Q regarding childhood depression

[ConcernedMom]

My son is 21 years old and currently a junior in college. He has a high GPA and has studied abroad in a foreign country. He has decided after college to pursue his lifelong dream of becoming a commercial pilot. He will probably go overseas after graduation to teach English for a year or two in order to raise cash to pay for flight training, however, I’ve encouraged him to go through the medical certification process now before he continues to make too many plans around his goal.

He started the application process with the FAA in Dec. 2011 and we disclosed up front that he was diagnosed around the age of 10 with bipolar II depression. He was sort of a whiny, attention seeking, but strong willed kid during his adolescent years, but it’s my understanding now that this was a common diagnosis placed on kids during this time period. During a 5 year period, he was treated at various times with Lexapro, Zoloft, or Depakote.

I finally became fed up with his doctor’s oddities and took him to a different psychologist who performed many tests and said that there was basically nothing wrong with him that emotional maturity wouldn’t fix. We removed him from Depakote and he has been medication and symptom free for 6 years without problem. Later on, I discovered that his first doctor’s medical license was restricted and conditioned during the time period that he was seeing my son, due to his own chemical dependency and mental health issues.

Now, the FAA has requested a forensic psychiatric evaluation and a battery of tests performed by a clinical psychologist. I’ve been in contact with the forensic psychiatrist’s office that was recommended by the FAA and while they seem very knowledgeable on the process, they quoted $5000-6000 to fulfill the FAA requirements. This does not include travel expenses, as this doctor is located in another state. My specific questions are:

• Is it worth my time to price shop different psychiatrists/psychologists who can fulfill the FAA requirements? My understanding is that there are just a handful of these psychiatrists in the country.

• Assuming that his examination and tests turn out fine and he receives a favorable report, will the FAA make a decision or will there be additional requirements to fulfill?

• Will the FAA make him go through this process every year to renew his medical certificate? This would be outrageously expensive.

• Will his childhood record continue to follow him throughout his career with the FAA and possibly make him an unattractive candidate for hiring, etc?

Thank you in advance for any information or advice that you can provide.

 

[My Flight Surgeon]

It depends on what they wanted. If they want a full Neuropsychological testing evaluation as well as a psychiatric evaluation, the price in in the ball park.

If the FAA approved him after the testing, it will probably be the last time they ask for anything.

As far as getting hired, employers do not have access to FAA medical files.

Where do you live? I may be able to provide a couiple of names. As you noted though, there are only a few of these guys around.

 

[ConcernedMom]

Thank you doctor, for your response. This is what the FAA asked for in their letter:

1. A detailed assessment from a forensic psychiatrist, with sufficient detail and depth;
2. A detailed report from a clinical psychologist based on a battery of tests, including: the complete Wechsler Adult Intelligence Scale; the Minnesota Multiphasic Personality Inventory; and 3 or more of the remaining tests:

a. A cognitive function such as Trails Making Test​

b. A projective test such as the Rorschach​

c. A personality inventory test such as the NEO-R​

d. A symptom screening test such as the Beck or Hamilton​

​

While the cost is considerable, I understand the necessity of the testing, however, I can't help but be concerned that the FAA will still deny his application even if all tests and evaluations turn out "normal". It seems so excessive for the thousands of kids out there who were caught up in the trend of oversold diagnoses for what was probably the natural adolescent developmental process, which causes emotional distress and moodiness.

We are located in Minnesota and while travel distance is not a significant concern to us, the competence of the doctors are of concern. We've already been burned once as I've described above, so I'm trying to be careful and perform due diligence on the names I am receiving. We've received names of two psychiatrists in Chicago and one in Arizona thus far. Other names/referrals would be welcome.

Thank you again.

 

[L B Fowler Jr MD]

​

While the cost is considerable, I understand the necessity of the testing, however, I can't help but be concerned that the FAA will still deny his application even if all tests and evaluations turn out "normal"..

As Dr, Forred implies if these necessary steps reveal normal results, an airman's medical certificate will likely be issued

 

[exneophyte]

Thank you doctor, for your response. This is what the FAA asked for in their letter:

1. A detailed assessment from a forensic psychiatrist, with sufficient detail and depth;
2. A detailed report from a clinical psychologist based on a battery of tests, including: the complete Wechsler Adult Intelligence Scale; the Minnesota Multiphasic Personality Inventory; and 3 or more of the remaining tests:

a. A cognitive function such as Trails Making Test​

b. A projective test such as the Rorschach​

c. A personality inventory test such as the NEO-R​

d. A symptom screening test such as the Beck or Hamilton​

​

While the cost is considerable, I understand the necessity of the testing, however, I can't help but be concerned that the FAA will still deny his application even if all tests and evaluations turn out "normal". It seems so excessive for the thousands of kids out there who were caught up in the trend of oversold diagnoses for what was probably the natural adolescent developmental process, which causes emotional distress and moodiness.

We are located in Minnesota and while travel distance is not a significant concern to us, the competence of the doctors are of concern. We've already been burned once as I've described above, so I'm trying to be careful and perform due diligence on the names I am receiving. We've received names of two psychiatrists in Chicago and one in Arizona thus far. Other names/referrals would be welcome.

Thank you again.

I certainly understand your frustrations as I've dealt with the FAA twice to get medicals, but let me tell you there is hope and that you've come to the right place. I live in Richfield, MN near the airport and recently went through a similar process and was able to find a psychologist to administer the psychiatric tests that the FAA wanted right here in Minneapolis. I got the feeling when I was in the process, that the psychiatrists who could do the tests was almost a closely guarded secret so I'm going to refrain from posting it here, but will instead send it with my contact information in a private message. You can receive it by clicking the "Inbox" button in the upper right hand corner of your browser window.

Here's my story in case you want to read a success story:

The first time was when I was 17 and wanted to become a professional pilot. I was also diagnosed with a mild depression(called dysthymia) when I was about 10. When I was about 14, I was declared successfully treated and proceeded to obtain a first class medical. Lots of records had to be sent in and a few tests were also required, but in the end I got the first class medical after about a year into the application process.

A few years later while finishing up high school, I decided to go back onto medication(Zoloft, then switched to Effexor) for treatment which meant no more medical because at the time the FAA considered medication for any psychiatric condition as automatically disqualifying. I instead became a technology guy obtaining a degree in information systems and now own my own business developing technology solutions for my customers.

Two years ago, the FAA reversed that policy and now allow 4 SSRI's for treatment, but the applicant has to take the tests that were requested of your son and a few others. As a result of this recent policy change the FAA is extra sensitive about anything psychiatric, but it meant that I could get my flight medical and take the medication. I went through the new process, was issued a medical, and am currently taking flight lessons.

 

[My Flight Surgeon]

You just have to work through the process. The FAA is in a position of insuring aviation safety. They must do their due diligence before issuing a medical certificate ot insure the pilot does not have apotentially dangerous condition.

In Arizona there are 2 psychiatrists we use: Dr Desch and Dr Eikelberg.
In Illinois, Dr Altman in Skokie
In Minneapolis, Dr Cline