Pyschiatric Evaluation

Discussion in 'Medical Topics' started by ChrisAD, Dec 7, 2018.

  1. ChrisAD

    ChrisAD Guest

    Hello,

    I'm going in for the psychiatric evaluation next week for my medical. I experienced anxiety/depressive disorders and the FAA grounded me after I began taking medication. I have been off the medication for over 60 days and I am going in for a psychiatric evaluation. The doctor said it would be between 2-3 hours long. I was wondering if anyone who has been evaluated knows what it's like and what questions they'll ask?
     
  2. AggieMike88

    AggieMike88 Touchdown! Greaser!

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  3. Kenny Phillips

    Kenny Phillips Cleared for Takeoff

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    Thankfully they don't require all pilots to take a cog screen.
     
  4. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    I am pretty sure there will no pulling out your fingernails ... and waterboarding is out too! Seriously a biggie ... did the medication help?
     
  5. ChrisAD

    ChrisAD Guest

    Yes but I didn’t want to take them indefinitely
     
  6. Half Fast

    Half Fast En-Route

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    Lou, just out of curiosity.... How does the FAA view things like St. John’s wort or passion flower for anxiety? A guy I know at church found SJW to be very effective, though I doubt it works for everyone.
     
  7. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    they are supplements and do not have to be reported!
     
  8. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    Therein may lie a problem. Medications do help depression unless one does not have depression. Hopefully your case will be deemed to be minor and insignificant.
     
    Last edited: Dec 8, 2018
  9. Half Fast

    Half Fast En-Route

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    I wonder whether many airmen use them for that reason, and whether airmen on an anti-depressant might use one of them to help discontinue the drug.
     
  10. bbchien

    bbchien Touchdown! Greaser!

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    Things that matter:

    Sole episode or one of a few episodes
    Severity of episode: was reality testing affected?
    Was there any suicidality?
    One or multiple meds required?
    Age at onset.....
     
  11. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    I had a similar case, airman wanted to come off SSRI. I asked him to consult his doctor, friends, co-workers and loved ones (the wife!) He stayed on medication and though it took time, $ and a SI, he now flies safe and happy and has a wife to come home to!
     
  12. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    I edited my post, as it was in error! the fact a SSRI helps, ipso facto means a degree of depression is present. The HIMS process is used to first determine the degree, then the treatment.
     
  13. Rushie

    Rushie Pattern Altitude

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    We knew what you meant. At least I did.
     
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  14. benyflyguy

    benyflyguy Cleared for Takeoff

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    St. John’s wort has significant serotonin reuptake inhibition and can be rather effective so much so that when inadvertently taken with a SSRI can lead to serotonin syndrome. Problem lies with lack of regulation in supplement world so from bottle to bottle you could be getting wide fluctuations of bioavailability-again making potentially dangerous.
     
  15. Half Fast

    Half Fast En-Route

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    All that makes sense. All supplements have some risk of variation in potency, not being as tightly controlled as regulated drugs.

    I know SJW is often prescribed in Europe, especially Germany. There is some clinical evidence showing it to be as effective as SRIs, but I'm sure it's less effective with some people than others. I wouldn't be surprised to learn many pilots are using it rather than a prescription anti-depressant.

    Passion flower is often used, too, for anxiety.
     
  16. Rushie

    Rushie Pattern Altitude

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    This is true, you should never take SJW with a prescription SSRI. But lack of government regulation doesn't mean supplements are unregulated. Private testing labs and self regulation of an industry can be as good or even better than government regulation. However it means the user has to take responsibility for finding out whether a particular product is what it claims to be.

    First you vet the producer. A reputable company will have test reports available and the product will be as potent as it claims, in fact, they are often accurate to a closer degree than prescription medications are required to be. This might especially be true since prescriptions drugs have started to be sourced outside the USA.

    Then one needs to educate oneself about herbal and supplement products. What's the difference between whole herbs and extracts? How do you read the shorthand to compare products and calculate equivalencies? And so on.

    Then you need to get yourself thoroughly educated on the subject of your disorder, including all the theory and available evidence for the science behind how the supplement is supposed to treat it, as well as everything about standard prescription drug treatment. You need to be able to compare them. Not only do you need to compare the benefits of traditional prescription drug to alternative herbal or supplement treatments, you need to compare risks and side effects. Both have them so there are four categories you need to become thoroughly acquainted with: benefits of each and risks of each.

    Not only do you need to know the equivalencies of various herbal preparations to each other, you need to know the equivalencies of them to approved prescription drugs. For example if you are on a prescription SSRI and wish to switch to an herb, you need to know how to begin substitution to accomplish a smooth transition.

    In short, you need to own your own treatment, as opposed to blindly trusting a doctor. If you don't then you can waste money on worthless supplements at best or really hurt yourself at worst.