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Brigadier General (Ret) Stephen N. Xenakis, M.D.

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PBS's 'This Emotional Life': Memorial Day -- Remembering Military Suicides

Posted: 05/31/10 09:28 AM ET

For some families, this Memorial Day will be especially hard. Their loved ones -- spouses, parents, sons and daughters -- didn't die the hero's death. They were one of 160 soldiers last year who committed suicide, despite the military's unprecedented effort to stem the tide.

How does it happen? After surviving harrowing combat, why would a young soldier decide to take his or her own life? The Army is spending $50 million to figure it out, and we may get an answer in a couple of years. But for some, that will be too late.

While no one can truly understand the tormented heart and mind that would lead someone to actually pull the trigger, swallow the pills, position the rope that will end a life, there are some conditions that can certainly explain the despair. The story of Ryan' Doc' Krebs, featured on The Wounded Platoon (Frontline May 18, 2010), gives some clues.

'Doc' Krebs had spent two tours in Iraq as an infantry company medic and he saw more than his psyche could possibly handle. His favorite sergeant died in his arms and too many friends lost their lives to IED's and snipers. He asked for help from mental health, but didn't get what he needed. A little medicine and encouragement to go back to the front, his buddies needed him.

When he got back to the States, he slipped into a downward spiral of drugs and erratic behavior that made his life even worse. He was getting medication for depression and PTSD, but it did little to alleviate the depression, the anxiety, the horrifying flashbacks of combat, the paranoia. So 'Doc' Krebs tried to kill himself, but failed. His story does not actually have an unhappy ending. After several years and some luck in getting into treatment, he is attending group therapy, off most of his medications, and his mind feels clear. He is lucky that he didn't die. But what he lost is unable to be calibrated.

His story, while individual, has universal themes. He was traumatized. He reached a crisis point where there were no means of escape, not a glimmer of light at the end of the tunnel. Sadly, there are too many young men and women who share his experience: they wake up in agony and can't imagine that this day will be any different from the day before. And the response from the military has been well intentioned but often ineffective.

When I talk with some of these troubled soldiers, I am reminded of a young man I saw many years ago when I started my practice. He was 24 years old and had been brought to the emergency room because he tried to kill himself. As far as he was concerned, his biggest problem was that his suicide attempt failed because he had severe cerebral palsy and could not move his arms and legs to even eat. He begged me to help him die. He was a prisoner in a body that could not function, while his mind was agile and ambitious and frustrated and tormented.

These soldiers who want to kill themselves are imprisoned by their experiences. Terrified by nightmares, they can't get out of the fog created by drugs and medications designed to alleviate their pain. Their intimate relationships fall apart, and they get into trouble with the law. Their lives spiral out of control right in front of them. They get talked to, and subjected to lots of lectures about responsible behavior.

Recovery is hard, but not magic. Soldiers like Krebs, and his battle buddies, need a hand when they are falling; and they need caring helpers who will dry them out, be there when they relapse, connect them with peers and help them transition into a more productive and saner life. Certainly the military and many civilian service providers are trying to address the needs of the soldiers, but there is not a uniform system and the demands on the troops are relentless. These young traumatized soldiers need time to get straight and grow up, and fix the mess they have gotten into. But time is the one thing that is in very short supply when a fighting force is overextended.

Not all young men and women who commit suicide fit this kind of profile. Some are just plain reckless. It's hard to tell who can be helped. But, one lesson from the story of 'Doc' Krebs stands out. Simply lending a hand along the way, providing some support in a way that doesn't judge or demean the troubled spirit of the young man or woman goes a long way. The soldier thinking about suicide needs to know that there is hope -- that not all is lost, that there is a personal and professional future. The goodness and kindness of another human being can lift even them up, away from the brink.

Something to remember on this Memorial Day.

 
For some families, this Memorial Day will be especially hard. Their loved ones -- spouses, parents, sons and daughters -- didn't die the hero's death. They were one of 160 soldiers last year who commi...
For some families, this Memorial Day will be especially hard. Their loved ones -- spouses, parents, sons and daughters -- didn't die the hero's death. They were one of 160 soldiers last year who commi...
 
 
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04:42 AM on 06/01/2010
The article asks, "How does it happen?"

Well, quit glorifying war. That's got to be quite a mind warp for soldiers. Also, being in war, and even the training, has got to be a rather f*****d up experience, overall.

When someone commits suicide, we have to ask "How do we keep missing the obvious?".
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Enroh Mot
Veritas Lux Mea
11:00 PM on 05/31/2010
One of the side effects of anti depressants is suicidal tendencies, I was a medic in Vietnam we smoked pot, which doesn't cause suicidal tendencies, it just helps a person to relax.
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11:38 PM on 05/31/2010
I am all for legalizing pot.
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Enroh Mot
Veritas Lux Mea
11:48 PM on 05/31/2010
I'm for making war for profit illegal.
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HamletsMill
All Myth is Astronomy
09:22 PM on 05/31/2010
I always say my brother died in Vietnam, it just took the bullet 12 years to find him in his room.
I miss you Kevin.
10:24 PM on 05/31/2010
RIP, warrior.
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HUFFPOST SUPER USER
filo
We're all Bozos on this bus.
09:10 PM on 05/31/2010
The cost of freedom.

http://www.youtube.com/watch?v=c8ljcPBbMt0
HUFFPOST SUPER USER
edgarcaycedoc
09:06 PM on 05/31/2010
General,

I agree with everything you advocate here. But somewhere between the top ranks and the lower enlisted supervisors, there needs to be education of the nature of mental illness. When I was in the Army and Airforce (six years total) I cannot begin to fathom how many came across my desk who needed, and wanted, treatment. Yet they would not pursue treatment, because it was a career ender, and the "discharge codes" which the dischargee did not know, were known to civilian employers. Once a person seeks "mental help," there career is over, and their prospects for success in the civilian sector are usually severely diminished. The military needs a good education for the first line supervisors and even those in the peer group in which the soldier serves. If we do not assure this, we will continue to have abnormally high rates of suicide.
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11:41 PM on 05/31/2010
Yes. And it may be difficult or impossible for them to get life insurance as a civilian. I don't know how health insurance works for veterans, but if they have to buy their own, it will cost an arm and a leg.
08:31 PM on 05/31/2010
I just heard a report that said 18 soldiers a day committ suicide. I believe they said it was those who served in Iraq. Is this report true?
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Enroh Mot
Veritas Lux Mea
10:53 PM on 05/31/2010
That's Veterans, after they get out of the military.
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HUFFPOST SUPER USER
Jack2011
08:30 PM on 05/31/2010
My cousin, as well as three other young men he served with, killed themselves last year - within months of each other. All good men. They deserve to be remembered.
10:24 PM on 05/31/2010
RIP, warriors.
08:16 PM on 05/31/2010
Some heroes paid with their lives and limbs. Others paid with their minds and souls.

Every soldier who ever served in combat, who willingly went to harm's way for another person, is a hero.
08:24 PM on 05/31/2010
Well said.
10:25 PM on 05/31/2010
May their souls rest where their minds could not.
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08:09 PM on 05/31/2010
disclosures -disclosures
military medicine is an oxymoron. First you breakdown a troop, enable him to kill,
by dehumanizing people and enhancing conflict resolution skills using weapons.
like training an attack dog, and then asking it to play with the kids when they retire.
the responsibility is not to the patient, but the commander and the mission.
subject to policies established and implemented often by civilians who never served.
for good or not, this is socialized medicine, except treatment may vary by grade or time served.
recruits and their families, should be made aware of the consequences of trauma, stress,bad nutrition and toxins.
the experience of an induction physical is now becoming the industrial medical model.
maybe if the public was more aware of the sequalae, the zeal for war might be diminished.
having seen thoracic surgeons who had the courage to balk, when they saw what was expected of them, with modern ballistics, it would be impressive if this was part of testimony to congress or the VA.
curious to know how far forward the General served?
have dd214- didn't ask for hp "medal"
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HUFFPOST SUPER USER
offred
A biocitizen is 3/5 of a corporate citizen
07:34 PM on 05/31/2010
Thank you, Dr. Xenakis. Well said.
06:35 PM on 05/31/2010
We should also start a new holiday: "Collateral Damage Day."
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06:06 PM on 05/31/2010
Finally the suicides are being addressed.

I'm told that the number of suicides is now higher than combat deaths. There is also the issue of the military forcing the wounded to admit that their wounds are a result of a pre-existing condition (sic). If the government and Pentagon that are so generous with the taxpayers' money to fund the killing machines in Iraq, Afghanistan, Pakistan, Yemen and beyond, but will not take care of the soldiers, we can no longer afford this murderous insanity.

This is no longer Bush's war. Considering Obama's initiatives and signed war funding bills, this is now Obama's war. He's supposed to be a smart guy, even a lawyer. Not sure if he understands the world around him, but someone should tell him to take a page from the Chinese and Russians who have secured access to huge natural resources in Africa. WIth negotiations and contracts. Someone should tell Obama about this.
07:28 PM on 05/31/2010
I've been asking myself the question of numbers: how many known suicides since kids started dyin' over there? Why the secrecy about numbers?
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Enroh Mot
Veritas Lux Mea
12:29 AM on 06/01/2010
There's a lot of things they keep secret.
05:32 PM on 05/31/2010
silence is betrayal
silence hurts the heart
05:26 PM on 05/31/2010
'Doc' Krebs experience points out the importance of SIMULTANEOUSLY providing both psychiatric AND psychological intervention to treat mental health patients suffering from depression or PTSD. That is, treatment for those and similar conditions is most successful when it includes both drugs and psychological therapy.

Simplistically, drugs mitigate the symptoms, and therapy gives the patient and caregiver insight into what causes the symptoms and how do deal with them. I may be mistaken, but I sense that the military frequently relies solely on drug therapy.