Collateral damage

Author: Kerry Temple ’74

Some wounds are obvious. Others are hidden to the eye. But invisible scars — the ones lurking in the human psyche — can be just as crippling, similarly painful, and possibly much tougher to repair.

Various studies suggest that 20 to 30 percent of U.S. veterans from the wars in Iraq and Afghanistan suffer from Post Traumatic Stress Disorder (PTSD), lingering and debilitating anxiety-related behaviors, experiences and physiological responses after exposure to psychological trauma. Symptoms include nightmares, flashbacks, difficulty falling or staying asleep, hypervigilance, anger and rage.

PTSD can lead to significant impairment in social and occupational functioning. The afflicted may have a hard time holding a job, maintaining relationships, overcoming substance abuse or sustaining their desire to live. They’re hurting, and it’s an ache impossible to explain.

“That’s the thing that’s so jacked up about PTSD,” says Keith Hull, who served in Iraq and Afghanistan with the Marine Corps. “It’s a mental degradation that you can’t describe. If you hurt your arm, you have a mark. But if you hurt your mind . . .”

Hull, 37, lived under a bridge until finding the Tennessee farm where he and other vets help each other return from service. His description of PTSD in Esquire was anything but clinical: “It feels like something’s trying to come out of my chest. Like in Alien? That’s how I think of it — it feels like something is trying to rip through my chest. It’s like: I don’t understand it either, motherf——er! I just know I’m f—-d up and I need help.”

Despite the efforts of the military, healing the fractured mind has so far proven to be a losing battle. The statistics are alarming. But they further illustrate what an elusive beast the victims and their health care providers are grappling with. Unfortunately, suicide provides a useful window onto this bedeviled terrain.

The Army’s suicide rate increased in 2010 for the sixth consecutive year (that rate having already doubled between 2001 and 2006). It was the second year in a row that the U.S. military lost more troops to suicide than it has to combat in Iraq and Afghanistan. And for every death, at least five members of the armed forces were hospitalized for attempting to take their lives.

As many as 18 vets commit suicide every day, if you count veterans from all eras, according to a 2010 report from the Veterans Affairs Department. The same report cited 950 suicide attempts monthly, with 11 percent of those who didn’t succeed trying again within nine months.

These numbers do not include deaths classified as accidental drug-related overdoses or the inordinate number of veterans killed in single-car accidents. Further complicating the murky picture is the variation in reporting across the different services. Some branches do not include nonmobilized reservists who kill themselves; the Defense Department does not count those who have left the service after deployment in Iraq and Afghanistan; and the Department of Veteran Affairs keeps track of suicides by only those enrolled in the VA health care system — which three-fourths of the veterans are not.

The causes are equally hard to specify. Of course, one is simply the horrific experience of combat and the residual mental anguish of those memories. That can be followed by difficulty resolving those sights and sounds with life back home, substance abuse and financial problems. Additionally, many point to the past decade’s long and repeated deployments, deployments that also strain familial relations — often cited as a leading cause of suicide. Yet a third of confirmed suicides are committed by troops who had never deployed, and of the 112 guardsmen who killed themselves in 2010, more than half had not deployed.

All branches of the U.S. military and the VA have significantly ramped up mental health services in recent years, but there is a long-embedded perception that seeking care can harm a soldier’s career and still not fix what’s broken, not undo what’s already been done. Soldiers are trained to fight, and those attributes that make a good warrior also make it more difficult to live any other way.