First appointment with clinical psychologist; what to expect moving forward

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TallTree

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I'm an 11 year active duty pilot with the Air Force. Two years ago, I began developing what I now know to be manic episodes that lasted about a month each. Six months ago, I drastically cut back my alcohol and caffeine consumption, and eventually quit completely, but now I experience severe depressive episodes that has led to some frightening behavior and experiences both at home and on the job (including in the cockpit). It reached a point where I decided I was a danger to myself and the mission, called my flight doc, and told him I no longer trust myself in the cockpit. I confessed to him most everything, including my self medication with alcohol and subsequent sobriety, and he referred me to the resident psychologist on base.

We just had our first meeting today and it went well, I think, given I was in tears for half the session. I don't think it's relevant to post the specific details or symptoms here, but she gave me some pamphlets for depression, anxiety, and breathing techniques. We'll be meeting once per week for a month and then we'll decide what to do from there.

What really precipitated this was that a family member, a few years older than me and who was diagnosed with bipolar disorder (I don't know which type), recently hung himself. I didn't know his diagnosis, and I see a frightening similarity between his symptoms and my own. I will let the psychologist determine the diagnosis, but what can I do to help her help me? What kind of outcomes can I expect from meeting with her and how will this affect my future career? It is more important to me, at this point, to get the help I need than it is to keep flying in the military, so I am prepared to be brutally honest even if it means an end to my dream job. Any help or advice or pointers on where to look or what to search for are greatly appreciated.
 
Have they mentioned inpatient to you at all? I went twice and especially the first time seemed to help. I went to Laurel Ridge and Chris Kyle. Laurel Ridge I think could definitely help you out if they haven’t mentioned this to you.
 
No. I do not believe I'm a danger to myself or others or am at risk for spending stupid money. They did mention something about medications, but only after we meet for 3-5 weeks. First we're going to try a few other things. I've read conflicting guidance about medications, though, and some sources appear to say that so long as the medication works for at least six weeks, then you can get a waiver for flying. I guess we'll see.
 
Well best of luck to you and hopefully everything pans out as you are wanting. This page seems like a good resource so thanks for your post and hopefully someone me can offer some helpful insight.
 
I suspect you are DNIF. If that continues it should drive a MEB. I applaud your seeking help. Manic symptoms are best treated with professional assistance.
 
You just have to keep going to sessions, bi-polar usually will result in many serious symptoms that affects your ability to perform your duties. Professionals look for many "markers" to substantiate your self reports this is why someone mentioned intake adverse actions and poor evaluations are some other markers. If you feel the therapy is insufficient you have to request to see a psychiatrist and that usually results in a MEB if serious mediations have to be prescribed.
 
Any updates? I am a pilot in a similar situation. The physiatrist suggested Zoloft, which apparently can be taken for 6 months and then you have the option to pursue a waiver to get back to flying.

I'm considering that I might not want to go back to fly. I was DNIF for a year in 2020, jumped back in the jet this year, and now I'll be dnif less than a year later.

I would be interested in hearing your experience if you still want to share. I'm wondering if my flight doc might agree to go ugly early and refer me for a MEB without waiting another year...
 
Here’s a quick recap of my experience.

Over the last few years, I started losing interest in flying my mission, which previously brought me quite a bit of joy and happiness as this was my lifelong dream. Then I started to not only lose interest in flying, I actually started to hate it. I even went out of my way to get a non flying deployment.

I’ve suspected I’ve had some form of bipolar for quite a while, given a few incidents and habits in my adult life, but it wasn’t negatively interfering with my life too bad, so I just kept quiet.

Then my family member killed himself as I describe above, and that’s when I called my flight doc and said I no longer felt fit to fly due to mental health reasons.

He was super supportive and DNIF’d me in such a way that only they would know the reason and referred me to behavioral health.

I had biweekly appointments with the psychologist there for about four or five months. She was awesome and loved talking to her because we had similar interests (meditation, literature, etc) and she recommended a few different things after every appointment. Things such as breathing exercises, reading books by authors she knew I’d respect based on my interests/background, researching certain topics, that sort of thing.

Unfortunately, none of that did shit for me because I started daily meditation years ago, I already had a worldview that has brought me inner peace, and I have been an officer for over a decade so I sorta already had this shit figured out. I think her material would be perfect for a 20 year old airman who was depressed or experiencing severe anxiety, and I think that’s primarily who she saw for patients anyway.

Behavioral health, to my understanding, is basically a filter for mental health. If you have issues, you go there and see if changing your behavior helps, and I’m sure it would for most people. The whole time I saw her, I was DNIF and had a reason that most people believed (I had a bone tumor two years ago that gives me chronic pain now).

About 4-5 months after seeing her, I found out that the bone tumor surgery didn’t healt correctly and I would have this chronic pain for the rest of my life. This destroyed me, and at our last meeting, I cried the whole time about how the Air Force fucked me over for life by misdiagnosing it as something else, allowing it to grow bigger, resulting in a botched surgery. It was a pretty painful meeting, but at the end of it she said that she wouldn’t be able to help me at that point, and she referred me to mental health.

My MHS Genesis post visit summaries said she thought I had major depressive disorder, but after meeting with the psychologist in mental health, she believed I had bipolar II. It sucks because every time I met with someone new, I’d have to go over everything again which is quite painful for me. She referred me to the psychiatrist there, and at our first meeting he concurred with the diagnosis and prescribed me lithium.

I’ve been seeing both the mental health psychologist and psychiatrist since then about once every two weeks.

The lithium has helped enormously, and I can go about day to day without my emotions rapidly cycling and it just makes me feel more “reasonable” (which confirmed the diagnosis, as lithium makes normal people feel dysphoric).

Unfortunately now that I’m on lithium, I want to keep flying my mission and I miss the hell out of flying and don’t want to get out and want to stay in until they force me to stop flying, just like I was a few years ago before I lost interest in something I normally enjoy (a classic symptom of depression). Now that I’m no longer depressed, I want to keep flying.

But bipolar or even use of lithium is an automatic discharge. I’m currently doing the VA exam process, so I’m maybe half way through. It sucks too cause I can’t fly for the airlines either.

So in your situation, you should absolutely get on that medication and see if it changes your perspective, as lithium did for me. You’re in a good position because you can ride it out and still make your fully salary, so there’s no rush. Im not sure how it would work if you took Zoloft for six months, and then said “nah it’s not working” because they might just try another medication.

But I would definitely not go ugly early as you say, the psychiatrist and flight doc (in my experience) have been very open to hearing my wants and desires, so hopefully they’ll do that with you.
 
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