that they need to refer to other providers and starts to create a trail.

[Guest]

I'm always annoyed when they don't fly the approach and landing the way I would have.

Fixed.

[Seriously]

I only get nervous flying on regionals....

[Butters]