Symptoms of anxiety but no diagnosis

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Hello all. I am planning on getting a 1st class medical but have a question on how to address a part of the medxpress form. I would like to preface this by saying I know to not actually fill out the form yet. I will be meeting with an AME for a consult beforehand, but I wanted to consult this forum as well for advice to see what others had to say.

Some years ago I reported some feelings of anxiety to my doctor. They wrote this in the clinical note, but did not diagnose me with anything (the diagnosis for the visit was the general "office visit" default diagnosis) and did not prescribe any medications. The doctor recommended seeking out a talk therapist and said so in the note, but I was able to improve my symptoms through lifestyle changes and never saw a therapist.

I am wondering how to address question 18m on medxpress (the question on anxiety, depression, etc.). I have never been diagnosed with any of these, so is this something I do not have to disclose? Or since there is a record of symptoms I should disclose it? I would like to avoid having to prove somehow that I do not have something I have never been diagnosed with (I don't even know how you do that?), but will jump through all the hoops if I have to. Thank you in advance for reading and any advice you can offer.
 
anon said:
Hello all. I am planning on getting a 1st class medical but have a question on how to address a part of the medxpress form. I would like to preface this by saying I know to not actually fill out the form yet. I will be meeting with an AME for a consult beforehand, but I wanted to consult this forum as well for advice to see what others had to say.

Some years ago I reported some feelings of anxiety to my doctor. They wrote this in the clinical note, but did not diagnose me with anything (the diagnosis for the visit was the general "office visit" default diagnosis) and did not prescribe any medications. The doctor recommended seeking out a talk therapist and said so in the note, but I was able to improve my symptoms through lifestyle changes and never saw a therapist.

I am wondering how to address question 18m on medxpress (the question on anxiety, depression, etc.). I have never been diagnosed with any of these, so is this something I do not have to disclose? Or since there is a record of symptoms I should disclose it? I would like to avoid having to prove somehow that I do not have something I have never been diagnosed with (I don't even know how you do that?), but will jump through all the hoops if I have to. Thank you in advance for reading and any advice you can offer.
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You're required to complete the form to the best of your knowledge. While a formal diagnosis isn't technically required to elicit a "Yes" answer, the question isn't whether you've ever felt anxious, but whether you've ever had an anxiety disorder.
 
The agency will want to see the ENTIRE record as "no formal diagnosis" is 50% of the time a ruse. A Good AME who has reviewed the ENTIRE File and concurs with your assessment might issue you, but the file will have to be sent to OKC for their second guesstimate. And it better be good: if the behavior is detailed enough the FAA will demand a psychiatrist's take anyway. PCPs are INEXPERT in this area.

"No formal diagnosis" is a RED FLAG.
 
bbchien said:
The agency will want to see the ENTIRE record as "no formal diagnosis" is 50% of the time a ruse. A Good AME who has reviewed the ENTIRE File and concurs with your assessment might issue you, but the file will have to be sent to OKC for their second guesstimate. And it better be good: if the behavior is detailed enough the FAA will demand a psychiatrist's take anyway. PCPs are INEXPERT in this area.

"No formal diagnosis" is a RED FLAG.
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The question was how to answer the question about mental disorders on Medxpress.
 
He needs a pre consult. AME needs to read the record and look at the insurance codes.
I'm just pointing out that the OP is not speaking the language of success, here, he' speaking the language of "hiding the ball" here. If the AME reviews the record and concurs and states such it pretty much drives the nail in the coffin of any such "We're not certain you are elligble for the certificate for which you applied. Please within 60 days send....." I do those evaluations all the time. But they wont ask a HIMS AME to do that after the fact. It'll be psychiatrist. If yo succeed BEFORE teh fact, its game set and match over you won.

Another example is the single DUI >5 years old with no BAC is another, although that eval is a LOT of work. I've never been reversed on that one but I do do the spade work.

("I was never diagnosed with _____" is the third most "lead in" to email from a worried aspiring pilot....)
 
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bbchien said:
He needs a pre consult.
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Always recommended.
bbchien said:
If the AME reviews the record and concurs and states such it pretty much drives the nail in the coffin of any such "We're not certain you are elligble for the certificate for which you applied. Please within 60 days send....."
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There wouldn't be any basis for that if he doesn't have to say "Yes" on 18.m.
bbchien said:
Another example is the single DUI >5 years old with no BAC is another, although that eval is a LOT of work. I've never been reversed on that one but I do do the spade wrok.
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That has to be disclosed.
 
Y'all probalby have figured out that airmen who attempt to dance on the head of a pin...well it doesn't generally work out well. But, "no diagnosis made" sure rings like dancing on the head of a pin.

If he chooses to omit, no skin off the AME's back- but remember the doc visit box is a subpoena list, and it gets exercised each time there is an incident or accident investigation. If subsequently it is subbpoenaed, and "there it is" but not reported on his flight physicals, it really works out badly for his AIRMAN certificates....and I've seen "all certificates revoked" for this, and an invtation to not reapply for every rating PVT-->ATP for 12 or 24 months as warranted, to follow the discovery.

NO branch of the agency will tolerate omission. The manta is report "report report, explain explain explain".

That is why you go with all your records for the pre flight physical consult and no medxpress 12 digit code. It might be a yawn. But the majority of times it's not. If it was significant enough for the PCP to make a note of it....

Then, after the investigation begins, the airman calls to protest. And my reply is "I can't help you, you didn't discuss nor mention it to me...."

"Let the buyer beware"
 
bbchien said:
Y'all probalby have figured out that airmen who attempt to dance on the head of a pin...well it doesn't generally work out well. But, "no diagnosis made" sure rings like dancing on the head of a pin.
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Not sure why you are jumping on the OP. He says in his first post he is meeting an AME for a consult before he fills out MedExpress. What else would you have him do?
 
Ed Haywood said:
Not sure why you are jumping on the OP. He says in his first post he is meeting an AME for a consult before he fills out MedExpress. What else would you have him do?
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MauleSkinner said:
Use language that doesn’t raise red flags, maybe?
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Ding, Ding Ding!
How about...."would you look at this record is there anything to be concerned about (that needs documentation) here?
 
MauleSkinner said:
Use language that doesn’t raise red flags, maybe?
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What are your red flags? We've seen countless posts here where applicants have created problems for themselves by answering with more than the form asks for. There's absolutely nothing wrong with seeking to understand what must be disclosed and not wanting to disclose more than that.
 
Anon(OP) said:
The doctor recommended seeking out a talk therapist and said so in the note
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...Meaning....the doc thinks there's enough there to warrant "talk therapy" (e.g CBT?)....that sez he thinks there's something there. He's kinda like pilot who thinks a DUI pleaded down to wet reckless doesn't count.
Anon(OP) said:
I have never been diagnosed with any of these
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Lindberg......it's kinna (loosely) like the judge in the Captain Bob Walsh case. The judge thought there definitely was something there.....and upheld the Martha's Vineyard airport authority. When a court sides with an action such as in that situation there is very likely something there. Yet the leadoff here, is "I was never diagnosed...."

Okay, "pink flag" maybe not red, but there is a flag on the play and it ain't a checkered flag.
Nobody @ FAA's buying that. He can omit- but he'll be looking over his shoulder the next time he has to see somebody in the EAP program....or he violates....or he bends metal, or somebody anon call him in to the hotline. They are HARD on omitters.

Maybe a HIMS AME known to the agency can evaluate that to the Agency's satisfaction.....Maybe not. The notes have to get read by someone who knows what's what and who the agency recognizes as knowing what's what. Even if there is something there is sounds like it could be fast tracked. But omission is another kettle o'fish entirely.

Don't be doing that.
 
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MauleSkinner said:
I’m seeing the red flags that Bruce noted.
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Like the posters that come here, I never drink and I'm not an alcoholic, but this one time I did and got an OWI...

The OP is perhaps downplaying exactly what happened in an effort to get someone to confirm what he wants to do is ok, ignore it and pretend its nothing.
 
midwestpa24 said:
The OP is perhaps downplaying exactly what happened in an effort to get someone to confirm what he wants to do is ok, ignore it and pretend its nothing.
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I’m not speculating on his motives, but simply agreeing with the doc that there are words and phrases people use that more often than not indicate a problem. In medicals, “there was no diagnosis.” In flight training, “I’m not a good test taker.” Maybe the OP is trying to slip something by, maybe he just used the wrong words. It’ll probably become clear when he meets with a doc.
 
OP here. Thank you all very much for the replies. I think I had some poor wording choices in my original post; I definitely do NOT intend to omit anything or lie to the FAA. I posted here just to see what the general consensus was and so I could know a little more of what to expect my AME to say about the situation when I go in for a consult.

@bbchien it seems as though you're saying my medical will be deferred? I'm not entirely surprised by this, but do you know what I can expect in the deferment process or how long that could take? I imagine I'd have to meet with a psychiatrist to clear me somehow, although I'm still not sure how one goes about proving they DON'T have some sort of mental disorder. I understand you can't really answer this for certain since you are not my AME, but I'm just looking for some sort of ballpark.

Thank you all again for taking the time to respond to my post.
 
anon said:
OP here. Thank you all very much for the replies. I think I had some poor wording choices in my original post; I definitely do NOT intend to omit anything or lie to the FAA. I posted here just to see what the general consensus was and so I could know a little more of what to expect my AME to say about the situation when I go in for a consult.

@bbchien it seems as though you're saying my medical will be deferred? I'm not entirely surprised by this, but do you know what I can expect in the deferment process or how long that could take? I imagine I'd have to meet with a psychiatrist to clear me somehow, although I'm still not sure how one goes about proving they DON'T have some sort of mental disorder. I understand you can't really answer this for certain since you are not my AME, but I'm just looking for some sort of ballpark.

Thank you all again for taking the time to respond to my post.
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bbchien said:
Even if there is something there is sounds like it could be fast tracked. But omission is another kettle o'fish entirely.
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Nope. Get the consult; bring your records and NO MedXpress
AnonOP said:
"in the clinical note, but did not diagnose me with anything (the diagnosis for the visit was the general "office visit" default diagnosis) and did not prescribe any medications. The doctor recommended seeking out a talk therapist and said so in the note"
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You had something. Symptoms at least.
AnonOP said:
since there is a record of symptoms....
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EXACTLY how it was treated in the record, and how you present yourself become critical.
bbchien said:
How about...."would you look at this record is there anything to be concerned about (that needs documentation) here?
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And for god's sake don't wave the red flag around. There is a "FAST TRACK" path that the AME can do, if he's got the memo. Look it up. but your going for a consult is every bit as much for him to evaluate you as it is for you to evaluate him. If if he sez "leave it off" you've got the wrong guy.

This is what the AME side of instruction looks like:

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To do this he has to document evertying in the "decision tool" as he will be reviewed by the home office. If he does his job well and the reocrd backs it up, this routinely is upheld by the home office and then you did not omit.

There are a lot of "oh just leave it off" guys on this board but they won't be there for you, when the accident /incident investigation turns this up.

Do it right.

B
 

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WDD said:
You know what they call being anxious at times? Life

You know what they call someone who has never been anxious? Not normal.
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Correct!

Threads like this and the subsequent flaming that goes on by certain individuals really chap my hide.

There are over 50,000 pilots employed at the Big Four Airlines in this country alone.
Does anybody really believe that not a single one of those folks has ever experienced a moment here and there in their lives of being anxious or feeling a little down about circumstances that life throws?

So now….
If a pilot casually mentions to his/her GP that they have been feeling a little anxious about something but isn’t diagnosed with anything or subscribed a medication, they STILL have something to be worried about???

What’s next? The thought police?
A pilot can be on the hook for NOT reporting to some doctor that they are feeling a certain way?

I’m just happy for the OP here that his Doctor wasn’t so pill happy. Many folks aren’t so lucky.
 
Hugh Despenser said:
Does anybody really believe that not a single one of those folks has ever experienced a moment here and there in their lives of being anxious or feeling a little down about circumstances that life throws?
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But most have not experienced debilitating anxiety, which is what the FAA is concerned about.
 
Hugh Despenser said:
What’s next? The thought police
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Next? They’re already here. Seen several folks nailed for exhibiting behavior that could possibly lead to a relapse…

Another guy has unspecified problems that may lead to subtle incapacitation, at some point in the future… therefore he’s not eligible for a medical AT ALL. Of any kind. That was signed by suzi.

And on and on.
 
MauleSkinner said:
But most have not experienced debilitating anxiety, which is what the FAA is concerned about.
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lol

The FAA, on its forms, doesn’t ask about “debilitating” anxiety.

It asks about anxiety- period.

Lying around awake at two-in-the-morning worrying about something might be defined as anxiety to some of the hard-liners around here. It doesn’t mean the person can’t get out of bed in the morning and fly an airplane safely from A to B.
 
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Hugh Despenser said:
lol

The FAA, on its forms, doesn’t ask about “debilitating” anxiety.

It asks about anxiety- period.
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Well, maybe your personal definition of anxiety is a little off…
Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing restlessness, fatigue, inability to catch one's breath, tightness in the abdominal region, nausea, and problems in concentration.
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Note that the OP mentioned “symptoms.” Any of the above symptoms wouldn’t be conducive to flying.
 
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Hugh Despenser said:
lol

The FAA, on its forms, doesn’t ask about “debilitating” anxiety.

It asks about anxiety- period.
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Not quite. The actual language on 8500-8 is "Mental disorders of any sort; depression, anxiety, etc."

Anxiety is not necessarily a mental disorder. It must meet specific criteria in the DSM to rise to that level. That is why the form asks if you have been diagnosed. Feeling anxious, talking to your doctor, etc would not by themselves meet DSM criteria for a disorder.
 
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That being said the faa seems to not care about the DSM, indeed at the last hims conference in Denver it was the subject of group scoffing.

Nor do they care about professionals in the appropriate fields, EVEN when they are also hims shrinks. Chuckleheads WITHOUT expertise, experience or credentials like to over ride their opinions.
 
MauleSkinner said:
Well, maybe your personal definition of anxiety is a little off…

Note that the OP mentioned “symptoms.” Any of the above symptoms wouldn’t be conducive to flying.
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“Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing restlessness, fatigue, inability to catch one's breath, tightness in the abdominal region, nausea, and problems in concentration.”
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lol…is all that gobbly-gook from an FAA document somewhere or google AI?

So, to quote the wonderful FAA’s MedEx form….

In your entire life, you have never been worried about a situation or problem you were dealing with
that caused you a bad night of sleep (which caused fatigue)?

You never, in your entire life, had “the butterflies”?

If not, you must have ice in your veins. That can’t be normal either.

Who determines what an “overreaction to a situation” exactly is?

Not much of this stuff is as black and white as the FAA and some people on this site make it out to be.
 
Hugh Despenser said:
lol…is all that gobbly-gook from an FAA document somewhere or google AI?
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It’s from the dictionary.
Hugh Despenser said:
So, to quote the wonderful FAA’s MedEx form….

In your entire life, you have never been worried about a situation or problem you were dealing with
that caused you a bad night of sleep (which caused fatigue)?

You never, in your entire life, had “the butterflies”?

If not, you must have ice in your veins. That can’t be normal either.

Who determines what an “overreaction to a situation” exactly is?

Not much of this stuff is as black and white as the FAA and some people on this site make it out to be.
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that’s the problem when people decide to make up their own definitions rather than using the actual definitions that exist.
 
Hugh Despenser said:
“Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing restlessness, fatigue, inability to catch one's breath, tightness in the abdominal region, nausea, and problems in concentration.”
———————————————————————————————————————————————————————————————-

lol…is all that gobbly-gook from an FAA document somewhere or google AI?

So, to quote the wonderful FAA’s MedEx form….

In your entire life, you have never been worried about a situation or problem you were dealing with
that caused you a bad night of sleep (which caused fatigue)?

You never, in your entire life, had “the butterflies”?

If not, you must have ice in your veins. That can’t be normal either.

Who determines what an “overreaction to a situation” exactly is?

Not much of this stuff is as black and white as the FAA and some people on this site make it out to be.
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Let me guess, you’re not a doctor? ‍♂️
 
dmspilot said:
In a majority of cases, the person filling out the form and answering the questions isn't a doctor.
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He’s not filling out the form. He’s providing an alternate definition so that a person filling out the form can hide his condition.
 
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If a person is now worried and has anxiety about this thread about having anxiety ………..
 
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