Tuesday, August 16, 2011

Post Traumatic Stress Disorder & Suicide In The Military: A Very Personal Story

"For every suicide, there are an estimate of six survivors (according to suicidologists, this may be a conservative number)."

Today's moving post was written by one of those survivors - my friend Betsy. August 12th, 2011 marked the one year anniversary of her brother-in-law's passing. 

Many of us have heard of Post Traumatic Stress Disorder. We've seen the news stories and know the statistics. We're aware of the remarkable sacrifices that our troops make every day. Perhaps we even try to imagine ourselves in their shoes during and after war. However, few of us (myself included) have had these realities thrust into our backyards, devastating our own families. 

This post allows us crucial insight into a tremendous epidemic in our country. Betsy eloquently puts a face to the statistics, as she describes the emotional impact of a potentially preventable suicide. Betsy, thank you for your profound passion and courage to speak about a "taboo" issue; for allowing us an intimate view into your life and the lives of your loved ones. You've done us all a profound service, but most of all you've ensured that your brother-in-law's death will never be in vain. 

Betsy would also like to give special thanks to 3 special women: Libby Johnson, Rachel Oberg-Hauser, and Michelle Schreiner. Each of them contributed to a group suicide prevention intervention paper that Betsy worked on for graduate school. According to Betsy, these women were "beyond supportive of [her] raw emotions and grief while working on this project throughout the semester."

Most do not like to talk about suicide.  There seems to be something so otherworldly and frightening about it.  Suicide carries with it a unique stigma in society.  The mysterious nature of what drives someone to die by their own hand makes us fear what we do not understand. The deliberate act of ending one's own life seems to carry with it an element of choice, even despite our recognition that there must have been incomprehensible torment involved.  It is clear that most do not possess an accurate perception of the factors that lead to suicide, the number one being untreated mental illnesses such as major depression, bipolar depression, or post-traumatic stress disorder (PTSD).

Did you know that Army Reservists suffering from untreated mental illness who do not actively seek psychological intervention represent a particularly sensitive portion of the military at risk for attempting or dying by suicide? I had little knowledge of this group or of all those individuals in our military suffering the psychological consequences of war. And then I discovered the man my sister loved suffered from PTSD and most likely an untreated mental illness. Last summer, after 18 years of service to our country, he took his own life.

A year has passed since his death, and not a single day goes by without his death impacting my daily life and decisions. He was not my son or brother or my lover, but my guilt and grief still run deep. During the last months of his life, I tried unsuccessfully to get help for him and alert those surrounding him to the tragedy that could result if he remained untreated. After feeling unheard by the military and those in his immediate circle (people able to actively intervene), I was driven by desperation and called the police. Two days later, they entered his home with force and he shot himself. 
To this day, some people blame me for his death, and I still have a hard time accepting that some people cannot be saved. I worry about my mental health sinking that low and wonder if anyone would try to help me. I watch friends I love who suffer from mental illness and wonder if there is anything I can do to save them. When I receive a call from a troubled friend, my mind automatically goes to the worst case scenario. Just last week I jumped in my car and drove an hour to a friend who expressed suicidal ideation on the phone. For now that friend is safe, but what about the next time? What can I do? What can we do for our loved ones living with mental illness? I recently ran across this quote and keep it close to my heart. It guides me whenever I must decide how to help those I love...
‎"You cannot save people. You can only love them." Ana├»s Nin

We cannot save them, but there are things we can do to help. We can talk. We can end the silence. 
Although it is difficult for me to define our country’s approach to conflict as socially just, this much is clear: America has been constantly at war for at least the last ten years. This not only affects the ones fighting these battles, but it impacts all of the people in their lives.

Suicide is an unsettling phenomenon that eludes an easy explanation. It is a major public health crisis, with nearly a million people committing suicide each year worldwide. The inability of others to conceptualize the mind set of suicidal individuals makes the issue perplexing and ridden with stigma.  Suicide rates vary among ages, genders, occupations, and cultures. For Americans, suicide is the eleventh leading cause of death with more than 34,000 deaths a year (Center for Disease Control and Prevention [CDC], 2010). 

Since September 11th, 2001, an estimated 2 million individuals have been deployed to serve in the Operation Iraqi Freedom or OIF, and Operation Enduring Freedom OEF to fight the war on terrorism. Effects of war are significant when the current rates of suicide in the Army alone surpassed the overall suicide rate of US civilians. According to the ARMY Health Promotion Risk Reduction Suicide Prevention Report of 2010, there were 1713 attempted suicides, and 239 deaths due to suicide among soldiers just in 2009 in the Army. These statistics are what the Army reports, but may be underestimated due to a lack of information on soldiers that have returned home from deployment and soldiers who are no longer in service.

Although difficult and not without its challenges, we must bring about change in this imperfect world of preemptive war.  We owe it to our soldiers to ensure that they're as whole as possible. Americans must learn to truly care about members of the military. These individuals are serving our country and, as such, should be viewed as part of our family since family members fight for each other. Thus, we are socially obligated to provide them with the best medical and mental health care. Until world peace exists - an unlikely scenario given the current conditions of conflict in numerous war zones - we need to work within our culture of war to at least understand the adversity our troops face. I believe we must treat the alarming rise in the rate of suicide among the reservists as an emergency and stop this avoidable casualty of war. 

For every suicide, there are an estimate of six survivors (according to suicidologists, this may be a conservative number). A suicide survivor is a family member or friend of a loved one who has committed suicide. They may experience a myriad of emotions related to grief: shock, denial, guilt, anger, despair, disbelief, stress, sadness, rejection, loneliness, confusion, self-blame, helplessness, pain and depression; all of which are natural elements of the grieving process. After suicide, survivors often struggle with feelings of guilt and understanding why the death occurred. Many carry the burden of guilt with them and wonder in what ways they could have prevented it. This can be very detrimental to one’s health, and working through these types of emotions takes time. Due to the stigma surrounding suicide, survivors may also experience shame and embarrassment while coping with the death.

Change needs to start at the very top. And change is possible! Similarly to his predecessors, President Obama wrote letters of condolence to the families of fallen soldiers, except to those who die by suicide. They do not consider these lost lives as a casualty of war, but they are. Additionally, the Purple Heart is also not issued to those suffering from PTSD. As Michael Blumenfield writes, “This is outrageous! These men and women have all volunteered and knew they could be in harm's way. There is no basis for treating them as if they purposefully became psychological casualties. There is no way to minimize the grief of their loved ones but this failure to acknowledge their loss only compounds it (Blumenfield 2010).” In order to demonstrate that he is truly acting as the Commander-in-Chief, our president must passionately advocate for changing the existing policies of discrimination within the military - policies that perpetuate the stigma of mental illness and suicide. This summer the policy on writing letters of condolence for our soldiers who die by suicide changed in part to many grassroots efforts. This may seem small, but it is a victory nonetheless! With further efforts, we can continue to lessen the existing stigma!

Suicide is indeed a serious public health problem that demands our attention, but its prevention and control are unfortunately quite complex. Passively noticing this issue will simply be insufficient to cause major change. Whether we advocate for social change or directly influence policies., we must actively acknowledge that we each have the power to prevent suicide.

What will you do today to spread the word? 
What can you do to take notice of this issue?
How will you love those with mental illness?
We must go to war for those who go to war.  

Rest in Peace.


  1. It was not your fault, Betsy.

  2. Hi Betsy,

    This is Maya's Dad (Mark). It is appalling that our government (and I suspect most others), would not honor people who have suffered this way. I think its great that you tried to help your brother-in-law and that you are giving meaning to his life with your efforts to spread the word about this issue. Please accept my condolences over your loss and I hope you and your whole family find the peace and healing you deserve over time.

  3. A message from my great aunt Ruth:

    This story is totally heartbreaking. Brett looked like such a personable guy, including the dimple(s).