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“I’m a U.S. Army Aviator — and I Have ADHD and Anxiety.”

I am fourth generation Army. Flying is my passion, and I take great pride in my service abroad and at home. But when undeniable symptoms of ADHD first began to crop up, I feared that my dream profession as an Aviator may be at risk. Here is what my ADHD diagnosis has meant for my military career.

Nathaniel Swann, a U.S. Army aviator, in action.
Courtesy of Nathaniel Swann.

As a U.S. Army Aviator, I’ve spent the last 15 years flying helicopters and airplanes through some of the most dangerous locations on the planet and among the most elite units — completing my mission and bringing my precious cargo and aircraft home safely every time.

I am currently stationed in Georgia, serving as chief of staff of a large unit. This organization deploys globally to threat locations around the world, so I like to say I’m basically running a worldwide airline with all the benefits and challenges that come with it. At age 36, and now a Major, I’ve held 12 different positions and have moved 10 times since I began active duty. And, yes, I still fly.

Nothing I had seen on the ground or in the air in both combat and training, however, could have prepared me for the diagnoses of attention deficit hyperactivity disorder (ADHD) and anxiety I received two years ago — a turn of events that nearly ended my piloting career.

From Military Brat to Aviator

My interest in aviation began with my father, who was a general flight surgeon for the Army. The signs of my ADHD, in hindsight, were also obvious from an early age.

I was born a “military brat” — and I’m also fourth-generation Army. Because of my father’s career, we moved around a bunch — seven times, actually, by the time I was 18. This is probably the main reason my ADHD wasn’t detected until adulthood, despite the fact that I was known as a wild, rambunctious kid who didn’t think much before he spoke, and who spoke at a million miles an hour (and still do to this day).

[Click to Read: Can You Join the Military with ADHD?]

My father, an aero-medically trained general surgeon, spent a lot of time supporting aviation operations for the Army. We would often go with him to work, sometimes to the flight line or to meet with other pilots — and I just thought it was the coolest thing.

Determined to follow the aviation route, I attended Middle Tennessee State University on a 4-year ROTC scholarship and graduated in 2005 with a degree in aerospace administration. I joined the Army immediately after graduation, and went to flight school, where I was trained to fly both helicopters and airplanes.

My piloting career for the Army has since taken me around the world to places like South Korea, Afghanistan, Iraq, and South America.

I believe my ADHD, even if I didn’t know it at the time, probably helped me perform at my best when flying or directing the units and teams I oversaw. I could hyperfocus when necessity required it in high-stress environments, and I was able to jump from one thing to the next — fast. Fellow combat-tested soldiers have told me they had never seen someone respond to events as quickly as I did, and get it right each time.

[Opinion: Uncle Sam Wants You! (Maybe)]

Everyone freezes to some degree in moments of extreme stress, as they analyze and weigh “fight or flight.” Maybe it’s the way I’m wired, but I’ve found that my freeze response is more stunted than most everyone else’s. A stressor, I also learned, can trigger intense concentration and quiet everything else around me.

This was the case in late 2009, when a suicide bomber drove through the gates at FOB Chapman in Khost, Afghanistan, about a mile away from our base. He detonated himself, killing several CIA agents and injuring dozens of others, as portrayed in the movie “Zero Dark Thirty(#CommissionsEarned).

As the on-duty battle captain for the Aviation Task Force nearby, I directly led the organization of a sustained, rapid response, directing our fleet of aircraft to the site to carry victims to safety. Our airplanes and helicopters were taking off and landing minutes apart in what was ultimately a multi-hour operation. I can only hope our team’s efforts positively impacted the lives of our defense partners nearby, who were sometimes miles apart.

My ADHD Diagnosis — Fight or Flight?

After we redeployed from Afghanistan, I returned to the States and continued my military career, climbing the ranks and looking forward to the next exciting venture, going from Georgia to Alabama to Kentucky to Kansas, and then on to West Texas.

My growth had been steady, but as I moved up the ranks from a young officer with clear, prescribed tasks, to a Major in charge of wide-ranging organizational directives, problems began to appear.

Flying was never an issue. I honestly found it a reprieve from the daily hardships of office work, but I found it harder and harder to manage the demands of my new executive positions. I had problems integrating with other teammates, and would see things from a perspective that often clashed with that of my organization. I could work with those who saw the world as I did, but experienced significant friction with the ones who did not share similar views.

Focusing was also becoming a lot harder. I would get easily distracted by less critical issues as I worked to resolve the larger ones. My professional relationships threatened to deteriorate as I found myself screaming at some of my colleagues over conflicting issues. I was forgetting things, like people’s names and recent conversations.

I knew I couldn’t continue this way, so in the spring of 2018 I spoke to our unit’s aeromedical psychologist. While obvious to her, it had not occurred to me — as I went through my history and listed my many problems ranging from work issues to the demands of fathering a 3-year-old at the time — that part of the issue could be post-deployment stress. After all, I had deployed on five separate occasions by this point.

But then she asked me another question: “Do you always speak this fast?”

As random as I found her question, I answered yes. In fact, we call it “Swann Squawk” in my family — whomever talks the fastest and the loudest is the one who gets heard. And I’ve got a million things going on in my head all at the same time that need to come out.

The psychologist asked about testing me for ADHD. While I was happy to go down that path, she advised that things could get “interesting” and “complicated.” “You can’t fly and be on stimulant meds,” she told me.

Permission to Fly

Testing and further conversations with the psychologist eventually led to my ADHD diagnosis. Because my flight status would be revoked if I went on stimulant medication, she placed me on Strattera, a non-stimulant drug, to see how I’d fare. I was also given Wellbutrin to help manage additional anxiety and stress issues.

I was grounded for several weeks as I stabilized on the ADHD medication and while we followed all guidance in the Aeromedical Policy Letters (APLs). If all went well and I showed signs of improvement, I could potentially obtain a waiver to continue to fly.

I was not without fear of losing my flight status, and had many, many questions about the process. How will I know how much medication is enough? What if Strattera doesn’t work for me? What if I don’t make enough “improvement?” My provider, however, put me at ease — and slowly I began to see changes. My interactions with others, also, substantially improved. My mind quieted to some degree, allowing me to focus more readily, rather than rely on a stressor to activate concentration.

Given my positive response, my provider filed a waiver on my behalf, which was approved just over a year ago, allowing me to fly — all while treating my ADHD.

Who’s at Risk?

Opening up about my ADHD and anxiety diagnoses has allowed me to do some of my best mentorship in the Army. I tell others that many people do have internal limitations of one kind or another, but that doesn’t mean we can’t find success and persevere.

My ADHD diagnosis has also given me a lot to think about, especially the arbitrary, external limitations often set on people like myself.

The reality is that I’ve always been a safe pilot, and I’m probably safer now on medication. But it’s also known that stimulants are generally more effective in treating ADHD symptoms than are non-stimulants. While I’m doing well on a non-stimulant, its counter — the very substance that could preclude me from flying — could make me an even better decision maker, whether in the office or in the sky.

At this time, there’s just no way of telling, as making the switch would surely cost me my life’s profession. For now, I will be ever hopeful that the Federal Aviation Administration (FAA) will complete a review of its medical requirements and remove the barrier to entry for those of us with ADHD, and not further limit those who see themselves living a life among the clouds.

The views expressed within are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the United States Government.

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