I am at a crossroads

TLDR because I know you folks tend to have trouble with your attention spans: to meds or not to meds, that is the question…well…one of them anyway :weary:

Hello, brains! I’m new here. I am a 35-year-old Marine Corps helicopter pilot. I was diagnosed with ADHD in Kindergarten. I was on meds (Ritalin and later, Adderall) until I decided to stop taking them when I was about 12 or 13 because I didn’t like how zonked out they made me feel in class. Honestly, I felt like maybe my diagnosis was incorrect. In the early 90s, it seemed like EVERY hyperactive kid was getting diagnosed with ADHD, and much the same way that opiates were being overprescribed for people who don’t actually need them in more recent years, I felt that they were doing the same sort of thing with ADHD meds back then.

I would often sort of joke about having ADHD whenever the symptoms presented themselves in my daily life, but I never REALLY bought into the idea that I actually had ADHD. Around this time last year, however, some dramatic events in my life forced me to take this more seriously. My actions put both my career and my marriage (of 15 years) in Jeopardy. Faced with the prospect of losing everything and feeling utterly unable to control my own destructive behaviors, I began having a lot of dark thoughts. Long-neglected post traumatic stress issues from my combat experiences in Iraq between 2006 and 2008 (well before I became an officer and a pilot) began bubbling back up to the surface, and I was in a very dark (and frankly, suicidal) place.

I began therapy with a military therapist while I was deployed, at first just to talk me off the ledge, so to speak, and to help implement some structure in my life that could help stave away the depression and anxiety about the uncertainty of my future. When I returned stateside, that therapy became more focused on PTSD – for which I received an actual diagnosis – and I underwent a cognitive behavior therapy regimen to address that stuff. Oh and my wife and I also did some marriage counseling…to mixed results, if I’m being honest.

Somewhere along the line, my wife recommended a book to me called the ADHD Effect on Marriage. She recognized that a lot of the problems in our relationship could be squarely placed on symptoms of ADHD that have been unaddressed for so long. A lot of things started to click, and I started to dig deeper to gain a better understanding of the ways in which ADHD has been affecting me over the years that I didn’t even realize.

Recently, I had an appointment with a military psychiatrist as a requirement to obtain a waiver for PTSD so that I can still continue to fly. During this appointment, we talked about the specifics of the events over the past year (and my actions over the past couple of decades leading up to them), the CBT, etc. He asked a question about whether I had ever taken any medication for any mental health conditions before. I said no before correcting myself with an off-handed and dismissive comment about having been on Ritalin and Adderall when I was a kid. This opened up a whole new conversation in which he explained to me that – in the very short time that he had observed me and in listening to me describe the events of my life – he felt that ADHD was very severely impacting my life, and he strongly recommended I try medication.

The problem with trying medication, however, is that it is an automatic disqualifier for flight status. So now I’m in the position of having to choose between trying medication to see if it works for me, and thereby never flying an aircraft in the military again, or continuing to be able to fly while fighting the symptoms that have already almost caused me to ruin my life. And then there are all the what ifs. What if the medication doesn’t help me or that I hate the way it makes me feel, as when I was a kid? What if – after giving up the flying part of my career in order to, among other things, be a better husband – I find that medication doesn’t actually help at all and the self-destructive, chronic, impulsive behaviors that have strained my relationship are still there? It’s kind of terrifying to think through either course of action to its conclusion. :grimacing:

Anyhoo…that’s me. Sorry for the wall of text. I haven’t ever actually written any of this out before, so I guess typing this up is part of me working through these things.

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Sounds like your choice is basically to either gamble everything, or gamble everything.

Given that it’s such a major event for you, I think it’s worth being explicit about something: This is ultimately a matter for that you have to discern (preferably with support from those close to you), and not really something where anyone can just give you the right answer (if there even is one). So what we (the peanut gallery here) will be doing is giving you reflections and anecdotes which you will be using as lenses through which to get a better picture of your feelings and your priorities and your situation, and hopefully you’ll reach a point where you can see enough of the picture to be clear on your way forward :slight_smile:.

There are two lines of questions which occur to me, firstly:

Would there be any military piloting roles available to you at all? Would there be any instruction roles? (such as the classroom stuff that no doubt outnumbers the fun, in-the-seat stuff :stuck_out_tongue:) What would you actually end up doing if you remained in the military? If you left it, would you be permitted to fly in civilian aviation?

Secondly:

What happens if your ADHD starts affecting you in the field? You may have done well so far, but what if deteriorating elements of your life like your marriage lead to issues with losing focus or acting impulsively? I don’t want you be out there second-guessing yourself, but while you’re on the ground you need to take a breath and have a clear-eyed look at how things could go wrong and the likelihood that they will go wrong (I’m sure you already follow this sort of process in your job, even if you’ve never applied it to your head); the psychiatrist or therapist might be able to help you with this sort of exploration (and good self-analysis is hard, so having skilled support may be a welcome force multiplier).

Sidenote: It’s kinda bullshit that a doctor giving you go-pills would disqualify you :expressionless:. Maybe the real answer is to switch to a role where they hand out the tank jet candy on a regular basis? :stuck_out_tongue:

EDIT: Also, if you’re an officer, it’s always worth asking, “What would I expect from/tell someone in my command?” An honest answer may give you what you need… or give you cause to reconsider how you carry yourself as an officer :grimacing: (or not actually get you anywhere. That is also an option… pretty much always).

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@K-Span

Thanks for sharing here . . . a good place for so many! While I don’t have any concrete suggestions I just want you to know that you are not alone.

I am more than twice your age with ADHD and I can relate to a lot of things you described as being difficult for you. My son who is nine years older than you was diagnosed with ADHD before he was five years of age. And his 12-year-old daughter also has ADHD.

As a child and during his college years my son took ADHD medication. In a somewhat similar situation, but not exactly, my son stopped taking medication once he began working as an electrical engineer because he wanted to avoid explanations following routine random drug testing, that came with the territory. Obviously, your situation is more problematic, . . . “either or” . . .

Just curious, what about pilots who take other medications? What about a pilot who had slightly elevated blood pressure that was well-controlled, consistently controlled within normal limits, because of taking medication . . . would he not be allowed to fly as well?

I started this last night and since then see that someone has responded. I’m sure you’ll get quite a few more. Best of luck to you! . . . And thank you for your service to our country!

There would be physical health requirements, and they have to be safe without the meds, but I would expect there’d be more leeway. The problem, as I understand it, is that there is a blanket ban specifically on anyone who has ever been prescribed ‘psychiatric’ medications, with the logic behind it being both rather reasonable and bloody stupid: one thing you really, really don’t want is the person controlling that gunship hovering above you to have a psychotic break, be suicidal, or otherwise mentally unstable, and if someone has had any sort of episode that has been bad enough to require medication, the probability is that much higher that they’ll be a problem… on the other hand, as you may already have realised, it does mean that the guy who’s been feeling a little off, and is not sure other people are hearing that noise, has a very good reason to be wary of seeking medical attention.

Bollocks it may be, but your average military has no allergy to arbitrariness * shrug *.

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No. Taking ADHD meds is a non-waiverable disqualifier.

In addition to being a Huey pilot, I’m also a forward air controller. So in my current role, I’m the battalion air officer at an infantry battalion; I haven’t flown a H. I’m up for orders soon, and if it’s not a flying billet it would likely be another FAC billet. Something at the regimental level or higher. A staff job basically. Or it may be an option for me to go be an instructor at the schoolhouse that produces FACs/JTACs. And I’m sure there are other non-flying staff billets that I could potentially fill. So it’s not as though taking meds would be the end of my career; just the end of the flying part of it.

Nope. The FAA prohibits it.

You can obtain a waiver for most medical conditions that are disqualifying for flight status. For example, I have GERD and take daily medication to control it. I have a waiver for GERD. I have a waiver for a history of kidney stones. I’m getting a waiver for sleep apnea and for PTSD. But ADHD cannot be waived.

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First of all, welcome to the HowToADHD forums @K-Span , and thank you for your service!

Second, I am musing about the irony that in WWII, pilots were issued stimulants (some sort of amphetamine, I believe) to keep them flying long hours. So, now I find it ironic that the military doesn’t permit the use of ADHD, which I presume is due to the abuse of the stimulant meds. According to what I’ve read, action-oriented occupations such as emergency services (police, firefighters, paramedics), and the military.

  • Doubly-ironic because people with well-treated ADHD symptoms can be much more effective at everything they do (work, marriage, etc).

Does this ban on ADHD medications only apply only to stimulants (Adderall, Ritalin, and the like), or would it include non-stimulant meds like Strattera (atomoxetine)?

For non-medication treatments, the usual is behavioral therapy, such as the CBT you’ve already done. Some research indicates that exercise (particularly the kind that involves balance and complex movements, such as martial arts, yoga, etc) can help with ADHD.

@K-Span

Well, that’s good . . . :sunglasses:

what a choice to have to make. i hate that you are in this situation. i wish you – and your wife – all the best as you navigate this difficult decision.

and hey, i’m really glad you got help when you were in that suicidal place. it’s nice to have you here with us.

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I’m not entirely certain. I did find this article about an Army aviator who is on Strattera, so maybe that is an option. But naval aviation is governed by different regulations, so I’ll have to discuss it with my flight surgeon whenever I return from the ground side of things.

Edit: This article indicates that even Strattera is disqualifying according to the FAA. :disappointed:

From the tension of the decision I presume that flying really feeds your emotional wellbeing? I.E. never flying again would emotional hurt vs just requiring a career path change.

From the outside, the choice to me is clear, but A) I can’t fly and don’t wish to, and B) I am already on meds… so… Bias.

I would think that the … ah… immediate need to focus on not driving the multi-million dollar machine of doom into the ground would sorta push through the ADHD factors for flight safety (Honestly, would worry more about pre-flight issues than in-flight issues).
Assuming that is the case, then I would like at what factors of ADHD are affecting your home and work domains and what impact, if any, medication or other ways to cope would have on those domains.

If finding a non-medication coping mechanism can likely resolve the issues at play, awesome. Otherwise… being honest, you might find yourself losing flight status, marriage, and everything regardless of if you took the meds.

I would say this as a first step: try to find a way to build non-medicine coping skills for the issues you struggle with. Not knowing your exact battles, I can’t offer ideas, but there are some out there. Let your doc know you are trying to avoid the meds to retain flight status, and that you would like to touch base with them on the issue as needed. If you can, work with your CO on the issue. I don’t know if your CO and you are on good enough terms to address it head on, but at the least you can make clear that the stuff you and doc are dealing with has some bleed over into your work stuff, and that you are working the issue to the best of your ability.
Talk to wife. I presume you and she are already talking about this, but ask for her to let your try some ideas and after a week or two to give some honest but kind feedback. I don’t know what kind of education she may have on the issue, but her learning more and becoming an ally can only help.
If coping skills aren’t enough, then you can always fall back to trying some meds and expect that you did all you could to retain flight status and your marriage both. It may just be that you can only keep the one. :confused:

My grandfather was Army Aircorp, went over to the USAF after it was split off. Washed out of flight school after he fly the trainer craft (with instructor in the back) under a bridge. Turns out you shouldn’t do that.
Gramps had undiagnosed ADHD. Dad was diagnosed after 14 years in service, first as a Flight Sim Tech then as a cook (cause dad just had to fill in that last line for desired postings… and the last tech listing was Dietary Tech… curse you ADHD!).
They never bothered to check my sister and I. Homeschooled, so we never knew anything was different. I was diagnosed at 32 (Ish?) and my sister probably has it (Along with a whole host of other issues too…). Oh… and my mom too… And we think most of dads siblings (he has 7). All the boys went into long term military careers except the one who went Army and was medically discharged after ramping a motorcycle poorly and landing with the bike on top. Ouch.

Military life is both great and terrible for ADHD. Lots of rules and regs, clear expectations… but one real bad impulsive choice and the world comes undone.

Best of luck, man. We are here if you need to vent.

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@K-Span , I just found this article, and it reminded me of your discussion here. I don’t know if it will have anything for you, but I hope that you’re getting all the good information that you need to make your decision at the crossroads you’ve found yourself at.


I also have a story to tell, about when my dad was at a crossroads with his military career.

He was an officer in the Navy, and he was being trained by the ship’s Executive Officer on steering the ship while taking on fuel from a tanker while underway. The Captain was off duty, but he wandered into the Bridge. The XO was completely deferential to the Captain, and so he didn’t correct the Captain when the senior officer barked out orders. (Note: it was never noted in the ship’s log that the Captain was on the bridge at this time.)

The two ships were going into a strong headwind, and of course that means the rushing air was drawing the two ships together. My dad was focused on the safety of the maneuver, and so he kept a good distance. The Captain preferred that the ship’s be closer, and so he ordered my dad to adjust the course. Then the Captain and XO got to talking, and my dad unconsciously drifted farther away again. The Captain noticed and ordered him to steer closer a second time, which my dad did obediently. The whole time, the XO (who was responsible for the bridge, the ship, and my dad’s training at the time) never spoke up, never explained to the Captain or corrected the Captain on anything.

Again, my dad steered away unconsciously. His training hadn’t yet progressed to the micro-adjustments needed to keep ships close together going into a headwind, while compensating for the drawing force of the wind.

When the Captain again ordered the ship closer to the tanker, my dad obeyed, and physics took over. The wind forced the ships into a collision. And the Captain (who was off duty and according to the log was not on the bridge at that time) disappeared from sight. Nobody was hurt, both ships were damaged, my dad got scared that he would be the scapegoat.

His “crossroad” moment was a sudden desire to drop from active duty to the Navy Reserves.

What he didn’t know at the time was that the Admiral had the Captain’s character figured out. There was an “unofficial” investigation, which consisted of the Admiral’s Chief Petty Officer taking the ship’s Chief Petty Officer out for a drink. That’s how the whole truth of the incident got to the Admiral. The Captain was given a choice: a thorough official investigation, or retire a little early…he retired.

By the time of the Persian Gulf War, my dad had far exceeded his maneuvers training and was in a reserve unit which specialized in training ship groups on new maneuvers.

Since he was a Reservist, he was home most of the time, so I got a lot more time with him…all of my Jr High and High School years. (He completed his full 20 years in the military between Army enlisted in the 70’s, Navy active duty through much of the 80’s, and Navy Reserves into the 90’s. He has full retirement benefits today. He retired as a Lieutenant Commander. I have always been immensely proud of his military service and tried to follow in his footsteps, but was unable to serve in the 90s due to asthma.)

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Hi Christopher (@K-Span), as I visit this forum, and today being the Veteran’s day, I thought of you and wondered how you were doing and if you made the decision you were struggling with.

I am managing my ADHD without medication - it has not been easy but it works well enough for me. On the other hand I have never been in situations of extreme stress (such as in a combat) and don’t know how well I’d manage it.

Best of luck to you!

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The same for me. I do take meds for depression but without ADHD meds I struggle too! Over the years my biggest challenges: emotional dysregulation, short-term memory, and organizational problems (especially at work when I spent 1/3 of my time looking for paperwork that I lost on my desk). These challenges persist, I am 75 and have been retired for a number of years so ADHD on the job is no longer an issue. Been married for 48 years (to the same woman) where the biggest problem has been the emotional dysregulation. I overreact and get angry over little things. But I’m still married and continue to work on the problem with varying degrees of success. Oh , I almost forgot :joy: . . . my short term memory sucks . . . but then again I just said that . . . but (no kidding) forgot!

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Thanks. I’m doing alright. Still not on medication, just managing on my own…poorly at times.

Are you me from the future? What often frustrates me is that I’m not even sure how much of my emotional dysregulation is attributable to ADHD and how much is rooted in PTSD and how much is just me being a shitty person. :man_shrugging:

Do any of you feel reluctant to attribute various symptoms to your ADHD diagnosis? Like it’s a cop-out or something? I feel like that a lot.

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Browse around the site. You will be amazed to find out just how many traits most of us share! Not just emotional disregulation, also blaming ourselves! The latter partly because we (as well as other neurotypicals) judge ourselves by the NT standards. It is sort of like blaming ourselves for not being able to see clearly because we have poor eyesight. The same way our ADHD is not the whole of us. It is just a trait. But it is also very different from poor eyesight in that there are many positives as well about ADHD! And there is nothing equivalent to glasses that correct our eyesight.

Learning to not blame ourselves is definitely worth it. Just as you would be compassionate to your kids, spouse or colleagues if they were having a hard time, being self-compassionate and avoiding self-judgements helps a lot. I certainly attribute many things to my ADHD and then try to deal with the ones that make my life (& of those around me) difficult. Easy to say but hard to practice and be consistent! But I have it and I just have to deal with it. I lived most of like without knowing I had ADHD so just knowing I was not alone was a huge relief to me. Before then I had sort of given up on changing myself (“this is who I am” and I can’t change!) but knowing ADHD had a lot to do with my issues, gave me a renewed hope and a strong desire to change what I can. Not sure if this makes sense to you but that is how I felt and feel. I can’t change having ADHD but I can certainly learn to cope with it better, right?!

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Yes and No.

If you attribute your problem behaviors to ADHD, and . . . let it go at that . . . without any attempt to take steps to improve such behavior (as hard as that has been or may seem) . . . Then “YES” . . . it is a cop out!

If then, on the other hand, understanding that the same behavior can partially or totally be explained by ADHD . . . There is hope. That insight, that acceptance, can enable one to do what is needed to put some “reigns on the race horse”! And then, perhaps find an ADHD coach, another :brain: or :brain::brain::brain:, a Cognitive Behavior Therapist, a BOOK, AA or NA (If you are self medicating) . . . OK, you got the idea.

I will also mention . . . Learning that one has ADHD, naming the demon, putting a label on it . . . Can metaphorically or, in some cases actually, be a lifesaver! Until my son was evaluated and found to be a roaring example of a 5 yr. old with flaming ADHD . . . My wife and I did not know how to begin to get him the help he needed. Just as important, putting a label on it enabled my son to have some modicum of understanding that he was not “STUPID” . . . As he would call himself when he ''failed" .because he could not do what other kids his age were able to do with ease. His self doubt and underestimation of his intelligence and abilities never quite went away! After graduating from HS he enrolled in a vocational program to become an auto-mechanic. And then during the summer before he started, on one sunny day he asked my wife . . . “Mom, would you be upset with me if instead of going to the vocational school I went to college?”

So he did!

It was not an easy road for him. It took him seven years after dropping out of two colleges . . . to finally discover what he wanted to study . . . he graduated from a prestigious technical college with a BS degree in Computer Engineering. And he loved math so much, and was so good at it . . . that he wished he had gone for a degree in Electrical Engineering . . . Because there would have been even more, and more difficult, math required. Turned out that his degree and what he studied was easily transferable to Electrical Engineering. And that is what he has been doing ever since graduation. And finally, I’ll add that the “Stupid” kid graduated with a GPA of 3.97 :slightly_smiling_face:!

So “yes” and “no”!

I wish you the very best that may lay ahead for you . . . no matter what!

:sunglasses:

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I’m the opposite.

I’ve spent three decades of attempting to fix my issues with a attention, distractibility, working memory, procrastination, time management, and organization on my own. I’ve made little improvement in all that time, despite learning multiple time management systems, organization systems, methods to deal with procrastination, memory tricks and techniques, etc. I’ve learned a lot, but little has helped. I’ve tried to make adjustments to my diet and activity, and I’ve also tried various supplements (perhaps improving up to 10% over my baseline norm).

Thinking of myself as a “normal” (i.e. neurotypical) person with these issues made me very self-critical.

Thanks to my ADHD diagnosis, my lifelong struggles finally made sense. It was a relief for me to realize that it wasn’t a lack of effort on my part, it was a deficiency in my brain that wasn’t being addressed. Successful treatment has helped me immensely! I’ve stopped criticizing myself for my deficiencies and am now more accepting of myself as a whole (treating myself with almost the same level understanding that I have for other people).

I still take ownership of my past shortcomings and failures. It’s my life, I lived it. I was the guy who waited 30 years from the time I first noticed my struggles until I finally went to a mental health professional for help. My diagnosis is not a copout, I don’t use it as an excuse… It’s an explanation for my struggles and limitations, and it gives me direction on how to better address them.

I still struggle, even with medication, but now my struggles are about the skills I wasn’t able to develop before. Now that I can manage my attention, I realize that I need to make a new effort to develop my productivity skills (e.g. time management & organization). It’s better to start again at 46 with a better understanding, than to continue to flounder in ignorance and criticize myself for “just not getting it”.

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@j_d_aengus

So well put . . .

:sunglasses:

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An update: soooo I just started taking medication today (at 36 years old) for the first time since I was maybe 12 or 13. I know that this means I will likely never fly again. But I’m hoping the benefits will make the sacrifice worth it. :crossed_fingers: It’s probably more important that I take care of my mental health rather than worry about my career. It sucks, and I will really miss flying. But I can still do so much more.

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Such a difficult decision to make, but undoubtedly one that will help you.

I’m sure it will open up other possibilities for you.