Air Force the usual antidepressant question

[deleted1020355]

I am a rising senior in undergrad; currently, I am applying to Texas schools for MD/DO.
3.8/506
Anyways, I began zoloft last summer (summer 2019) due to an acute episode of OCD. I had no idea that I was stuck in the OCD cycle (obsession-compulsion) until a psychiatrist pointed it out to me. Thankfully, I responded well to the SSRI and it helped me become more receptive to healing and growing stronger.
Doing research, I was enthralled by the opportunities offerred by HPSP and practicing medicine with the military. I did read about the gatekeeping against those with a psychiatric history. So, in a month's time, I discontinued my antidepressant.

Currently, I am stable. All is fine. I do feel intermittent relapses of depression, and it stings that I cannot use a simple medication to help me out. I do HIIT/lifting/running/diet. Sometimes that just is not enough. However, I remain working on goals and self-betterment.

On a different note, I share dual citizenship with Israel. There, if you have a stable/managed psychiatric history, then you will not be barred from serving. No, you will not be a combat soldier; however, you are allowed to proudly serve your country.

Question 1: If like 50% of the DoD is on an SSRI (SNRI or tricyclic), then why are incoming recruits DQ'd for antidepressant usage?

Question 2: How soon after discontinuation of an SSRI would a medical waiver be likely accepted? I have heard of people still make it through the whole process despite having used these medications way back in childhood.

Thanks for helping and hearing me out.

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[M-tab]

To answer your first question, the DoD always has higher accession standards than retention standards. They want to start off with recruits in the best position possible and accepting any recruits who require psychiatric medication to maintain some sort of stability is just a liability.

To answer your second question, you might be able to get a waiver without discontinuing the medication because of the position you are applying for. The standards on acceptance of conditions and waiver approval shift significantly year to year based on recruiting needs. Believe me, if WW3 kicked off, the DoD would probably be willing to raid group homes and state psych facilities for bodies to put in uniform.

Aside from all that, you would need to renounce your Israeli citizenship if you commissioned in a U.S. armed service.

Finally, I would strongly recommend against joining the military for medical school. It just is not worth it. The first years of training are identical to civilian training, so you would be in a better position to become whatever kind of doctor you want to be first, then revisit the option to join the military. The military will always have room for doctors and they only leverage you have once you are in is deciding to leave after your service commitment. I joined in July 2011 and I wont be able to separate until May 2027. That day cannot come soon enough.

 

[SirGecko]

To answer question one: The standards for new acquisitions and retention are of course different. DOD sees accessions/retention standards the same way you would think of buying a tool. You don't want to buy a broken tool even if it's really just a small scratch but you might keep using a tool you already bought if it is still functional.

As for the specifics of the medication and your diagnosis it is usually not recommended to modify treatment purely to seek to gain a position as the underlying reason you needed the treatment is also disqualifying if not managed. You don't know they won't grant a waiver for something until you ask. Generally they don't want large changes close to the time when a waiver is applied for, they want to see the situation is stable.

 

[fishdoctor0225]

To answer your first question, the DoD always has higher accession standards than retention standards. They want to start off with recruits in the best position possible and accepting any recruits who require psychiatric medication to maintain some sort of stability is just a liability.

To answer your second question, you might be able to get a waiver without discontinuing the medication because of the position you are applying for. The standards on acceptance of conditions and waiver approval shift significantly year to year based on recruiting needs. Believe me, if WW3 kicked off, the DoD would probably be willing to raid group homes and state psych facilities for bodies to put in uniform.

Aside from all that, you would need to renounce your Israeli citizenship if you commissioned in a U.S. armed service.

Finally, I would strongly recommend against joining the military for medical school. It just is not worth it. The first years of training are identical to civilian training, so you would be in a better position to become whatever kind of doctor you want to be first, then revisit the option to join the military. The military will always have room for doctors and they only leverage you have once you are in is deciding to leave after your service commitment. I joined in July 2011 and I wont be able to separate until May 2027. That day cannot come soon enough.

May I ask why your service commitment is so long? Did you do HPSP and a long residency or USUHS? Just curious!

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[M-tab]

USUHS + 4 year psych residency + fellowship