SI for misdiagnosis of Bipolar Disorder

Myguy13

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Myguy13
I’ve recently got misdiagnosed with bipolar disorder type 1 . I’m currently an ATP pilot who has been flying for 10 years so this really is a shock to the system.

I was wondering if anyone had any information for how long it could take to receive a special issuance medical if shown to be a misdiagnosis.

I have no prior history of this illness and I’m working to be stepped off medications as we speak . I expect a long path but I have no resources as of right now.

Also has anyone in here been in my situation or know someone in my situation?

Thank you!
 
myguy13 said:
I’ve recently got misdiagnosed with bipolar disorder type 1 . I’m currently an ATP pilot who has been flying for 10 years so this really is a shock to the system. I was wondering if anyone had any information for how long it could take to receive a special issuance medical if shown to be a misdiagnosis. I have no prior history of this illness and I’m working to be stepped off medications as we speak . I expect a long path but I have no resources as of right now. Also has anyone in here been in my situation or know someone in my situation? Thank you!
Particularly if this diagnosis involved board certified psychiatrists, you are taking at least a 10 year holiday from aviation. There is no such thing as an "SI for bipolar".

That diagnosis, may be in error but the difficulty is that the ability to "reality test" is EXACTLY what is at stake here, so your conviction that this is an error already has its credibility called into question (whether fair or not). So the FAA will regard the local board certified psychiatrist (not APRN) as an expert.

For this diagnosis, reconsider of the diagnosis really requires 10 years of documented successful life test (multiple recommendation letters), lack of events and lack of meds. That would be very very unlikely for a true bipolar to accomplish, and makes the diagnosis "reconsiderable". Thus the 10 year holiday. Never mind if it was drug induced - FAA isn't having any of that, either.

B
 
What context did you get the diagnosis? I do know a pilot who got that in the context of Fitness For Duty, which was annulled, and got back to flying in like 18 months…
 
Cali guy, it you have a denial that has not been reversed you cannot exercise sport pilot.

And it doesn’t work for the OP, he’s AIRLINE.
 
Cali guy, it you have a denial that has not been reversed you cannot exercise sport pilot.

And it doesn’t work for the OP, he’s AIRLINE.
It is no wonder pilots are so cautious to share any concerns they have about any issues. How frequent is a misdiagnosis of this type in the general population?
 
How frequent is a misdiagnosis of this type in the general population?
No one knows, but undoubtedly it's more frequent when coming from non-psychiatry trained medical providers. Unfortunately, it's just too easy for a physician to code a visit from the "walking worried" as something like depression, anxiety, personality disorder, PTSD, ADHD and others. Once that appears on a medical record that is reviewed by the FAA it's difficult to correct without considerable time and expense.

Not that it was trigged by a physician visit, but read the Bob Hoover story for an eye-opener about reversing a perceived mental health issue with the FAA.
 
It is no wonder pilots are so cautious to share any concerns they have about any issues. How frequent is a misdiagnosis of this type in the general population?
Not a good thing I guess, but I completely understand why pilots avoid seeking help.
 
It's common among the general public to refer to feeling sad about anything as being depressed, but using that word in the presence of a medical practitioner seems to have the potential for far-reaching consequences for pilots.

Merely having emotions is not a "disorder," IMO.
 
I have read that other countries have a different outlook on nero diversity but that it is still very difficult for people with nero diversity such as bipolar in aviation. Nero diversity is diversity and the meds do actually work
You can call things like mild ADHD or Asperger's "neuro diversity" if you want, there's a fine line between, say, being ordinarily scatterbrained and ADHD (which is severely overdiagnosed, IMO), but calling a serious debilitating medical condition like bipolar disease "neuro diversity" is denial (like your medical will be) and political wokespeak. We might as well call leprosy "epidermal diversity."

Yes, psych meds do work, but the problem is (and I've seen this multiple times in a relative) when the meds are working, you feel fine and figure you don't need the meds any more, so you stop taking them, and...
 
It's common among the general public to refer to feeling sad about anything as being depressed, but using that word in the presence of a medical practitioner seems to have the potential for far-reaching consequences for pilots.

Merely having emotions is not a "disorder," IMO.
And at least at Kaiser they seem to be pushing for mental health issues. At my last annual physical the Doc must have asked at least three times if I was depressed or having mental health issues. I think the increased probing is the result of the social isolation on folks brought on by the pandemic, but geez, no I'm fine, just take the vitals and let me outta here...

My bets there's going to be a lot of diagnosing that might be iffy.
 
You can call things like mild ADHD or Asperger's "neuro diversity" if you want, there's a fine line between, say, being ordinarily scatterbrained and ADHD (which is severely overdiagnosed, IMO), but calling a serious debilitating medical condition like bipolar disease "neuro diversity" is denial (like your medical will be) and political wokespeak. We might as well call leprosy "epidermal diversity."

Yes, psych meds do work, but the problem is (and I've seen this multiple times in a relative) when the meds are working, you feel fine and figure you don't need the meds any more, so you stop taking them, and...
A family member has been variously diagnosed as having ADHD and/or Aspergers. I'm not sure what the current diagnosis is, but it was clear that something of that nature has been present. Also, I used to be close to a person who was diagnosed and being treated as bipolar, and the validity of the diagnosis was obvious. So although we hear accounts of faulty diagnoses, there is no doubt in my mind that there is also such a thing as a valid diagnosis.
 
So my question is HOW did the OP get misdiagnosed with such a serious disorder and what level of medical provider entered that into a medical record?
 
That's what I was wondering, what type of doctor diagnosed it. If it was simply a PCP, they have done you a disservice.
 
Some of us worry enought about misdiagnosis that it approaches Tools' worry about the integrity of testing (I have never ever ordered a fingerstick PETH and never will). But the agency, I think properly, does not want "failure of reality testing (unless rigorously disproven)" on the flight deck...and with no errors.

Being in a zero air transport accident environment, is VERY TOUGH on the agency. Things can only go south.

B
 
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but lets be real here - like dbahn and TrueCourse are asking - how in the world did this diagnosis happen and from whom. There must have been some sort of reason that they thought that this was actually the issue. Im not disagreeing that the dx could have been wrong - but there must have been something going on for some diagnosis of some kind to be made. its not like you walk in with a bad cough and a fever - and you come out with meds and a bpd diagnosis. And how in the world do you have an ATP and get dispensed some sort of BPD drug (and take it) and know that that isnt an issue ?

And as someone also alluded to earlier - psych meds work. But regardless of them working or not - just about every person who is on them - believes that they are "fine" and can successfully/safely fly. They also believe that when they are on them - that they should be legally allowed to take them to co-exist in the world and be able to fly because the drugs are "legal". And of course the FAA is dealing with many factors here - not just whether they will continue to take them or get off of them, but a myriad of other mental health and a whole slew of other things.
 
How do you get diagnosed, fill a prescription, take the medication and not know why you are doing it?

"I have no prior history of this illness and I’m working to be stepped off medications as we speak ."

Especially knowing the business you are in!
 
but lets be real here - like dbahn and TrueCourse are asking - how in the world did this diagnosis happen and from whom.
Here's a not unusual pathway. A person is feeling anxious, or sad, or some other bothersome mental symptom. They try to see a psychologist or other professional therapist, but it turns out they need a referral, so they see their primary care doc, who refers them but needs a diagnosis, so they provide one and code it. Now they get to see the mental health professional and he likely acknowledges the symptoms and either agrees with the diagnosis or comes up with a better one. (Did you expect him to tell the patient that "they're fine" even though the PCP said otherwise?) Now it's all a matter of electronic medical records somewhere, and the FAA can demand them and pull your medical certificate if you don't provide them. That begins the spiral, which can actually pick up additional diagnoses as the patient tries to extricate himself from the problem he's created by seeking mental health guidance in the first place.

The FAA (rightly so) won't believe anyone in that situation trying to convince them that "they're fine" and were just misdiagnosed, so they only have the medical record to go on.
 
Here's a not unusual pathway. A person is feeling anxious, or sad, or some other bothersome mental symptom. They try to see a psychologist or other professional therapist, but it turns out they need a referral, so they see their primary care doc, who refers them but needs a diagnosis, so they provide one and code it. Now they get to see the mental health professional and he likely acknowledges the symptoms and either agrees with the diagnosis or comes up with a better one. (Did you expect him to tell the patient that "they're fine" even though the PCP said otherwise?) Now it's all a matter of electronic medical records somewhere, and the FAA can demand them and pull your medical certificate if you don't provide them. That begins the spiral, which can actually pick up additional diagnoses as the patient tries to extricate himself from the problem he's created by seeking mental health guidance in the first place.

The FAA (rightly so) won't believe anyone in that situation trying to convince them that "they're fine" and were just misdiagnosed, so they only have the medical record to go on.
obviously. .. i agree that there could be an "error" - but what I disagree is that nothing at all was wrong. But i also think that its a big leap for a PCP or a psych professional to go from feeling sad to bpd. . . and prescribing and him taking BPD prescription drugs. So in agreement that perhaps - depression (mild, moderate, whatever) could definitely be involved. But its a big jump to go from that to BPD.
 
obviously. .. i agree that there could be an "error" - but what I disagree is that nothing at all was wrong. But i also think that its a big leap for a PCP or a psych professional to go from feeling sad to bpd. . . and prescribing and him taking BPD prescription drugs. So in agreement that perhaps - depression (mild, moderate, whatever) could definitely be involved. But its a big jump to go from that to BPD.
And I agree with that as well, but the FAA is, " . . . just the facts, Ma'am, just the facts". And the only facts that the FAA has are what's in the medical record, however inaccurate it might actually be.

But related to you point, what's the next step? The airman has to provide those records, which almost certainly may simply substitute another diagnosis, which could be helpful to him if it doesn't require the full 10 year bipolar wait.
 
Correct me if I'm wrong, but my understanding is a PCP can, if they chose, diagnose someone as bipolar and prescribe meds for it. Most will not do this. It's something that a psychiatrist should be testing/evaluating. Maybe the OP saw their PCP and during a referral to a psychiatrist was given a diagnosis code with a prescription?
 
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Some of us worry enought about misdiagnosis that it approaches Tools' worry about the integrity of testing (I have never ever ordered a fingerstick PETH and never will). But the agency, I think properly, does not want "failure of reality testing (unless rigorously disproven)" on the flight deck...and with no errors.

Being in a zero air transport accident environment, is VERY TOUGH on the agency. Things can only go south.

B
That phrase "failure of reality testing" reminds me of the Alaska jumpseater who thought he was dreaming and tried to shut down the engines in the real world. :eek2:
 
What type of physician diagnosed you as bi polar? Was it a hims psychiatrist?
 
Yes, psych meds do work, but the problem is (and I've seen this multiple times in a relative) when the meds are working, you feel fine and figure you don't need the meds any more, so you stop taking them, and...

I have watched this scenario play out a few times in friends and loved ones. When they go off the meds they still believe they are ok ...
 
wokespeak??? Lol I’ve never been called that before but ok. Bi polar is not as debilitating as you think in fact the people I know who had it (especially the ones who got it from taking adhd meds at a young age which, should be illegal to prescribe to people under 25) have very strong resolve it’s not debilitating for them and the real reason they stop taking meds is not because they feel fine. it’s because the meds prevent them from doing the things they want to do in life do to government regulations and the stigma against their nero diversity in society.

The system needs to incentivize taking meds and seeking treatment.

One question I asked that has yet to be answered is are there advocacy groups that are working towards a drivers license medical with a signed affidavit from there own dr saying any conditions they may have are totally controlled as to not interfere with private pilot operations? As a Republican I can definitely get on board with that.

There are a lot of good fine upstanding middle-upper middle class conservatives on the libertarian side of things getting left behind in aviation and who want to fly in Central America.

Call it political wokespeak if you want but nero diversity is diversity and bipolar is part of nero diversity.

If your condition is corrected then you should be able to fly, at least in your private life regardless of what you have even if it not just bipolar. Your own doctor should make the decision as to whether your condition is corrected at least for private pilot purposes
The system needs to incentivize taking meds not subjected people for it.
 
The administrator disagrees with you, as do multiple experts.
In accord with its policy of not allowing airmen to certify ON ADDERAL (they “forget” their meds and perform poorly) if there were a five year implant/depo prep of a mood stabilizer, they might consider SOME applicants….but the rate of throwing the meds away , “and I feel fine” is…stupefying. Add an aircraft…in the mix…..total no bueno on that portion of “neurodiversity”.

Remember, 95% of accidents are due to p-poor pilot decisionmaking and performance.
 
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wokespeak??? Lol I’ve never been called that before but ok. Bi polar is not as debilitating as you think in fact the people I know who had it (especially the ones who got it from taking adhd meds at a young age which, should be illegal to prescribe to people under 25) have very strong resolve it’s not debilitating for them and the real reason they stop taking meds is not because they feel fine. it’s because the meds prevent them from doing the things they want to do in life do to government regulations and the stigma against their nero diversity in society.

The system needs to incentivize taking meds and seeking treatment.

One question I asked that has yet to be answered is are there advocacy groups that are working towards a drivers license medical with a signed affidavit from there own dr saying any conditions they may have are totally controlled as to not interfere with private pilot operations? As a Republican I can definitely get on board with that.

There are a lot of good fine upstanding middle-upper middle class conservatives on the libertarian side of things getting left behind in aviation and who want to fly in Central America.

Call it political wokespeak if you want but nero diversity is diversity and bipolar is part of nero diversity.

If your condition is corrected then you should be able to fly, at least in your private life regardless of what you have even if it not just bipolar. Your own doctor should make the decision as to whether your condition is corrected at least for private pilot purposes
The system needs to incentivize taking meds not subjected people for it.
FYI, discussing politics is not allowed on Pilots of America.

 
No disrespect to the OP, but I see a lot of posters willing to just blindly accept that the psychiatric diagnosis was incorrect. What we have is a poster claiming misdiagnosis, without any evidence to support that conclusion (which he would be ill-advised to post here regardless). The clinician likely had some evidence to support the bipolar diagnosis. Certainly psychiatric diagnoses are made in error, and while it's entirely possible the OP doesn't actually have this disorder, it's well-established that people with BPD often perceive themselves to be completely fine. While the gold standard may be evaluation and treatment by a board certified psychiatrist, good luck accomplishing that in many parts of the country, particularly more rural areas. If a psychiatrist is even available, it can frequently take months to get an appointment. PCPs may not be fully trained to diagnose and manage these issues, but the reality is that they're forced to do it every day because there's no one else available.

It may be in vogue here to slam PCPs for making psychiatric diagnoses, and assuming they're usually wrong, but as mentioned in earlier posts, the airman clearly sought evaluation and treatment for something, and didn't like the answer he was given. And he doesn't reveal his age, family history, or symptoms -- nor should he, in a public forum -- but in certain demographics, BPD may not be evident until it suddenly is, often dramatically. It's not inconceivable the OP obtained his ATP and an airline job before becoming seriously symptomatic.

As discussed above by Drs. Chien and Bahn, once the FAA sees a diagnosis in an airman's medical records, whether psychiatric or medical, it assumes the diagnosis to be correct unless and until the airman can prove otherwise. While pilots and wanna-be pilots disagree with this system, can you imagine a scenario in which, given a disqualifying diagnosis, the FAA simply accepts the airman at his word that the trained, experienced clinician was wrong and non medically-trained pilot doesn't actually have the condition? That would be chaotic, to say the least. I hope for the OP's sake he can establish a less onerous diagnosis, but it will undoubtedly be an extensive, expensive fight. And if he does suffer from the diagnosis, his goal needs to be getting on the right meds, and adhering to treatment recommendations. If that's the case, his flying days are unfortunately over.

[Edited to add an additional point, which is that psychiatric diagnoses are often much more nuanced than medical diagnoses. You either have diabetes or you don't; you have a kidney stone, or you don't. There's not much room for disagreement here, yet in psychiatry, I have personally seen, on more than a few occasions, residency-trained, board certified psychiatrists disagree on a diagnosis. For many mental health conditions, there are few objective tests available, and evaluation and diagnosis is necessarily more subjective. A lot of folks outside medicine aren't aware of this, assuming establishing a psychiatric diagnosis to be clear-cut. Obviously, this further complicates determining the eligibility for a medical in the aviation world.]
 
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And since we're on the topic, I have a suggestion for pilots who are concerned about mental health issues that may ultimately get revealed to the FAA. Find a good therapist that works on relationship counseling and discuss problems in your own relationship, whether spousal or other. Make it clear that you are paying for the visit and absolutely need to avoid a coded diagnoses of any kind. Once you air any relationship concerns, you ask for an opinion about any underlying mental issues that might need attention. That clears the way for you to decide the next step, even if it puts your FAA medical certification in question, but at least it becomes your decision and it's not subjected to erroneous (and in some cases fraudulent) coding. (For example, even the OP might have seen someone for relationship problems and been put on medication that would only be covered by insurance for certain diagnoses, such as bipolar disease, so the provider did that. The treating physician often has no idea what the repercussions are with the FAA and thinks he's doing something of benefit to the patient. I'm not guessing that's what actually happened, but that's a common and often innocent pathway that gets airmen into trouble.)

The MedXpress instructions say, "List visits for counseling only if related to a personal substance abuse or psychiatric condition." That provides a loophole that airmen should utilize if possible, just to avoid the many pitfalls
 
And since we're on the topic, I have a suggestion for pilots who are concerned about mental health issues that may ultimately get revealed to the FAA. Find a good therapist that works on relationship counseling and discuss problems in your own relationship, whether spousal or other. Make it clear that you are paying for the visit and absolutely need to avoid a coded diagnoses of any kind. Once you air any relationship concerns, you ask for an opinion about any underlying mental issues that might need attention. That clears the way for you to decide the next step, even if it puts your FAA medical certification in question, but at least it becomes your decision and it's not subjected to erroneous (and in some cases fraudulent) coding. (For example, even the OP might have seen someone for relationship problems and been put on medication that would only be covered by insurance for certain diagnoses, such as bipolar disease, so the provider did that. The treating physician often has no idea what the repercussions are with the FAA and thinks he's doing something of benefit to the patient. I'm not guessing that's what actually happened, but that's a common and often innocent pathway that gets airmen into trouble.)

The MedXpress instructions say, "List visits for counseling only if related to a personal substance abuse or psychiatric condition." That provides a loophole that airmen should utilize if possible, just to avoid the many pitfalls
I agree - but the vast majority of the public (and pilots are part of) - will want to have insurance "cover" that and not even contemplate, realize, or essentially be too cheap to pay "out of pocket" for something like this. People have forewarned - but hey - you elect to be cheap about it - suffer the potential consequences.
 
A working ATP with a decade of experience went in to see a shrink using his insurance and real name?


Sorry but just based on that obviously bad decision making and blindness for a clear threat, I have more of a issue with that


Did you subconsciously want to be pulled off the line? Was this to collect loss of medical insurance?
 
And since we're on the topic, I have a suggestion for pilots who are concerned about mental health issues that may ultimately get revealed to the FAA. Find a good therapist that works on relationship counseling and discuss problems in your own relationship, whether spousal or other. Make it clear that you are paying for the visit and absolutely need to avoid a coded diagnoses of any kind. Once you air any relationship concerns, you ask for an opinion about any underlying mental issues that might need attention. That clears the way for you to decide the next step, even if it puts your FAA medical certification in question, but at least it becomes your decision and it's not subjected to erroneous (and in some cases fraudulent) coding. (For example, even the OP might have seen someone for relationship problems and been put on medication that would only be covered by insurance for certain diagnoses, such as bipolar disease, so the provider did that. The treating physician often has no idea what the repercussions are with the FAA and thinks he's doing something of benefit to the patient. I'm not guessing that's what actually happened, but that's a common and often innocent pathway that gets airmen into trouble.)

The MedXpress instructions say, "List visits for counseling only if related to a personal substance abuse or psychiatric condition." That provides a loophole that airmen should utilize if possible, just to avoid the many pitfalls
QFT

So many of these issues could be avoided by clearly discussing expectations with your providers.
 
No disrespect to the OP, but I see a lot of posters willing to just blindly accept that the psychiatric diagnosis was incorrect.
The question posed is about overcoming a misdiagnosis. How could anyone answer such a question without assuming there's a misdiagnosis. It should be self-evident that if the diagnosis is correct, then the answers about overcoming a misdiagnosis would not apply. The fact of the matter is that misdiagnoses are not uncommon, for reasons you identified, so it's not a far-fetched claim.
While pilots and wanna-be pilots disagree with this system, can you imagine a scenario in which, given a disqualifying diagnosis, the FAA simply accepts the airman at his word that the trained, experienced clinician was wrong and non medically-trained pilot doesn't actually have the condition?
I don't see anyone suggesting that the FAA just take the airman at his word. But the FAA won't even take the word of a trained, experienced clinician unless he ticks a bunch of boxes and jumps a bunch of hoops, even if the original diagnoser did none of that. Often, the FAA won't even take the word of the original trained, experienced clinician that he got it wrong.
 
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The question posed is about overcoming a misdiagnosis. How could anyone answer such a question without assuming there's a misdiagnosis. It should be self-evident that if the diagnosis is correct, then the answers about overcoming a misdiagnosis would not apply. The fact of the matter is that misdiagnoses are not uncommon, for reasons you identified, so it's not a far-fetched claim.

I don't see anyone suggesting that the FAA just take the airman at his word. But the FAA won't even take the word of a trained, experienced clinician unless he ticks a bunch of boxes and jumps a bunch of hoops, even if the original diagnoser did none of that. Often, the FAA won't even take the word of the original trained, experienced clinician that he got it wrong.
bad spot to be in (for both the FAA and the applicant). Every person who is on meds for whatever - feels like they are ok and good enough to fly. Doctors not understanding the implications of flying also do the same. And there are MANY board level certified docs that flat out lie to the patient about their true mental condition as well. They tell them they are fine (what they want to hear), and that they can do this and do that without many limitations and that carries forward to everything. Very few are going to sit their patients down and say - even though I prescribed you medications that are mind altering, you are not going to ever be able to fly (or do whatever). They punt that to the next doctor that this patient has to deal with.
 
wokespeak??? Lol I’ve never been called that before but ok. Bi polar is not as debilitating as you think in fact the people I know who had it (especially the ones who got it from taking adhd meds at a young age which, should be illegal to prescribe to people under 25) have very strong resolve it’s not debilitating for them and the real reason they stop taking meds is not because they feel fine. it’s because the meds prevent them from doing the things they want to do in life do to government regulations and the stigma against their nero diversity in society.

The system needs to incentivize taking meds and seeking treatment.

One question I asked that has yet to be answered is are there advocacy groups that are working towards a drivers license medical with a signed affidavit from there own dr saying any conditions they may have are totally controlled as to not interfere with private pilot operations? As a Republican I can definitely get on board with that.

There are a lot of good fine upstanding middle-upper middle class conservatives on the libertarian side of things getting left behind in aviation and who want to fly in Central America.

Call it political wokespeak if you want but nero diversity is diversity and bipolar is part of nero diversity.

If your condition is corrected then you should be able to fly, at least in your private life regardless of what you have even if it not just bipolar. Your own doctor should make the decision as to whether your condition is corrected at least for private pilot purposes
The system needs to incentivize taking meds not subjected people for it.
There is a huge difference between crashing a car and injuring/killing a few people and crashing an airplane, regardless of the size of the aircraft. Here's a question for Californiaman...you are flying a small, single engine aircraft (cessna 172 for example), you have an engine out over a highly populated area. You have a choice of crashing into a school playground filled with kids with a very high probablilty that you will live but kill/injure many kids, or crashing into the side of the building that will definitely kill you but no one else. What are you going to do?

This is my favorite argument in my computer science classes concerning autonomous vehicles.

And by the way, we don't care about your political preferences. You want to fly in Central America? Get a pilots license in Central America.
 
Only a fool would advocate for a true BP patient to be in the air.

HOWEVER, the processing of validating a diagnosis or misdiagnosis needs to improve.

I'm in a similar boat: went to my PC at 19 when my parents strong-armed me because my grades started slipping in school. With little conversation I walked out with freshly inked script for meds (Duly doc for those in the chi burbs). This came with the obv ADHD ICD and an ICD for seizures... I've never had one in my life.

Fast forward: the meds didn't make me feel good while going through an abusive relationship, so I went to a psychiatrist. He upped the dosage and gave me a benzo.

I wanted a second opinion so I found another board cert psych. He put me on a different stimulant, kept the benzo, an SNRI, and an anticonvulsant. Naturally coming with ICDs of (drumroll): BPII, ADHD, Borderline pers, depression, and anxiety. The doctor continually noted he wasn't dx but trying to "clean up my brain from the meds I was previously on". In the end, he stopped all prescriptions and I haven't needed to see him nor a therapist since.

I'm pretty darn confident that 4+ years of zero medication or counselling, graduating college, being a top-performer in my job with promotions, and stable relationships would reflect I probably don't have that condition.

Even if the board cert psych came forward explaining his dx process and clinical opinion, the FAA wouldn't give a darn.

This is purely anecdotal, but I'm probably not the only one that has fallen victim to this. While I'm biased, there needs to be a solution for dx validation.
 
I read your post, Cloudsurfer, and all it makes me think is that the FAA is not the one at fault here. I think everyone agrees that those with actual bipolar/ADHD/depression/fill-in-the-blank mental issues should not be flying because they don't have the mental capability consistently to safely fly an airplane. It seems to me that doctors should stop prescribing medications and assigning diagnoses that apparently aren't true. If that stopped, you wouldn't have to worry about the FAA at all.

Maybe it is as much a problem with parents as with the doctors. There are legitimate diagnoses of ADHD and the like, but at this point in time, it's more socially acceptable to zombify a hyperactive (but cognitively healthy) child with medication than it is to teach him how to deal with that hyperactivity and channel it to benefit him. It's easier to put a moody teenager or college-age young adult on anti-depressants or other drugs than it is to help them learn to vent their stresses, frustrations, and disappointments in a healthy manner and teach them how to make goals and see beyond tomorrow or next week. If parents would parent their children and doctors would say, "There's nothing wrong with this child that some lifestyle changes couldn't fix" instead of putting every non-cookie-cutter child on drugs, I don't think this would even be an issue.
 
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thats absolutely the case - but no one in society takes responsibility anymore - and certainly not something that they can use as a crutch to explain away problematic behavior - oh my kid is <insert whatever disorder here> . . it unfortunately cripples them when it comes to an aviation career in the future which they hadnt considered or honestly dont really give a damn until their kid is denied. but when their is a diagnosis, the FAA has no real choice - they have to accept it at face value until you can prove otherwise with a doctor that is within their system - and not one you choose that will just "sign off". If doctors were legally liable/responsible for sign offs - I imagine you will see a lot less of doctors signing off just to sign things off.

Also, some medical professionals have indicated that there is some level of unknown brain function changes that happen after long term use of certain medications. Those are something that the drug taker, the drug manufacturer and many others are unwilling to reveal or accept, and unknown to what degree in each individual person. And the FAA has hinted at that - but I dont believe has come out and said anything about it. I guess the best analogy one could make - you know those people who have taken acid/LSD for a long period of time, or marijuana (pot heads) - its like you know they have been on drugs for a long period of time, even if they are currently not under that influence. Some mental changes have taken place. . .
 
cloudsurfer, ADD: it works like this:

Kid's grades are slipping. Mom gets ambushed at 4:00 pm in the principals office with teacher and and school LCSW, told "Johnny needs a pill". Mom does NOT have time nor $3,000 to get Johnny to a private evaluator and so takes thr path of least resistance.

Mom And Johnny appear at the PCP's. PCP knows johnny is going to get those pilsl form somehwere. So you do a questionnaire and that serves as the basis for an Rx. That is "someone with a license thinks Johnny needs meds".

The fault is with us, the parents. I had a battle with one of my offspring's teachers....but they did not understand who the dad, was.
She got NO MEDS and is now a director level employee in a State Brueaucracy. Great Job, six figures, etc.

Credit to Walt Kelly ("Pogo"): "I have met the enemy and he is us".

But Bipolar is a different ball of wax. There was, in addition to the tru biploars, in about 2001, a group of kids who didn't really have Bipolar disease, but the DSM had not yet been revised to have the option of "Oppositional Defiant disorder". So some kids from that age were given THAT diangosis: Bipolar (As there was as of that time no option). Now, some think that Oppositional Defiant Disorder is part forebrain late developenent (LACK of development) but there are some that clearly, are"failures of parenting". In these limited numbers of cases, it's LACK OF excellent PARENTING. Again, "I have met the enemy and he is us". Parenting, is hard.
 
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Doc;

You're describing a system (re: ADHD) that seems far more likely to yield a false positive than any other result. Why on earth isn't trusting something like that "arbitrary and capricious" (to borrow a relevant phrase)?

BTW, I've got the T-shirt from this rodeo. My local government schools wanted my daughter (now 18) medicated for ADHD since second grade. Their recommended doc was happy to rubber stamp her second-grade teacher's dx.

It took me, a medical layman, to recognize the problem was/is anxiety -- her childhood play-acting was always crisis-focused, and she jumps at her shadow. She shows some improvement on a low dose of Zoloft since her teen years. Fortunately (in at least one sense), she has no interest in flying, so that isn't an issue.
 
"I have met the enemy and he is us".

Isn't at least part of the problem the complexity of the insurance system? The PCP has to declare a diagnosis on paper in order to get paid by an insurer, so declare s/he will.

I was faced with an insurance choice between plans/employers. Not even the billing director at several practices I used regularly could tell me what would be billed and what my out of pocket would be between the various plans that they all accepted. It is therefore (conveniently) impossible for even the most diligent consumer to shop with price in mind.
 
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