Grief and anti-depressants

  • Thread starter Thread starter Anon
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Anon said:
Met with psych nurse yesterday. She will work with me to ensure diagnosis does not make FAA process worse.

She proposed situational anxiety and situational depression. One week of Xanax to get sleep pattern stable, then 3-4 months of Lexapro.

Looking at the Situational Depression and Anxiety/Depression tools, this looks like it will pass review without deferral, assuming my situation resolves itself without recurring.

Seems to me the Xanax is riskier that the SSRI from an FAA perspective. Should I ask her to write for situational depression and Lexapro only?
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With all due respect,I wouldn’t have a nurse handle this. I had a brief period once where I had anxiety when my mother had cancer. I swore up and down nothing was bothering me. One day I literally didn’t have the energy to walk five feet. Anxiety is a weird thing. I would go to an MD or at the very least a PhD.
 
SoCal 182 Driver said:
Obviously I've been trying to understand the parameters here, and @Half Fast has been patient in answering my questions.
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The regulations and processes are clearly, IMHO, confusing and nonsensical. I’d be interested in hearing definitive feedback.

It’s confusing because, as I understand it, you can have conditions and medications that disqualify you from holding/being issued a class 3, but are not an issue for basic med. So, you can fly under basic med with those otherwise class 3 disqualification(s). Unless you first applied for a class 3 and were denied, or revoked for class 3.

So, per the FAA, if we know about it, you can’t fly under class 3 OR basic med, OR sports pilot for that matter. If you keep us out of the process, but would otherwise be denied a class 3, you’re fine to hop into a 6000 lbs aircraft with 5 passengers and fly up to 250kn.

Makes perfect sense.
 
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@Anon - I almost lost my son. 3 years of chemo, radiation, relaspes, doctors telling us there was no hope, 14 hours head/neck surgery, the list goes on and on...
While I would never claim I'm in the same boat, my mind lived there fear for 3 years, and I'm still far from 100%. A SSRI and therapy was very helpful.
If you ever need to talk I'm all ears. Don't hesitate to reach out if I can help in any way.
 
UTLonghorn_1979 said:
The regulations and processes are clearly, IMHO, confusing and nonsensical. I’d be interested in hearing definitive feedback.

It’s confusing because, as I understand it, you can have conditions and medications that disqualify you from holding/being issued a class 3, but are not an issue for basic med. So, you can fly under basic med with those otherwise class 3 disqualification(s). Unless you first applied for a class 3 and were denied, or revoked for class 3.

So, per the FAA, if we know about it, you can’t fly under class 3 OR basic med, OR sports pilot for that matter. If you keep us out of the process, but would otherwise be denied a class 3, you’re fine to hop into a 6000 lbs aircraft with 5 passengers and fly up to 250kn.

Makes perfect sense.
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This is what the FAA gets for abusing and taking advantage of pilots.
 
bryankloos said:
@Anon - I almost lost my son. 3 years of chemo, radiation, relaspes, doctors telling us there was no hope, 14 hours head/neck surgery, the list goes on and on...
While I would never claim I'm in the same boat, my mind lived there fear for 3 years, and I'm still far from 100%. A SSRI and therapy was very helpful.
If you ever need to talk I'm all ears. Don't hesitate to reach out if I can help in any way.
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Thanks for sharing. That must have been incredibly hard.

I'm coming up on 2 weeks on an SSRI. It does seem to be helping.
 
Xanax or SSRIs you'll be grounded for two years. They'll make a nightmare to beat and it'll cost you thousands in a HIMS appointment and HIMS AME.

My advice is do what's best for you first. Take care of yourself.

And possibly see a doctor in Mexico to keep everything off the books.
 
I have been on Lexapro for a month now. I am very glad I made this decision. I was not in a sustainable place. The SSRI is a huge help.

In the last 2 weeks I have flown a few times with a pilot friend. It reminded me how much I love to fly.

I am starting to think forward to a future flying again. I have been reviewing the fast track tools. Are the options below correct?

1. Discontinue use when ready, wait 2 years, then reapply for a class 3 using the fast track tool.

2. Discontinue use within 6 months of diagnosis, wait 6 months, then reapply for a class 3 using the "adjustment disorder" tool.

3. Get on BasicMed and continue use as long as needed and Doctor concurs.
 
Wonderful progress and good on you for your hard work and perseverance.

I doubt it would be an attractive option in current form, but, just to see all the plays - a fourth option is to exercise sport privileges as a PPL. Post MOSAIC, it could be more attractive.

As you consider your options, keep in mind what options 3 and 4 could do for you, and the jeopardy 1 and 2 pose if unsuccessful for any reason.
 
Anon said:
I have been on Lexapro for a month now. I am very glad I made this decision. I was not in a sustainable place. The SSRI is a huge help.

In the last 2 weeks I have flown a few times with a pilot friend. It reminded me how much I love to fly.

I am starting to think forward to a future flying again. I have been reviewing the fast track tools. Are the options below correct?

1. Discontinue use when ready, wait 2 years, then reapply for a class 3 using the fast track tool.

2. Discontinue use within 6 months of diagnosis, wait 6 months, then reapply for a class 3 using the "adjustment disorder" tool.

3. Get on BasicMed and continue use as long as needed and Doctor concurs.
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@bbchien will give the best advice for this.

When the time comes, if he’s able to consult his small fee is worth ten times the cost.
 
Anon said:
I have been on Lexapro for a month now. I am very glad I made this decision. I was not in a sustainable place. The SSRI is a huge help.

In the last 2 weeks I have flown a few times with a pilot friend. It reminded me how much I love to fly.

I am starting to think forward to a future flying again. I have been reviewing the fast track tools. Are the options below correct?

1. Discontinue use when ready, wait 2 years, then reapply for a class 3 using the fast track tool.

2. Discontinue use within 6 months of diagnosis, wait 6 months, then reapply for a class 3 using the "adjustment disorder" tool.

3. Get on BasicMed and continue use as long as needed and Doctor concurs.
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Keep in mind that option 3 does not preclude using 1 or 2 later on. There’s not really any good reason not to get Basic Med; no risk, no harm.
 
Anon said:
I recently lost my son. I am struggling with my mental health and it feels like I am getting worse. I plan to get help. I may ask for medication.

I have a PPL and 3rd class medical.

What are the likely impacts?
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I'm so sorry
 
bbchien said:
The situational depression tool only helps us if the DURATION on the med is 6 months or less.
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I have now been on the SSRI for 3.5 months. I am doing much better. Deeply sad, but not depressed or anxious.
Next month I plan to gradually reduce my dosage to zero.
My Class 3 medical expires in November.
Assuming I am able to stop the SSRI without issues, my plan is to wait 6 months, then seek regular issuance under the situational depression criteria.

To recap:
- I was diagnosed with adjustment disorder with anxiety.
- I was prescribed one medication, an SSRI.
- I will have taken the med for 5 months.
- I will have been off the med for 6 months.

Any hitches to my plan?
 
Update:

I weaned myself off meds in March. Duration on SSRI was 5 months. I relocated and did not fly as PIC during that time.

I return home next week and plan to resume flying. I will go back to the prescribing psych nurse next month for a follow-up to document no side effects or return of symptoms.

My Class III is due in November. Should I do a consult first, or am I safe proceeding with renewal at that time?
 
I don't know where people get the Wait two years. The queiston 18(m) on the aplciation is "have you ever in iyour life".

Nontheless, if you are offf prior to 6 months you need a letter from your prescriber that sez Eight things.
(1) Diagnosis
(2) Date of onset of Rx
(3) Date of end of Rx
(4) What was used to treat
(5) That there was no suicidality
(6) Doc has to state the stimulus for the depression and that it has passed,
(7) That to his knowledge this was your one and only event in your life requiring psychiatry support
(8) That he has seen you >>60 days from the end of the treatment, that you are recovered and thta there are no symptoms left to treat.

If you have such a note, good AME can reissue you in the office. But the doc cannot miss a one of the eight items. EACH and every, needs to be addressed, LITERALLY. And that letter needs be within 90 days prior to your renewal.
 
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Anon said:
Update:

I weaned myself off meds in March. Duration on SSRI was 5 months. I relocated and did not fly as PIC during that time.

I return home next week and plan to resume flying. I will go back to the prescribing psych nurse next month for a follow-up to document no side effects or return of symptoms.

My Class III is due in November. Should I do a consult first, or am I safe proceeding with renewal at that time?
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Glad to hear it; I’m always a fan of a consult first if there’s an SI involved. Good news is you don’t have to wait to renewal to do the consult and you can use the intervening time to make sure all the ducks and docs are squared away.
 
bbchien said:
I don't know where people get the Wait two years. The queiston 18(m) on the aplciation is "have you ever in iyour life".

Nontheless, if you are offf prior to 6 months you need a letter from your prescriber that sez Eight things.
(1) Diagnosis
(2) Date of onset of Rx
(3) Date of end of Rx
(4) What was used to treat
(5) That there was no suicidality
(6) Doc has to state the stimulus for the depression and that it has passed,
(7) That to his knowledge this was your one and only event in your life requiring psychiatry support
(8) That he has seen you >>60 days from the end of the treatment, that you are recovered and thta there are no symptoms left to treat.

If you have such a note, good AME can reissue you in the office. But the doc cannot miss a one of the eight items. EACH and every, needs to be addressed, LITERALLY. And that letter needs be within 90 days prior to your renewal.
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Ok, I'm ready to do this.

One complication: the prescriber was a Psych NP at a counseling practice
. Unfortunately she has moved on and has been replaced. Her replacement would have access to my records there, but has not met with me.

My PCP is a PA at a military base clinic. She was involved in the decision to prescribe, and she has had appointments with me since then. She has access to my military medical records for the past 40 years.

Which would be better to sign the letter?
 
Found a HIMS AME psychiatrist in area who offers consultations and does Basic Med. I scheduled a consultation tomorrow. If he says Class 3 is too hard, I'll go to him for Basic Med.
 
Anon said:
Found a HIMS AME psychiatrist in area who offers consultations and does Basic Med. I scheduled a consultation tomorrow. If he says Class 3 is too hard, I'll go to him for Basic Med.
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Have you already held a class 3? It’s a prerequisite for Basic.
 
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