Psychological
Attention Deficit Hyperactivity Disorder (ADHD)
Insights:
Symptoms:
- Age-inappropriate levels of attention
- Impulsiveness
- Hyperactivity
- Mood lability
- Low frustration tolerance
- Explosiveness
- Often treated with stimulants
Considerations:
- Do they comply with the treatment plan?
- Do they tolerate their medication without disqualifying side effects?
- Consider using the ADHD Clearance Letter
Waiting Period: The FMCSA handbook does not designate a specific waiting period for this condition
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Bipolar Mood Disorder
Insights:
Bipolar mood disorder is characterized as one or more manic episodes accompanied by one or more depressive episodes.
Manic Symptoms:
- Excessively elevated mood or irritable mood
- Diminished judgement
- Increased likelihood of substance abuse
- Possibility of delusions or hallucinations
Depressive Symptoms:
- Loss of motivation
- Loss of interest
- Loss of appetite
- Poor sleep
- Fatigue
- Poor concentration
- Indecisiveness
Severe depression symptoms:
- Psychosis
- Severe psychomotor retardation or agitation
- Significant cognitive impairment
- Suicidal thoughts or behavior
Considerations:
- Has the driver had a nonpsychotic major depression unaccompanied by suicidal behavior? If so, how long has the driver been symptom free?
- How long has the driver been symptom free following a severe depressive episode, a suicide attempt, or a manic episode?
- Are there adverse medication side effects?
- Has treatment been shown to be adequate, effective, safe, and stable?
- Is the nature and severity of the underlying mental disorder likely to interfere with safe driving?
- Consider using the Bipolar Clearance Letter
Waiting Period: There is no waiting period
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Major Depression
Insights:
Major depression consists of one or more depressive episodes that may alter mood, cognitive functioning, behavior, and physiology.
Symptoms:
- Depressed or irritable mood
- Loss of interest or pleasure
- Social withdrawal
- Appetite disturbance
- Sleep disturbance
- Weight change
- Fatigue
- Restlessness and agitation
- Impaired concentration
- Poor judgement
- Suicide thoughts or attempts
Considerations:
- Has the driver had a nonpsychotic major depression unaccompanied by suicidal behavior? If so, how long has the driver been symptom free?
- How long has the driver been symptom free following a severe depressive episode, a suicide attempt, or a manic episode?
- Are there adverse medication side effects?
- Has treatment been shown to be adequate, effective, safe, and stable?
- Is the nature and severity of the underlying mental disorder likely to interfere with safe driving?
- Consider using the Depression Clearance Letter
Waiting Period: There is no waiting period
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Post-Traumatic Stress Disorder (PTSD)
Insights:
- An anxiety disorder that develops following frightening, stressful, or distressing life events
- May be associated with behavior changes, mood swings, and suicidal ideations
Treatment:
- Psychotherapy
- Mild to medium severity can be successfully completed within a year
- Severe PTSD can take longer
- Medications
- Antidepressants can decrease anxiety, depression, panic, aggression, impulsivity, and suicidal thoughts
- Benzodiazepines can provide quick relief of anxiety, but the individual can develop dependance on the medication and possibly worsen the PTSD over time
Considerations:
- Are there medication side effects for this driver?
- Has treatment been shown to be adequate, effective, safe, and stable?
- Is the nature and severity of the underlying mental disorder likely to interfere with safe driving?
- Has the driver been evaluated by a behavioral health specialist? If so, what are the specialist’s recommendations?
- Consider using the PTSD Clearance Letter
Waiting Period: There is no waiting period
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Personality Disorders
Insights:
- A mental disorder with a rigid and unhealthy pattern of thinking, functioning, and behaving
- A person has trouble perceiving and relating to situations and people
Considerations:
- Do they tolerate treatment w/o disqualifying side effects
- Has treatment been shown to be adequate and effective?
- Is the nature and severity likely to interfere with safe driving?
- Does the driver have prominent negative symptoms?
- Substantially compromised judgment
- Attentional difficulties
- Suicidal behavior or ideation
- Overt, inappropriate acts
Waiting Period: There is no waiting period
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Schizophrenia & Psychotic Disorders
Insights:
“It is unlikely that individuals who are highly susceptible to frequent states of emotional instability (e.g., due to schizophrenia, affective psychoses, paranoia, severe anxiety, or depressive neuroses) would satisfy the physical qualification standard.”
Characteristics:
- Psychosis (Hearing voices or experiencing delusional thought)
- Loss of motivation
- Loss of apathy
- Reduced emotional expression (Flat Affect)
- Compromised cognition, judgment, and attention
- Increased likelihood of suicide
Related Conditions:
- Schizophreniform disorder
- Brief reactive psychosis
- Schizoaffective disorder
- Delusional disorder
Considerations:
-
- Does the driver have a diagnosis of schizophrenia or active psychosis?
- How long has the driver been symptom free?
- Are there medication side effects for this driver?
- Has treatment been shown to be adequate, effective, safe, and stable?
- Is the nature and severity of the underlying mental disorder likely to interfere with safe driving?
Waiting Period: There is no waiting period
Certification Interval: The FMCSA handbook does not designate a specific certification interval for this condition
Dementia
Insights:
A progressive decline in mental functioning that affects memory, language, spatial functions, problem-solving, and behavior.
“Driving a CMV requires memory, alertness, concentration, communication, organizational skills, attentiveness, performing simple and complicated tasks, and having awareness of one’s surroundings. Therefore, a driver with dementia may not have the ability to drive a CMV safely due to cognitive deficits.”
Symptoms:
- Memory loss
- Difficulty in communication, especially finding the right words
- Reduced ability to organize, plan, reason, or solve problems
- Difficulty handling complex tasks
- Cnfusion and disorientation
- Difficulty with coordination and motor functions
- Loss of or reduced visual perception
- Changes in personality and behavior
- Metallic taste in mouth
- Decreased sense of smell
- Depression
- Anxiety
- Hallucinations
- Mood swings
- Agitation
Waiting Period: There is no waiting period
Certification Interval: Consider diqualifying a driver with dementia