Tag: mental health

The Lost Ones

Not that long ago, someplace far away where American soldiers and sailors were deployed, there were two brothers. One was good at building bombs and the other was different. And the one that built the bombs used the one that was different to put those bombs in places and on things that killed people. The one that built the bombs did it because he believed he was fighting for one side in a war. And the other one did it because his brother told him to. He didn’t really understand why. He just knew what he was supposed to do.

First bombs…then play. First bombs…then eat.

One day they were both picked up by the local police. First was the young man with the far off stare and the odd walk that fidgeted with his hands. He flapped his ears sometimes with his fingers. He giggled with delight when he saw people he liked and he simply couldn’t resist watching his favorite cartoon over and over again on the beat up television in his family’s home. He wasn’t hard to find. He wasn’t hiding. But he was confused and scared when they took him away. He didn’t understand. He just wanted his brother. And his TV.

The one who built the bombs was a little harder to find but he was picked up a few hours later. Lives were saved in the community.  It was a good thing that was done.

I’m comfortable with sharing the level of detail in that story because they’re not real. I made them up. Once, a long time ago there actually were two brothers that were planting road side bombs in some far away place. And they were found and arrested by one of the local law enforcement teams my team was assisting. I’d forgotten about it for a long time. It was an unremarkable mission. It was pretty easy actually. I filed it away somewhere in the back of my head with a thousand other memories of far off places and semi-dramatic events.

A few years ago, on a long peaceful run in the hills of Southern California it came back to me. As the endorphin lubricated synapses fired on overdrive in my brain, I cycled through the long slideshow of my past. It’s a meditative experience that I found settled my nerves in the weeks and months after I left military life. That particular day, a thought popped into my head from a distant corner of my conscience. It was about the two brothers and a random thing one of the locals told me about them.

“One of them isn’t right. Like a child.” he said.

And then I remembered the picture of him. He looked a little off. Like he wasn’t all there. I didn’t really pay it much mind. We heard lots of things about lots of people when we did that work. Most of them weren’t true. But we knew with certainty that those two were trying to hurt people. So they had to be stopped. And we helped. And they were stopped.

But they came back to me as I climbed higher into the mountains, running harder and harder, my lungs burning, the music in my ear buds blaring. A thought that I wish I never had came to me. It was the memory of that picture and the look on that man’s face. It was the look my autistic and cognitively impaired son has in most pictures we’ve taken of him. And then the hidden guilt of countless missions and operations and times when in another environment, the human part of my brain might have been more engaged took over. I filled in the blanks of how it all happened with a guilty imagination. And a story formed thinking only of my son in that situation. It burned into my mind. And for a long time, it’s something that I thought about, even though I really didn’t want to. And it hurt.

First bombs…then play.  He must have been so scared.

It’s not a traumatic story. Not the part that actually happened. But I wanted to share it.Because sharing it makes me feel better.  We veterans have a lots of stories in different shapes and forms. And no one gets to hear them. Because they’re nearly impossible to share in the course of normal human interaction. You can’t. So you don’t. And the result is that vets are all walking around in a world connected by people sharing their thoughts and their minds real time and virtually in a world where we may never again be in the same room with someone who knows what it smells like when someone vomits on the hot barrel of a .50 caliber machine gun and it starts to boil and bubble off it. Or what it feels like when you hold an eight year old at gunpoint because he was getting water for his family and accidentally wandered into your camp. And it scared you. They’re not remarkable stories. You couldn’t make a book or a movie about them. But we all have them. And we move around 21st century America with them in our heads and an unmet need to share the language no one but us can understand. And we live, at least a little bit, apart from everyone else, no matter how close we try to get to them.

For the first time in our history Veterans serving and separating from service are at a higher risk for suicide then the rest of the public. According to a 2014 study published in the Annals of Epidemiology, Veterans who separated from service within the last ten years are more likely to take their own lives than other Americans. And not just by a little-41 to 61 percent more. It’s not the combat. Those who never served in Iraq or Afghanistan are actually at a higher risk then those who did. And it’s not the repeat deployments either. The data tells us that doesn’t really matter. What the data does tell us is that when a service member detaches, in modern day America, he or she is at high risk for substance abuse, mental illness and eventually suicide. And it’s not the war’s fault. Or the president. Or the last president. Or the next president. Or Muslims. The data doesn’t really tell us why. But I’m pretty sure I know.  So I’ll tell you.

It’s because they’ve lost their family.

Your family is who you live your life with, suffer your failures and celebrate your successes with. It’s who you lean on to get through things, even if leaning just means standing right next to someone going through the same shit you are and drawing strength from the simple notion that they exist, there, with you. And for many service members in our voluntary force, who weren’t pulled away from another life to serve briefly to be released back into that life with an entire generation of others with the same experience, that loss of family is complete and sudden. And that alone is trauma enough to matter.

I separated from the military twice. And both times, I experienced a deep emotional impact. As a person with no history of mental illness, addiction or acute trauma, and the support of a strong family and church, I got through. But not by much. When you take away any of that support or add previous trauma or mental issues like anxiety, depression or even ADHD, the risk is far higher. For the past two years, my wife has worked as a drug and alcohol counselor in a facility for homeless, addicted veterans. And the common links she makes with almost all her clients is the existence of a pre-existing issue and a lack of a support network when they separated.

It’s not what the American people have asked us to do. It’s what happens to some of us, when we stop.

There’s a common idea that Americans fighting American wars and struggling through the trauma of combat are killing themselves in droves because of PTSD from their service in those wars. The 22 a day number has spread through social media and gained tons of attention. But both the ubiquity of the PTSD term and the 22 a day number are deceptive. Over half of those 22 a day are over fifty years old with decades between their deaths and their service. And statistically, most veterans coincidentally fall into the largest at risk bucket for suicide in America-white men over fifty. The 22 a day is more of an eye opener for the mental health, addiction and suicide epidemic in America at large. Because there’s 90 other Americans a day that kill themselves that never served. And it’s a different problem, with a different solution. The veteran issue is much more focused. And it’s not about fighting or serving . It’s about stopping.

So what can you do?

Well, this Veterans Day, start with a little more than the Facebook posts and expressions of gratitude. Those are great. But we get them all the time.  And for this problem, it really doesn’t help that much. The ones in need aren’t looking for gratuity. They’re not looking for you to feel sorry for them either. Chances are, they loved their service. And if they fought, they wouldn’t change the experience that they had for just about anything. The ones in need are looking for something else- their family. And if they don’t find it soon after they get out, many of them will be in trouble quickly. So if you can, go find someone who loves someone who just got out and share this with them. And if you know someone yourself, go talk to them or email them or Facebook message them. And instead of telling them you appreciate them, ask them a question. Ask them to tell you what it was like to serve in your military. And ask them what they saw. And then listen. And then make plans to get back together and talk some more. And don’t act like what they did was incomprehensible to you. Or that you could never do it. Chances are you could. Because what seems like appreciation, is really just a wedge between the old world and the new for us. And it hurts more than it helps.

If you’re really interested in digging in and caring, go buy Sebastian Junger’s Tribe. It’s the best account of what’s really going on here that I’ve come across. When I read it, I was moved to tears by his recognition of this message and the crisp description of what I lived through. And once you read it, go give it to a vet. It will help. Because this isn’t about pity or public guilt or shame. It’s about reestablishing the connection to their next world. And until they do, they’re lost. And the ones that stay lost for too long, stay lost forever.

Happy Veterans day. Now share.

Choiceless

When I met my wife, she was a high school health teacher; a good high school health teacher. One educated in public health and child development. One who ran grants for tobacco cessation and the SADD club for her school. One who got involved in the “whole person” health of her students. People like her have largely been replaced these days by the football coach or the PE teacher, at least here in southern California they have. There’s no bitterness on our part. She left a long time ago to start a family and moved on to helping other people in other ways. I offer that bit of information instead as framing for a different discussion. It’s this. At some point, my wife spent most of her time involved in the well being of high school aged kids. As a result, she observed a few things. And now, those observations are material to a national debate we’re about to have.

About 15 years ago, before we had our own kids, I came home from work to find my wife reading an article about a man named David Reimer. Some of you may recognized the name. David Reimer was born in 1967 and as a result of a botched circumcision, he lost his penis as a newborn. Taking their doctor’s advice, they decided to raise their son as a girl. The results were not good.

David, suffered chronic depression as a child. He tried to commit suicide multiple times until finally his parents told him about his medical background and his real gender at 14. . He decided, then, to live as a man. In 2004, at the age of 38, David eventually succeeded in taking his own life with a self inflicted gun shot wound to the head in a grocery store parking lot.

I remember my wife telling me about the article. And then looking at me and saying, “This is a bigger deal than people think.” After years of watching kids in her school and studying child development, and talking to them about their health she had come to her own conclusions about gender identity. And it not really being a choice.

It’s pretty intuitive. No major break through. I didn’t choose my gender. You didn’t choose yours. But what the David Reimer story was also telling her, and this is what she was trying to tell me but I missed it, was that, if you try to force the wrong gender on someone, the consequences are disastrous for that person. Additionally, this may go beyond just the extreme edge case of David Reimer, a man who lost his physical gender at birth. This was more common. And she was right. I dismissed it as over sensitive nonsense. Like I dismissed the autism epidemic.

Until my son was diagnosed of course.

Reimer eventually was the subject of a book, written in 2006 by John Colapinto called As Nature Made Him. The book provided us with a unique case study that served as a basis for the first half of a modern, mature, compassionate view of gender identity. The first half being that trying to convince someone who is one sex, that they are another, will have horrific psychological outcomes. That’s the first part of the thought. The second part is a little more complex. And it involves science.

In 2015, the Medical University of Vienna released a press release detailing the findings from a study they were conducting on the mechanics of brain activity as it related to gender identity. For those of you wary of half baked medical studies conducted by fly by night organizations, rest easy. The University of Vienna has been around for a while-1365 to be exact. It had four Nobel Prize winners in the 20th century and is the oldest German speaking medical institution in the world. When they say things, it’s usually a fair bet that there’s some science involved. Here’s a piece of it.

“In a current study, brain researcher Georg S. Kranz of the University Clinic for Psychiatry and Psychotherapy of the MedUni Vienna was able to demonstrate that the very personal gender identity of every human being is reflected and verifiable in the cross-links between brain regions”

In English now: They used a technology called Magnetic Resonance Topography (MRT) to study brain activity in men, women and people who identified as transgender.  What they found was pretty straight forward. They identified that the way a person’s brain communicates with itself is different for a man then it is for a woman. No shocker there.  But this second part is more interesting. For people who identified as transgender, their brain worked like neither. It was somewhere in between.Which tells us something very important.  Our physical gender tends to usually dictate how we identify our gender as a function of how we form our thoughts about it, mechanically in our brains. But not always. Sometimes, our brain is “wired” in between. And if you add this last bit of outside evidence in here, that we don’t choose how our brain is wired, you can get to a complete thought on gender identity. It looks like this.

Forcing someone to identify as a gender that they do not, is extremely unhealthy. And since we now know, because of science, that identifying with a gender is neither completely dependent on physical sex nor a choice, forcing someone who doesn’t “feel” like they are a particular sex, to be that sex, is an extremely damaging thing to do.  Especially for a child. Which agrees with two things. The first was the observation my wife was making for me 15 years ago after watching thousands of adolescent high school kids come through her class and talking about sex and sexuality. The second is the horrifying story that the data tells us. Which is this.

According to a 2015 study by the American Foundation for Suicide Prevention, 41% of people who identify as transgender, attempt suicide. For the rest of the population, that number is 4%. That’s four out of every ten. Ten times worse than the rest of us.

In March of 2015, the North Carolina state legislature passed HB2, a state law declaring that people may only use the public restrooms designated for a specific gender for that gender identified on their birth certificate. Governor Pat McCrory signed it into law. These people, many that are kids, are living miserable lives. And we’re making it worse with politics by passing laws to pump up the base.

Now, I wouldn’t have expected my conservatives friends to pass a law protecting these folks. But it wasn’t too much to ask them not to expand government to make life on them harder. But I guess that’s the state of conservative politics in America today.

Here’s where I net out on this. I don’t know what my life would be like if someone forced me, tomorrow, to live as a woman. I had a temper tantrum this morning when Starbucks ran out of the blonde roast before I came in. Chances are, wearing women’s clothes or having mostly women friends and even dating only men, would bother me. And maybe I too would be one of the 41% who just couldn’t go on. I don’t know. But I learned a long time ago not to dismiss things I don’t understand because it doesn’t make sense to me. And this falls in one of those buckets. And when in that bucket, I try to think of who gets hurt the most, assuming all involved are well intentionted. And for this one, it’s not close.

I’ve seen enough memes in the last week about “perverts” using women’s bathrooms and scare tactics around predator men sitting in the stall next to your daughter. And I get that this is new and for some it may feel like the world has gone mad with acceptance and tolerance. But what’s going on here is a compassionate movement to help people that science and data have told us are in a heap of trouble unless we make it easier for them to assimilate into our society. I’m not entirely sure that our state legislatures have bigger problems on their plates than ones that require bathroom legislation, but it feels like they do. Only one in five of them are funding their pensions. We’ve got urban neglect and infrastructure collapse. Let’s put our consensus energy there instead. I’m not entirely sure who a bill like H2B helps. I know who it hurts though. And they’ve had it bad enough already.

 

Coming Back

In the ten years I spent on active duty, I spent a little less than two of them in an active war zone.  That may seem like a lot.  Or maybe it doesn’t. I don’t know, my frame of reference is broken.  I have friends who deployed eight or nine times in the last fifteen years.   I was never wounded.   I never lost any men.  Though I went into harms way often, nothing that harmful happened to me.  As far as I know, all of the men and women who served under me are still alive, except one.  He died of cancer.  The handful of times I didn’t think I was going to make it was because of the elements or the laws of physics or a bad decision that I made. I have no purple heart.  No combat action ribbon.  No “V” for valor on the bronze star I was awarded.  I saw some dead bodies.   I know people who have been killed.  But I’m whole.  That’s my war story.  No movie deal to follow.

About 2.5 million people have served in Operation Iraqi and Enduring Freedom.  Most of their experiences look like mine.  For every “Lone Survivor” there are dozens who had a different experience.  Those who served well but got out whole. Or at least we thought we did.  It doesn’t work that way though.  For many of us, more than any of us will tell you,  our return was a dark one.  We struggled to make sense of the world that was poorly designed for assimilation from war.  It was hard to concentrate. It was hard to care about things that didn’t seem to matter.

When we left the military, the jobs we took felt like a waste of time.  Our families, no longer a distant burden, were unmanageable.   We operated at a level of precision for too long in an environment where variance was handled with swift action or threat of violence.  Our children bore the brunt of our frustrations.  They didn’t and won’t ever understand why we were different.  Our environment regulated us for so long we lost the ability to regulate ourselves.  We acted out, self medicated, engaged in at risk behavior.  We created the crisis we craved.  And the worst part is we all knew people who had it much worse.  People who lost more.  People who lost everything.  People who had better reason to feel the way we did.  People who earned it more than we did.  And so we crawled into a dark despair made worse by shame.  Shame that we couldn’t handle it.  When others handled more.

The human mind struggles to sort out the types of stress we feel.   We don’t do a great job of categorizing the stress that comes from direct trauma and the stress that simply comes from long periods of vigilance.  I know this because a counselor told me.  A counselor I sought out after months of panic attacks, sleeplessness and a never ending feeling that something terrible was going to happen.  It wouldn’t go away.  It was always there.   It was exhausting and I almost didn’t make it out of it.  But I was lucky.  Lucky to have people in my life that helped.  I leaned on my friends and my faith.  My wife was as forgiving of my behavior towards her and my children as she was insistent that I get help.  And when I did, my journey to normal began.  It’s been four years since I returned.  And I’m still not completely whole.  But I’m close.  And close is as good as anyone can hope for, war or not.

It’s Veteran’s Day.  Today our world will be filled with messages of gratitude for those that served.  Those always feel good.  I will never get sick of hearing, thank you for your service.  But there’s something I needed more than thanks not too long ago.  I needed help. So my ask this Veteran’s Day is this.  Most of us know someone who served.  Instead of tagging them in a post on Facebook today, try this.  Give them a call. Send them a text.  Knock on their door.  Ask them how they’re doing, and be ready to listen.  Far too many of us are suffering in silence.  Far too many of us are too buried under our shame to talk about it.  No medals.  No war stories.  No heroism.  Just silent pain.  And sometimes, all it takes is for someone to ask that one question to turn us from the darkness to the light.   And if you’re like I was, in pain, get help.  It won’t go away on its own.  The cold lonely truth is that  you’ll never fully return until it does.  And we want you back.   All of you.