Removing the stigma behind PTSD from our military and society

Capt Richard Desmond — Mon, 20 Oct 2014 09:52:16 -0400

It was a crisp and clean morning in Fairfax Virginia. I forced myself out of bed at the wee hours of the morning, strapped on my well-worn old combat boots, and sipped on my coffee on the way to the event. We arrived around 0800 as people milled around the registration booth. People were chipper despite the morning hours. Maybe it was the pleasant weather. Maybe it was the electricity that seemed to permeate through the air. The crowd was excited. They wore colored beads, photos of loved ones on banners, and cheered as the emcee announced how much money we raised. This vitality was a stark contrast to the event we were participating in. We were walking in support of suicide prevention. The pictures of smiling young faces were family members lost to suicide.

Though there was no stigma in the air that morning, as soon as the walk ended it felt that we returned back to a realm where suicide and mental illness bears the scarlet letter of shame. I have known three colleagues who felt there was no other way out. I knew them all personally, served with them in the Air Force, and was shocked at their choice. I tried to empathize why they thought death was the only release from this pain or if there were any warning signs I saw but ignored. But like so many of the survivors of suicide victims I was left with burning unanswered questions.

Suicide in nature is an absolute solution to a temporary problem. It is easy to state that without being in that suffering soul’s predicament where the pain is so overwhelming it clouds everything. Mental illness is just that, an illness. But in many cultures it is viewed as a weakness and a pariah. It is that thing we whisper about and never dare to actually talk about. With the sad passing of Robin Williams there was a spark at a national level to talk about this devastating disease. But I believe it has passed the mainstream media and we are still left with the stigma. According to a recent Huffington Post article, Veterans account for 10 percent of the US population but account roughly to be one out of every 5 suicides in US. CNN calculated that every day 22 veterans commit suicide and our community outpaces every demographic for suicide.

I’m not debating the why or how of this escalating issue, but appalled that in this day and age anyone struggling with mental illness feels a stigma or bias to being treated. Whether that person is active duty, a veteran waiting for a mental illness appointment, or your coworker, no matter who you are—those who suffer from this disease are afraid of bias of others around them to be perceived as weak. Other diseases such as cancer, diabetes, nor heart diseases are not viewed this way. So why are depression, bi-polar, and other mental illnesses?

We are fighting a war on stigma. We are fighting a war to aid people to get the help they desperately need. We are fighting a war so that everyone does not feel alone in their desperation. I am fighting so I will not have to add anymore friends to a rock to remember their life that was cut tragically short and possibly could have been avoided. I am fighting for VO, Ferg, and Omar and those who have survived them.

We learn how to identify the signs of depression in the military and how to point the individual in need in the right direction for help. But there is more the military can do to show service members with depression it’s okay to seek help.

How can we remove this stigma from our military and society? Does awareness have to go beyond introductory training programs? Maybe it has to be incorporated in our public school systems?

Response by PV2 Private RallyPoint Member made Oct 20 at 2014 12:07 PM

PV2 Private RallyPoint Member — Mon, 20 Oct 2014 12:07:34 -0400

I'm out of thumbs ups but if I could, I would give this 10 thumbs up! Thank you so much for sharing this and for what you are doing.

Response by SGT Private RallyPoint Member made Oct 20 at 2014 1:24 PM

SGT Private RallyPoint Member — Mon, 20 Oct 2014 13:24:49 -0400

As being a combat veteran and now working in Behavioral Health I can say the stigma for PTSD from my little bubble seems to be reversing a little bit. Of course not saying that is what is going on everywhere, but at my workplace now it's on questinnaires, asked about, and I havn't heard a disparingly word about it since switching MOS's. I am glad to be in my new MOS so that I can actually help individuals who are suffering from PTSD, like members of my old unit.

Response by CPT Aaron Kletzing made Oct 20 at 2014 1:53 PM

CPT Aaron Kletzing — Mon, 20 Oct 2014 13:53:43 -0400

Thank you for writing this, Capt Richard Desmond -- I enjoyed reading it. Thought-provoking and sincere. I hope you write more content here on RP on the Command Post!

Response by SFC Private RallyPoint Member made Oct 20 at 2014 3:45 PM

SFC Private RallyPoint Member — Mon, 20 Oct 2014 15:45:10 -0400

I believe there is a significant increase in visibility for PTSD and suicide but I believe we still have a very long way to go. My command alone has lost 6 personnel to suicide this year. I feel that part of the problem is the Army has gone to a more hands off approach to leadership and training. A great majority of training conducted currently is done via CBT or blackboard or whatever other Internet based training environment you use and leaders are not given sufficient time or resources to conduct the old school SGT's time events. We have so many required training suspenses that take precedence over good troop leading procedures and the young Soldiers are the ones paying the price. Many young troops are not counseled regularly and told what is expected of them or how good they are doing. Political Correctness has made the art of bonding with your Soldiers and getting to know them inside and out and their families extremely difficult. That's the first step in preventing suicide get to know your troops so when they have a problem you have a better chance of recognizing it. And lastly, we have a significant amount of Soldiers out there who have PTSD but don't say anything for fear of losing their job as well. The fear that your security clearance will be revoked if diagnosed with PTSD or placed on medications for it. How do we fix that? Sorry I'll get off my soapbox now.

Response by CWO3 Private RallyPoint Member made Oct 20 at 2014 6:03 PM

CWO3 Private RallyPoint Member — Mon, 20 Oct 2014 18:03:50 -0400

Skipper, I don't know if you are retired from the services or still active. PTSD started as Shell Shock, Combat Fatigue during WW1, WW2, Korean War, Vietnam. It was the Vietnam War that coined the phrase PTSD. Then we had many conflicts between Vietnam and the First Persian Gulf War. 24 years ago is a long time for me. Now Traumatic Brain Injury is on the list. Disability, Disorder, Injuries are not the same, but for government purposes it is. Our society and our media decided the 5 W's and now no one trust men and now women who served our Country proudly and are scared to hire them. WE have had an all volunteer Armed Forces. Just plain and simple the DOD industrial complex along with our media will send our men and women in Harms Way every chance they have. It doesn't matter if you are a Democrat or Republican. As a Retired Marine Chief Warrant Officer with over 21 years of service and a combat disabled veteran I can tell you this, It starts at the very top of our government. We now have non-combatant civilian's working on all military bases. Why I ask? Because of the budget? Or because DOD is threaten by us Retirees who are the stake holders for the folks in uniform. If we don't do anything, then we all might as well dig our own grave. James K.

Response by SMSgt Michael Carl made Oct 20 at 2014 11:48 PM

SMSgt Michael Carl — Mon, 20 Oct 2014 23:48:43 -0400

PTSD is a multi-faced beast. Many folks have it from actually being involved in combat and seeing the horrors of war. I often look to history and try to learn how other generations dealt with it. I think for the WWII vets, they came from a tougher generation (Great Depression) and learned early how to deal with adversity early in life. I never heard my Grandfather say a word about WWII nor Vietnam. Not to say he didn't have it.....but to say he learned early in life how to deal with it. My thoughts....and I stress....my thoughts, we are too wired into internet and look for comfort, friends and solutions from a smartphone, txt msg, email.....when in the past....there was real human contact....friends, family, fellow service members. The American Legion, the Veterans of Foreign Wars are no longer organizations of those who served in WWII, Korea, Vietnam.....they also belong to Iraq and Afghanistan. Get away from the internet....go find a local....talk to people who know and who have been there and who can relate. No need to drink.....unless coffee or tea.....just go and talk it out. You will find a friend an ear, or a shoulder. And as for the multi-faced beast.....many go to war and work inside the FOB, or on support only missions....yet they still feel a sense of loss when they come home. I served in Iraq and was a Fobbit. I served in AFG and did 140 missions OTW with only one hairy event....but it was deescalated quickly. It is just to say many come home feeling that no one understands what they went through or what they were willing to give. Many come home feeling a sense that they didn't do enough because they didn't serve in a real combat role. That is in no way to say there is a comparison with those who actually saw combat....or were blown up by IED and never had the chance to fire at the enemy. So I say, find your fellow service members at the AL or VFW and talk it out. I am still active duty....but I will gladly talk with anyone who served and can relate to what I have been through and I at least come with a sense of what they may have been though and hey....a connection. At the risk of sounding like an ass....let's not just talk about helping each other out....let us all do something about it....use the internet as a tool....but reach out and lend a hand. It isn't just up to military mental health to solve.....we are all vets and we are all in this together. For ever one of my brothers or sisters that we lose to suicide....I think we as a family failed them......We know who came back from deployment....we as leaders can help....stay engaged.....look for the signs.....inquire....and YES....get the HELL into their business!!!

Response by CPT Endre Barath made Oct 21 at 2014 2:03 PM

CPT Endre Barath — Tue, 21 Oct 2014 14:03:22 -0400

CPT Richard Desmond, what a valuable post, very thought provoking....There is no simple answer to the question.....my take is with the lack of Media Support, the lack of Political Support and the super competitive business environment this "stigma" will be here a while. Paralleling that there are still many other "stigmas" that exist even though they get front page billing such as prejudice for race, ethnicity, religious beliefs and sexual orientation to name a few and they are still here with all the support...

Response by SSG Warren Swan made Oct 21 at 2014 3:21 PM

SSG Warren Swan — Tue, 21 Oct 2014 15:21:55 -0400

Sir, thanks for going out and actually doing something that involves being part of the solution.

PTSD/PTS or whatever you call it for today, has been around for as long as there has been war. It affects each one differently, yet affects all of them the same. In todays Army, we're taught to train as you fight, go as hard as you can, and that winning is everything. We don't die for our country we facilitate them dying for theirs. This is great when training for battle, when getting the troops mentally engaged for upcoming battle, and a belief system for when they are in battle. I'm sure every great commander has had those in mind with their troops.
What is never discussed or trained on is the lingering aftereffects of battle. Yes upon redeployment there is the trusty mental health professional asking all the "right" questions that you've been briefed on and given the "right" answers to so you can be a "GO" at that station. Your only goal is to get on block leave without being "that guy". No one wants to be Carl. You give up your sensitive items, and think that the deployment is over because your home. You mourn the losses, party your brains out, spend time with family whatever, but you're home so to speak. Most importantly you made it past mental health.
Six months down the road, you have to be rescreened for your six month PHA. You go through all the stations and again you're sitting with mental health except there is a problem. You HAVE come home from the war, and ALL the baggage has been delivered in one complete delivery. While in there you have two choices: 1. Admit you have a problem and suffer the repercussions from your unit (yes I know that's not supposed to happen) or 2. Keep quiet and tell yourself it's nothing. Those feelings, images, desires, dreams are all what a "warrior" should feel after combat. 3. Although not a choice, Mental Health might catch on to you by the way you're speaking and notice the code words coming from you and recommend you for help at that point (and you'll suffer the repercussions from your unit at that point).
At those three choices is where the FAIL begins and the possibility of this troop becoming one of the 22 a day comes in. The right thing as a leader is to know that once this troop needs help, not to ostracize them, talk negatively to them, make them feel they aren't part of the unit's/Army's greater scheme but that's just what happens in some cases. Negative counseling statements, bad NCOERS, OERS, with no real oversight from superiors. This troop feels alone, no one understands, and while there are others that do, we're back home now and the f*ck f*ck games have begun anew. So in the meantime said troop has gotten into trouble, gone from a stellar performer to a "who the hell is this" person, has family problems and a litany of other issues that when looked at individually mean nothing, yet when grouped as a whole, mean everything.
There is NO training manual. AR, FM, DA PAM or MILPER message that tells you how to turn the switch from warrior off so you can transition to non combatant. No number of rotations to NTC, Graf, Hoenfels, or anywhere else will do this. But there is a common sense manual that isn't published, and resides in everyone called compassion And in the ranks this is lacking. I know you don't have to hold hands and sing kumbya, but once a problem is noted, constant positive reinforcement, constant medical care oversight, and constant but not overbearing counseling is nessicary. The first goal shouldn't be to just get the troop out of my hair and out of the Army. Now I've heard there is mando training to help deal with this, but honestly how much attention is given at mando training? Even the briefer doesn't want to be there normally.
The military as a whole has to stop with the overbearing "Hooah" mentality. YES it's needed to survive in the battlefield. YES it's needed to sustain a certain level of unit cohesion, but when Hooah trumps troop health, leaders need to take a step back and reevaluate the situation. Who are we here to protect? Is what I'm doing good for the Army's mission and the betterment of the troop? Changing the mindset of the pentagon's leadership isn't important being it's at the BDE, BN, and CO (or comparable service level) where the rubber hits the road. If there is TRUE by in from the Command level at each, then change can be effected at the next lower level all the way down to team leader. There are policy letters spelling out everything else, why can't there be policy letters explaining how the command will effectively support troops mental health and their quest to get better, how once diagnosed with PTSD/PTS, that troops NCO chain will meet with him/her and explain how they will be WITH them every step of the way, not step IN the way, and the CoC and NCO chain both outline with the support of Mental Health a plan of action to get this troop back into the game, not at first chance put him/her out of it for good. We're not going to be able to prevent all suicides and that really hurts IMO, but the ones we can, as leaders we need to put the best foot forward and do our due diligence and get the troops the support and care they need, not the Art15's, and chapter paperwork (unless needed). Those troops answered the call, and as leaders we should answer their calls also.

Sir I apologize for writing something so long, but some of what you wrote struck a personal chord on things I've seen and dealt with in regards to Soldiers mental health, and how they were treated upon return.

Response by SGT Joshua Gonzalez made Oct 28 at 2014 5:19 PM

SGT Joshua Gonzalez — Tue, 28 Oct 2014 17:19:10 -0400

Thank you CPT Desmond. I know how you feel and the fight that are in everyday. There is a movement that is fighting the same things. Go to http://www.warfighters.com and join the fight

Response by 1SG Private RallyPoint Member made Nov 2 at 2014 4:14 PM

1SG Private RallyPoint Member — Sun, 02 Nov 2014 16:14:45 -0500

The answer is fairly simple; stop stigmatizing those with PTSD.

If you are looking for a way to get others stop also, be nice, be persuasive, set a good example. If you are looking for a way to make others stop, I think you're out of luck.

Response by CWO3 Private RallyPoint Member made Nov 4 at 2014 6:55 PM

CWO3 Private RallyPoint Member — Tue, 04 Nov 2014 18:55:33 -0500

Skipper, I appreciate what you are trying to do, but don't do it alone. Semper Fi, James

Response by SSG Edward Evans made Nov 12 at 2014 8:24 PM

SSG Edward Evans — Wed, 12 Nov 2014 20:24:12 -0500

I'm willing to lend and ear to ay soldier that needs it. We need to learn to listen and not judge. Too many times I've seen Cmdrs and SGMs make fun of solders for problems. The problem my seem simple to us, but to the individual it may be the difference between life and death. NCOS in leadership roles need to learn how use empathy, EMPATHY is not bad word. Sorry that's all I can handle right now. Good luck, Sir.

Response by CPT Richard Riley made Feb 15 at 2015 9:04 AM

CPT Richard Riley — Sun, 15 Feb 2015 09:04:53 -0500

I would respectfully apologize Capt Richard Desmond for missing this when it first appeared, and request permission to add this in the "Resources for Veterans & Service Members' discussion under the PTSD thread.

Response by 1SG Private RallyPoint Member made Feb 15 at 2015 10:15 AM

1SG Private RallyPoint Member — Sun, 15 Feb 2015 10:15:40 -0500

This is close to home for me, for many reasons.
When it comes to stigma, it is undeniably present. Seeking mental/behavioral health assistance threatens your security clearance. It threatens your reputation. It means that you "fell out" when everyone else handled their challenges.

I think however that stigma is the least of a person's worries if they are contemplating suicide. It may keep them from seeking help in a timely manner, but the underlying issues driving suicidal ideation lie elsewhere.

Suicide is an act of desperation for someone who sees no other way out. It is very often a rational, well thought out decision with preparation and thought given to how their affairs get settled in the aftermath. You will not win a debate with a suicidal person. You will not "talk them out of it". What you can do is place a hand on their shoulder and care. Really care. If it is in your means to assist them with addressing the underlying issues, do so. No one wants to die, but some can't tolerate living. There is a difference. Give them an opportunity to contribute to the mission in ways that they care about. Give them responsibilities and purpose. Empathize, but don't try to tell them you "understand" because you experienced (blah, blah, blah). You are not in their shoes. Acting like you are brings resentment and erects barriers.

One last thing. DO NOT give them a reason to question your motives when you reach out to them. It is not about you, or the Army, or the unit. It is about that person and their challenges and that is it.

Response by 1LT David Moeglein made Feb 15 at 2015 1:06 PM

1LT David Moeglein — Sun, 15 Feb 2015 13:06:37 -0500

Great question Capt Richard Desmond. Those of us who experience the signs and symptoms of PTSD need to reach beyond our isolation and shame to get help. Once we get the help, then we share our stories of recovery with others.

The efficacy for the medical treatment of alcoholism was less than 1% prior to the advent of Alcoholics Anonymous. Now the culture of recovery in AA is palpable and inspiring. Today, no recovery program worth it's salt exists without integrating 12-step recovery in some way.

Recovery from PTSD may seem daunting when we live in isolation, but it doesn't have to control our lives. As service members, we are trained to survive in a war zone. Recovery from PTSD is a different kind of war. Like battle, we need to lock arms with battle buddies to win this. When we do this, we not only survive, but win.

Response by CPT Jack Durish made Feb 15 at 2015 5:51 PM

CPT Jack Durish — Sun, 15 Feb 2015 17:51:37 -0500

Everything begins at the beginning or it fails. Sounds obscure doesn't it. However, it's true and we all need to look for a proper beginning.

The beginning of the cure for PTSD most likely must begin with the acknowledgement of the problem. (Sounds like Step 1 of the 12 step program, doesn't it?)

In this case, Step 1 is the same for society. Few argue with the recognition of alcoholism as a disease. Is the recognition of PTSD as universal? I wonder. Maybe society needs to take the first step as well. Only then will it stand ready to accept those who suffer from PTSD and help them.

Just a thought...

Response by CPL Aaron Cottingham made Feb 15 at 2015 11:31 PM

CPL Aaron Cottingham — Sun, 15 Feb 2015 23:31:02 -0500

Thank you, I apologize for being brief. For now I leave it at thank you so much.

Response by Amn Anne Hofferkamp made Sep 29 at 2015 10:11 PM

Amn Anne Hofferkamp — Tue, 29 Sep 2015 22:11:19 -0400

Stigma is part of society. The way to get rid of it or reduce it is to bring new ideas into the fore. For example, we now have a black president so there's an increase discussion in minority affairs than years ago. Case in point, the CMH was awarded to Jews and blacks who had previously been denied the honor. Society doesn't pay attention to a cause until a celebrity joins it. For example, AIDS has been around since the 70s but it got major funding when Earvin "Magic" Johnson went on tv saying he was HIV positive in the 90s. Magic doesn't need a cure because he can afford to pay for antiretrovirals. Unfortunately, real people aren't multimillionaires.

What it boils down to is each person has to do their part. If you don't have PTSD, call a veteran to check on them daily. In today's society, people are always "busy". It's time to make time for each other.

As far as the "D" in PTSD, feel free to give feedback to the American Psychiatric Association which is responsible for writing the DSM-5. The DSM-5 has the definition for PTSD. http://www.dsm5.org/Pages/Feedback-Form.aspx

Ask Questions or Provide Feedback | APA DSM-5

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Response by PO2 Private RallyPoint Member made Sep 30 at 2015 6:00 AM

PO2 Private RallyPoint Member — Wed, 30 Sep 2015 06:00:52 -0400

So long as military and veterans keep turning on each other and saying others are weak, attention seeking, entitled, faking, or anything else they say to degrade the person who seeks help then nothing will change I fear.

Response by MAJ Ken Landgren made Nov 16 at 2015 8:04 PM

MAJ Ken Landgren — Mon, 16 Nov 2015 20:04:43 -0500

Sometimes in the darkest moments of PTSD where yesterday, today, and tomorrow crash together in swirling thoughts of racing thoughts, and hope is gone. Everything is dark and the pain feels insurmountable. It becomes easy to think about eliminating the pain, racing thoughts, and darkness because they is no hope. They already experienced a death of sorts by losing themselves to the whims of PTSD. Within the cauldron of losing a sense of humanity, the person needs to know the one person or organization that will save them. This is a rational decision from an irrational person. The need to have enough hope to say, "I cant do this anymore and I need help." Hope is key to winning my friends.

Response by SP5 Michael Rathbun made Nov 16 at 2015 11:20 PM

SP5 Michael Rathbun — Mon, 16 Nov 2015 23:20:59 -0500

One thing we can try to do is to make people aware that PTSD is NOT military- or combat-specific.

Traffic accident? Tornado? Home fire? Terrorist activity?

ANY traumatic experience can induce some degree of Post-Traumatic Stress Disorder. There are probably more civilians than veterans that really need help with understanding why they are the way they are after whatever the Event was.

Response by Capt Private RallyPoint Member made Nov 17 at 2015 9:41 AM

Capt Private RallyPoint Member — Tue, 17 Nov 2015 09:41:22 -0500

Several things have been pointed out. Certainly, we must lead the way in not making PTSD anything but what it is. And, it does not have to be military related. The loss of a child, spouse, or loved one are example that can contribute to PTSD.

I believe it is imperative that we quit using PTSD as some kind of excuse for bad behavior. All to often we tend to excuse the action due to PTSD.

Finally we must stand for treatment of those who need it.

Response by MAJ Ken Landgren made Nov 17 at 2015 5:54 PM

MAJ Ken Landgren — Tue, 17 Nov 2015 17:54:03 -0500

No because 10% of the population enjoy denigrating others.

Response by SGT Jay Ehrenfeld made Nov 20 at 2015 2:21 PM

SGT Jay Ehrenfeld — Fri, 20 Nov 2015 14:21:16 -0500

Simple enforced the laws against the civilian whose refuse to follow the laws of the Supreme Court in 1968 when the left and democrats forced the supreme court to make decision on banned mental hospital. we still easy target for their outraged, but when we forced them to discussion about he civilian mental issues they refuse too

Response by Capt Tom Brown made Jan 2 at 2016 4:47 PM

Capt Tom Brown — Sat, 02 Jan 2016 16:47:37 -0500

Thanks for another thought-provoking piece of insight. We can never do enough to address the issue of SM suicides.

Response by MSG Private RallyPoint Member made Apr 20 at 2016 1:56 PM

MSG Private RallyPoint Member — Wed, 20 Apr 2016 13:56:19 -0400

we fought and served some of the crap we went through cant even be imagined by non participants, you say ptsd and they shy away, they think you are a killer, maybe public education, we were the 1%, and we did our jobs so why should i be circled out because i did my job

Response by MAJ Ken Landgren made Aug 17 at 2018 4:39 PM

MAJ Ken Landgren — Fri, 17 Aug 2018 16:39:06 -0400

I survived PTSD because of team effort. A SSG told me if I need help to go the hospital. I had leaders who helped to include my family. My family stuck with me despite the incredible nonsense I put it through. Therapists and psychiatrists were instrumental in my recovery and finding a new normal for me. I literally had a whole village treating me. I made a vow that no matter how much I hurt, I would never commit suicide as the hurt would pass on to the family. I have a deep empathy for those who have lost all hope. Hope provides sustenance when the journey is too arduous and the finish line is blurred. My advice is to ask for help, especially when the hurt and pain knows no boundaries.

Response by SGM Bill Frazer made Aug 17 at 2018 11:11 PM

SGM Bill Frazer — Fri, 17 Aug 2018 23:11:14 -0400

Why should take it to the schools- several of our Vet to Vet counseling groups have done it at the request of JROTC units. Suicide is the 2nd largest killer of teenagers , just under cars. 14 kids per day commit suicide in the nation.

Response by MAJ Ken Landgren made Dec 23 at 2019 4:50 PM

MAJ Ken Landgren — Mon, 23 Dec 2019 16:50:14 -0500

Thank you for the well written story. I have ambivalent feelings on PTSD as it took me 6 years to find peace, but I feel my experience has made me a better a person, and I have the experience to map out symptoms and coping skills. Now I have a better experience, empathy, and compassion for those who have similar tribulations. My experience with PTSD has allowed me to help several people with PTSD, so I feel it is a good trade off even if I experienced the excruciating pain of deciding to live or die.

I find it quite gratifying to help others by painting the picture for them. I feel one of the pivotal steps is to find reasons to survive. In regards to removing the stigma, I agree lets train those in the military and educate kids in school. I also think mental health specialists need to be trained better to spot PTSD.