Living With P.T.S.D. and Allowing Myself to Get Help

Finbarr O’Reilly/ReutersSgt. Thomas James Brennan, center, leading the Third Platoon, Fourth Squad of the First Battalion, Eighth Marines, in Helmand Province in February 2011.

An alarm clock chimes across a pitch-black room. I slowly rise. Standing in my bathroom, I brush my teeth and shave away yesterday’s stubble – part of every Marine’s mandatory morning routine. The person in the mirror seems somehow unfamiliar. Downstairs, the morning pot of coffee brews. I finally begin to wake. Leaving home, the roads are lined with beautiful farmland, backlit by a rising sun. Morning dew glinting off the fields gives way to a kaleidoscope of neon signs as I reach town. Pulling into the parking lot, I take a deep breath and step out of my truck.

Our Marine morning routine consists of running on dirt pathways along a beautiful flowing river. Our footsteps echo off pine trees. Three miles later it ends with sore feet and tired lungs. Staring into the shower’s flowing water, I dread this time of day the most. Drying myself off I dress in my camouflage utilities. Only recently do I feel as though I cannot live up to the Marine Corps insignia I wear over my heart. Being a United States Marine means showing no weakness, no pain, especially to your subordinates. As I button my shirt my facade takes shape, and I am off to fake the day.

Driving home, I am greeted by the sun as it sets across the farmland. I park my truck and then open the door to my house. Unbuttoning my uniform and slowly taking it off, the facade I wore all day fades away and relief washes over me. “Daddy, Daddy, you’re home!” my daughter yells. Most parents feel a sensation of happiness when greeted by their children. At this moment I am sad, empty. I give her a hug, but she feels far away. I lie on the couch, feeling lost.

There are 1.7 million Veterans from Iraq and Afghanistan, and at least a third of them suffer from post-traumatic stress disorder, or P.T.S.D., according to the National Center for P.T.S.D.

I am one of them.

P.T.S.D. is an anxiety disorder that can occur after a traumatic event. Given that troops deployed to Afghanistan and Iraq see fallen comrades, experience combat, or survive horrific events, the likelihood of a veteran being diagnosed with P.T.S.D. is high. According to the Department of Veterans Affairs, someone with P.T.S.D. is at least twice as likely to commit or attempt suicide, or experience substance abuse. Tens of thousands, if not hundreds of thousands, are suffering from alcoholism and drug abuse, depression or mood disorders, according to a 2010 report by the Coalition for Iraq and Afghanistan Veterans.

The Center for a New American Security discusses the stigma in the service associated with mental health treatment. In a study on the rising suicide rate in the military, the organization found that troops were two to four times more interested in receiving care than reported but were afraid of repercussions from their superiors. That same fear initially kept me from getting treatment. But I finally sought help. My superiors met me with neither resistance nor support. It felt like I lost their respect, that they forgot who I was and what I had done for the Marine Corps during my tours in Iraq and Afghanistan.

P.T.S.D. is something that some in the military do not accept or understand. Unlike physical wounds, it is invisible, intangible. I once heard a senior Marine say P.T.S.D. was “fake.” In a way this makes sense for a military institution that prides itself on toughness and resilience in the face of adversity. But the time has come to realize that all battlefield wounds must be healed.

“While the military is making some steps to make it easier and more accepted to seek care there is still a long ways to go,” says Jason Hansman of Iraq and Afghanistan Veterans of America. “Even with top military officials coming out and saying they seek help that is still not enough to correct this stigma.”

Some 57 percent of those who suffered mental health problems on active duty received treatment in 2010, up from 36 percent in 2008, according to the Department of Defense. The department is slowly trying to remove the stigma associated with P.T.S.D., depression and mental health treatment.

But nearly a million disability claims are still delayed in processing, as reported by the Department of Veterans Affairs. Without a disability claim, veterans must pay out of pocket or use private health insurance for mental health treatment. There are reports of suicidal veterans being turned away because of lack of staff. When a veteran requests V.A. mental health treatment, he must be seen within 24 hours. This happens in most of the time, but follow-up appointments that should be completed within two weeks are often delayed nearly two months.

The countdown to returning home from deployment starts the moment you step foot on the bus to deploy. Arriving home to the daily grind, you wonder if it would have been easier to stay abroad. Overseas there is a sense of normalcy amid the chaos. Reconnecting with your family and revealing what you have become is often scarier than taking that next step on patrol.

I arrived home from deployment scared yet happy, excited yet terrified. I left when my daughter was 2 and returned when she was 3. I had deployed before but never as a father. When I left, she was completely dependent on me. Now it was, “I can do it myself, Daddy.” That depressed me. Stepping on the bus you expect time to stand still and things to be somewhat the same when you got home, but things change. One, two, threes turn into eight, nine, tens, and bath time turns into her taking her own showers. I would turn the water on for her and she would have me leave the room, closing the door behind me. The morning rituals had changed. She has begun to make her own breakfast, wanting to pour her own Cheerios and milk. She even started turning on the TV herself. The days of her sitting on my lap watching “Dora the Explorer” were over. I felt slightly abandoned. Of course she still came for me, just not the way she once did. Life as you once knew it drifts away, and the little girl you left behind seems all grown up.

Everywhere I traveled on deployment I brought a wall of my daughter’s artwork. I kept a picture of her in my pocket, but by the time I got home it barely resembled her.

There was more. I saw disturbed patches of dirt as threats – potential roadside bombs – loud noises made me jump and silence made me paranoid. Seven months in a combat zone makes it difficult to switch off. Multiple close calls with death made me feel like I should not be alive. I avoided contact with my wife and daughter. I went through the motions. Hugs and kisses felt hollow. Smiles had no feeling, tears bore no sadness. I had become so numb that I was just a shell of my former self. I often found myself lying on the couch, blankly staring at the television for unknown amounts of time. Survivor’s guilt was affecting me. I could not look at my legs without thinking of those who were still struggling through physical therapy or worse.

Unlike so many other families, mine was lucky. I came home. Not the same person, but I was home. I struggled daily. Images of what my wife would be like if I had died rushed through my head frequently. Life without me in it became my fascination. Daydreaming became my escape from reality. I would imagine my daughter riding her bike for the first time without me. Or my wife at the altar remarrying years later. I was physically present, yet mentally troubled with thoughts of my demise.

Every 24 hours a member of the military commits suicide. Every 80 minutes a veteran does the same. Nearly one in four suicides in this country is either a veteran or service member, yet we only make up 9 percent of the population according to the Census Bureau. High suicide rates are largely due to the isolation and hopelessness felt by many service members once they return home, according to Iraq and Afghanistan Veterans of America.

This plague in our military community is due partly to the lack of mental health providers in the V.A. system. In 2012 the department says it is planning to hire 1,600 new mental health professionals. But changes in manpower and policy will not occur overnight.

My change started slowly. Thankfully I did not lose any of the Marines in my squad on my most recent deployment, but four of us were wounded on an operation. Three were hit by an explosion from a rocket-propelled grenades and suffered traumatic brain Injuries. As the smoke from the explosion cleared, I looked them over; faces blackened with soot, their eyes dilated. We shared the same look of fear. I began maneuvering my men across the battlefield despite wanting to abort the mission. Minutes later, I was briefly knocked unconscious by a second explosion. I distinctly remember feeling failure as we were airlifted to Camp Bastion Air Field for treatment. On the medevac helicopter all I could think about were my Marines still on the ground. I imagined their resentment and disapproval of the decisions I had made that day. I would ask myself repeatedly whether they would ever trust me again.

The injuries reminded me of the people I had lost in the past. Suppressed emotions surfaced. As a leader I was strong, but as an individual I began to fall apart. The day I was injured shook me. I felt as though I was not the strong leader my men deserved. My Marines were wounded because of my decisions, and I have not forgiven myself for that. I hated going out on patrols after that day, because I feared another attack. Those Marines will never be the same because of me.

The traumatic brain injuries we suffered are the most prevalent injuries facing troops in the Middle East. They come from a blow, jolt or blast to the head. According to the Mayo Clinic, traumatic brain injury ranges from mild, with symptoms of short-term memory loss, mood swings, light sensitivity and sensory problems, to moderate, with symptoms of long-term memory loss, slurred speech, loss of coordination, and seizures, or to severe, which can resemble mental retardation. The Brain Injury Association of America estimates that more than 360,000 troops have suffered traumatic brain injuries since 2001, with many unreported cases. The Pentagon’s Defense and Veterans Brain Injury Center reports that approximately 30 percent of all casualties evacuated from Afghanistan and Iraq and treated at Walter Reed Army Medical Center had traumatic brain injuries.

Afghanistan changed me, and I knew it. I felt it before I got off the bus, and it worsened as time went on. It did not take long before the change began to show. My work and family relationships began to suffer. I became sluggish and depressed as my past caught up with me. For months, my daughter’s smile could pull me out of any funk, but eventually not even she could cure me. On Oct. 29 2011, seven months after I came home from my deployment, I began treatment.

Some wounds have healed. Others still have scabs. In order to fully heal I need to peel back those scabs to reveal what lies beneath. Therapy has revealed many weaknesses, but it has also highlighted my strengths. I have since forgiven myself for what happened on the day we were injured. I now feel when I cry. There is emotion behind my hugs and kisses. My past no longer haunts me.

The sense of failure for getting my Marines wounded still exists, it is just not as strong. Decisions I made cannot be changed. Combat broke me, but it also rebuilt me into a stronger person. I am now someone who almost lost his brothers and family but now cherishes the showers my daughter takes on her own and the independence she develops daily. My life has changed. I handled these changes in ways both bad and good. What matters most is that the family I left behind when I deployed now has their husband, father and son back. And I can still be someone who cherishes the ebb and flow of life.

Thomas J. Brennan is a Sergeant in the U.S. Marine Corps. He served both in Iraq and Afghanistan with the First Battalion Eighth Marines. Now, 27 and still on Active Duty, he is stationed at Camp Lejeune in North Carolina.