War's pain comes home

[SEATJERKER]

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...writer.
First published: Sunday, November 12, 2006

For nearly a year, Christopher DeLara sped ruthlessly around Baghdad's lawless streets, riding adrenaline and paranoia as he dodged hidden bombs and insurgents.

But 18 months after his return to the U.S., doctors no longer allow the Army administrative specialist- turned-gunner to get behind the wheel.

The 33-year-old veteran's readjustment to civilian life is tormented by sudden blackouts, nightmares and severe depression caused by his time in Iraq. Since moving to Albany last June, DeLara accidently smashed the family minivan, attempted suicide, separated from and reunited with his wife and lost his civilian driving job.

"I go from a job where I'm taking care of everything to coming back and being lucky if I know who the hell I am, or don't have a breakdown," DeLara said from his living room couch, his eyes glazed and droopy from prescription drugs.

DeLara is among more than 38,000 Afghanistan and Iraq veterans fighting war's invisible wound -- post-traumatic stress disorder.

The twin post-9/11 conflicts are generating a record number of PTSD cases, and the skyrocketing number of troops seeking care has Veterans Administration hospitals scrambling to provide increased services for the disorder.

previously as shell shock or soldier's heart, psychiatrists officially diagnosed PTSD in 1980. While almost all combat veterans experience stress, PTSD patients suffer long-lasting trauma and relive their wartime experiences until their mind and body cannot cope.

Many suffer problems at home, and some turn to drugs and alcohol to self-medicate.

The number of Iraq and Afghanistan veterans getting treatment for PTSD at VA hospitals and counseling centers increased 87 percent from September 2005 to June 2006 -- to 38,144, according to the U.S. Department of Veterans Affairs.

At least 30 percent of those who fought in Iraq or Afghanistan are now diagnosed with PTSD, up from 16 percent to 18 percent in 2004, said Charlie Kennedy, PTSD program director and lead psychologist at the Stratton Veterans Affairs Medical Center. Of the 400 Capital Region vets in the program, 81 served in Iraq or Afghanistan, Kennedy said, and that number is growing.

The new generation of Middle East vets now account for 40 percent of monthly referrals, compared to 20 percent in 2004-05, Kennedy said.

The hospital treats PTSD with individual and group psychotherapy, and antidepressants like Zoloft in more severe cases.

"This kind of warfare is devastating," Kennedy said. "You don't know who is your friend and who is your enemy."

Treatment can be difficult

DeLara's experiences provide a glimpse into the imperfect world of PTSD treatment. Some discharged troops can't find adequate resources and counseling because of bureaucratic mix-ups or due to the nature of the ailment itself.

For DeLara, a life filled with postwar trauma never entered his mind when the Iraq war started. He was prepared to do a job. Rippin' to go.

"We were kind of pissed we weren't part of the first wave into Iraq," DeLara recalled. "We were all excited, but at the same time, nervous. I don't think we really knew what we were getting in to."


The slim, 5-foot-6 soldier grew up in Poughkeepsie and met his wife, Cathy, at Schenectady County Community College. In 2000, he enlisted in the Army. The military offered structure, a career and money to support his new family.
Although he signed up for four years of duty, the Army kept him until June 2005 through a "stop loss" order, which has held thousands of U.S. troops in combat zones beyond the length of time they signed up for.

DeLara had no prior history of mental illness when he and 90 soldiers with the 1st Calvary Division Engineer Brigade convoyed into Iraq in early 2004.

DeLara, stationed at Camp Liberty near Baghdad International Airport, provided transportation and security for senior officers. His part-time assignment was tracking U.S. injuries and deaths, typing casualty and award letters for the soldiers' families.

Stress builds in daily life

Last spring, he returned to Fort Hood in Texas a healthy, if disillusioned, man. The residual buzz of war, Army base life and the constant meetings to get discharged kept DeLara "in Iraq mode" for months.

After his discharge, he, Cathy and their young triplets -- Lauren, Lauri and Christopher -- moved to Albany to be closer to Cathy's family.

The couple rented an apartment and lived on savings from DeLara's Iraq service while they searched for work. Idleness and stress crept in.

"Sitting at home wasn't real to him," said Cathy, 35, who has a master's degree and eventually landed a job as a music teacher at Albany city schools.

DeLara began experiencing Iraq-related nightmares and severe mood swings. "My driving was horrible, really fast, and no rules, like in Iraq."

Driving alone in Greenfield in late June, he lost his concentration making a left turn and was struck by a vehicle going 55 mph.

He escaped with bruises, but the shock of the accident shook him up badly.

"It all came crashing down from there," Cathy said with a sigh.

As his nightmares and insomnia intensified, DeLara denied needing help.

"I guess you could say I was too proud," he said. The couple separated for three weeks while DeLara stayed at a friend's house.

"We were fighting, and he was having a hard time adjusting to all the kids and financial difficulties," Cathy said.

But DeLara's deteriorating condition shocked and worried her. Cathy went to Stratton VA Medical Center for advice. DeLara agreed to meet Kennedy, the lead psychologist, but the session didn't go well.

"It's not easy to talk about," DeLara said. "Talking about it is disturbing. It bothers me. When you talk about it, you relive it," especially in nightmares. It is Cathy who patiently urges him to talk about his predicament.

A sudden breakdown

DeLara tried to work his way out of the hole. In August 2005, he took a job as a heating and air conditioning technician. Though his difficulties continued, the family bought a house on Cambridge Road. Maybe now, they hoped, the worst of their troubles were behind them.

this spring. DeLara's confusion evolved into anxiety and anger at the war, the Bush administration, the VA and his disorder.
In June, DeLara erupted in a surprisingly loud verbal outbreak, drawing police and EMTs to his home. He was hospitalized at Stratton for four days and medicated for PTSD.

He spiraled down. At home, the blackouts continued. One time, he passed out, cut his chin and needed stitches. Blackouts made it too dangerous to drive, doctors said. They ordered him to quit his job.

In September, Cathy had to call an ambulance to pick up DeLara at a McDonald's. He'd forgotten where he was, and how to drive the one mile home. Afterward, at Stratton, doctors discovered the medication DeLara was taking had caused a liver malfunction. They gave him a different drug.

A few weeks ago, DeLara shocked even himself. He doesn't quite remember why, but he downed a handful of sleeping pills, vodka and wine. He woke up in the Stratton VA hospital.

Doctors opted to keep DeLara at Stratton for a week to try new medication, but his doctor took a two-week vacation without supplying a prescription, the DeLaras said. They left the hospital feeling hopeless.

Neither VA doctors nor counselors told DeLara he could apply for military compensation toward his PTSD disability until his suicide attempt, almost a year after his initial VA visit, the couple said.

"No one told us he could get service-related help," Cathy said. "There just hasn't been any help, and we've gotten to the point of crisis several times."

Complex process

Officials at Stratton would not respond to specific medical cases, citing privacy laws. But they boast that the Stratton VA center in Albany has the most experienced PTSD clinicians in the region, who provide new outreach programs to catch cases like DeLara's.

Workshops at the medical center instruct military families about how to get treatment, and it increasingly collaborates with the Albany Veterans Affairs Veterans Center, a separate resource for veterans that offers free counseling, job-seeking services and housing assistance to all veterans, Kennedy said.

DeLara said he feels more comfortable talking at the Vet Center because some counselors there are combat military veterans and can relate to what he's seen.

New York Army National Guard Maj. Matthew Tully, a Colonie attorney who helps veterans get benefit claims filed, said the process of applying for VA disability compensation for PTSD has grown arduous and lengthy.

Tully, 32, served in Iraq and experiences flashbacks of mortar attacks and small arms fire. Diagnosed with a 30 percent PTSD disability, Tully began receiving benefits about 12 months after filing.

But to get such prompt compensation, veterans need a medical diagnosis, plus proof the disorder is related to military service and has a quantifiable impact on their lives. The review process to get claims approved can take years if soldiers or Marines don't know the system, Tully said.


If vets suspect they have PTSD, Tully advises expediting the diagnosis by seeing a private doctor.
"The VA is going over and above what it did for Vietnam and Korean vets, but unfortunately it's falling way short," Tully said.

Reaching out to veterans

Kennedy said the center recently approved a sixth mental health care provider, up from two in the late 1980s. Most critically, it hired social worker Jennifer Audette in December as part of the nationwide Seamless Transition Program.

Audette's job is to leave the office and go to military events to reach and educate troops and their families about PTSD. The increased outreach has made Iraq veterans more aware of PTSD and more willing to seek help, Kennedy said.

In response to the growing demand, the center is seeking a case management worker and training military chaplains to do more outreach, Kennedy said. "We realize large institutions are difficult to negotiate."

But a lot of veterans are frustrated by recent cuts to VA services, said Edward Tick, an Albany psychotherapist and PTSD author.

"The VA is caught, unfortunately, in between its task of being answerable to the federal government and its more noble task of serving vets," Tick said.

The VA and Department of Defense acknowledge "we haven't done this transition thing as well as we would have liked in the past," said Lorn Gingrich, a Stratton social work executive.

The Stratton VA is working to hasten claim forms, he said.

Caught between two worlds

For DeLara, who expected a military career, life is a daily struggle.

He and Cathy are trying to raise their 6-year-olds, including an autistic son, on her salary alone. DeLara's disability payments from work haven't kicked in.

The paperwork he received from Audette to prove his disability sits unmarked on the kitchen table. Filling it out would stir up too many painful memories, DeLara says. And the claim approval could take years, he says.

Like lots of vets, DeLara lives a paradoxical life, still caught between two worlds. He hates watching the news and being asked if he ever killed anyone in Iraq. But he keeps pictures of burned corpses from Iraq to remind him of his stay there.

He tries to plan a post-military life and recently signed up for classes in human services at Hudson Valley Community College, paid for by the GI Bill. He continues playing drums for a local band named Wait Until Dusk.

But the family is waiting for the sun to rise again.

"I believe in us, our relationship," Cathy said on a gray November afternoon. "We've never not loved each other. But there's been really tough times, and it's traumatic for the children to see him angry, upset and depressed. I'm just trying to hold everything together."

Dennis Yusko can be reached at 581-8438 or by e-mail at dyusko@timesunion.com.

...TBC,...

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[Robert Ryan]

The beast is alive and thriving again. Destroying the victims, and destroying families. It just keeps killing in one way or the other. And all it does is continue to grow, and enjoy doing it.