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When commercial pilot Troy Merritt realized that his anxiety and depression were getting worse, he wanted to seek treatment.

But he hesitated, because he feared what would happen next. 

"I faced months to years out of work, navigating the complicated certification process to get my medical [certificate] back. And the possibility of being told I could never fly again," Merritt said.

"These prospects only worsened my anxiety and depression, and made an important personal health decision even more difficult," he said.

Merritt, a first officer at United Airlines, spoke at 

 in Washington, D.C. Wednesday devoted to mental health in aviation. 

Pilots and other aviation professionals described their personal struggles with anxiety, depression and substance abuse, and urged federal regulators to reform rules that often discourage people from seeking treatment because they're afraid of losing their medical clearance to work and fly. 

National Transportation Safety Board convened the gathering

 to encourage aviation professionals to seek treatment if they need it, and to call attention to policies that may be preventing that from happening.

"The safety risk comes from a culture of silence around mental health, not about seeking help," said NTSB chairwoman Jennifer Homendy.

The Federal Aviation Administration has signaled it is open to changing its policies around mental health. This week, the FAA 

a new advisory panel to evaluate those policies and issue recommendations "to identify and break down any remaining barriers" that discourage pilots and air traffic controllers from seeking mental health care.

"We need to get folks to act earlier in the process. Early, before things get really bad," said Penny Giovanetti, a top medical official at the FAA. The agency is committed to "dispelling the myths and destroying the barriers," she said.

Giovanetti acknowledged a lack of trust between the FAA and pilots, who don't believe the agency's assurances that they can fly again after a mental health diagnosis. 

The vast majority of pilots do ultimately get their certification back, Giovanetti said. But she acknowledged that the process can often take months or years, calling those excessive delays "the elephant in the room" that can discourage pilots from seeking treatment.

 in October when an off-duty pilot was accused of trying to shut down the engines 

 Joseph Emerson for attempted murder, but it did charge him with 83 misdemeanor counts of recklessly endangering another person and one count of endangering an aircraft. 

Emerson's family says he was suffering from depression, but avoided seeking treatment because he was afraid of losing his medical certification. 

Pilots say that practice is widespread, as many worry that it will be expensive and time-consuming to get their medical certifications back if they seek treatment. 

"Every week my Instagram, my LinkedIn, my texts are filled with pilots who are asking for help. What do I do?" said Dr. William Hoffman, a clinical neurologist who has studied health care avoidance by pilots.

"I wish there was more we could do, other than contribute to these discussions about how do we think about this in a new way," Hoffman said at Wednesday's summit.  

Pilot Troy Merritt says he ultimately decided to seek treatment, and is glad he did. 

"Today I have no regrets for taking care of my mental health. It was absolutely the right thing for me to do," Merritt said.  

Merritt says his treatment has gone well, and he hopes to begin flying again in six months to a year. In the meantime, Merritt says he is fortunate to have disability insurance through his union, which has helped support him while he is grounded — a luxury not all pilots have. 

"There are so many untold stories of pilots — pilots I know personally — who struggle with their mental health. And avoid care because they feel trapped by the system, and their options within that system," Merritt said. 

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Joel Rose

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At a summit on mental health in aviation, pilots and safety experts urged regulators to reform rules that discourage people from seeking treatment because they're afraid of losing clearance to fly.

Pilots say they're afraid to seek mental health care. The FAA says it's listening

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