Every week, it seems, we hear about an even more tragic kind of military death—that of veterans who take their own lives, most often when they’re back at home, seemingly safe and sound. It is, of course, an even deeper loss because unlike most combat-related fatalities, these deaths seem to be much more preventable. If only we’d seen the signs. If only we’d stopped him or her before it was too late.
Data released by the Veterans Administration in February 2013 puts the number of U.S. military vets lost every day to suicide at a staggering 22 veterans. And as we learn more about what’s affecting the men and women coming home from Iraq and Afghanistan, it’s becoming clear that post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), through explosions and other concussive events, may be strongly linked to vets taking their own lives. This week, researchers at the National Center for Veterans Studies, in Salt Lake City, reported in the journal JAMA Psychiatry on a link they found between the number of TBIs and depression and thoughts of suicide.
These findings are just the most recent piece, though, in a troubling puzzle that stretches back decades and probably centuries. Until recently, neither the public nor medical professionals really understood the tremendous psychological and emotional impact of war on those who serve in the military. “We have all these soldiers coming back with TBI, and we now know what that is, but in World War II it was called ‘shell shock’ or ‘battle fatigue,’ and it's like you just had to get over it,” says Dale Maharidge, the Pulitzer Prize-winning author of Bringing Mulligan Home: The Other Side of the Good War (Public Affairs/Perseus). Maharidge’s book tells the story of his father, Steve Maharidge, who served in World War II as a Marine in Love Company. While a good father in many ways, Steve came home from Japan prone to sudden, rageful outbursts that traumatized his family.
A specific incident would haunt Steve Maharidge much of his life: Maharidge writes that his father and the 22nd Marines landed on Okinawa, Japan, with the first wave: On May 30, 1945, near the village of Naha, one of his company tossed a grenade into an open tomb where Japanese soldiers were suspected of hiding. The tomb was an ammo dump. The sympathetic detonation killed the grenade thrower, Pfc. Herman Walter Mulligan, and the blast wave gave everyone nearby, including Steve, concussive brain injury. That explosion rolled through the years, haunting Steve for decades. “Mulligan was like a ghost I grew up with,” Maharidge writes.
Demons didn’t just torture Maharidge’s father, though. In researching the book, Maharidge talked to dozens of his dad’s fellow Marines, most of whom had barely spoken about their service in Japan—even to their own families—in the many decades following the war. “You have the myth of the ‘good war’; I really feel it’s a myth,” says Maharidge. “None of the guys I talked to called it a good war. They don’t use that language. We mythologize it. They came home to a hero’s welcome, they were embraced, they re-entered society in the great years in middle part of the last century. That mythology is dangerous, and today we like to do that, too, just as much. We have to look at the reality of war—what it means, what it does.”
Maharidge says he was particularly struck by how conservative about war many of the men in his dad’s company were when he spoke to them. “One man said, ‘We’re always at war, we’re an aggressive nation,’ ” remembers Maharidge. Another man, who is politically conservative, told the author, “If we thought about the survivors we would think twice about going to war.” “Everyone I talked to for the book was anti-war,” notes Maharidge. “These guys know what war is like. They don’t want to see more. One guy I saw two weeks ago reiterated to me how his grandson wanted to join the military after 9/11 and he told him not to go, said it’s not worth it. It’s surprising how anti-war these guys are and it was not a liberal or conservative thing.” And what would cause men in their 80s and 90s to make such strong statements, particularly about something they experienced nearly 70 years ago? “It’s the nightmares, which recur as they get older—the horror became almost cinematic,” recounts Maharidge. “A number of them told me, ‘It never leaves you; you never get over it.’ ”
There’s little reason to think today’s soldiers are any different in the trauma they experience. But there is more hope, in that we are beginning to appreciate the impact combat has on those who serve, and we’re getting somewhat better at figuring out how to mitigate that impact. Says Maharidge: “The positive thing for today’s soldiers and kids, is that the men [in my dad’s company] who dealt with it the best are the ones who talked about it the most.” Simply put, Maharidge found that, “the more you talk about it, the less it bothers you. You take the demon and expose it to light and it withers,” he explains. “It’s the same for any victims of trauma today. If you talk about it with your family it makes it less harmful for you.”
The soldiers who dealt with the trauma of war the best were the ones who talked about it the most.
While opening up can help relieve depression, sadness, anxiety and feelings of isolation, it won’t resolve the damage that can occur with traumatic brain injury. “The experts I talked to said that PTSD and TBI, which is physical damage to the brain, go hand in hand, they’re not separate,” Maharidge says. “In my dad’s case, he probably did have PTSD and he had TBI. He would remember parts of the war and recall them in great, horrible detail in fragments. When he would scream and explode when us kids spilled water, that was the brain injury—that inappropriate emotional response.” These are experiences kids today are having too, just as Maharidge did decades ago. He wishes now that he’d been able to respond in a better way to his father’s explosive moments. “There’s no treatment for TBI, that’s the sad thing,” he says, “But I would recommend that [kids] bite their lip. I would yell back at my father and we’d have these huge fights. I would like to think now that I could let him rage and walk away, because you’re fighting with the brain injury. That’s not your dad or your mom.”
Reacting calmly and walking away from an angry outburst takes tremendous patience, of course, and it may be useful—once everyone’s calmed down—to gently try to get a veteran to open up. “There were moments when my dad would talk. I realize now that I could have asked him questions,” says Maharidge. “Don’t be afraid to talk to your parents, or to a vet. You can see the war-damaged person and try to be sympathetic.” In fact, that may be the single best thing any individual can do: Ask questions, when it seems appropriate, and listen. “You may have a parent or uncle or aunt who was in the Gulf War who has issues,” Maharidge suggests. “In our family circles there are veterans everywhere. Just talking to these veterans means a lot to them…The soldiers I talked to have a message for not just today’s soldiers but also the children of today’s soldiers. I grew up with a father who had TBI from the war; we didn’t know it was war-related. These old guys have something to say not just to today’s soldiers, but also to their kids.”
Do you think there needs to be more awareness of psychological and emotional impact of war on soldiers? What do you think about the link between TBI and suicide?
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Lorie A. Parch is a Los Angeles-based writer specializing in health and lifestyle topics. Takepart.com