Single, Short Psychiatric Visit in my Past.

A

Almond_Dandy

Guest
Hello pilots, I'm looking for some advice / insight on my specific situation. Any help would be much appreciated by me, and hopefully my post can help others as well.

Within the last three years I had one short visit to a psychiatric office (not a hospital). This was triggered by me essentially asking my physician for a referral, which I did because my mother and my spouse were worried because I was unemployed (I have substantial savings and was not interested in employment at the time), fighting constantly with my spouse, and smoked weed for recreation (not illegal in my state, although I understand this matters none to the FAA).

So, I told my physician I would like to talk to someone for the reasons above. My physician essentially told me "I'm not a psych(ologist / iatrist) so don't take this too seriously, but maybe you have xyz mental issue" (don't remember exactly what they said, but I don't think it matters because they're not that kind of doctor, and also said not to take it seriously). They also told me to stop recreational weed use, so I did. I think a simple visit to a therapist or two would have absolutely sufficed considering I have zero history of mental issues, but I went where my doctor referred me to, which was a psychiatric office. At the time I wasn't exactly aware of a difference.

My visit was very short. I filled out a questionnaire on paper, but don't remember what I said. I probably mentioned smoking pot and fighting with my spouse. I had a 20 or so minute talk with a person, where she mostly just asked "why are you here" to which I mostly just talked about the fights that led to my spouse asking me to come here (no physical violence, not verbal abuse, just intense stress). It was all very preliminary, with only a few questions like (do you ever see things that aren't there, hear things, etc). She did not prescribe me anything, did not mention any potential prescriptions, did not diagnose me with anything or even mention a potential diagnosis. She recommended me to return for a longer evaluation as she seemed short on time, but due to the holidays, their nearest appointment was three weeks out. In those three weeks I had a nice Christmas and New Years spent with my spouse and immediate family. I also talked to my psychologist relative, who taught me the difference between therapy, psychiatry, psychology, etc. Ultimately, I decided that the stress, stopping recreational weed use, combined with the improvement in my relationships, simply was not reason enough for me to return for more sessions. After this, I called my parents more often and got better at talking to them, talked to my spouse more reasonably to solve our issues, and cut weed and weed-smoking friends out of my life. Case closed, right?

Well, now I want to get my private pilot license. I lean heavily towards blunt honesty, so I'm not taking any shortcuts. For a class III medical, I'm past the two-year illicit drug use deadline, but not the three-year doctor visits deadline. I'm afraid that if this psychiatric visit is mentioned, I will be given heavy scrutiny that may be overblown, just like how I felt the visit itself was a bit overblown. Should I just wait for the three year deadline or is that insincere? Even if the three year deadline passes, I'm also worried about my physician mentioning "xyz mental issue", and whether they or the psych put something in my medical records that would come up later that I'm not aware of. Example: my physician spit-balled that mental issue, so did they also spit-ball drug issues because of recreational weed use? Will the FAA see that I used weed for recreation and jump straight to "drug dependency"? I did not mention why my spouse, family, and myself were having issues (family never approved of the relationship, spousal relationship events that would naturally cause stress for me, married at 19, unemployed because I had substantial savings and was interested in starting a business, etc). Again, no shortcuts, but if I can legally, ethically, morally avoid talking about this embarrassing (for me) part of my life, I would very much like to.
 
I also forgot to mention that I have no criminal history related to this visit or weed use. I have two tickets for speeding from more than four years ago, and I once got a ticket for drinking a beer on a public beach on the fourth of july two or three years ago. Although, I'm fairly certain I was cited for the glass container on the beach, and not for actual public drinking. Ticket was paid, and that was it.
 
First, start reconsidering acting on everything your spouse tells you to do. :)

The thing that will get you is question "m" and "n" on the 8500-8/MedExpress. You have to report these things if you have "ever in your life been diagnoses with, had, or do you presently have any of the following". The 3 year limit may allow you to not list the visit, but if you've "had" the condition ever in your life you must report it. Lying entails severe penalties if you're caught.

"m": Mental disorders of any sort: depression, anxiety etc.
"n": Substance dependence or failed a drug test ever; or substance abuse or use of illegal substances in the last 2 years.

From your account I'd say it's fair that you may have had at least situational depression or anxiety. You'll have to decide on that. The counseling in and of itself probably wouldn't be an issue as I doubt the therapist entered a formal diagnosis into the record after 1 visit. The real issue is you now have a medical record with a physician and mental health professional that almost certainly includes that you recreationally use weed. If that gets in front of the FAA without the proper preparation, your life is going to get difficult.

Get the medical records from the physician where you received the referral AND the documentation from the mental health professional visit. Request the ACTUAL records from the hospital/health system medical records department not some print out or summary letter. You want to review what the FAA would require you to produce under additional scrutiny. Get the records reviewed by a qualified AME before you put in an application for the medical. Pay the AME to act as your personal physician, NOT to administer an FAA medical exam. I would select a HIMS AME as your case includes what the FAA could interpret as substance abuse (use of an illegal substance).

It wouldn't hurt to start documenting your abstinence with some form of drug testing. Preferably random lab administered testing similar to what DOT safety sensitive professions require. I'd also be sure to make primary care physician is aware that you're no longer using weed. Ideally you don't want any reference to the weed in the record, but if it's already there you want to document when you stopped. The rule in medicine is if it's not documented in the medical record it never happened.

If you're not done with weed FOREVER just forget about aviation. It's not me being judgemental, it's just reality.
 
Figure out if this is a problem first

Ask for all medical records from the shrink as well as doc who recommended the shrink and said you may have XYZ issue

How did you pay for the shrink? If it was insurance that might be a issue depending on how it was billed

I would also ask for your rap sheet about the drinking on the beach
https://www.edo.cjis.gov/#/

Normal person would have no issue with your non issue, but FAA is not normal, I had a student who went in for a medical, he took those ADD pills for a short time when he was little, like lots of his generation, FAA says that means he must be so mentally defective he can’t fly a plane, the person is very successful in life obviously no issues, he decided not to continue flight training out of frustration of the hoops the FAA said he had to jump.

No matter your choice do not submit a medical or fill out any online or official application for one until you know what the doctors and court entered for you and you know it will go through.
 
In the land of lake woebegone, where the women are strong, the men are good looking and the children are all above average, even if she doesn't "call out" cannabis use disorder (nor use the code), it will be clearly recorded.

Consider for a moment a candidate with your history, vs. one with no such history. Which one would the agency be willing to certify.

Have the patience to go > 3 years, or get an evaluation.
 
First, start reconsidering acting on everything your spouse tells you to do. :)

The thing that will get you is question "m" and "n" on the 8500-8/MedExpress. You have to report these things if you have "ever in your life been diagnoses with, had, or do you presently have any of the following". The 3 year limit may allow you to not list the visit, but if you've "had" the condition ever in your life you must report it. Lying entails severe penalties if you're caught.

"m": Mental disorders of any sort: depression, anxiety etc.
"n": Substance dependence or failed a drug test ever; or substance abuse or use of illegal substances in the last 2 years.

From your account I'd say it's fair that you may have had at least situational depression or anxiety. You'll have to decide on that. The counseling in and of itself probably wouldn't be an issue as I doubt the therapist entered a formal diagnosis into the record after 1 visit. The real issue is you now have a medical record with a physician and mental health professional that almost certainly includes that you recreationally use weed. If that gets in front of the FAA without the proper preparation, your life is going to get difficult.

Get the medical records from the physician where you received the referral AND the documentation from the mental health professional visit. Request the ACTUAL records from the hospital/health system medical records department not some print out or summary letter. You want to review what the FAA would require you to produce under additional scrutiny. Get the records reviewed by a qualified AME before you put in an application for the medical. Pay the AME to act as your personal physician, NOT to administer an FAA medical exam. I would select a HIMS AME as your case includes what the FAA could interpret as substance abuse (use of an illegal substance).

It wouldn't hurt to start documenting your abstinence with some form of drug testing. Preferably random lab administered testing similar to what DOT safety sensitive professions require. I'd also be sure to make primary care physician is aware that you're no longer using weed. Ideally you don't want any reference to the weed in the record, but if it's already there you want to document when you stopped. The rule in medicine is if it's not documented in the medical record it never happened.

If you're not done with weed FOREVER just forget about aviation. It's not me being judgemental, it's just reality.

First point taken, we have talked about it a lot and I chalk most of it up to us being young, young, young, with little outside support. Last point taken as well; weed and aviation do not mix, and for me if it's a choice between the two, the choice is easy: Aviation. So, I'm glad I cut it completely when I did.

You and DanStrange make really good points about the first steps I should take. Simply, I should request to see my medical records, because I really don't actually know what those doctors ultimately thought of my predicament. And, pretty soon after, I moved as well so I haven't spoken with that physician in a while.

In my mind I was not depressed, maybe some anxiety but pretty situational anxiety. Mostly, I was upset with little guidance.

In the land of lake woebegone, where the women are strong, the men are good looking and the children are all above average, even if she doesn't "call out" cannabis use disorder (nor use the code), it will be clearly recorded.

Consider for a moment a candidate with your history, vs. one with no such history. Which one would the agency be willing to certify.

Have the patience to go > 3 years, or get an evaluation.

I really appreciate your reply. I think cannabis use was clearly recorded, I just don't know if the FAA sees my use as dependence or abuse, perhaps I'm just confused by the wording on 8500-8? After I review my records maybe it's just something I discuss with the right AME?

I'm not interested in aviation as a career, is the "agency" really choosing between one candidate or the other? I would have thought it's just based on qualification. I have the patience to go >3 years, and also the patience to jump hoops for the FAA. I would just like to do it the "right" way, so that there are no headaches down the road for myself or anyone else.

I appreciate the replies. I will take a look at what my physician and the psychiatrist may have put in my medical records, maybe talk with my old physician if they're open to it, and move from there. If you have any more guidance I am all ears.
 
weed and aviation do not mix, and for me if it's a choice between the two, the choice is easy: Aviation. So, I'm glad I cut it completely when I did.

I really appreciate your reply. I think cannabis use was clearly recorded, I just don't know if the FAA sees my use as dependence or abuse, perhaps I'm just confused by the wording on 8500-8? After I review my records maybe it's just something I discuss with the right AME?

I appreciate the replies. I will take a look at what my physician and the psychiatrist may have put in my medical records, maybe talk with my old physician if they're open to it, and move from there. If you have any more guidance I am all ears.

I wish we saw more interactions like this. Get the records, see what's in them, find a good AME that's willing to assist you (like Dr. Chien), be 100% honest/cooperative, maintain this problem solving mindset. Do this and you'll maximize your chances of obtaining a medical and minimize the pain required to do so. Just don't submit to an FAA medical exam until you have high certainty that you'll "pass" and provide the FAA with all the required documentation in one shot. A good AME won't let you anyway.

On a side note. You may face "unfairness" from the FAA and be presented with requests and a process that seem unreasonable. The question is how committed you are and how much time/money you'll expend to demonstrate that commitment. If you want it bad enough there's usually a way. That's just the cost many have faced to become a pilot. My personal experience has been that aviation has positively impacted my life in so many ways (expected and unexpected) that there's no question in my mind that it's worth it. Good luck and I hope you get it all sorted out!
 
I wish we saw more interactions like this. Get the records, see what's in them, find a good AME that's willing to assist you (like Dr. Chien), be 100% honest/cooperative, maintain this problem solving mindset. Do this and you'll maximize your chances of obtaining a medical and minimize the pain required to do so. Just don't submit to an FAA medical exam until you have high certainty that you'll "pass" and provide the FAA with all the required documentation in one shot. A good AME won't let you anyway.

On a side note. You may face "unfairness" from the FAA and be presented with requests and a process that seem unreasonable. The question is how committed you are and how much time/money you'll expend to demonstrate that commitment. If you want it bad enough there's usually a way. That's just the cost many have faced to become a pilot. My personal experience has been that aviation has positively impacted my life in so many ways (expected and unexpected) that there's no question in my mind that it's worth it. Good luck and I hope you get it all sorted out!

I'm %100 committed and typically honest to a fault, "unfairness" be damned". I'm just hoping twenty or less minutes with that psychiatrist won't keep me from being a pilot in the future. I've read about psychiatrists making very quick diagnoses, although they hinted at nothing during our brief encounter. They just told me I could come back for a full eval at a later date, no medication whatsoever. Now I'm just waiting on a reply from their office to get my records (COVID keeps this office to limited hours and staff...)
 
I don’t know all the specifics of what was mentioned & documented. I’m also not saying to lie about anything. Could the counseling session be in the ‘marital issues’ category? Again, don’t know what all lead to it.

The recreational Marijuana use is the next issue.
 
I'm %100 committed and typically honest to a fault, "unfairness" be damned". I'm just hoping twenty or less minutes with that psychiatrist won't keep me from being a pilot in the future. I've read about psychiatrists making very quick diagnoses, although they hinted at nothing during our brief encounter. They just told me I could come back for a full eval at a later date, no medication whatsoever. Now I'm just waiting on a reply from their office to get my records (COVID keeps this office to limited hours and staff...)
Have you looked at the medxpress form, read the instructions carefully, and considered which parts of your story do and do not need to be disclosed?
 
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