Amy Macavinta: November 2008

By Amy Macavinta

Deseret News

Published: October 19, 2008

Ronda huddled in her room crying, and afraid.

Before her husband locked her in, he gave her detailed instructions on how to escape should the intruder find her. Then, with his gun in hand, he methodically cleared each room in their Utah home, only to return and report that nobody had broken in and they were safe.

What he didn't know, however, that she wasn't afraid of the intruder.

She was afraid of him.

The couple married just one week before he was mobilized as an individual reservist with an extensive Special Forces background. He was deployed to both Iraq and Afghanistan, and life since his return has been difficult.

Once lighthearted, her husband, B.W. (his full name is not being used at the request of the family), was angry, impatient and often had nightmares. He regularly cleared the house, searching for intruders, covered the windows of their condo with tinfoil on a Hawaiian vacation and decided to sell their house, on impulse, during a trip to Home Depot because he couldn't handle the lights and noise of the city.

"I didn't know if he had an on-off switch, and I couldn't tell if he was awake," Ronda said. She worried about the outcome if someone did break into their home at night, especially if that "intruder" was just one of his adult sons who needed something.

Additionally, her husband is always busy. "He can't sit still; he can't rest," she said. "He tells me that 'if I am idle I can't stand myself."'

This went on for a year and a half. Ronda started doing some research, and believing he was experiencing symptoms of post-traumatic stress disorder, she asked him to get help.

"It was hard to tell him, but I had to try to bring him back to where I was, as a civilian," Ronda said.

Marnee Price had a similar story after her husband, Warren, returned from a 14-month tour of duty in Iraq. Within three or four months, she noticed he was often angry, or tired, and lost all desire to do anything. The couple fought constantly, although she chose to blame the stress at his work.

"For a while, it would just hurt," Marnee said. "We avoided each other because you never knew what was going to come out of his mouth."

Marnee, who has four children and does day care in her home, learned that she had to keep the children as quiet as possible to prevent triggering a burst of anger. He also started to push their friends away with his anger.

"You learn really fast who your friends are when trials come," she said.

For Jaime Taylor in Riverdale, PTSD has completely turned her life upside down. Her husband, Jake, was part of an Army Reserve unit in Logan but deployed for 17 months with an Army unit based in Los Angeles. Some of his symptoms were the same — extreme anger, depression, nightmares — and he doesn't like to be at home, surrounded by the chaos of a houseful of children.

In addition to that, as a gunner, Taylor was in vehicles targeted by improvised explosive devices seven different times and now has seizures and memory problems. Jaime said her husband rarely allows himself to sleep until daylight comes, and even then he doesn't sleep well.

Jake has a traumatic brain injury and continues to have seizures related to repeated subjection to blasts. He can no longer do his job in the Reserves, so he will be medically discharged from service.

"He would go back (to Iraq) in a second, so he is very upset about being discharged," said Jaime. "He's never unpacked his bags. They're still in a corner, ready to go."

Warren, Jake and B.W. are among the thousands of veterans coming home from the wars in Iraq and Afghanistan only to fight the battle of PTSD. None of these wives was prepared to deal with changes that PTSD has brought to their families.

Marnee said she did attend a National Guard briefing that she said lasted no more than 10 minutes. In that meeting, the wives were told it could take half the length of the deployment to return to normal.

"I felt like I was counting down to seven months," Marnee said, "but it all opened up at six months, and so we never got back to normal."

For Ronda, there was no such briefing. For a year and a half after her husband returned home, there were times when she wasn't sure their marriage was going to make it. He rarely talks about Iraq with her, and one time went so far as to tell her he didn't want to "walk through her mind with his dirty feet."

"I felt like he was shutting me out, and it was really lonely," she said.

His side

Warren Price knew deployment had changed him.

"I see things now in black and white, life or death," he said. "The whole world changed for me."

Price described himself as a man who was outgoing and liked to be the center of attention. He loved Scouting and camping, and he had an active social life with his wife and their friends.

He served in the Utah National Guard's 116th Engineer Co. as a medic, from December 2003 through February 2005. When he came home, he was thrilled to be back with his family and he was eager to take his wife and children to Disneyland.

But within a matter of months, Price found that life wasn't as wonderful as he thought it was.

"I didn't notice I was anxious all the time," he said. "I was alienating my friends."

One of his first wake-up calls came from his three sons and his daughter, who "were cowering around me. They wanted to be around me, but they were afraid of me."

In the three years since he came home from Iraq, he has been plagued by anger, anxiety, depression and nightmares. When he is awake, he carries an enormous guilt for lives he couldn't save. He continually wonders if things would have turned out differently during a particular gunfight where he froze, unable to fire because he thought there might be women in the back of the car coming toward him.

"My opinion of PTSD is 180 degrees different after deployment than it was before," Price said. "I had heard of it — and I thought it was bogus. I thought they (returning servicemen) should just suck it up and get along in society. And then lo and behold, I get home and I can't."

B.W. can't travel with his family because of his paranoia — on planes he insists on making sure that the person next to the emergency exit can operate it — and is plagued by nightmares that force him to relive his combat experiences.

Security at airports, on the other hand, simply disappoints him. He calls security personel "unfriendly" and said they treat passengers "the same way I treated our POWs."

Then there was the night he locked his wife in a room and cleared the house with a pistol, only to return and find her crying.

"I didn't know for six months it was me she was scared of," he said. "I had no clue that I was the source of her tears and that she was afraid of me."

At night, he may get four hours of sleep, with the aid of medication. Night operations require a soldier to be especially keen and alert, he explained, so "it is danger time."

During the day, he tries to keep his brain occupied all the time. "Sitting still is difficult; I am always moving, always thinking, because when I stop, I start .. " He drifted off, unable to complete his thought.

Having PTSD isn't just about the memories. Over time, the body learns to react to perceived danger automatically, without conscious thought. B.W. said the first time it happened to him after deployment, he heard a noise in the room he was working in at the time — a noise that repeated itself in the same cycle as a .50 caliber machine gun. His pulse increased, and he started breathing rapidly. He said he thought he was having a heart attack.

According to the National Center for Post-Traumatic Stress Disorder, behaviors associated with the trauma generally appear as depression, anger, lack of concentration, anxiety, panic and sleep disorders. Memory problems and a lack of concentration are also common. To deal with the problems, it is common for veterans to turn to alcohol or drugs.

"The brain spends so much time and energy scanning for threats that the everyday things become very mundane," explained Dr. Kitty Roberts, from the VA's PTSD Clinical Team.

Treatment

In the last three years, Warren said he has been suicidal at times and has been in an inpatient psychiatric ward twice. He has been in both individual therapy and group counseling but admitted to just going through the motions. He used and abused prescription medications provided by the VA. He either slept a lot or was zoned out, forgetting conversations and family activities.

"I told myself 'I can function,' but I was lying to myself," he said. "I didn't like the guy who came home, and I didn't like the person I had become."

In January, Warren said his psychiatrist recommended inpatient treatment at the National Center for Post-Traumatic Stress Disorder in Palo Alto, Calif. The only catch was he had to be clean. So, he quit all of his medications cold turkey.

"I wanted to keep my family, and it was going to take something drastic," he said. "And this was the 'drastic."'

Warren said his treatment consisted of learning the skills to cope with his anger and depression, followed by a lot of role-play homework.

"I don't know if I have fully mourned the loss of 'me.' I don't like who I am now. I am still coming to terms with the idea that the old guy is dead."

But the effort just might be paying off. He spent the Fourth of July weekend with his family and said that for the first time, he didn't yell as much as he had before. His kids were the same, he said, but he was able to communicate with them better.

While Warren feels optimistic about the skills he learned, he said it has been an adjustment since he returned from treatment. But they are getting along as a family and he is doing everything possible to remove the stress from his life.

He is also reaching out to other vets, using his experiences to help others. He is hosting a Vets4Vets retreat in Midway. He is also working with the VA on vocational rehab that will allow him to go to college and get a degree in recreational therapy, which will allow him to help other returning veterans.

During 2002 and 2003, B.W. served numerous tours in Iraq and Afghanistan with Special Forces Command. On his return, he said, he didn't feel changed, he felt normal. But eventually he realized there had to be something to the things his wife was telling him. He is currently in individual counseling through the PTSD clinic at the George E. Wahlen Department of Veterans Affairs Medical Center in Salt Lake City, but he readily admits that he is still "trying to figure this stuff out."

These men did their service in the Guard or the Reserves. Once they made the decision to seek help, it was there for them. But getting help doesn't always come easily.

Taylor served in the Army Reserves, where most soldiers are attached to an active duty unit for deployment. They remain part of that unit for the period of deployment plus 180 days, and then they are returned to Reserve status.

Claude McKinney, public affairs specialist for the 96th Regional Readiness Command, said that because Army reservists are citizen soldiers, they are only eligible for medical benefits during that time period. At the end of the 180-day period, all medical care then becomes the responsibility of the Veterans Administration.

Because Jake also has shrapnel wounds, he has been working with the VA administration for his medical care since he got home. There are at least two staff members who were provided detailed descriptions of the symptoms her husband encounters on a daily basis, Jaime said. It took the help of state senators to get help with Jake's claims, and not a word was ever said about PTSD.

"No one contacted us; no one told us there was a PTSD clinic," she said. "No one told us he needed to be evaluated for PTSD."

Jaime was later told that the information was not offered because she hadn't asked. But then, she had no idea just what all the right questions were, either.

Dr. Steve Allen, director of the PTSD clinical team, said that soldiers such as Jake Taylor who deploy on an individual basis are harder to reach out to because "they are coming and going without our awareness." And, he said, this is a problem nationwide. There are proposals in place to register all service members with the VA at discharge, rather than the VA trying to identify those soldiers and provide outreach services after the fact. This is a procedure that is currently working very well within the Utah National Guard.

Help available

The veterans who shared their stories here are only three of 300,000 nationwide who have deployed to Iraq and Afghanistan since 2001.

In April, researchers reported that nearly 20 percent of those service members are experiencing either major depression or post-traumatic stress disorder, yet only half of them are seeking help.

There are any number of reasons why veterans are reluctant to seek treatment for PTSD. For some, they do not want to be viewed as "weak" or they don't want to jeopardize their careers.

B.W. said that even though he works in an environment that one assumes would be helpful, he rarely shares his daily struggles because there is a stereotype associated with veterans who suffer from post-traumatic stress disorder.

"I am intelligent and articulate ... I don't want to be judged by PTSD," he said.

And even though he felt he had embraced a new point of "normal" in his life, he agreed to enter counseling when his wife expressed her concern about him.

"People are afraid of asking for help, but the tragedy is, the more they delay asking for help, the more ingrained those behaviors become," said Allen.

In Utah, there are a number of resources available to help teach veterans how to cope with the myriad afflictions they will experience after combat. And, Allen said, evidence shows that cognitive processing therapy provides a significant reduction in symptoms.

"It can't undo what's happened to a person, but it can help a person function more effectively," Allen said.

At the VA PTSD Clinic, there are both individual and group counseling programs offered to veterans who have been diagnosed with PTSD. But, Allen said, the idea that the veteran is the only one who needs help is "old school." The Veterans Administration as a whole is becoming ever more aware that the spouses and children also need help and the clinic is adding programs to meet those needs.

Twice a month, veterans of Iraq and Afghanistan meet for couples therapy, something that has been helpful for the wives. Warren and Marnee started going six months ago.

"He opened up more in a group setting and then we could have a conversation — sometimes — about what he is feeling," Marnee said.

Not only has this group session helped them talk more, but it has been a tremendous help to Marnee, just to know she is not the only one going through these changes in her marriage.

In addition to couples therapy, Marnee also attends monthly meeting just for the spouses — mostly women, but husbands whose wives served in combat can go — where she learned, most importantly, not to take his behavior personally.

Ronda attends the meetings with her husband as well. She said it isn't easy to spill her guts to strangers, and sometimes the sessions are "brutal." But, she said, without that group, she doubts her marriage would have survived.

Roberts, who is in charge of family programs within the VA's PTSD clinic, said that just because the programs are offered does not means the veterans will come. They also often fail to see the extent of their own problem, and it is not unusual for older veterans to offer to end their counseling so others can get treatment, even when there is room for everyone to be treated.

Sometimes, it is a matter of education, not knowing what is available and where.

Bart Davis works as the transition assistance advisor for the Utah National Guard. His job is to help returning soldiers and their families after deployment. He can answer questions about benefits, education and employment. And he can help identify and access the numerous programs available to service members and their families.

Davis said he makes sure that returning Guardsmen complete their evaluations on their return and sees to it that they are registered in the VA. This is all done within days of getting off the plane. The entire process takes up to 10 days, but if something catches his eye about a soldier's behavior or specific responses on the evaluation, Davis will make arrangements for that individual to be seen at the VA in as few as two or three days, and he has had two soldiers sent to the VA on the same day.

"The ones who say they are 'fine' keep me busy," Davis said.

Davis can spot the ones who need help pretty easily, because he is one of them himself. He is a Vietnam vet who is so soft-spoken that one would never guess he sometimes has difficulties of his own.

His own combat experience gives him the ability to talk to other veterans, brother-to-brother. He knows firsthand what deployment does to a marriage, and how difficult it is to reconnect with children after a long absence.

"There aren't many emotions and transition challenges that you may be facing that I can't identify with and understand," Davis said.

While he is employed by the Utah National Guard, he is committed to offering a hand to any veteran who needs it, no matter in which branch they served.

"My office is open to everybody," said Davis.

That same open-door policy applies at Hill Air Force Base. Candi Ackerman and Colleen M. Netzer are both registered nurses who help coordinate the needs of the veteran and his or her family. Ackerman said they will help anyone who has a military ID card.

Ackerman and Netzer cannot make referrals for counseling, but like Davis, they can help locate the most suitable resources for a service member's needs.

Ronda described life after war, with PTSD, as "a whole new way of life." But it doesn't have to be the end of life.

Patience Mason is an author who is well-known for her works about PTSD. All of her writings stem from experience, since she has been married to a Vietnam veteran for 45 years.

"We lived with PTSD for 14 years during which I felt there was something wrong with me because I couldn't make him happy," she said. "He thought he was crazy. We did not associate any of it with Vietnam."

In her publications, Mason puts a lot of emphasis on how PTSD affects the family. She frequently shares her experiences from her own home. The one thing that was most helpful was realizing she didn't cause her husband's pain, she couldn't cure him, and she couldn't change him.

"To recover, family members need to take the focus off the survivor. By focusing on ourselves we take the burden of 'making us happy' off the survivor," she said. "We also put the focus on what we actually do have the power to do, changing our own actions and reactions. We cannot change others, but we can waste our whole life trying."

Resources for vets

SUICIDE PREVENTION HOTLINE: 1-800-273-TALK (8255), A 24/7 hotline for veterans in crisis

MILITARY ONE SOURCE: 1-800-342-9647

militaryonesource.com

Veterans may call up to 8 times per issue before a referral is required

WOUNDED SOLDIER & FAMILY HOTLINE: 1-800-984-8523

A referral service to help veterans find the agency that best fits needs George E. Wahlen Department of Veteran Affairs Medical Center 500 Foothill Dr., SLC, 801-582-1565

PTSD Clinical Team

Steven N. Allen, PhD

Coordinator

VA Salt Lake City Health Care System

(801) 582-1565, ext. 2390

Kitty Roberts, PhD

Veteran & Family Support Groups

VA Salt Lake City Health Care System

(801) 582-1565, ext. 2389

OEF/OIF Support Office 1-800-613-4012

Andrew Kalinen, Transition Patient Advocate, and Outreach, ext. 4264 for help in transition from military to VA

Andrew Wittwer, Combat Case Manager, ext. 2150

Maria Fruin, Program Manager, ext. 5246

Danica Richans, Polytrauma Case Manager, ext. 2038

Bart Davis

Utah National Guard Transition Assistance Officer

801-523-4937

bart.o.davis@us.army.mil

utvethelp.com

**will take calls from any vet requiring assitance, regardless of branch of service

Candi Ackerman, Colleen M. Netzer

Hill Air Force Base, Case Managers & Special Needs Coordinators

801-586-7351

**will provide assistance to anyone with a current military ID card

battlemind.org

ncptsd.va.gov

E-mail: a_macavinta@yahoo.com

Amy Macavinta

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