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War’s Silent Stress: The Family at Home

depressionWar’s Silent Stress: The Family at Home originally appeared on the Opinion page of the Virginian Pilot on August 9, 2009.

MUCH LIKE the news of servicemen killed in action in Iraq and Afghanistan, last month’s news of the death of a military spouse at Ft. Bragg made only local headlines.

A 40-year-old Army wife, who was four months pregnant, was found dead of what appeared to be a self-inflicted gunshot wound. The woman had called 911 with threats of hurting herself, but the police arrived too late. Her husband is an Army sergeant who worked in Civil Affairs and had been deployed multiple times.

When the news broke, there was a short burst of e-mail traffic among the leadership of Blue Star Families, a nonprofit, nonpartisan group of military spouses working to promote awareness of the myriad issues facing today’s military families.

“I don’t know why I find this so surprising but the story says she was 40,” wrote the wife of a Special Forces NCO. “I guess I assumed that someone in that state of despair would be younger — like maybe she’d have better coping skills at 40.”

The majority of the Blue Star Families members are veterans of three, four and five deployments, and at least one member has endured eight deployments in the past seven years. Often these deployments last well beyond a year, as anniversaries, holidays, births and birthdays tick by, never to be celebrated together.

My husband, a recently retired Marine Corps officer, deployed only once in the five years we have been married. A difficult seven months, but it was, after all, only one deployment.

Post-conflict disorder and depression are being addressed by our military for the service members who return from Iraq and Afghanistan. But the effects of these deployments on spouses and families are just beginning to get some attention. While statistics on depression and mental illness among military spouses are not available, some Blue Star members are openly surprised that suicide among the spouses of deployed troops is not more prevalent. In fact, the stereotypical overwhelmed military spouse is 19 to 22 years old, the wife of a junior enlisted service member, whose ranks make up almost 44 percent of our active duty military. Many of these spouses have very young children, are far removed from extended family, are on a limited and usually single income — approximately $1,500 per month for a family of four — and few have the coping skills that come with age and experience. But mental health experts remind us that depression knows no boundaries — not age, income level or military rank.

Sadly, last month’s tragedy was not an isolated incident, though news stories about suicides can be hard to find because many media outlets honor an old journalism standard of not reporting suicides. On Nov. 28, 2006, police in Fayetteville, N.C., discovered a 39-year-old mother and her two children dead inside the family car. The mother had killed herself and her two young children with carbon monoxide poisoning. Although no one knows what went through her mind when she climbed inside the vehicle and strapped her two children into their car seats, the military wife had a history of postpartum depression. Nonetheless, she was described as a positive and upbeat woman who mostly kept to herself. Her husband, a lieutenant colonel in the Army, had been deployed to Iraq just two months before, just after the birth of the couple’s daughter.

A few members of Blue Star Families’ leadership have admitted to being treated for depression. One member said that the combination of her husband’s three recent heavy-combat tours to the dangerous Helmand Province of Afghanistan and the stress of taking care of two young children led her to deep despair, thoughts of suicide and hopelessness and, eventually, to a depression diagnosis and a prescription for Wellbutrin.

She described how military spouses get addicted to news reports during deployments, despite knowing the information will make them miserable. The Internet allows the family to catch every bit of reporting on the area where their soldier, Marine, airman or sailor is deployed. This has the effect of almost putting the spouse into combat with them. “There is nothing as intense as doing a Google search to find out if the love of your life, the father of your children, is dead or alive,” she said. While the family member can be literally paralyzed with worry, she also must raise kids, work, pay bills and deal with the sometimes infuriating and insensitive comments of civilians around her.

Officers and senior NCO’s are trained to detect Combat Stress Disorder in their men and women serving in combat. Often a precursor to Post Traumatic Stress Disorder, a crippling mental state, the men or women who show signs of combat stress are given rest, a good hot meal, a DVD or book and a strong verbal reminder that they are going back into the fight after their short break. Unlike the military, their spouses are not trained to detect symptoms of depression, burn-out or what another generation called “combat fatigue” — in themselves or each other.

Thankfully, much already is being done to help military families. There is a push for more mental health counselors on bases. Teams of Military Family Life Consultants funded by the Department of Defense are available to all services. They provide counseling to service members and their families, and there is no chain of command notification and no paperwork. Nonetheless, many spouses — even in the Blue Star leadership — have never heard of these services.

In addition, studies are beginning to surface about Secondary PTSD — a mental health issue that has been lurking around in this country since at least the Vietnam War. Secondary PTSD has shown up when the spouse and/or family respond to their changed environment with anger, substance abuse or violence, replacing a peaceful and loving home life. Repeatedly, Blue Star Families have found with so many of the good programs out there, the challenge is letting families know what is available.

Now more than ever, communication is key. As media reports query the long range effects of multiple deployments on children, and with the increased awareness for detecting and treating PTSD in our military, it is time to close the loop on mental health and our military families and begin talking about the potentially harmful effects of repeated longterm deployments on the spouses of our service members.

Civilian or military, the first step to help for depression is talking about it.

Rosemary Freitas Williams is a director of communications for Alexandria-based Blue Star Families, whose members on 70 military bases work to educate those who make decisions about military life and its unique challenges.


Service Dogs for Veterans


Oprah’s show last Thursday highlighted the Puppies Behind Bars’ Dog Tags Program. I first became aware of this awesome program when Sen. Al Fraken (D-MN) introduced his first piece of legislation in the Senate seeking to fund a program providing service dogs to veterans.

Sen. Franken joined with Sen. Johnny Isakson (R-GA) to introduce the Service Dogs for Veterans Act. Sen. Isakson saw firsthand what the love and comfort of a companion animal can do for someone suffering. Before his mother, Julia, died of Alzheimer’s disease in 1998, one of the few things that brought her noticeable joy was her interaction with service dogs at an Alzheimer’s facility where she spent her last years. Their bill was rolled into the Department of Defense Authorization Bill, which was passed by the Senate.

I’m crazy about dogs, and I think that their power to heal and comfort is unsurpassed. I never really considered the impact of companion animals on our wounded warriors until I read Jay Kopelman’s book From Baghdad to America: Life Lessons from a Dog Named Lava. Kopelman, a Marine veteran of Operation Iraqi Freedom, writes about his transition back to civilian life with help from Lava, who is not an “official” service dog. Needless to say, I cried like a baby nearly the entire time reading his story. Luckily, I was in Chicago’s O’Hare airport when I picked up his book and reading it while flying on a large jet, so it’s not like anyone saw me.

When Sen. Franken introduced his bill, I started doing some more research on service dogs for veterans, and I came across this Time article and this Wall Street Journal article. The WSJ article told the story of Capt. Luis Carlos Montalvan, an Army veteran who served in Operation Iraqi Freedom and now suffers from severe PTSD and other war-related ailments. Capt. Montalvan was the inspiration behind Sen. Franken’s proposed legislation, and he is also the proud recipient of Tuesday, one of dogs from Puppies Behind Bars’ Dog Tags program.

PhotobucketPhoto by Leslie Granda-Hill

You can watch his story here and read his first person account here.

Besides tugging on my heartstrings for my love of dogs and our military, I am most impressed by the recognition of these charitable organizations and Sen. Franken’s bill of the disabling effects of PTSD and other mental health disorders as a result of war. Our minds are such powerful organs, and when they are damaged, they too need to be treated and given time to heal. Unfortunately, the damage is not visible like the loss of a limb, but the pain and suffering is just as real.

Other charitable organizations are doing great work by providing service dogs to our wounded warriors, including NEADS Canines for Combat Veterans, Freedom Service Dogs, Inc., America’s VetDogs, and Patriot Paws Service Dogs. If you know of any others, please let us know!

Hug them even if they can’t hug you back.

My first post…to this blog was going to be scientific with statistics and research data. After all, I am a medical researcher, data analyst, I manage information; constantly seek answers, always curious. This afternoon however, I had a conversation with a mom whose son has TBI and PTSD…and orders to deploy again. Perhaps then, you will indulge my speaking from the heart instead of from ‘my brain’. I guarantee enough of that will be forthcoming.

There is nothing more heartbreaking than to look into your child’s eyes and feel compelled to ask”what have those eyes seen?” And the eyes, well what you see is ‘dead air’.  The definition of Dead air” is “unintended interruption in a broadcast during which the carrier signal is unmodulated-no sound on a radio signal or a black screen on a television signal.”

I’ve asked my son this very question. I imagine many of you have either asked or wanted to ask your son, husband, sister, brother, wife, boyfriend, girlfriend; Army, Air Force, Marines, Navy, National Guard, Reservists…

After my son’s first tour of duty to Iraq, his wife (my daughter-in-law) asked him to tell her “what it was like over there.” His reply was it would be very difficult for her to understand because she had no context in which to do so.

Prior to March while researching and preparing materials for my web site Military Health Matters Resource Center for “Brain Injury Awareness Month” I came upon a set of  presentation/video packages  designed to train senior NCOs and Officers on the proper  identification of TBI, mTBI and PTSD and correct redeployment protocols. We’ve all seen films or documentaries of the wars, videos of IED explosions, combat support hospital operations, or the like but none of these have ever come as close to making the kind of impression these did. They were vignettes or scenarios with real people and real situations.  Agonizing to watch but impossible to turn away from; invoking the very same feelings you may experience while watching a horror movie that never seems to end. Only this isn’t a movie…but it is absolute horror.  I am writing an article on PTSD and TBI that I am subtitling: “the living hell within”. That would be an understatement.

I was very encouraged to hear Secretary Gate’s 2010 budget proposals this week in particular the priority of investment in ‘human’ capital – our kids and loved ones. More on this next time… as soon as my brain returns.

Hug them even if they can’t hug you back.


Proud 82nd ABN Mom

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