Looking to get 1st class medical with anxiety history

[Alwayzinthesky]

I’m looking to start a career in aviation and to get started I of course need to get my first class of medical. My only concern is a couple years ago during Covid, I opened up to my PCP about being stressed out at work and was diagnosed with anxiety and was on an SSRI for a couple of months. I’ve been off of it for a couple years and my stress is managed by exercise, meditation, etc.
I am wondering the best way to go about this and if it will be deferred. I have not filled out the MedXpress forms yet because I don’t want to put the wrong thing. I’ll have all my medical records from this time period as well. does anyone have experience with this or advice?

 

[AvNavCom]

does anyone have experience with this or advice?

My advice is to schedule a "consultation" (*not* an exam) with an AME and bring everything you have. Ask your questions there and hear it right from the horse's mouth. The AME guide is freely available online and can help you understand what the FAA wants, but it's no substitute for discussion with the experts. This is important stuff that you don't get to screw up without consequences, so asking random folks on the internet is not advisable.

 

[MVM19]

... and was diagnosed with anxiety and was on an SSRI for a couple of months.

I've been in your shoes for similar reasons as well. All in all, it does seem doable based on the information you presented, but I agree with the other poster — a consult-only appointment with no MedXpress filled out is a good path forward. If you have the cash, I'd recommend filling out a confidential inquiry with Left Seat in Oklahoma City or Aviation Medicine Advisory Services (AMAS.) I used the latter – both with their retained services and just their one-off confidential inquiries - and they were extremely helpful and helped me jump through the hoops of becoming a pilot with an anxiety diagnosis. You don't need to go this route, but it gave me some peace of mind.

Part of this depends honestly on what the diagnosis was exactly and what meds you took. The FAA views things like Generalized Anxiety Disorder, Adjustment Disorder, etc differently than other more serious diagnoses like Major Depressive Disorder. If it wasn't one of the handful of currently allowed SSRIs, then it might be slightly more challenging but the shorter period on the SSRI could be promising (ideally this stoppage was documented by your doctor and could be backed up with a multi-year pharmacy record showing the last time you ever ordered the SSRI.)

The good news (IMO) is that – very, very slowly - the FAA is making progress towards reform on mental health. In 2024, the FAA released some major changes towards mental health reform that actually helped remove me from the Special Issuance workflow that I was in. It was a big relief for me and allows me to fly on a fully unrestricted medical.

To level set expectations, if you do have to go through the special issuance process, it is somewhat costly and time intensive. Be aware of this in your planning.

You've still got a good chance, from what I can see, but a professional would be able to tell you better than us forum posters. Good luck!

 

[Alwayzinthesky]

I've been in your shoes for similar reasons as well. All in all, it does seem doable based on the information you presented, but I agree with the other poster — a consult-only appointment with no MedXpress filled out is a good path forward. If you have the cash, I'd recommend filling out a confidential inquiry with Left Seat in Oklahoma City or Aviation Medicine Advisory Services (AMAS.) I used the latter – both with their retained services and just their one-off confidential inquiries - and they were extremely helpful and helped me jump through the hoops of becoming a pilot with an anxiety diagnosis. You don't need to go this route, but it gave me some peace of mind.

Part of this depends honestly on what the diagnosis was exactly and what meds you took. The FAA views things like Generalized Anxiety Disorder, Adjustment Disorder, etc differently than other more serious diagnoses like Major Depressive Disorder. If it wasn't one of the handful of currently allowed SSRIs, then it might be slightly more challenging but the shorter period on the SSRI could be promising (ideally this stoppage was documented by your doctor and could be backed up with a multi-year pharmacy record showing the last time you ever ordered the SSRI.)

The good news (IMO) is that – very, very slowly - the FAA is making progress towards reform on mental health. In 2024, the FAA released some major changes towards mental health reform that actually helped remove me from the Special Issuance workflow that I was in. It was a big relief for me and allows me to fly on a fully unrestricted medical.

To level set expectations, if you do have to go through the special issuance process, it is somewhat costly and time intensive. Be aware of this in your planning.

You've still got a good chance, from what I can see, but a professional would be able to tell you better than us forum posters. Good luck!

This is very helpful. I have no other diagnoses like major depressive disorder, the only thing on my insurance and medical records states “anxiety disorder”. And I was on Lexapro, an approved SSRI. With that being said, I do have a consult with the HIMS AME later today. I will update what he recommends. I’ve never heard of AMAS.
I do have some extra cash and will do whatever is necessary to get my first class med certificate.

Congrats on getting that special issuance removed! That can be a relief. I will update. I am not too worried as I know I don’t have any serious diagnosis and I am completely healthy mentally; I just know that FAA won’t like that one box marked ‘yes’ on the MedXpress about previous conditions.

 

[Alwayzinthesky]

I've been in your shoes for similar reasons as well. All in all, it does seem doable based on the information you presented, but I agree with the other poster — a consult-only appointment with no MedXpress filled out is a good path forward. If you have the cash, I'd recommend filling out a confidential inquiry with Left Seat in Oklahoma City or Aviation Medicine Advisory Services (AMAS.) I used the latter – both with their retained services and just their one-off confidential inquiries - and they were extremely helpful and helped me jump through the hoops of becoming a pilot with an anxiety diagnosis. You don't need to go this route, but it gave me some peace of mind.

Part of this depends honestly on what the diagnosis was exactly and what meds you took. The FAA views things like Generalized Anxiety Disorder, Adjustment Disorder, etc differently than other more serious diagnoses like Major Depressive Disorder. If it wasn't one of the handful of currently allowed SSRIs, then it might be slightly more challenging but the shorter period on the SSRI could be promising (ideally this stoppage was documented by your doctor and could be backed up with a multi-year pharmacy record showing the last time you ever ordered the SSRI.)

The good news (IMO) is that – very, very slowly - the FAA is making progress towards reform on mental health. In 2024, the FAA released some major changes towards mental health reform that actually helped remove me from the Special Issuance workflow that I was in. It was a big relief for me and allows me to fly on a fully unrestricted medical.

To level set expectations, if you do have to go through the special issuance process, it is somewhat costly and time intensive. Be aware of this in your planning.

You've still got a good chance, from what I can see, but a professional would be able to tell you better than us forum posters. Good luck!

UPDATE: my HIMS AME consultation went really well.i went in depth about the situation and he says since it was situational anxiety, and the symptoms have resolved, I just need to put that on the Medxpress and he doesn’t think it will be deferred.

 

[MVM19]

UPDATE: my HIMS AME consultation went really well.i went in depth about the situation and he says since it was situational anxiety, and the symptoms have resolved, I just need to put that on the Medxpress and he doesn’t think it will be deferred.

Amazing! One of the best outcomes you could ask for. Good luck and happy flying.