by Sue Ann Rybak
– This is the first article of a multi-part series
Many Iraq and Afghanistan Veterans return home only to face a different kind of battle. Veterans and their families struggle to heal the invisible wounds of war.
After an exciting and emotional homecoming, many veterans and their families are left alone to deal with life’s everyday challenges – from finding a job and paying the mortgage to adjusting to new family roles and rebuilding relationships often strained by the physical and psychological effects of war.
Specialist Eamonn Kelly, 30, of Glenside, is one of the many returning Iraq and Afghanistan veterans struggling to adjust to civilian life.
Before going to Iraq in March 2010, Kelly described himself as “easygoing.”
“I had a hard time settling down,” he said. “I guess when you are on edge for a year, it’s hard settling down to civilian life.”
Kelly said he felt anxious and angry all the time when he first came back from Iraq.
“I was hyper-vigilant and always felt on edge,” Kelly said.
Eamonn’s mother, Genevieve Kelly, 56, said that when he first came back from Iraq she had to go pick him up at the Veterans of Foreign Wars Post in Glenside once or twice a week because he was getting in fights with people.
“That was never Eamonn,” said Genevieve Kelly. “He was always levelheaded. There was never a problem with Eamonn in high school. Eamonn never drank that much. He never smoked – in fact, he was totally against smoking until his tour of duty in Iraq. It changed him.”
“I was a pain in the ass to my family and girlfriend when I first got back,” Eamonn Kelly said. “I don’t mean to be angry. Now, I get in more fights than I have in my entire life.”
Kelly said he tried to unwind by going to the gym, watching television, playing rugby or going out drinking with his friends.
Despite having severe headaches and back pain, Kelly said he was fortunate. While in Iraq, Kelly was in four IED (improvised explosive device) blasts while driving an MRAP (Mine Resistant Ambush Protected vehicle). Kelly said his platoon was hit a total of 12 times.
“The Iraqis wouldn’t let you out during the daytime because it interfered with their traffic pattern,” said Kelly, a combat engineer with the 228th Combat Engineer Company. “So, it was pretty hard to drive around at night looking for bombs.”
He said he had difficulty initiating or maintaining sleep.
“I have to have some kind of background noise – usually I turn the television or the radio to help me relax,” Kelly said.
“Eamonn is not the same person he was before he went away,” said Edward Kelly, 54, Eamonn’s father. “His memory is terrible.”
He said many veterans hesitate to get help because they are afraid it will go against them.
“They don’t want it on their military or medical record,” he added. “Nobody wants to have a diagnosis of mental illness on their record.”
Following the advice of former Vietnam veteran Ronald Jenkins, Kelly decided to seek counseling when he came back in March 2011.
“It was difficult to open up to somebody – especially someone who didn’t serve in combat,” said Kelly. “I talked to my friend Ronnie more than anything else.”
Kelly is just one of the thousands of Iraqi and Afghanistan Veterans struggling with the invisible wounds of war.
The Alarming Statistics
According to a 2008 Rand Study entitled “Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences and Services to Assist Recovery,” one in five Iraq and Afghanistan veterans admitted having symptoms of post traumatic stress disorder or depression. The National Alliance on Mental Illness defines post-traumatic stress disorder (PTSD) as an anxiety disorder that can develop after a person witnesses a traumatic event.
About 19 percent of troops surveyed in the Rand study said they might have experienced a traumatic brain injury (TBI) as a result of roadside bombs. The report stated that “according to the Army’s Mental Health Advisory Team, 11. 2 percent of soldiers met the screening criteria for mild traumatic brain injuries, but less than half of these (45.9 percent) reported being evaluated for a concussion.’”
Effects of TBI vary. Symptoms can include emotional problems, vision, hearing or speech problems, dizziness, sleep disorders or memory loss. The study found that of the 1.7 million veterans who have served in Iraq or Afghanistan, about half a million are suffering from PTSD, depression or TBI.
Dr. Jonathan Morley, chief of psychology at Chestnut Hill Hospital, said the symptoms of PTSD and TBI often overlap. While the vast majority of TBI’s are mild or moderate, these invisible injuries often contribute to issues related to mental health.
“The problem is both TBI and PSTD don’t just have one pattern, and that often makes diagnosis difficult because not every traumatic brain injury from any source gives the same exact behavior, emotion or cognitive response every time,” Morley said. “We are just beginning to realize that trauma to the brain – even some we thought were completely reversible – has lasting effects. The problem is we don’t know where the line is, and its not the same in everybody. There is a lot of individuality in how people respond to trauma, both physical and psychological.
Morley said doctors used to believe only people who became unconscious after trauma to the head had a concussion.
“But, we have now discovered more recently that blows to the head that aren’t that bad still can do damage, especially if they are repetitive and cumulative,” Morley said. “Traumatic brain injury sets in motion some degenerative process that can take many years to manifest, unless the injury is so great at the time that you have so much damage that you are symptomatic right from the start. The brain is more susceptible or has a mild dysfunction that means it can’t recover from the second blow as well as it could recover from the first injury.”
“The ramifications of ignoring signs of PTSD, depression and TBI are often devastating: suicide, substance abuse, domestic violence, depression, divorce, homelessness and unemployment,” according to Morley.
Removing Barriers to mental health services
The Rand study reported that “only about 1 in 3 soldiers and Marines who screened positive for PTSD once they got home reported receiving mental health care.” The study cited a shortage of trained mental health staff, inadequate screening process and the stigma associated with mental illness as the primary reasons.
Many veterans do not seek counseling because they are concerned about the effect of a mental health diagnosis on their career. – a fear that is hard to deny when the Department of Veteran Affairs “Fifth Annual Report for the Department of Veterans Affairs Undersecretary for Health’s Special Committee on Post-Traumatic Stress Disorder” admitted that “’no one seems to expect them [soldiers] to answer truthfully.”
And the results are tragic. A recent report found that veterans are killing themselves at a rate of one every 80 minutes.
“America is failing our nation’s heroes,” Paul Rieckohoff, founder and CEO of Iraq and Afghanistan Veterans of America said in a statement. “We need strong leadership, innovation, empathy and – most of all – urgency to change this tragic trend. As a nation, we cannot continue to allow men, women and children of our military and veterans families to fight this battle alone. We need reinforcements.”
In 2009, IAVA fought to pass a bill mandating that every returning service member be screened for mental health injuries. But much work remains to be done to help vets get the services they deserve and desperately need.
Jason Hanson, senior program manager for health programs at Iraq and Afghanistan Veterans of America, said people can help by supporting legislation that will ensure that veterans receive the benefits they deserve. One such bill is the Mental Health Access Act of 2012. The bill, which is sponsored by Sen. Patty Murray (D-Washington) would improve mental health and suicide prevention services provided through the Veterans Administration.
The Mental Health Access Act of 2012 requires the Department of Defense to create a comprehensive, standardized suicide prevention program, expand eligibility for a variety of Department of Veterans Affairs mental health services to family members, strengthen oversight of DoD Mental Health Care and the Integrated Disability Evaluation System, improve training and education for health care providers, create more peer-to-peer counseling opportunities, and require the VA to establish accurate and reliable measures for mental health services.
“It is often only on the brink of crisis that a service member or veteran seeks care,” Murray said in a statement. If they are told ‘sorry, we are too busy to help you,’ we have lost the opportunity to help, and that is not acceptable.”
Looking to the future
Kelly said he was fortunate to have a friend who was a Vietnam veteran he could talk to.
“It was easy to talk to Ron because he understood everything I was going through,” Kelly said.
He said Jenkins encouraged him to seek short-term counseling.
Kelly said he still gets nervous sometimes in crowded places and loud noises till bother him, but he is focusing on his future.
Currently, Kelly is studying nursing at Montgomery County Community College. He plans to attend Gwynedd-Mercy College in September. Kelly currently is a combat medic in the National Guard. He wants to continue his career in the Army. After earning his nursing degree, he hopes to become a commissioned officer.
Kelly said at times it can be difficult studying because he has trouble remembering things.
“I am very forgetful now,” Kelly said.
He said they were originally supposed to get a CAT scan when they were checked out, but the doctor wasn’t there. Kelly added that the Army did perform a test to check basic neurological functions.
“I probably should have said something, but I just wanted to go home,” Kelly said. “I didn’t want to get stuck there.”