When Service Members Need Mental Health Help

Baghdad in 2007: Ryan Rigdon, then 24, held his life in his hands, but it was all in a day's work. As a Navy senior explosive ordnance disposalman, his job was using robotic technology to disarm roadside bombs. He had volunteered, received extensive training and was deployed to Iraq right after the U.S. military surge.

"The first day I was there working we had seven roadside bombs we had to take care of," Rigdon says. He and his team cleared post-blast sites where soldiers had been killed. One memorable night, Rigdon left his truck to collect evidence and unexpectedly came upon a live explosive device in some rocks. He had no choice but to disarm the device by hand. How did he keep a steady mind and steady hands? "You just focus on what you're doing," he says. "You can't freeze up -- it won't do you any good."

The carnage only got worse. "We're just responding to incident after incident, and it builds up on you a little bit," he says.

Stress on Two Continents

Rigdon had left a pregnant wife and a daughter behind when he deployed. When his wife was near delivery, he wanted to check on her but communications were down. He met his second daughter at 3-months-old when he returned to South Carolina. While he was there, his other daughter started having seizures.

In 2008, he was redeployed to Tikrit, Iraq. Meanwhile, stress was building back home, as his wife coped with the baby and their daughter's continuing seizures. On top of that, his family was being transferred to Fallon, Nevada, leaving her to deal with the move from Charleston. His wife was always supportive of his career, Rigdon says. But they didn't talk too much about the gritty details. He didn't feel entitled to any special sympathy: "Who am I to complain when I've seen people killed?" And he didn't want to show weakness or fear.

In 2009, Rigdon joined his family stationed on the naval base in Nevada. But deployments and extreme stress had taken a physical and mental toll. He suffered constant headaches and tinnitus from repeated blast exposure. And he was on the path to developing post-traumatic stress disorder.

PTSD can occur after witnessing or experiencing lift-threatening events, including military combat. Symptoms include reliving the trauma in flashbacks and nightmares, and feeling edgy, irritable and constantly on guard, making it hard to sleep. Depression, anxiety and substance abuse often co-exist with PTSD -- and job and relationship problems can follow. About 11 to 20 percent of those who served in Iraq or Afghanistan have PTSD in a given year, according to the U.S. Department of Veterans Affairs. Counseling, including cognitive behavioral and exposure therapy, can help, and some patients benefit from certain types of antidepressants.

Silence No Longer an Option

By 2011, Rigdon says, "I finally had to get help because I was freaking out." And his wife and kids were paying a price. "I'd be flipping through the house at night, thinking something was in there, you know, just going nuts," he says. "I just had crazy dreams that something was going on, so I flipped the bed over."

Rigdon was drinking a lot. "I was actually using alcohol to calm me down," he says. "I was having panic attacks. I know alcohol wasn't the right drug to use, but I was also too proud to ask for any pills for a long time."

Mistrustful of the military medical system ("it's hard to know what they'll write down in your file") and afraid of losing his security clearance, Rigdon sought counseling from a civilian therapist. After several sessions, his therapist wrote a letter to the military requesting he be separated from active duty. In May 2012, Rigdon was medically discharged and placed on the Navy's Temporary Disability Retirement List. That, he says, meant the possibility of later being deemed fit for duty -- and losing retirement benefits. He moved to the Dallas area with his family to start a new job.

In Dallas, Rigdon connected with Give an Hour, a nonprofit group in which mental health professionals nationwide volunteer an hour each week to returning troops and family members. Give an Hour was founded by Barbara Van Dahlen, a clinical psychologist. She had seen the effects of untreated PTSD firsthand, both in her father, a World War II veteran, and then in the 1980s working with Vietnam veterans and their families long after the war was over. "They were still reliving war days as if they were yesterday, instead of 25-some years after the fact," she says.

Rigdon was grateful for the counseling he received and says it left him with lifelong coping tools. However, he continued to shy away from taking medication.

Dallas in 2013: Ryan Rigdon held his life in his hands, but now it was personal. PTSD, family alienation and financial and future uncertainty had all converged. "You know, my head's all jacked up, my ears hurt all the time, my body hurts all the time," he says. "I was just tired of it. I was letting my family down; I was feeling worthless."

One night he was crying in bed while his wife slept. He got up and went into the bathroom, where he was moments from taking his own life. The weapon was in his hand, but the thought of his wife or daughters finding his body stopped him.

The next day, Rigdon confided in a coworker -- a retired Army man. "And he's like, 'Dude, we need to get you to the VA,'" he says. Rigdon went, and started medication with Prozac, which he's been taking since. "And it's really, really helped," he says.

Preventing the Worst

The United States has been at war for 13 years, and military suicide rates have been rising. In 2011, the U.S. Department of Defense created the Defense Suicide Prevention Office. "For the last decade, the Department of Defense has seen an increase in suicide over time," says DSPO director Jacqueline Garrick. In the past, the military suicide rate was lower than the civilian sector, but now, she says, the military trends "much closer to the civilian rate."

The latest Department of Defense Suicide Event Report summarizes suicide deaths and attempts by members of the Air Force, Army, Navy and Marines in 2012. Of 522 deaths, 319 occurred among active component members; 203 occurred within the reserve component. Nearly 93 percent of deaths were among men, and nearly 40 percent who died were very young, between 17 and 24. About 29 percent of those who died had revealed thoughts of harming themselves prior to taking their lives. Forty-two percent had a history of a diagnosed mental illness. Slightly less than half had been deployed in recent combat operations. Preliminary data for 2013 show a decrease to 474 deaths by suicide among active and reserve members combined.

Garrick says a major goal of DSPO is "creating streams for health seeking" in partnership with the Department of Veterans Affairs. The Military Crisis line is available to service members, veterans and concerned loved ones at 1-800-273-8255 (press 1), or by sending a text message to 838255.

Career concerns shouldn't keep service members from getting the help they need, Garrick says. "Less than 1 percent of the military has lost a security clearance because of a mental health issue." But she acknowledges that fear "is a primary driving force" in keeping people from seeking treatment. However, she adds, "When you don't get the help that you need when you need it, problems only get worse. And problems that have gotten worse and spiraled out of control leaves us less ability to help, to save a career, to provide the levels of support early."

Peer Support

The DSOP created Vets4Warriors, a program through which military and family members can email, chat online or call trained veterans for peer support, information and referrals 24/7. Mark Graham, a retired Army general, is director of the program's national call center.

Graham has powerful reasons for helping people with this kind of work. In February 2004, he and his wife Carol lost their son Jeffrey to a bomb blast in Iraq. In June 2003, eight months earlier, their younger son Kevin, a college student and Army ROTC cadet, took his own life. Today, he says, the military is making progress in reducing stigma and encouraging openness about mental illness, in an ongoing effort to break down barriers to mental health care. And countless groups and initiatives, many civilian-based, are working to connect people to care.

"You read a lot about the number of suicides, and the number is high," Graham says. "But one thing you'll never know is how many people have not died by suicide because of all the work organizations are doing."

Nobody's Immune

Today, Ryan Rigdon, now 32, says "things are really good. My wife is happy and my kids -- they're awesome kids; they're extremely happy -- we've got a beautiful home here in the Dallas area. You know, I'll probably be on medication for the rest of my life, but I'd rather do that than go back to what I used to be."

His advice to service members like him who are struggling: "If you come from a Special Operations type of community, don't be too proud to ask for help. Everyone has their breaking point; everyone eventually needs something. I wish I would have never taken as long as I did to get it."

Lisa Esposito is a Patient Advice reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at lesposito@usnews.com.