Did you know that about 700,000 American children have had at least one parent deployed in the Middle East since our invasion of Afghanistan? Today, over 155,000 kids have a deployed parent overseas supporting our operations in Afghanistan and Iraq.

While a resilient bunch, a lot of worry and strain are being carried on their little shoulders. Are they getting all the support they need?

Back in May, I spoke at a "Healing the Hidden Wounds" summit organized by National Public Television and NAMI-TN. Among the stream of amazing speakers drawn together that day was a 24-year military wife and mom (and active professional social worker with Ft. Campbell's Family Readiness Group and the Centerstone Community Mental Health Centers).

Susan Pease's words were among the more poignant of the day. She tried to answer the question, "What do military families need?" From my notes, here were a few of her responses:

• Military kids are desperately in need of resources and supports. Their needs appear to be among the most overlooked of all aspects of of our nation's protracted wartime stance. While Military Family Life Consultants, Military OneSource and MilitaryHOMEFRONT are wonderful resources, more are needed.
  
  
• Military children are acting out and need more peer group programs. Some are stealing prescription drugs from parents, coping with abandonment issues and angry that their deployed parents have missed so many important days (like graduation, etc.) over the years. These are signs that more substantial peer group programs are needed to help cushion their experience. Parents can't do it all.
  
  
• Parents are also under stress and need more child care tools. Left behind on their own -- as strong and capable as they are -- they are starved for supports and tools to help their kids to cope with the many emotions they feel before, during and after deployment. Parents need more adolescent care help, and parenting help, and activities that will bring kids together and foster ways for them to be able to talk their feelings and anger and worries out with each other.

Lizette Alvarez of the New York Times writes of the special blast category that is combat-related traumatic brain injury (TBI). The entire piece is well worth a read, but I'd like to share a few of the more statistics-heavy grafs:

As many as 300,000, or 20 percent, of combat veterans who regularly worked outside the wire, away from bases, have suffered at least one concussion, according to the latest Pentagon estimates. About half the soldiers get better within hours, days or several months and require little if any medical assistance. But tens of thousands of others have longer-term problems that can include, to varying degrees, persistent memory loss, headaches, mood swings, dizziness, hearing problems and light sensitivity. ...

Little is known medically by doctors or scientists about what happens to a brain as a result of a powerful bomb blast, as opposed to car crashes on a highway, blows to the head on a football field or a bullet wound. These are the first wars in which soldiers, protected by strong armor and rapid medical care, routinely survive explosions at close range and then return to combat.

The bomb blasts, which throw off energy waves — atmospheric overpressures and underpressures — that are absorbed by the body, add a little-studied dimension to the trauma. Scientists are only now beginning to study the extent of the damage.

Recently received the following request:

We are currently recruiting research subjects to participate in either of three federally funded research protocols conducted in Manchester, NH and Boston, MA. Is there a way that we might solicit participation from your readership?

Specific details, contact info in extended.

Jackie Eckhart of the Virginian-Pilot is one of the lucky few to have had the opportunity to review a copy of a free comic book, "Coming Home: What to Expect, How to Deal When You Return from Combat," now being offered to service members at Military OneSource. Well, the way she tells it, the men in her life understood the value of the magazine better than she did at first:

"Coming Home: What to expect, how to deal when you return from combat" is a new project by Military OneSource. Created by comic book masters Sid Jacobson and Ernie Colon, who formerly worked at Harvey and Marvel comics, it is aimed at service members who have worn combat gear every day for a year. It's aimed at people who see potential IEDs at every intersection. It is aimed at guys who come back to the States to feel fury at traffic, and women who find that half the world thinks they're bad mothers because they had to serve overseas, and family members who can't understand why their returning soldier or Marine is drinking so darned much.

This comic is aimed to help folks who need to learn about post-traumatic stress disorder. Because I wasn't one of those people, and I wasn't sure how I felt about treating a subject as serious as combat and operational stress response in a comic book, I threw "Coming Home" into a stack of reading material to look at later.

Not a minute later my 14-year-old picked it up. Then the kindergartner. Then our houseguest, a 48-year-old former Navy helicopter pilot. "What kind of aircraft is that?" he asked, holding the cover up to the light from the sliding glass doors. Then he read the whole thing.

Recently, a sculptor pointed me in the direction of her series of figurative pieces created while she was in therapy for PTSD. At the Tri State Sculptors website, Kim Marchesseault (who blogs at Spackel) says of her work:

My work is about relationships among people, with self, with the universe. It’s a study of why we are here, what makes us who we are and how each one of us affect everyone and everything around us. I move shapes and lines until they work together to soothe and heal.

Kim, who in the past has practiced a wide variety of art expression including bronze casting and mural painting, was kind enough to answer a few of my questions regarding her ethereal ceramic sculptures. I believe her creations and answers offer us a glimpse into the heart of someone processing their PTSD. Her impressions are deep, funny at times, and always thought-provoking.

A heartfelt thanks to Kim for sharing so much with us.

The Philadelphia Inquirer spent nearly a year reaching out to the Pennsylvania National Guard's Alpha Company following their return from Iraq. They lost six troops while overseas; the Inquirer spoke with almost all of the 131 who made it home alive. The paper's coverage, packaged in a four-part series, began yesterday.

First, Alpha Company's stunning PTSD figure:

Of all the things that Alpha Company has had to struggle with since it came home from Iraq, the most pervasive may be post-traumatic stress disorder, or PTSD. Of the 126 veterans interviewed or surveyed by The Inquirer, almost half - 46 percent - said they had been treated for PTSD, most at VA hospitals and clinics in the region.

Alpha's rate of PTSD is higher than that of most U.S. troops who served in Iraq or Afghanistan - partly, no doubt, as a result of its being a frontline combat unit that lost six men. Shelley M. MacDermid, a Purdue University professor who served on a Defense Department mental-health task force last year, said typical PTSD rates among returning veterans were about 14 percent.

"Those are big numbers," she said of The Inquirer's Alpha findings.

National Guard and Reserve units, in general, have shown slightly higher PTSD rates than have regular Army units, she said. The Defense Department task force said this might be in part because civilian-soldiers were separated after they returned home, rather than staying together as units in which the members could support one another.

Ira Katz, director of mental-health services for the Department of Veterans Affairs, said that among the 300,000 or so veterans who have been seen by the VA, about 20 percent have been diagnosed with PTSD. But he said that twice that number - about 40 percent - have had some "mental condition."

"That's not all that different from your [46] percent," he said.

Both MacDermid and Katz said that PTSD had become a popular shorthand for all sorts of emotional symptoms that veterans experience. These may include depression and anxiety disorders, but not rise to the level of PTSD.

From Sunday's Chicago Tribune Magazine:

PTSD can make the bravest soldier, police officer or chaplain curl up and cry, explode with rage or drown in drink, remembering something they saw or did when only chance seemed to separate life and death.

It is why [Army medic Eugene] Cherry brought a seething anger home along with his dog tags. They dangle and dance at the end of a chain hanging from the knob of his bedroom door. When he closes the door to the outside world the tags make a sound like the tinkling clatter of wind chimes or an alarm on the perimeter.

Cherry knows that soldiers have a hard time accepting as real a war wound they cannot see. "I was in denial for a long time," he says. "I always thought I was strong enough not to let that stuff get to me." So have thousands of other soldiers returning from combat in Iraq and Afghanistan

"Eugene speaks for many, many people," says Tod Ensign, director of Citizen Soldier, a veterans advocacy group based in New York. "We've only just begun to see the beginning of the PTSD problem. A tsunami is coming."

A detailed piece from the Dayton Daily News:

For two years Elizabeth Bowen watched her husband, Ryan, endure more than 40 surgeries, frequent nightmares and the devastating effects of Post Traumatic Stress Disorder. ...

It was Oct. 26 and Ryan already had been in Georgia for six weeks, much of it spent waiting for word from the Army medical board that would determine his level of disability for injuries he received when a roadside bomb exploded under his tank in Baghdad during his second tour.

The 24-year-old Army specialist had just said goodbye to friends heading to Iraq for a third tour. "Some of these guys I've known since the first time," he said. Back in his hotel room, his mind began racing. He started pacing, hyperventilating.

Then he began to cry.

From the Associated Press:

A soldier who served two combat tours in Iraq was arrested Wednesday for leaving the Army without permission more than a year ago to seek treatment for post traumatic stress disorder.

At a news conference hours before his arrest, Sgt. Brad Gaskins said he left the base in August 2006 because the Army wasn't providing effective treatment after he was diagnosed with PTSD and severe depression. "They just don't have the resources to handle it, but that's not my fault," Gaskins said.

Tod Ensign, an attorney with Citizen Soldier, a GI rights group that is representing Gaskins, said the case is part of a "coming tsunami" of mental health problems involving Iraq and Afghanistan vets. Last month, the Veterans Administration said more than 100,000 soldiers were being treated for mental health problems, and half of those specifically for PTSD.

As a recent incident over Christmas clearly shows, the holidays can be difficult for many returning veterans. The intensity of feelings and reactions is increased, and depression can often be most debilitating during what is supposed to be a season of cheer.

One explanation of this is found in today's Mail Tribune:

"The holiday period is a hard time for them," said Hood, head of the trauma rehabilitation program in psychology services at the U.S. Department of Veterans Affairs' Southern Oregon Rehabilitation Center and Clinics in White City. "Post-traumatic stress disorder and all trauma effects are directly related to memories of the past interfering with our normal, everyday functioning," she explained. "That happens by something going on in the environment bringing up or triggering the memory."

And no holidays compare with Christmas and New Year when it comes to generating memories, she said. "It can be anything — songs on the radio, the smell of cookies baking, Santa in somebody's office," she said. "Those memories may be good but just the fact your brain is working more on memories is going to make the other stuff come up," she added. "This time of year, we focus a lot on helping people get through the holidays and how to take care of yourself." ..

"Anger is the biggest issue they are dealing with," Hood said of her experience working with veterans. "That includes anger that things have changed, anger that they've come back and things aren't like they dreamed how it would be, and anger that they've changed. "A lot of them are angry that they no longer enjoy the things they used to," she added. "Many have a feeling of distance from their old lives, feeling a loss of connection."

And for some it could be anger or fear over having to return to the combat zone again. And again. And again. In the age of multiple deployments and stop-loss orders and IRR call-ups, how can we expect our troops to put it all behind them, when they know they'll have to face it all over again?

Reporter Nathan Comp of Madison's excellent Isthmus paper delivers a comprehensive piece on how local vets are transitioning back to life at home and dealing with the VA. Latest combat PTSD stats, too.

Comp also makes note of the work that ePluribus Media and I have been doing on the PTSD Timeline -- work difficult to cheer, but that we are pleased to see being used to inform others.

Hard to choose which grafs to highlight; here are a few:

Slowly, very slowly, Thomas Staskal is coming to grips with things he saw and did in Iraq. He is depressed, anxiety-prone and has an acute fear of crowds. Since returning home to the Green Bay area in November 2005, the 25-year-old Army reservist has lost three jobs and flunked out of college. Common things, like a flash of lightning, can induce the shakes.

“I used to have dreams where I was chased by the people I had to kill in Iraq,” he says, over doughnuts and milk at his east-side Madison apartment. “I no longer wake up from the nightmares, but the panic attacks are getting worse. One of the problems is that I’m angry, but I don’t know at what.”

Rarely is a soldier’s return seamless, but for battle-weary vets like Staskal, post-traumatic stress disorder can crash their landing in the civilian world. ... Staskal and his girlfriend moved to Madison in August, just before the start of the new school year. When he tried enrolling at the local VA hospital, he learned that transferring his file from Appleton would take 30 days. After that, he’d be put on the waiting list. Meanwhile, time was running out on the two years of VA benefits that reservists are given.

“If you are on active duty, there’s a lot more help,” says Staskal. “The reservists get shafted. I don’t function 100% and the Army should help me, but they’re not. You can’t just use us then leave us out to dry, which seems to be what’s happening.”

High recommendation to read the whole piece. Thx, Nathan.

An informative and in depth piece on combat-related posttraumatic stress disorder appeared this weekend in The Spectrum out of St. George, (Southern) Utah.

In addition to a brief history of PTSD, and a look at how the book Down Range: To Iraq and Back is being used to help troops in the combat zone deal with the stress of war, you'll read how one Vietnam veteran recently came to terms with the PTSD that had been tailing him (yet that he refused to believe existed) since his return home decades ago. A solid piece of reporting that challenges those who believe PTSD is hogwash to take another look at their own reasons for denying its existence.

Click on 'Article Link' below tags for more...

From The Spectrum:

Despite the signs, 57-year-old Steve Cantonwine spent the last 34 years believing his symptoms were simply part of his personality - one that had been steeled by the rigors and scenes of the Vietnam War. "To me, there wasn't anything wrong with me. I was a Marine. I didn't believe in post-traumatic stress disorder. 'They' were just a bunch of people that were whining and crying for sympathy," said Cantonwine.

But his wife, KayAnne, always knew something had a grip on him, though she didn't have words to explain their experiences. So the two blindly worked their way through, daily facing and unknowingly dealing with the symptoms of PTSD. "I don't think you can see and do the kinds of things you have to do in war to survive and not be affected in some way. They can't ever go back to the way things were, too many things have happened. But there's healing that takes place," said KayAnne.

As soldiers now serving in today's foreign wars prepare to return home, families like the Cantonwines, along with the medical community and military officials, are sharing their knowledge and experiences with PTSD and offering resources and education to soldiers, their families and the community.

PTSD, the piece continues, is not only for those who've served in combat.

Events leading to PTSD include plane or train crashes, vehicle accidents, cave collapses, sexual abuse, rape, domestic violence and other trauma. But the differences in healing and symptom management may vary for individuals depending on the severity, length and intensity of the event.

Cantowine, a Marine who'd returned from two tours in Vietnam in 1973, had shown signs of PTSD for decades, but it wasn't until 2004 that he realized he was having problems coping.

After he left the Iron County Sheriffs Office, Cantonwine began work as an over-the-road truck driver. During the long hauls, depression set in and in April of 2004, the second trigger hit. Cantonwine, along with his best friend - a fellow Vietnam veteran - was involved in a rollover outside Coeur d'Alene, Idaho.

The two events, a major life change coupled with a traumatic event - both triggers for PTSD - sent Cantonwine reeling. He struggled through nightmares that echoed the dreams that once plagued him when he first returned home from the war and he battled suicidal thoughts and tendencies. "I didn't feel like there was anything left for me. One was to be a Marine. One was to be a cop, and being a cop was taken from me," he said.

Those events landed Cantonwine in the doctor's office for medical assessments where his primary care provider quickly cued into his condition and recommended treatment for PTSD.

At first, he refused to believe that he had PTSD, denial being a common defense mechanism. His wife, however, could see that the doctors were on to something.

"I had a lot of signs as I look back on it," Cantonwine said, recalling symptoms of the last 30 years. Signs from uncontrolled bouts of anger that included scenes of road rage to an obsession with adrenaline that he sought out through employment as a deputy, EMT and as a hospital volunteer. "Some vets had drug and alcohol problems. Steve's was adrenaline. That's what fed him. It was like a combat rush," said KayAnne.

And his authoritative qualities as a Marine and deputy, at times, carried over to loved ones. "He expected perfection from co-workers and family. I think it goes back to 'If you don't do things right, people might get killed.' There wasn't a lot of room for excuses," said KayAnne.

Of all the symptoms, it was the anger that worried his family most. "We never would know what would make him angry," said KayAnne, noting that at times her husband's ire would last for several weeks. Cantonwine's anger never led to physical violence or abuse, but his tension was hard to live with and often left the family on edge.

When Cantowine finally reached out for help, he also found acceptance and a feeling of 'fitting in' that had been elusive in the civilian world.

Cantonwine traveled to the VA hospital in Denver to receive treatment and still attends group therapy sessions. "He always felt like a fish out of water in the civilian world and all of a sudden he was surrounded by people who felt the way he felt," said KayAnne.

And Cantonwine appreciates the opportunity to learn skills to manage his symptoms. In the past year, he has missed only one group session, which was for surgery on May 3 when doctors removed a 2-pound cancerous tumor from his abdomen, possibly linked to Agent Orange exposure. "We don't sit and talk about specific memories. I don't have to tell them what my flashbacks are, what nightmares I'm having. But we're able to sit there and offer support to one another," he said.

Despite frustrations with the VA's bureaucratic process, the treatment and ongoing healing Steve has received have become welcome blessings for the Cantonwines. "Now things are so good. Steve's learned how to manage it and he's healing," said KayAnne.

The Silver Lining

The silver lining to this journey is, of course, how the struggles of our Vietnam vets can be lessons for learning how to do better with the next generation of warriors returning home from combat. Cantowine wants to ensure that we learn the lessons, and not repeat the same mistakes.

"People have woken up and Vietnam vets primarily brought it out into the forefront," said Cantonwine. "I don't want to see anybody go through what I went through or see anyone put their family through what I did unknowingly."

"I think we've come to a place where you can support the soldier without supporting the war and it's too bad we didn't know that in Vietnam," said KayAnne.

This isn't to discount the fact that there are very real problems that still face our returning veterans as they move towards reintegrating into civilian life.

Despite the gains made in recent years, the strain of transitioning home today is as great as ever on soldiers and their families. "It wasn't easy and it's not going to be for this new set of war veterans," said KayAnne. "I think the biggest thing for the vets is the stigma that they perceive in asking for help. They all want to think they're just fine and haven't been affected by anything."

As a wife of a Marine, KayAnne had to learn the delicate balance of simply being there for her husband and listening without prying when he returned home. And for healing to occur, Andrews and Cantonwine say vets need to be heard. "Hearing it sometimes isn't pleasant. Vietnam vets, nobody wanted to hear their stories, what happened to them. It was such an unpopular war that they soon learned not to talk about it," said KayAnne.

Today, Barbara Stringham is anxiously counting the days until her son returns home with the Utah National Guard's 2nd Battalion, 222nd Field Artillery, which has served a year in Iraq.

While her son was home on leave, Stringham found herself struggling with the balance between her own instinct as a mother to nurture and her son's need for space and need to handle things on his own. "They've just served in open-hand combat. They've seen death and destruction. They don't know to receive that nurture from a mother. They're soldiers. They're supposed to be tough. Some of these guys are going to just need to break down and the public needs to know that's OK. Heck, we as family members sometimes need to break down," Stringham said.

And while family members like Stringham say they may not fully comprehend all that their soldiers have been through, they know lasting changes have taken place. "I just hope that he doesn't go through the mental anguish that you hear so prevalent from soldiers. It's scary as a parent because you're at a disadvantage. You don't know where to turn for the help they need," said Stringham, a member of the Triple Deuce family support committee that assists families during their soldier's absence.

Though Stringham wants her son to feel open to talking with her, she's prepared for him to set the pace. "You don't want to pull it out of them. In time they'll share, but they have a lot to cope with. And also I think it's something of them not having to relive it. When he's home and he's home for good, he wants it to be behind him and not have to relive it, he doesn't want to have to relive it over and over and over again," she said.

Stringham and other family members say their focus will center on one thing as soldiers return home, integrating them back into the society that they served and getting them back into their daily routine. Families are also hopeful the military and VA will continue to support soldiers who served in military action.

Though communities like St. George are preparing for top-notch celebrations upon their return, Stringham's looking ahead to the coming weeks and helping the soldiers adjust. "That initial homecoming day will be full of hoopla and pageantry - and that may carry through for the next few weeks. But afterwards, that's when the help really, truly needs to be there in the next months and years ahead," Stringham said.

Be sure to read the rest of the piece for an IM interview with 1st Lt. Bryan Hofheins, physician assistant of the Utah National Guard, 2nd Battalion, 222nd Field Artillery, and an interview with Gaylan Springer, chaplain for the 222.

And consider sending your thanks to The Spectrum for providing us with such rich coverage of this topic.


Related Posts

• Iraq War's Effects on Former Veterans Goes Nationwide
  
• Today's War Can Be Difficult for Prior Veterans
  
• The Longevity of War's Wounds

The Carl T. Hayden Veterans Affairs Medical Center in Phoenix, Arizona offers its patients a wide variety of services in its PTSD care program. Dr. Dennis Grant offers the following combat trauma management tips via the VAMC's PTSD Resources page.

Click on 'Article Link' below tags for more...

Dr. Grant's Combat Trauma Management Tips:

Make sure you have a Safety Plan for suicidal thoughts and feelings.

Keep a journal listing of your positive thoughts and memories of your military experiences to balance out any negative and destructive messages that you have accumulated through the years about your combat assignments, especially about wars that have been controversial in our history. Especially rediscover the positive experiences and memories from your combat assignment.

Understand how you are defined as an American and why you were willing to fight in a war. Thomas Jefferson defined an American when he wrote the Declaration of Independence and what an American believes in and fights for. Abraham Lincoln, in the Gettysburg Address eloquently stated the same reasons.

Make sure you know your trauma anniversary dates, how they effect you emotionally and physically, and have a plan of action to manage them.

Practice the Cognitive Therapy principles taught in class:

• Remember and discover in yourself that thoughts control feelings
  
  
• Irrational thoughts are the ones that control problem emotions such as depression, survivor guilt, poor self-esteem, anxiety episodes, global anger, and others.
  
  
• Write out your thoughts when experiencing problem emotions, discover the irrational ones, and write out rational ones that dispute and counter them. Use your group or staff to help with this if needed. Discuss these in your support group and compare experiences.
  
  
• Keep a written record of these, add to them each time the problem emotion recurs, and review what you have written, especially the rational thoughts, when these problem emotions resurface.
  
  
• Remember too, this takes practice and is an ongoing method to use more than once.

Remember: Combat PTSD is a sign of courage and bravery, not weakness.

If you'd like to get more information on this course, please contact Dr. Dennis Grant at the Carl T. Hayden VAMC PTSD program.


Related Resources

- First Aid for Combat PTSD
- Reconnecting with Your Kids After Deployment
- Coping Tips Following a Traumatic Loss
- More PTSD Resources (in right-hand column)

Snapped by embedded Los Angeles Times photographer Luis Sinco, tagging along with Charlie Company, 1st Battalion, 8th Marines in Fallujah on November 9, 2004, this photo would run in 100 newspapers worldwide. The Times gives us an update on how the iconic Marine is doing. Through both a new article, and a photo gallery, you'll peer into Lance Corporal James 'Blake' Miller's life as he fights his latest battle -- with PTSD. All my best to him.

Click on 'Article Link' below tags for more...

From the LA Times:

He survived a harrowing all-night firefight in November 2004, pinned down on a rooftop by insurgents firing from a nearby house. Filthy and exhausted, he had just lighted a Marlboro at dawn when an embedded photographer captured an image that transformed Blake into an icon of the Iraq war.

His detached expression in the photo seemed to signify different things to different people — valor, despair, hope, futility, fear, courage, disillusionment. For Blake, the photograph represents a pivotal moment in his life: an instant when he feared he would never see another sunrise, and when his psychological foundation began to fracture.

A year after the photo spread like wildfire around the world, Miller would receive an early but honorable discharge from the military due to his PTSD.

He feels adrift and tormented, dependent on his new bride, his family and his military psychiatrist to help him make sense of all that has befallen him. He barely sleeps. On most mornings, Blake says, he has no good reason to get out of bed. Often, his stomach is so upset that he can't eat. He has nightmares and flashbacks. He admits that he's often grouchy and temperamental. He knows he drinks and smokes too much. "He's not the same as before," said Blake's wife, Jessica, who has known him since grade school. "I'd never seen the anger, the irritability, the anxiety."

Blake says he feels guilty about taking money — $2,528 in monthly military disability checks — for doing nothing. Yet he's also frustrated that two careers made possible by his military training, police officer or U.S. marshal, are out of reach because law enforcement is reluctant to hire candidates with PTSD.

So he broods, feeling restless and out of options: "I'm only 21. I'm able-bodied as hell, yet I'm considered a liability. It's like I had all these doorways open to me, and suddenly they all closed on me. It's like my life is over."

The article goes on the document a recent trip to a restaurant with this wife; although he was able to control it, Miller admits he became enraged when he believed a man was was looking at his wife Jessica's bottom.

Jessica, who graduates this spring from Pikeville College with a psychology degree, has persuaded her husband to undergo visualization techniques in which she helps him confront his demons.

"It's understandable that Blake has PTSD, after all he's been through," she said. "Ordinary people can't comprehend what it's like to be constantly shot at and have to kill other human beings. They need to know what it means to send people like Blake out to fight wars. You're going to have a lot of people breaking."

Five other members of his platoon of about three dozen have been diagnosed with PTSD, Blake said. A dozen men from his unit were killed in action. A Journal of the American Medical Assn. study published in March found that more than a third of troops who served in Iraq sought help for mental health problems within a year of returning home.

After offering more details on how the photo itself was snapped and made its way into the history books, the piece then moves on to reveal how Miller's PTSD made itself known in the days following his return home.

In early January 2005, as Blake's unit prepared to leave Iraq, what Marines call a "wizard" — a psychiatrist — gave a required "warrior transitioning" talk about PTSD and adjusting to home life. Blake didn't think much about it until he returned to Jonancy in late January and his nightmares began.

He dreamed about the 40 enemy corpses that he counted after the tank demolished the house, he said, and that he had been shot. "He'd jump out of bed and fall to the floor," Jessica said. "I'd have to hold him to get him to wake up, and then he'd hug me for the longest time."

Sometimes, Blake mutters Arabic phrases he learned in Iraq or grimaces in his sleep, and Jessica will keep whispering his name until he wakes up. Some nights, he doesn't sleep at all. "I tend to drink a lot just to be able to sleep," Blake said. "Nothing else puts me to sleep."

He decided last summer to see a military psychiatrist at Camp Lejeune, N.C., where he was based. In August, he was diagnosed with PTSD. But before he could be put on "non-deployable status," his unit was sent to New Orleans to assist with Hurricane Katrina recovery.

While aboard a ship off the Louisiana coast, Blake was taking a cigarette break when a petty officer made a whistling sound like an incoming rocket-propelled grenade. Blake says he remembers nothing about the incident, but was later told that he slammed the officer against a bulkhead and attacked him.

By November, Blake was forced to take a medical disability discharge. "They said they couldn't take the risk of me being a danger to myself and others," he said. He fears that he may have another blackout. "It's terrifying that at any moment I could lose control and not know what I'm doing," he said. "What if next time it's Jessica?"

He suffers from flashbacks along with his nightmares (flashbacks are images that appear 'real' in the person's mind while awake).

This February, while smoking a cigarette and staring out Jessica's dorm room window, Blake said, he thought he saw a dead Iraqi man on the grass. Later, he had visions of an Iraqi father and son fishing — a scene he'd witnessed in Iraq just before a grenade exploded nearby. "I can't tell anymore what really happened and what I dreamed," he said. "Sometimes I feel like I'm dying."

Blake visits a Veterans Administration psychiatrist in nearby West Virginia and speaks with him by phone several times a week. He said his psychiatrist told him that his PTSD has to be managed; his disability will be reevaluated in March 2007.

Meanwhile, he has slowly turned against the war. "We've done some humanitarian aid," Blake said, "but what good have we actually done, and what has America gained except a lot of deaths? It burns me up." Jessica, who sports an "I Love My Marine" sticker on her car, says she and Blake are behind the troops though they no longer support the war.

The piece moves on to describing the Kentucky community in which Miller grew up, then closes with Miller reflecting on things.

For Hillbilly Days, an annual street festival late last month in Pikeville (pop. 6,304), Blake shaved his scruffy beard and got a military "high and tight" haircut. He agreed to help at a Marine Corps recruiting booth at the festival. Just putting on his Marine fatigue pants and boots for the first time since his discharge brought back more memories, and he tried to tamp them down.

He was so worried that the Marlboro Man photo would dominate the recruiting booth that he begged the recruiters not to display it. He also persuaded them to remove a large version of the photo that had hung in the recruiting station in downtown Pikeville. "I can't stand to look at it anymore," he said. Even so, he says the photo has provided him a platform to try to educate others about PTSD.

At the festival, Blake's mood brightened as he chatted with the recruiters. Wearing a Marine T-shirt with the message "Pain Is Weakness Leaving the Body," he was cheerful and animated. He playfully harangued young men, challenging them to a pull-up contest.

Though he has turned against the war, he said, he often wishes that he was back in the Corps and with his buddies. He still recommends the Corps to potential recruits, but advises them that it's a job, not a way of life. He recommends noncombat positions. "In order to do your job in combat, you have to lock up your emotions," he said. "Basically, you're turning people into killers."

Please consider thanking the Los Angeles Times for their coverage of this important issue. We need more of this kind of reporting to get more engaged and ready to advocate for our returning troops.


 Related Posts

• Los Angeles Times Photographer Offers Heartbreaking Update On Marlboro Marine
  
• Top Notch War Reporting: A Review and ^5
  
• PTSD Combat News Roundup: June 15-28, 2006
  
• NMHA : Iraq Veteran's Mental Health Awareness Work Honored
  
• MSNBC's Hardball Reports on Combat PTSD
  
• #3 | Returning Vet PTSD: The Marlboro Marine

Bridget C. Cantrell, Ph.D. is a leading clinical psychologist specializing in the area of combat-related PTSD, Chuck Dean is a veteran of the Vietnam War. Together they've created a vital little resource for PTSD survival: Down Range to Iraq and Back. I'll share a few helpful tips from Chapter 5 with you tonight.

Little Sebring, OH is gearing up to offer its returning veterans a program of great importance. Robert Roerich, MD and Darla Hough have received approval from the local American Legion to use their space and resources for the first veteran and veteran family support group, tentatively called Veteran Freedom Fighters of America. Kick-off meeting is on Wednesday, May 10, 2006 from 7-9 p.m. All veterans and military family members are encouraged to participate in this program which will meet the 2nd Monday of every month (with an option to have additional meeting and support groups to be determined by its members). Contact 'Doc' Roerich if you have any questions.

Click on 'Article Link' below tags for map and directions, agenda, etc...

Sebring is a village of approximately 5,000 people in Mahoning County of northeastern Ohio. It is 5 miles east of Alliance, Ohio and 10 miles west of Salem, Ohio. I'm pleased to share preliminary details of their inspiring Veteran Freedom Fighters of America program (please check back for any additional updates as I receive them):

WHEN?

Kick-off meeting is on Wednesday, May 10, 2006 from 7-9 p.m. All veterans and military family members are encouraged to participate in this program which will meet the 2nd Monday of every month (with an option to have additional meeting and support groups to be determined by its members).

WHERE?

American Legion Post #76
395 W California Ave
Sebring, OH 44672


Click on above image for GoogleMaps directions. Or phone the American Legion at (330) 938-9082.

MISSION STATEMENT?

The Veteran Freedom Fighters of America (VFFA) support network was founded by a veteran’s wife and a psychiatrist who saw a growing need to provide a community based support network for our returning military back from Iraq and their families. With many veterans experiencing increased stress in the aftermath of war, a critical need was identified to help heal the unseen wounds of war by providing timely support. It takes a village to help our warriors transition from military to civilian life free of the social stigma of suffering from mental health problems such as anxiety, depression, Post Traumatic Stress Disorder (PTSD) and suicidal or homicidal acts.

A key component of fighting for mental peace of mind is knowing when there is a problem in relationships with friends and family. VFFA will help veterans and families fight for themselves, armed with knowledge of what problems can occur. The support group will not judge or stigmatize anyone but provide a nurturing, healing environment in order to truly return home.

AGENDA?

I. Welcome by Darla Hough and Robert Roerich. Introductions among attendees of the meeting.

II. Informal discussion and timeline of what problems can occur with returning military and their families. Feedback of what members have experienced if they wish to share with the group.

III. Survey of what resources group members would want in the group, which may include:

• Printed and digital information handouts on depression, PTSD, and suicide for personal use.
  
• Distribution of a support group work book for member’s use.
  
• Information on problems with spouse or significant other and children affected by a veteran with PTSD.
  
• Stress management
  
• Anger management
  
• Resource manual for families on financial assistance, filing disability claims from the VA, health care and referrals to outpatient, hospital and crisis hotlines.
  
• Setting up peer and family support groups with group facilitator.
  
• Social activities and group functions, fund raisers, grant applications.
  
• Outreach and networking with others at the local, regional, state and national level to set up veteran and veteran family support networks.

CONTACT?

American Legion Post #76 will send out an invitation to their members in their newsletter informing them of their support in setting this veteran and veteran family community support network. A Salem, Ohio newspaper and others may also run a news story about this.

It is not necessary to contact anyone before coming, but if there are questions about the support network, 'Doc' Roerich will post about it on www.roadmind.com which has an announcement about this meeting. Additionally, you may contact the American Legion at (330) 938-9082 for directions or email 'Doc' at Roadmind University if you have any questions.

As the VA struggles to meet the increasing needs of our returning troops (alongside taking care of the those who've served in prior eras) more and more local and state efforts are being made to reach out and offer assistance. Programs like the one started up in Sebring, OH are vital to augment programs offered by the VA, providing yet another option and safety net for our returning troops and their families.

As Dr. Roerich says, "With the VA overwhelmed, understaffed and underfunded, getting the word out on the grass roots effort of concerned citizens and families to set up community based support networks in every hometown in America."


Other local communities are pitching in to help their returning troops in targeted and unique ways including those found in Minnesota, Oregon, and New Jersey and Philadelphia to name a few.

Kudos to them all. And here's to seeing more of this kind of thing pick up steam!

As our troops continue to stream home to us, families are having to deal with a variety of adjustment issues. Soldiers, sailors, airmen, and Marines are likely coping with combat stress or post-traumatic stress disorder; and so, Navy hospitals have been reaching out to help their service members and families via traditional counseling and online videos to assist families in understanding some of the reintegration issues they'll be facing.

Click on 'Article Link' below tags for more...

[UPDATE Apr 09 2007]: View videos below.

From AP:

Sgt. Milton Caples made it home to his wife and daughter after a year as a security convoy driver in Iraq, but thoughts of suicide bombers and mortar attacks haunted him, nearly costing him his former life. Driving on the rural roads near his home, he would flashback to the streets of Balad and Tikrit, speed up and try to out run other drivers. "I would know I was doing crazy stuff. It would seem like I was driving but I wasn't there. I was looking at myself doing stuff in a video game or something," he said. "In some cases, I'm glad the police didn't see me because they would have taken my license away."

He spent his nights doing security patrols of the family home - repeatedly checking to see if doors and windows were locked, if anyone was prowling around outside. His anger ate away his relationship with his wife and daughter, who struggled to reach the fun-loving man they once knew.

Three years into the Iraq war and almost five years after the invasion of Afghanistan, American families like the Capleses are increasingly becoming part of its collateral damage. Learning from the mistakes of Vietnam, the military has long encouraged returning soldiers to seek counseling. Now its leaders are trying something different - reaching out to the soldiers' families.

Although treatment and medication have evolved since Vietnam, the warrior mentality still prevents most returning soldiers from getting the help they need, said Rick Weidman of Vietnam Veterans of America. "Real men don't eat quiche and they don't have problems like this - hooah," he said, giving the shout soldiers make.

To counteract this attitude, Navy hospitals have begun advertising their counseling programs as well as pointing families to their online PTSD video series.

The videos were designed not for service members, but their families. "The goal was to bring in the family in hopes that if the individual wouldn't come in on their own, we would reach them through the family. We made thousands of copies and distributed them to all kinds of places," said retired Navy Capt. Jennifer Morse, the San Diego Naval Hospital psychiatrist featured on the videos. The Navy began producing the videos in 2004 and is releasing a re-edited version of the project in the coming months.

"The intent is to get people help, not to fix them over the Internet. (To tell them that) they shouldn't be ashamed of their feelings after they have served in these situations," said Bill Hendrix the Navy's Pentagon-based coordinator of the Lifelines video project. The videos have been so successful that the Air Force and the Army are also using them to encourage families to seek counseling for veterans of both Iraq and Afghanistan, Hendrix said.

Weidman, of the Washington-based Vietnam veterans group, applauded the efforts to reach troops by reaching out to families. "The military, under significant pressure, has made some significant efforts," he said. Vietnam Veterans of America has long pushed the Department of Defense to develop such programs, he said.

But Capt. Jeffrey Weyeneth, a psychiatrist at Pensacola Naval Hospital, estimates continued counseling programs still reach only 10 percent of troops returning from Iraq and Afghanistan. "A lot of guys, they see it as a nick in their armor, 'If I want to do 20 (years) or more, I don't want to be seen as a nut case'. And confidentiality is difficult with the military because mental health can affect your ability to function in the military so confidentiality is not as absolute as it is in the civilian world," he said.

Returning soldiers who go without treatment often hide their stress from co-workers to avoid ruining their careers and instead take their problems out on their families, Weyeneth said. "A lot of these guys come back from war but never get out of the combat, the enemy just changes. They direct their anger at other people," he said.

You may access the full Lifelines video series online.

[One technical note: For some reason, this link wouldn't open the video page in my Firefox browser; Internet Explorer, however, downloaded it just fine, making the programs available for viewing.]

The videos have been made available on YouTube:

#1


#2


#3


#4



 Related Posts

• A Look at the Unease of Transitioning to Homefront Living Following Combat
  
• Increased Deployment Tempo Strains Military Family Ties
  
• Activities and Programming for Military Kids and Their Parents
  
• Do's and Don'ts List for Interactions with Returning Troops
  
• Military Families: Preparing for Your Troop's Return Home
  
• Reconnecting with Your Kids After Deployment
  
• DefenseWatch: Post-Deployment Stressful for Many Veterans
  
• Families: Recommended Reading
  
• Military Family Resource: MarineParents.com
  
• Weekend Australian: PTSD Effects the Entire Family

As the VA struggles to find the resources it needs to deliver top notch care to our returning veterans, some programs rise to the challenge. Lexington, KY's VA Hospital offers a unique residential rehabilition program to help local veterans coping with PTSD.

Click on 'Article Link' below tags for more...

From WTVQ Action News (ABC-Channel 36):

The medical community admits it was slow to recognize the debilitating condition, but continues to catch-up to try to help Veterans of all wars. Part of that progress is a one of a kind residential rehabilitation program at the V.A. Hospital on Leestown Road in Lexington. Group and individual therapy teaches coping skills, adjustment skills, anger management, relaxation and all the things needed to try to help the Veterans dimish their PTSD symptoms.

The Veterans we spoke to in the program said it's successful, effective and in some cases life saving. "I've tried to commit suicide twice," said Vietnam Veteran Paul Louallen of Lexington. Like countless other Veterans, Louallen suffered in silence for decades, not knowing what was wrong. He couldn't control his anger, nightmares and irrational thoughts. "I'd go days without sleeping. I was afraid to go to sleep," Louallen said. He couldn't hold down jobs, alienated friends and couldn't manage a successful personal relationship with anyone. He, like many Veterans suffering from PTSD, turned to drugs and alcohol to numb the emotional pain.

The veterans being treated in this important program include those who served in wars from Korea to Iraq. They are very satisfied with the treatment they're receiving.

The Clinic Coordinator for the program is V.A. Hospital Psychologist Bruce Nerenberg. "These Veterans can sit around in a circle because they feel that the other Veterans are watching their back, there's that kind of trust and they talk and share and realize that they're not alone," said Nerenberg. There are an untold number of Veterans who may not realize they're suffering from PTSD or refuse to get help because of the stigma of weakness that society attaches to the disorder. Program coordinator Nerenberg said the courageous aren't those who deny they have a problem, but rather those who get help.

Veterans may be referred to this program by their primary care physician or VA doctor. Call the Lexington VA Medical Center for more details at 859-281-3949.

Continuing to explore the various definitions of PTSD, today we'll look at what's found inside the covers of the Columbia University Encyclopedia. Other official definitions already examined in this series include those of the VA, the Army's Combat Stress Field Manual, as well as that found on the National Center for PTSD website. Seek knowledge, gain power...

Click on 'Article Link' below tags for more...

From the Columbia University Encyclopedia:

post-traumatic stress disorder (PTSD), mental disorder that follows an occurrence of extreme psychological stress, such as that encountered in war or resulting from violence, childhood abuse, sexual abuse, or serious accident. The stressful event is usually followed by a period of emotional numbness and denial that can last for months or years. After that period, symptoms such as recurring nightmares, “flashbacks,” short-term memory problems, insomnia, or heightened sensitivity to sudden noises may begin. In some cases outbursts of violent behavior have been observed. The usual treatment for PTSD is individual psychotherapy, including anxiety management, or group psychotherapy with others who have the disorder. Some antianxiety and antidepressant drugs are being studied for their effectiveness.

Citation:
"posttraumatic stress disorder." The Columbia Electronic Encyclopedia, Sixth Edition. Columbia University Press., 2003. Answers.com 10 Mar. 2006. http://www.answers.com/topic/posttraumatic-stress-disorder

 Related Posts

• PTSD Defined: Dept. of Veterans Affairs Center for PTSD
  
• Army Field Manual: Combat Stress Control Scope & Definitions
  
• DSM's Definition for PTSD
  
• PTSD: Veterans Administration Definition

Little Cloquet, MN -- population 11,201 -- is making a name for itself. Last week, community members and leaders gathered at the National Guard Armory in Duluth. The reason? They wanted to learn how to help 120 Iraq vets from the local Guard unit transition successfully back into the community. Little Cloquet is on the cutting edge. Click on 'Article Link' below tags for more...

The local paper, the Pine Journal, does a great job of touching authentically on many of the most serious issues facing the returning veteran. In the interest of education, I'll quote from it extensively:

Event facilitator Chaplain John Morris, himself a two-time combat veteran, referred to the session as a “nation-leading effort” because it was one of the first in the entire country to extensively deal with the re-integration of National Guard soldiers back into the community. In fact, the event was considered so ground-breaking that a television crew from ABC News was on hand to record it.

“The adjutant general of the state of Minnesota has committed the state’s resources to helping our combat veterans reintegrate,” said Morris. “I am here to ask for your help, because there is no way they can make a healthy integration without your help and support. We’re in this as a community, and everyone has a role to play. You have a chance to be a part of something no other state has done.” The program is part of a series of reintegration sessions designed to help the 120 soldiers from the local Guard unit make the necessary psychological and emotional adjustments after returning to the United States last month.

Morris went on to introduce Minnesota National Guard Sgt. First Class Keith Huff, a veteran of 18 years in the military who spent a year during 2003-2004 performing route clearance missions along 144 miles of roadway in central Iraq. “Basically, we went out every day looking for roadside bombs,” explained Huff, who displayed a piece of razor-sharp shrapnel similar to those used in the lethal homemade devices. “I went over there with 35 men under me, and I am proud to say I came home with 35 – though one had his arm blown off and another had his ear shaved off.”

Huff said when he returned home from the harrowing experience in Iraq, “I had no clue what I was getting into.” “I got off the plane, got in the car with my wife, and they told me, ‘See you in 90 days.’ I had no warning of how different the world seemed. That night I left the airport, I made it to my house in Litchfield in only an hour. I was king of the road in Iraq. There were no tickets to be issued and no one in our way. We were the law. My wife was really scared that night.” ...

“The younger guys are even worse,” he added. “Five of them have been involved in serious car accidents since they got back, and they have had countless charges of driving under the influence and reckless driving because they are constantly pushing the envelope for speed.”

Pushing the envelope and blowing up in anger are two markers of combat PTSD. The rage is often directed at loved ones.

Huff explained that combat veterans also experience a great deal of anger – much of it admittedly groundless – and their tempers are a lot shorter than most.
“My tolerance for things that upset me is a lot less,” he said. “If my wife leaves something in the wrong place, I jump all over her.” ...

“After an initial honeymoon period of three or four days,” he related, “there was instant friction between us. I was used to an immense amount of power, and I had to learn to communicate with her all over again. I was downstairs one day watching television, and I had it turned up really loud because after being in combat, my hearing is shot. My wife came up and stood beside me, and since I didn’t hear her coming, I actually squealed. Now, she has learned to announce herself when she moves through the house so she doesn’t startle me. We still struggle with things like that today. It’s a long road and process.”

He's not the only one having a hard time of it. Huff says 4 of his 35 'boy's under him are having a hard time holding down jobs or navigating a return to school. He reflects on their struggles, and then returns to his:

Huff said he found he, personally, was still not doing well last Christmas so he reached out for help. The social worker made him go through 45 minutes of explaining what he was going through and them “came at me with words I didn’t like,” he said. “I was hurt, felt talked down to, and didn’t connect.” He tried again in January, and the counselor suggested he try “closing his eyes and do deep breathing.” When he finally met with a doctor, he was frustrated and scared, but the man achieved an immediate connection with Huff when he told him he was experiencing “a normal response to an abnormal situation.”

“He made me feel accepted and understand that I wasn’t going crazy,” Huff summed up.
Huff told the audience at Tuesday’s event that what they were doing there that day was “a huge step for the community and yourselves.”

“If I had had the benefit of something like this when I came back,” he continued, “it would have made a huge difference.”

Next week, the paper presents Part Two of their new series. The Long Road Home will discuss the 5 leading challenges each troop faces when they arrive stateside, again. I want to applaud the little town of Clouquet, MN and its Pine Journal for their great work on behalf of PTSD education -- and the soldiers who've returned home to them.

More and more, local media is pummeling the national outlets when it comes to PTSD reporting. If you'd like, email the Pine Journal a quick thank you for their coverage; being a small paper, they'll probably really appreciate hearing that their efforts are being recognized. Perhaps consider contacting your local officials to ask if your community has any plans to organize something like this, too (especially if you live near a base).



Read Part II in the Pine Journal PTSD series. Then read a few more examples of the stellar PTSD reporting happening on the local level in communities all around the country.


 Related Posts

• House, Senate Pass Defense Bill Nationalizing Minnesota's 'Beyond the Yellow Ribbon' Reintegration Program
  
• Minnesota Holds Its First-Ever Combat Stress Conference; Warrior to Citizen Campaign Editorial
  
• As Another Suicide Occurs, Minnesota Leaders Urge DoD to Revise Post-Deployment Contact Rules
  
• Alternative Sentencing Considered for Minnesota's OEF/OIF Veteran First-Time Offenders
  
• Opinion: Proactive Community Needed to Help Troops Reconnect, Reintegrate
  
• Ed Schultz Show: Reintegration Program Discussion Wednesday
  
• Advice for OEF/OIF Vet Employers and Co-Workers
  
• Minnesota Continues to Excel in Troop Reintegration
  
• Cloquet, MN: Troop Reintegration Program Update, Advice
  
• MN Community Reaches Out to its Troops