MDD in remission + messy chart + unapproved med — where do I stand?

[Carolineandyou]

Hi everyone, aspiring student pilot here, 30F, looking for genuine advice about my FAA medical situation before I apply.


Here's my full picture:


MENTAL HEALTH:At my first PCP visit I mentioned I had been told by past therapists I might have bipolar disorder. My doctor documented this. I immediately went back for a follow up specifically to clarify — she updated my chart confirming bipolar was NEVER formally diagnosed by a psychiatrist, and my history better fits recurrent major depression. No history of mania, no suicidal ideation, no psychiatric hospitalizations. Currently in full remission, feeling well, no psychiatric medications, just have a therapist.


The problem: even though I clarified everything, my doctor ended up documenting ALL the original details again in the second note including my PHQ-9 score of 15 from the first visit.


EATING DISORDER:History of bulimia, in remission for over a year. Documented in chart.


MEDICATIONS/SUBSTANCES:- Currently only taking magnesium and omega-3s- History of anabolic steroid use approximately 10 years ago for 6 months- Currently taking retatrutide (GLP-1, not yet FDA approved in the US) obtained legally in anoher country.


QUESTIONS FOR THE COMMUNITY:1. Does recurrent MDD in full remission with no medication automatically disqualify me?2. Has anyone navigated a chart with messy initial documentation that got clarified later?3. Should I get a formal psychiatric evaluation BEFORE seeing an AME to get a clean professional opinion on record?4. Does the unapproved medication situation create problems even if it's legal in my country of origin?5. Any AME recommendations who are experienced with complex mental health histories?


Thank you — I want to do this right from the start.

 

[flyingron]

The problem (Dr. B will be along soon), is that bipolar doesn't magically go into remission. You'll have to prove you never had it and you don't have it now.

 

[bbchien]

1. Does recurrent MDD in full remission with no medication automatically disqualify me?2. Has anyone navigated a chart with messy initial documentation that got clarified later?3. Should I get a formal psychiatric evaluation BEFORE seeing an AME to get a clean professional opinion on record?4. Does the unapproved medication situation create problems even if it's legal in my country of origin?5. Any AME recommendations who are experienced with complex mental health histories?

...and if you have "recurrent" MDD, the only path forward is in the ON SSRI (minidose is fine!) certification pathway....
So, you will have to engage a HIMS AME who will set up you up for the HIMS psychiatrist and HIMS neuropscyhology evaluations. You DO have to be under the care of a board certified MD psychiatrist for this path to get anyplace- (not he ARNP, the DOC). The community PhD and psychiatrist MD use a different set of definitions of disease than in DSM5.

FAA denies 100% of recurrent depression, unmonitored and untreated.
And if you have any references to suicidality in your record you chances are limited....not zero, but limited and depends on details.

This pathway isn't cheap but from what you wrote, appears to be your only path forward.