Reporting Anxiety Diagnosis

[Cest La Vie]

Hey ya all,

It’s that First Officer ya all been hearing about. I need to self-report for an anxiety diagnosis. Please let me know what is the best way to go about it.

Recap: Anxiety diagnosis back in late 2019 by a brand new, trigger happy PCP who tried to explain a phantom pain in my chest (which later was confirmed through EKGs and X-Rays to be a minor case of costocondritis). I found out a few months later, and after taking a few in-house psychology tests, he listed the diagnosis as “resolved”, although we all know that won’t mead diddly squat to the FAA.

I was able to obtain a temporary leave of absence through my company due to Covid-19, which bought me some time, but I wasn’t able to make meaningful headway as most medical institutions were saturated with tasks... due to Covid.

The leave is ending soon and in order to not lose my seniority, or be terminated, I have to go on medical leave. In order to go on medical leave, it has to be approved by a third party company. More than likely, that third party company will need to see evidence that my medical was deferred.

I obtained another job during the pandemic, which doesn’t pay me much, but it keeps me alive and housed, so I can be patient and save up for whatever the FAA will hurl at me. I just don’t want to lose that seniority number...

Cheers and best wishes for all.

 

[AchillesLastStand]

Are you with an ALPA carrier?

 

[Beaker’s Flyin]

Sorry to add zero value to your situation, nor do I know the circumstances around your 2019 diagnosis, however I feel the need to vent. For all the MD's on the board. It seems as of late that "anxiety", which is a normal human reaction, is more widely being coded as a mental health diagnosis. If I present to you at a visit that something made me nervous or anxious and its not interfering with everyday life how can it lead to a mental health diagnosis? Is it not simply a symptom? People are getting screwed because of it with the FAA, and who knows what else in life perhaps down the road. The process seems broken. Is it liability related?

 

[dtuuri]

Recap: Anxiety diagnosis back in late 2019 by a brand new, trigger happy PCP who tried to explain a phantom pain in my chest (which later was confirmed through EKGs and X-Rays to be a minor case of costocondritis). I found out a few months later, and after taking a few in-house psychology tests, he listed the diagnosis as “resolved”, although we all know that won’t mead diddly squat to the FAA.
...

The leave is ending soon and in order to not lose my seniority, or be terminated, I have to go on medical leave. In order to go on medical leave, it has to be approved by a third party company. More than likely, that third party company will need to see evidence that my medical was deferred.

Medical leave? For what, costocondritis? If you weren't prescribed drugs for "anxiety" I don't see the problem. How would the FAA have any reason to think you have anxiety rather than sore ribs? I wouldn't feel compelled to answer that I had been diagnosed with anxiety, but I would feel compelled to consult with your AME before scheduling an exam to make sure. The AME MIGHT want a letter from your PCP.

Now, if you took some drugs—you're into a whole 'nuther ball game. FAA can learn about that and it might not WILL NOT square with your opinion of what your condition is. The AME WILL need a letter from your PCP, possibly including a pill inventory of the pills you took. Don't ask me how I know this.

 

[Cest la Vie]

Medical leave? For what, costocondritis? If you weren't prescribed drugs for "anxiety" I don't see the problem. How would the FAA have any reason to think you have anxiety rather than sore ribs? I wouldn't feel compelled to answer that I had been diagnosed with anxiety, but I would feel compelled to consult with your AME before scheduling an exam to make sure. The AME MIGHT want a letter from your PCP.

Now, if you took some drugs—you're into a whole 'nuther ball game. FAA can learn about that and it might not WILL NOT square with your opinion of what your condition is. The AME WILL need a letter from your PCP, possibly including a pill inventory of the pills you took. Don't ask me how I know this.

I was prescribed zero medication for the Anxiety... he tried to put me on some Benadryl but I staunchly refused. I was under the impression that he was under contract to push pills. Heard horror stories from my non-pilot friends.

 

[Cest la Vie]

Are you with an ALPA carrier?

Fortunately, yes. Unfortunately, already exhausted most of my AMAS options.

 

[AchillesLastStand]

I didn’t know we could exhaust them? Did they obtain your records and advise you on what to do next?

 

[bbchien]

I have a FO at a major who has OCD which a generous local psychiatrist wrote him for an SSRI. POW! He went from OCD not requiring medication to OCD needing medication, even though eh only took it for two weeks. We managed to get him a Special issuance that requires quarterly counselor, semi annual HIMS AME, and annual HIMS Psychiatrist evaluations. No meds. If he remains stable through 2026, the requirement will evaporate.

This is the value of a good aeromedical team. Of course we left that community psychiatrist off that team.

 

[Cest La Vie]

I have a FO at a major who has OCD which a generous local psychiatrist wrote him for an SSRI. POW! He went from OCD not requiring medication to OCD needing medication, even though eh only took it for two weeks. We managed to get him a Special issuance that requires quarterly counselor, semi annual HIMS AME, and annual HIMS Psychiatrist evaluations. No meds. If he remains stable through 2026, the requirement will evaporate.

This is the value of a good aeromedical team. Of course we left that community psychiatrist off that team.

It’s great to hear good news from the legend himself. I managed to buy myself a little more time, so I will be seeking out a HIMS AME to hello rectify this situation. Thank you so much.

 

[DaddyLlama]

I have a FO at a major who has OCD which a generous local psychiatrist wrote him for an SSRI. POW! He went from OCD not requiring medication to OCD needing medication, even though eh only took it for two weeks. We managed to get him a Special issuance that requires quarterly counselor, semi annual HIMS AME, and annual HIMS Psychiatrist evaluations. No meds. If he remains stable through 2026, the requirement will evaporate.

This is the value of a good aeromedical team. Of course we left that community psychiatrist off that team.

Hi @bbchien ,
I have been out of flying for 15 yrs or so and want to renew my medical. I lost my wife to cancer and was hospitalized from an isolated suicide attempt 6 years ago and have been stable since and had no such behavior previously or since. During that stay, I was diagnosed for bi-polar (2) depression. I am on Lamictal and Wellbutrin currently and have been for the past 6 years.

Is it hopeless to ever fly again or is there a path of any kind to get a class 3 medical?

 

[bbchien]

Seven Federal air surgeons in a row have vowed to never certify anyone even vaguely bipolar. I would duck and find an LSA-able Aeronca champ.

 

[DaddyLlama]

Seven Federal air surgeons in a row have vowed to never certify anyone even vaguely bipolar. I would duck and find an LSA-able Aeronca champ.

OK. Thanks for the info. Bummer. If I have a PPL, don't I need at least one Class 3 more recent than 2006 to qualify for LSA no medical? Or am I misunderstanding? My last medical was like 2004 or 2005 I think

 

[Half Fast]

OK. Thanks for the info. Bummer. If I have a PPL, don't I need at least one Class 3 more recent than 2006 to qualify for LSA no medical? Or am I misunderstanding? My last medical was like 2004 or 2005 I think

You’re confusing Basic Med with Sport Pilot. To fly under Sport rules, you simply need a valid driver’s license and to have never had a medical revoked or denied.

You’ll be limited to Light Sport Aircraft (like the above mentioned Aeronca), daytime VFR, and a maximum of one passenger. But that’s not so bad.

HOWEVER.....

There’s a reason folks with a bipolar diagnosis can’t get a medical. Legal for you does not necessarily mean wise or safe. Get your doctor’s opinion about flying and proceed very cautiously.

 

[Daleandee]

There’s a reason folks with a bipolar diagnosis can’t get a medical. Legal for you does not necessarily mean wise or safe. Get your doctor’s opinion about flying and proceed very cautiously.

 

[DaddyLlama]

Thank you @bbchien for your candor. I want to stay not only legal, but safe and responsible too.

I totally understand the fear and the public perception of the condition and the risk for the FAA from a liability standpoint. Not to mention the safety of public and the individual themselves.

It seems you have a platform on this topic. I wonder if you would indulge me with sharing my perspective, realizing it is only my perspective, there are other ones, and the overall perspective of the community at large, aviation community and the mental health community.

As some of these diseases are a spectrum and depending on where the individual falls on that spectrum it can be very treatable. And if the individual is willing to do the work it is possible to achieve stability. It strikes me that perhaps there is a more sophisticated and surgical way to approach this issue. I clearly see the extreme risk for the commercial side of aviation. Especially the sector transporting human lives that have paid to travel safely and have zero way of knowing a pilots personal struggles. But isn't there a missed opportunity here for the FAA and individuals to form a partnership regarding the class 3? By partnering in creating a solid treatment plan with a "certified" (By FAA) Pshyc Dr. And make this treatment plan a STRICT requirement to hold a class 3 medical and if the Dr feels at any point the condition is or is becoming to risky, then you cancel or suspend the medical as required. It seems that this would take a little work and the individual could bear the responsibility and cost of setting it up and executing the treatment plan. And as for enforcement there could even be some sort of indicator on your medical showing this circumstance to let FBOs know that they should check your medical online before renting a plane. I mean if we can have those with DUI convictions blow in a breathalyzer before starting a car, there must be a way to prevent individuals in a program like this from starting a plane etc. In this day and age, data is stored, transported and sorted at the speed of light.

It seems that the system as it is encourages individuals to hide conditions or even worse, not get treatment to prevent the loss of the privilege to fly. And I fully recognize it IS a privilege and a responsibility and not a right.

Being on this side of the fence, I didn't do anything to get this disease and it comes with a responsibility to get treatment and stay in that treatment. I take that very seriously. And given the opportunity, I know for me, it would be a very easy choice to get regular monitoring of treatment I already need and would be getting.

As I said though. I am sure there are many other perspectives and I'm sure its hard to know where to draw the line. In the end, we all love aviation and want to make it as safe as possible.

Thanks for your speedy responses and letting me voice my perspective.

 

[bbchien]

FAA medical views their task as to evaluate the risk that your known condition may interfere with competent execution of PIC duties. They cannot do that for bipolar disorder, so that diagnosis is not certifiable. The risk to you AND others, if that “how’m I REALLY doin” part off the brain stops working is....deadly.

as the original petitioner for the on SSRI protocol, for non severe recurrent depression we have such a protocol as you describe. We proposed that in 2006. Accepted in 2010! But it is not possible for bipolar disease.

You are misinformed as to hiding conditions. We gave up the medical “right” to privacy in 2010. Simply google “4 Delta Pilots Indicted”, or “27 pilots indicted”. FAA can get the information if it is in the public interest. There is no hiding any longer.

Now all that said, if one is able to show ten years of no meds, no events, and a 10 year well documented successful “Successful life test”, the diagnosis is incorrect. But if you discontinue and life spins out of control, that “no bueno”.

...so get good local psychiatry advice"...
B

 

[DaddyLlama]

@bbchien Thank you for taking time out of your presumably crazy busy schedule to provide good info and very valuable advise to the aviation community.