Photo By Staff Sgt. Aaron Rognstad | Joe Birge, a network systems analyst for the Department of Veterans Affairs, operates...... read more read more
Military members who serve in combat zones often return with injuries. Some return with wounds on the outside. Some return with wounds on the inside.
When wounds are treated, the prognosis for recovery improves; however when left untreated, the wounds often fester and leave scars deeper then the injuries themselves.
For Colorado Army National Guard Staff Sgt. Daryl Johnson, Sgt. 1st Class Travis Leland and Vietnam veteran Joe Birge, their wounds took the form of post-traumatic stress disorder.
They are part of a larger group nationally that grows in number as more and more service members return from deployments around the world.
"I couldn't sleep because it was too quiet."
COARNG Staff Sgt. Daryl Johnson, assistant brigade administrative NCO with the 169th Fires Brigade, was diagnosed with PTSD in August of 2009 due to events that he experienced on two separate deployments.
During Operation Desert Storm, as a machinist in the Navy on the battleship USS Missouri, Johnson said the intermittent stress of detonating mines, which two ships in his fleet struck, the constant firing of the Missouri's 16-inch guns and incoming enemy fire laid the foundation for his PTSD.
According to the Dictionary of American Naval Fighting Ships, the "Mighty Mo," fired a total of 759 16-inch rounds in a 28-day period during the war and came under fire from two Iraqi HY-2 Silkworm 1,000-pound warhead missiles; one missed and the other was intercepted by a missile fired from a British destroyer.
The latter came within 700 yards of the ship's bow and could have sunk her with a direct hit.
Upon his return to the US, Johnson said he was "pissed off all of the time," while exhibiting some of the traits of PTSD, but didn't seek treatment.
"I didn't see it as a problem," Johnson said. "Everyone else around me did, though."
According to Richard B. O'Connor's book, "Collateral Damage: How Can the Army Best Serve a Soldier with Post-Traumatic Stress Disorder," Army Veterans diagnosed with PTSD, compared to those without PTSD, are more likely to be violent with partners and children, with rates as high as 63% for some type of physical violence in the past year.
Johnson said that part of the reason of his divorce from his first wife was his anger issues – feelings of rage and hostility that he continued to suppress until after he returned home from his second combat deployment.
"I raged against everything and made scenes in stores and restaurants," Johnson said. "I yelled at waiters and cashiers for being too slow or getting something wrong."
Sixteen years later, after a tour with the 169th FiB to Mosul, Iraq, Johnson was again traumatized so much to the extent that this time he sought treatment.
"We got mortared and hit with small-arms fire so much that when I came back for my two weeks' [rest and relaxation], I couldn't sleep because it was too quiet," Johnson said. "Someone could've lit off a .50 cal. (heavy machine gun) and I would've fallen asleep. It was the steady, constant explosions and the stress of being where we were at that got to me."
Johnson said a small dirt berm and barbed wire were the only line of defense between him and the enemy at Mosul, and the base was under near-constant attack.
"Rounds were (coming in) all over the place at all times," Johnson said. "They'd come in and you'd feel the gravel hit you. Mortars would hit close and the door to your hooch or your office would swing open and you could see the shockwave at times."
Johnson said that a number of military personnel were killed in the attacks.
Upon his return home, Johnson's second wife told him he wasn't the person she remembered. She added that he was constantly angry. Johnson admitted to performing poorly on the job with the 169th FiB and seriously contemplated smashing his desk into little pieces. He couldn't concentrate, was frequently depressed, suffered from insomnia, had no appetite and was generally apathetic to everything and everyone around him.
"Driving to work, if somebody cut me off, I would get up next to them and try to push them off the road," Johnson said. "It was becoming apparent to everyone around me that I was not in control."
That's when Johnson realized it was time to get help.
Johnson said that initially he had trouble finding the proper assistance for his disorder. A speedy diagnosis and a hasty prescription for medication was one civilian doctor's solution to Johnson's problem. Instead, Johnson gave the Department of Veterans Affairs a try.
Unlike the civilian doctor that Johnson originally saw, the VA understood his problems instead of simply filling him with pills.
"A few months later, they put me on some medication and got me counseling and I've been pretty good ever since," Johnson said. "I just don't get as wound up now.
Johnson was given a prescription for an anti-depressant, one that is also used to treat social anxiety and obsessive-compulsive disorder. He also began seeing a Vet Center readjustment counselor and participating in a PTSD therapy group in Boulder. The cost is covered by the VA.
"The VA will get you fixed up fairly quickly," Johnson said. "They (the civilian psychiatrists) don't care about your problems and they can't relate because they've never been deployed. The VA has people that understand. It does take a while, but you have to be persistent with it."
Johnson said the doctor that diagnosed him was a Vietnam War combat veteran who empathized with some of what Johnson was experiencing.
Johnson said he feels he's made progress in his battle with PTSD. Combined with proper medication, counseling sessions and group therapy, all have helped tremendously.
"Everyone in there understands where you're coming from," Johnson said of his group therapy at the Boulder Vet Center. "It's good to get stuff off of your chest."
Death letters and video therapy
According to the fourth edition of the Diagnostic and Statistical Manual of Mental Health Disorders, PTSD can be divided into three categories: acute (duration of symptoms is less than three months), chronic (duration of symptoms lasts three months or more) and delayed (symptoms appear at least six months after the traumatic event).
Sgt. 1st Class Travis Leland, a noncommissioned officer in charge of operations at Joint Force Headquarters-Colorado, has suffered from chronic PTSD for more than 30 years, although he wasn't officially diagnosed until recently.
As a child, Leland witnessed a horrific accident. His younger brother was driving an all-terrain vehicle without a helmet when it flipped over and landed on top of him, instantly shattering his skull. His injuries were severe and he wasn't breathing.
"I can still see Garth's face and hear him choking," Leland said. "By the time help arrived, my entire coat was soaked in blood. It was a miserable scene being alone with him in the middle of a frozen corn field screaming for help."
Leland performed mouth-to-mouth resuscitation.
Miraculously, his brother lived.
"Thirty years after, I'm still dealing with it," Leland said. "I started isolating myself 30 years ago, and with that isolation as a child, I got used to it. I got used to the numbing and the avoidance. That's how I developed."
Leland, a former Marine who deployed to Bangladesh and Haiti on disaster missions, is also still haunted by events that happened in the early '90s during his time in the service.
"In Haiti we were constantly being strafed, both at the American Embassy and in our Marine house," Leland said. "A few nights the shooting sounded like a truck dragging an empty wood box up the road. We used to sleep in our bathrooms in our flak vests for fear of a bullet bouncing off the walls."
Leland was sent to Afghanistan in 2008 as part of a COARNG embedded training team that trained Afghan National Army and Afghan National Police.
The trip changed him forever – and once again set the wheels in motion for PTSD.
Enduring attacks from mortar and small-arms fire, Leland witnessed multiple friendly and enemy casualties in 27 firefights during an eight-month span.
"There's loss. There's confusion. There's constant frustration and battle fatigue," Leland said. "The loss of being away from your family as well is something you'll never get back."
Three months after Leland returned home, he began displaying odd behavior.
He said he was depressed, contemplated suicide, isolated himself within the confines of his house, overate and stayed up as late as possible in the early hours of the morning to avoid nightmares.
He'd always been an avid rock climber, but he began to scale large rock faces – without ropes
"When you push yourself harder because you can't get the rush, you turn to other things," Leland said.
So he began burning himself with welding sticks while he welded on various projects in his garage.
"I'd hurt myself in order to get the adrenaline back in my body," Leland said. "It was physical pain, but it was a way to get that rush back."
He wanted to seek treatment but was afraid of the stigma surrounding mental illnesses.
"My command team had seen these characteristics before and helped me in any way that they could," Leland said, "but it was something that they had to let me discover and act upon."
Finally, one year after Leland returned home from Afghanistan he sought out help from the VA. He talks to numerous doctors, psychiatrists and counselors on a regular basis about his issues and said he's on medication, but two other forms of therapy have also helped him cope with the demons that have followed him for years.
Interestingly enough, Leland writes letters to his fallen brothers-in-arms to include his departed Afghan students from the war. He calls them "death letters" and keeps them all together in a black hardbound book.
"If I had one thing I could tell these guys before they died – how I felt about them as a person – that's what I write down," Leland said. "It's getting a sliver of problems off of my back."
An excerpt from one of Leland's letters to Sgt. 1st Class David Todd, who died Aug. 20, 2008, from small-arms fire in Bala Morghab, Afghanistan, reads:
Dear David,
Dead is dead; we all should make peace with it as soon as possible. What I cannot accept is the fact that a leader such as you – a father, a master of arms, teacher, mentor and friend – is gone. When together, we never really talked much – like an old married couple. We didn't speak because we knew the drill. Our soldiers eat before officers and NCO's (sic). If you could get steaks for the boys you would build a hobo grill and it felt for a brief time that we were back home again in the back yard grilling.
Leland also made a 20-minute video titled, "Afghanistan: Frontier of Loss." The compilation is a visual – and at times graphic – look back at his team's experiences over the course of his deployment.
"It (the video project) helped my PTSD issues by my having to continuously look over my picture and video stock which drudged up bad memories as well as a new respect for the soldiers," Leland said. "I had a lot of nightmares in doing so. In writing the narration, I broke down for the first time since Afghanistan."
Fortunately, Leland is not alone in dealing with his condition. He has a strong support mechanism in place with his wife Anja and three daughters, Remington, 13, Savannah, 10, and Isabella, 7.
He made a promise to his wife to quit rock climbing and has quit hurting himself. He took up playing a banjo and is teaching Isabella to play a harmonica. He also hopes to establish a charity for children of actively-deployed family members.
He's presently undergoing further treatment with the VA.
"Of anything that I've gone through physically, going through this treatment has been by far noticeably harder," Leland said, "because I'm reliving it (the trauma) again."
He said the VA has helped him since he began treatment.
"The people working for the VA are dedicated," Leland said. "They have veterans from all wars working there – Vietnam, Korea and World War II vets – and we all talk about our different firefights and we can relate so closely that we can finish each other's stories. The counselors are not entirely made up of combat veterans but they are extremely wise and committed to our veterans."
"I was told a long time ago to talk about this."
A large portion of veterans from prior wars still suffer from PTSD, such as Vietnam War veteran Joe Birge
Birge, a network systems analyst for the Department of Veterans Affairs, came back from the war a different man. He still is haunted by the memories he carried home from his time in battle.
Birge, a native of Trinidad, Colo., was 18 in 1966 when he was drafted into the Army. Three months later, he was a cavalry scout in Vietnam.
One of his first vivid memories of the war was when he was assigned to his unit that he would remain with for the duration of his time spent in-country.
"I was on a cargo plane that came in for a landing on a dirt strip in this clearing in the jungle and it slowed down just enough for me to get out," Birge said, "so I jumped out with my duffel bag and the plane took off. So there I was in the jungle, by myself, wondering what the heck is going on. Then this jeep drove up and picked me up."
Birge was taken to Blackhorse Base Camp, home of the 11th Armored Cavalry Regiment, near the village of Xuan Loc. He was assigned to a squadron and immediately sent into the countryside on missions.
Birge took part in Operation Cedar Falls, a major search and destroy operation in the Iron Triangle in the Bing Dong province of the country. According to Andrew Weist, author of "Rolling Thunder in a Gentle Land: The Vietnam War Revisited," the Iron Triangle was a heavily fortified enemy area 25 miles north of Saigon that remained under Viet Cong control until the end of the war despite massive American efforts to destroy the communist forces who were there.
By day, Birge travelled by armored personnel carriers on dirt roads through the countryside looking for enemy movement. By night, he and his squadron would emerge from their steel transports and patrol the jungle on reconnaissance missions on foot.
"We were always in firefights," he said. "We fought in rice paddies, had shootouts in the thick jungle, or sometimes in clearings – you never knew where you'd be in a fight. We were always in combat."
Birge recalled a particular day out in the field when the enemy fired a rocket-propelled grenade at the tank in front of him.
"We had to go get the guy out of there," Birge said . "He was (physically) half a person."
Birge said the fighting got so close one day that his squadron leader called in an airstrike on their own position. Not long after that, he was shot in the left hand, patched up and sent back into the field.
Three months later, he tripped a claymore mine while in the midst of a firefight that would alter the course of his tour of duty.
"There was a big flash and the right side of my body had been blown open," Birge said. "I was in intense pain and ready to pass out. There was blood everywhere. My sergeant rushed over and hit me with a morphine shot and all of a sudden everything was cool. After that I was able to half-way walk to the helicopter."
It was Birge's "million-dollar wound." According to "War Slang: American Fighting Words and Phrases Since the Civil War," by Paul Dickson, the phrase was coined by military doctors that refers to a wound that is not life-threatening nor crippling but will send a servicemember home.
But he wasn't happy about his early ticket.
"When you're taken off the field, you feel like you let your pals down," Birge said.
His tour was over and after a series of hospital visits he ended up at Fort Carson, Colo., to finish the remainder of his time in the Army while he recovered from his wounds. It was right around the Fourth of July, 1967, when Birge noticed one of the early signs of PTSD.
"I was walking to the bank to make a deposit and some kid lit off a firecracker," recalled Birge. "I fell on the ground and began to low crawl."
He attributes anger issues associated with his PTSD to the demise of his first marriage. Other signs of it came as the years passed.
"When a helicopter flies over my house at night, I'll suddenly jump up because I'm ready to pop a flare for it to land," Birge said. "This sort of thing never goes away. Another thing is when I go out to eat with a group of vets – all of us want to sit with our backs to the wall. I also can't be near windows at night or an open curtain because I think someone is going to shoot me."
It wasn't until 1991 that Birge received professional help for his symptoms. After he was diagnosed with non-Hodgkin's lymphoma stemming from Agent Orange, a counselor at the VA pointed out that he had all of the classic symptoms of PTSD. Since then, Birge has been treated for his cancer and regularly sees a VA counselor for his PTSD.
"I was told a long time ago to talk about this – not to keep it pent-up," Birge said. "Two things I've used as a tool to help me with the PTSD are talking to certain vets about the war, and a sense of humor. Finely tune your sense of humor and make a joke of yourself."
Through all his hardships that life has thrown at him, Birge has always looked toward the bright side.
"One thing that's pulled me through is I've always had a pretty good outlook on life," Birge said. "I've always been a positive, upbeat guy."
Birge said the government addresses PTSD much more now than it did back in the Vietnam-era and the treatment available is more widespread compared to the 1960s and '70s.
"You didn't get the coverage of the problem back then," Birge said. "Nowadays I think the government and the military are looking at the problems and how to control them."
Assessing PTSD
According to an official Department of Veterans Affairs publication titled "Post-Traumatic Stress Disorder: An Overview of Combat-related PTSD for Veterans and their Families," PTSD is a psychiatric disorder that occurs following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents or violent personal assaults like rape. Those who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping and feel detached or estranged. The symptoms can be severe and last long enough to significantly impair the person's daily life.
According to psychologist and Tulane University professor, Dr. C. R. Figley, author of "Post-Traumatic Stress Disorder: History of a Concept," before it was officially diagnosed as a psychological disorder in 1980 by Dr. Robert Jay Lifton and Dr. Chaim F. Shatun of the American Psychiatric Association, PTSD had many coined terms.
During the American Civil War, a similar disorder was known as Da Costa's Syndrome, named after Dr. Jacob Mendes Acosta who studied anxiety disorders in soldiers of the era. The more recent 20th century terms of "shell shock" or "battle fatigue" are still part of the American vocabulary.
During World War I, shell shock was deemed a psychiatric illness resulting from damaged nerves during combat, according to www.psychiatric-disorders.com. Figley also notes that by World War II, U.S. military psychiatrists were dismissing PTSD and writing it off as "exhaustion," but it wasn't until the end of the Vietnam War that careful research and documentation into the disorder emerged.
"(PTSD) can be found in someone who has experienced some form of dramatic, life-changing trauma, specifically where life or limb or bodily integrity is threatened," said Terrence Russell, a readjustment counselor of nine years with the Fort Collins Vet Center. "We specifically see veterans who have served in a combat theater or who have undergone some sort of military sexual trauma."
Sgt. 1st Class Keith Byers, trauma support noncommissioned officer for the Colorado Army National Guard, assesses Soldiers who may have PTSD and points them in the right direction for assistance and proper treatment.
"I'm not a therapist – my original background was in the ministry – so I don't have a lot of specific training in counseling. I try to figure out their immediate needs and link them to the next level of care," Byers said. "Typically, if the individual has deployed or meets eligibility, that's going to be the [Veteran's Administration]."
CONG State Chaplain, Col. Andy Meverden, also helps those in need find assistance, and if necessary, treatment. He said that of the many people that he sees over the course of a month, less than five to 10 percent of them have symptoms associated with PTSD.
"Almost all of them who present PTSD-like symptoms have deployed," Meverden said of the Soldiers who come to him. "And yet, not all of those who present PTSD-like symptoms have been in direct combat. However, they may have been close to or experienced other potentially life-threatening situations like rocket or mortar attacks, [improvised explosive devices] or other dangerous situations."
Meverden, a combat veteran himself who spent a year in Afghanistan in 2002-03 with the 5th Battalion, 19th Special Forces Group, added that most Soldiers who are trained in combat arms – to include SF and military police – deal with their combat experiences with "little or no debilitating consequences."
"My further observation is that some support Soldiers who accompany combat troops are much less prepared for the combat environment and are likely to be traumatized by exposure to combat in their support roles, like a supply sergeant tasked to man a heavy machine gun on a Humvee or a cook tasked to provide perimeter security," Meverden said.
Avenues for help
Treatment for PTSD isn't hard to find if one is willing to look for it.
"Only a small percentage of people with PTSD who need help actually seek it out," Meverden said.
Russell agreed. "I don't think there's near as many [veterans] coming in for help as there should be," he said. "One of the criteria for diagnosis is that the person wants to avoid the problem, because to confront it reminds them of the horror when they first experienced it. Warriors are also supposed to be invincible and they want nothing to do with mental health because they think it's for crazy people."
Some of the many avenues for Guard members who feel they may be experiencing PTSD include:
•Department of Veterans Affairs hospitals provide free diagnoses, medical treatment and specialized PTSD counseling
oDenver VA Medical Center (303) 399-8020
oNational VA Health Resource Center: (877) 222-8387
oU.S. Department of Veterans Affairs: www.va.gov
•Vet Centers provide free diagnoses, readjustment counseling and referrals to psychiatrists as needed to prescribe medication
oDenver Vet Center: (303) 326-0645
oTo find a Vet Center closer to your home call: (800) 827-1000
oVet Center home page: www.vetcenter.va.gov
•Seventeen community-based mental health clinics throughout the state provide free counseling to National Guardsmen through the Colorado Department of Human Services. To find one in your area, call or visit:
o (303) 866-7400
owww.cdhs.state.co.us/dmh/directories_cmhc.htm
Among American Vietnam theater veterans, 31 percent of men and 27 percent of women have had PTSD in their lifetimes. Preliminary findings suggest that PTSD will be present in at least 18 percent of service members serving in Iraq and 11 percent of those serving in Afghanistan. A national study of American civilians conducted in 2005 estimated 7 percent of all people will have had PTSD in their lifetimes.
Source: National Center for PTSD
Symptoms of PTSD may include any of the following:
•Unwanted remembering or re-experiencing
•Shutting down, emotional numbing
•Active avoidance of trauma-related thoughts and feelings
•Depression
•Insomnia
•Irritability, anger and rage
•Being constantly on the lookout for danger (hyper-vigilance)
•Being easily startled by loud noises
•Anxiety and panic
•Self-blame, guilt and shame
•Relationship problems
•Physical symptoms and health problems
Source: "Post-Traumatic Stress Disorder: An Overview of Combat-related PTSD for Veterans and their Families," Department of Veterans Affairs, available through the VA.
| Date Taken: | 03.03.2010 |
| Date Posted: | 04.27.2010 15:19 |
| Story ID: | 48772 |
| Location: | DENVER, CO, US |
| Web Views: | 364 |
| Downloads: | 220 |
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