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Many in the military have scars from battle. Some carry invisible scars from battles within.
Those with post-traumatic stress disorder fight this battle long after the war is over. Often, those with PTSD live with depression that can lead to suicidal thoughts and tendencies.
According to a 2003 study in the American Journal of Psychiatry, patients with a major depressive episode and PTSD make “substantially more suicide attempts” than those with only depression.
A study analyzing data from the National Comorbidity Survey, a nationally representative sample, showed out of six anxiety diagnoses, PTSD alone was “significantly associated with suicidal ideation or attempts,” according to the Department of Veterans Affairs website.
Not all suicides in the military are a result of PTSD, but suicide rates still have risen in the service, prompting the U.S. Army to create an Army Suicide Prevention Task Force in the spring of 2009.
According to VA statistics, 20 percent of the veterans of the Iraq and Afghanistan wars, 10 percent of Gulf War veterans and 30 percent of Vietnam veterans suffer from PTSD. Including unreported cases, the numbers could be higher.
Retired Maj. Rob Appleby, owner of A Soldier’s Dream pay lake in Lebanon Junction, knows the risks of PTSD.
Appleby enlisted in the Army at 18 and served 18 years. After becoming an officer in 1994, he went to Korea, explosive ordinance disposal school and then took command of a unit at Wright-Patterson Air Force base.
He left active duty for a while and worked as a stock broker until Sept. 11, 2002, when he became active duty again. He was sent to Germany and then Bosnia for six months. He then took command of the 731st EOD in Manheim, Germany, before deploying to Afghanistan. There were a few deployments in between that he isn’t allowed to talk about, he said.
In Afghanistan, his unit was attached to the 25th Infantry Division and embedded with the 7th Special Forces group.
“That’s where everything started to go awry,” Appleby said.
In combat, he constantly had to be in a state of alert that’s difficult to turn off. When he returned to Virginia, he started noticing problems. He couldn’t drive a car for nine months.
Because he couldn’t drive, he stayed in a 10 x 10 room earning a master’s degree online. He was spending 22 hours a day in that room, hiding and neglecting everything else in life.
He started seeing a counselor who told him he’d never be able to return to active duty because of PTSD. It took him about four more months to get back behind the wheel of a car, taking things step by step. He still can’t drive alone.
“Seeing all the people on the side of the road was very traumatic,” he said.
He couldn’t handle civilian life or civilians because most were oblivious to what happens to soldiers in combat.
“They don’t realize that one day you’re able to shoot somebody and you’re fearing for your life and the next day you’re tolerating ignorance and bliss,” Appleby said. “It doesn’t work very well.”
He woke up some nights with hands around his then-wife’s neck. It never went further than that, but it scared them both. The PTSD had a lot to do with his divorce, he said.
There were some medications that helped, but they really only let him tolerate things, he said.
“The happy-go-lucky spirit that used to be there is gone,” Appleby said.
Depression was the worst part, he said. He has to fight it every day. He becomes unmotivated and has anxiety attacks that come out of nowhere. He can be happy one minute and “at the armpit of life” the next.
“I wouldn’t trade what I did (in the military) for anything, but I really wish people understood that ‘thank you for your service’ is nice to hear but the true nature of what happens is only known by veterans,” he said.
He’s found difficulty with counseling from the VA because of the turnover rate he’s experienced with counselors, sometimes going through as many as four in a year.
“One of the major problems people with PTSD have is trust, and just when you get comfortable with someone they are gone, so how do you really treat an illness that’s based on trust when you can’t see the same person more than once?” he said.
He thinks that’s part of why so many suicides happen in the military. Another reason he offers is many hide the illness because it can be seen as weakness.
Appleby realizes he should have sought help sooner, but while it was happening he thought it would go away.
“When you start having these feelings, it’s not weakness. It’s really your body trying to help you seek help before you do something stupid,” he said. “Don’t make excuses because the excuses get you past the point where it can be treated and get you to the point where you can’t be treated.”
If caught early it’s more treatable, but it can later become a death sentence, he said.
Because PTSD only recently has been recognized and there’s still a lot to learn, Appleby said Vietnam veterans probably had it worse. In his view, he feels this is why many of them have committed suicide, and he’s afraid that will happen to veterans of current wars.
Some soldiers he’s talked to stay in the Army, hiding their PTSD, because they don’t want to be dismissed. They don’t feel they have other options.
“There’s no real skill set for being able to kill people in the civilian sector and how does that transition the soldiers out?” Appleby said.
He asks that the community support veterans in tangible ways and is understanding and tolerant, offering a listening ear to those with PTSD.
Veterans Affairs lists a few key symptoms of PTSD: reliving events, avoiding situations that are reminders of events, feeling numb and feeling keyed up or jittery, always on the lookout for danger.
Appleby offers warning signs that are a bit more personal and often are ignored: periodic nightmares, flashbacks, nervousness and uncomfortable feelings around unfamiliar people.
“Still, to this day, when I walk into a restaurant I can tell you where all the entrances and exits are, and I can tell you who is where and who looks out of place,” he said. “It’s annoying to a point, but it’s also second nature — to know how the hell to get out if something goes wrong.”
Not everyone with PTSD is aggressive, he said. That’s a stereotype that bothers him. Sometimes when he tells others he has PTSD, they treat him like he has the plague or they are afraid of him.
He’s just the opposite. He internalizes all his issues.
“I’m more apt to bottle it up, and once and a while I’m a bit like a ticking time bomb, but I never have a fear of hurting anyone else.” Appleby said. “I’m more fearful of what I might do to myself.”
Appleby has a “phenomenal” Army Wounded Warrior Advocate. And he has remarried, this time to his high school sweetheart. Never an animal lover, he now has a beagle that can sense he is going to have a bad day before he knows it. She’ll lie down next to him and lick the side of his face as if to say, “It will be OK,” he said.
But he still deals with depression, anxiety and other symptoms of PTSD every day.
“I’ve lost a lot of what I enjoy in life and never see it coming back,” he said. “I don’t see ever being able to beat this illness.”
Becca Owsley can be reached at (270) 505-1741 or email@example.com.