An admission

admission [ədˈmɪʃən] noun

5. A voluntary acknowledgment of truth.

A few months ago I went to the eye doctor, and something that happened during that visit got me to thinking about doing this blog. I decided then to drop it — honestly I’ve gone back and forth on writing this one for quite some time — but then today I read an article in Time Magazine, and suddenly it seemed like the time was right.

I’ve never been much for going to the doctor and will try to avoid it as much as possible, even to the point of suffering through something that could probably be cleared up with a few pills. This drives my wife a bit crazy, but I suppose others have worse vices.

After retiring from the military in 2003 we enrolled in the medical plan offered at the base clinic; my wife works on base and it is very convenient for her for appointments and prescriptions. I avoid the doctor as much as possible, so it didn’t matter to me: I could avoid military docs as easily as civilians. But there have been times when going to the doctor was unavoidable, like my visit to the eye doctor, and there is a moment in those unavoidable visits that I have had a problem with. 

*  *  *

The moment is during the pre-doctor visit with the medical assistant, an enlisted Sailor in the Hospital Corpsman rating. The Corpsman takes vital signs, asks the same inane questions they always ask:

  • Do you get five or more servings of vegetables a day? Actually, I try.
  • Do you exercise regularly? Haha, noooo.
  • Do you drink or smoke to excess?  Not anymore and never have.
  • Are you under greater than normal stress? Haha, define ‘normal’ stress for me.

And then they ask the Big Question: What medications are you currently taking?

To answer this one, I’ve taken to handing the Corpsman a slip of paper and then looking the other way. Its just much easier that way: the paper has all my medications listed but most of all I don’t have to worry about the look they may give me when they get to the last one on the list.

The anti-depressant.

Yes, I suffer from depression, and take a pill every day to try to keep the juices in my brain in some kind of balance. The doctor who first prescribed me those pills about a year after I retired initially called them “mood enhancers” but later on, after they kicked in and I’d done some research on my own, we talked more openly about them. I won’t go into specifics about my issues, but I suspect I have always been this way. In a strange way, the Navy, with its rigid routine, well-defined rules and regulations, and clear expectations for success, kept me “inside the lines” as it were. Once I retired, much of that structure disappeared, and I drifted outside the lines.

But even though I understood the need and was grateful to the doctor who diagnosed me for asking the probing questions during a routine visit for something else — a visit scheduled for 20 minutes that lasted nearly two hours — I was deeply embarrassed and ashamed. I was, after all, both a man and had been a Navy officer before retiring: men are supposed to be strong and officers are the leaders in the military hierarchy.

Popping “happy” pills was a sign of weakness, right? Hadn’t I, and every other officer and senior enlisted Sailor I ever served with, always felt a little uneasy about and been dismissive of Sailors who were under “psych review” or had been referred to a mental health specialist? I held a Top Secret clearance for much of my career, and that certainly would not have happened if anyone suspected I was off-balance upstairs, right?

I have known retired officers and chief petty officers who continue to “wear their rank” even when in a t-shirt and sandals, but I have studiously avoided acting like I am still on active duty. I am proud of my service, but that part of my life is now over. Still, I couldn’t help thinking knowledge of this condition would make me be seen as defective, and laughable, to Sailors I once was in charge of.

My wife knew about the pills, of course, and she even went in on her own to thank the doctor for helping me. But when I called my parents, intent on telling them the way I usually tell them big news, by backing into it in a roundabout way, I chickened out after hearing some very negative statements about depression in general and how weak people pop pills for to fix everything these days.

I didn’t really blame my folks, because it would be true to say in my younger days I had some of the same thoughts. But that conversation confirmed to me that the less said publicly the better. My wife and kids were the only ones who really needed to know, so I’ve mostly kept it to myself. The few people outside my family who I’ve told are friends I trust implicitly.

*  *  *

During my recent visit to the eye doctor, I passed the slip of paper to the Corpsman and carefully studied the abstract artwork on the walls. This Corpsman was a second-class petty officer ashore recovering from a knee injury suffered on his ship, and during the first part of my check-in we had some fun talking about sea duty and complaining about the latest round of Navy uniform changes.

All in all it had been very relaxed, he treated me respectfully as a retired officer and I returned the favor to a Sailor who looked and acted sharp. Handing him the slip of paper, I wondered how his opinion of me might change. Surprisingly, when he came to the anti-depressant on the list his comment was: “This is one I’ve been seeing more and more of, practically every day as a matter of fact. Seems like everyone is on it now.”

I was floored. The Corpsman said it without prompting and with an even tone, just like we were back to discussing uniforms or shipboard food. I finished my appointment and went home, feeling pretty good, as if in some way a huge weight had shifted.

But later that night I began to worry. What is going on in the Navy? Why are so many taking anti-depressants? Is it the wars in Iraq and Afghanistan? Constant fears about deployments, terrorists, promotions? The sinking economy?

The Navy has changed dramatically since I retired, and I believe it is safe to say the entire military landscape has shifted in the past decade. There are tremendous pressures from constant warfare, higher tempo of operations, and separation from family and friends. The real rub is that you spend an enormous amount of time preparing for deployment — and really, most of the fun stuff you talk about for years after happens on deployment — but it is also the loneliest and most guilty you’ll feel in uniform. You want to do what you’re trained for, what you signed up for, but at the same time that means leaving your family and/or support system behind, missing birthdays, births and anniversaries, not being there when the car dies or the kids need medicine or someone to talk to.

The services are getting smaller, and budgets tighter, which means competition for promotions and the jobs and schools that can lead to those promotions is fierce. And don’t kid yourself that government employees and their families don’t feel the economic downturn the same as their civilian counterparts. Military families are homeowners too, so the mortgage crisis hit them just as hard, and even in good times most need the non-serving spouse to work just to get by. The pay and benefits are good, yes, but not great; no one in uniform is getting rich and the retirement plan has been watered down several times since Vietnam, and is likely to be changed for the worse again.

The military is a reflection of society, and our society has indeed seen improvements in all forms of health through pharmacy. So I suppose it is no surprise that the use of anti-depressants in the military has skyrocketed … but it is troubling. I resolved to write something for this blog about it, but then the old fears of being looked at differently, or thought of as somehow “less” came to mind.

I did what I have done for nearly ten years: I filed the idea away and continued to hide my condition.

*  *  *

Then late last week I saw the advance cover photo of the new Time Magazine issue, and when it became available I bought and downloaded a digital copy. I encourage everyone to do the same. The cover story “One a Day” details how one U.S. Soldier commits suicide every day (Note on the link: a subscription is required to read the full article; or you can do what I did and buy a copy at a newsstand or by digital download). More troubling figures from the story:

  • For all veterans of military service the total is one suicide every 80 minutes, around the clock.
  • More servicemembers have died by their own hands since the war in Afghanistan began than have been killed in action there.
  • Military veterans comprise 10 percent of the country’s adult population but account for 20 percent of the suicides.

What shocked and saddened me more than anything is the knowledge that of those suicides one-third had never been deployed to Iraq or Afghanistan, and half made just one deployment. The “easy” answer, if there can be one, is to blame our constant warfare since Sept. 11, 2001, but that does not appear to be true. More is at work here, and while the top leadership of the military are aware of this issue, and have taken some steps, are those steps enough? What more can and should be done?

In any organization the size of the Defense Department there is a delay from the time a policy is declared to when it hits the deckplates. There is an additional delay from when the average Sailor or Soldier hears “the word” to when it becomes ingrained into the culture. Right now the brass is talking and looking for solutions, but are the men and women nearest to the problem believing and embracing what is being said?

A very disturbing story is told in the article by the wife of a Army officer who killed himself. She contacted his superior to discuss the possibility of ordering him into treatment, knowing he would likely not agree to do so voluntarily. The commanding officer handled the situation about as poorly as could be — this was in a medical facility, of all places! — and in the end practically blamed the wife for creating marital stress that could be affecting her husband’s job performance.

What will it take to get the middle managers, the junior and mid-grade officers and senior enlisted, to believe and embrace what is coming down from the top? Because those in leadership positions in the middle of the pyramid, people like I was, are the ones with the most control over turning any policy into action. I hope those officers and senior enlisted leaders quickly become more enlightened on this subject. Unlike when I was on active duty, with the numbers of suicides we’re seeing today, they do not have the luxury of being uneasy when mental health issues are discussed.

*  *  *

The anti-depressant I’m taking is not a miracle cure. Some days I don’t feel as well as others, but for the most part the meds have evened out the bumps. The highs, for me, were never as plentiful as I would have liked before and now they’re not that high. But at the same time the lows don’t last as long, or get as deep.

There is a price to be paid, of course. What I do now, writing, is mostly creative and the meds blunt that; sometimes it seems my imagination is hazy, like an unfocused camera. I find it best to work on ideas right away after getting them; wait too long and the spark of that idea, what made me think it would work or be interesting, will be gone. ‘Frustrating’ does not begin to describe how it feels at times.

There are other costs, too, but so far, for me at least, the price has been worth paying. I hope others read this and decide the same thing: the price of living is worth paying, no matter what the cost. Admitting you need help is the toughest step, and one that cannot be skipped.

Once the person has made that leap, has admitted they need help, support and assistance must be available. Too much is at stake.

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3 responses to “An admission

  1. Wow what a wonderfully eye opening and honest post. My husband was in the army for 6 years, 2 deployments and I worried about him being depressed or suicidal often. I hope this helps get the word out to others, asking for help does not make you weak, it makes you stronger! Thank you so much for sharing!

  2. A very well written, insightful piece. There’s so much that can be said in response. I can start with the fact that the increase in use of anti-depressants by those in the service likely mirrors that of society. Almost everyone I know has been “offered” a prescription for some version of them (some found the medication helpful, others declined and improved through other means). While I know the medications can do good when prescribed properly, they also do harm. Certain types of those medications increase the risk of suicide, so it may not be the lack of the medication that is the cause of the “One A Day” phenom you mention, but rather, the use of them and/or their having been improperly prescribed or poorly monitored. I’ve often wondered how anyone can come through the perils of war and then return to blend into the droll existence of our mostly trivial times. From your research, it appears what I suspected is true — most cannot, and cannot be expected to. I also wonder if the type of training most receive in the military (i.e. worst-case-scenario variety) might have something to do with the subsequent increase in depression. I applaud your courage in sharing this story and appreciate your insight. I have long hoped that the medical profession would take a harder look at what they now dismiss as simple “depression.” I believe something much more complex is going on. I hope you’ll continue to share your experiences and creativity in written form, on both your good and bad days. I suspect whatever you convey will be a worthy read. 🙂

  3. Wow, Scott, thanks for this insightful article. The epidemic of suicides in our military is indeed shocking and something that needs to be addressed at a broader and more open level by the military and the DOD. We can’t let this type of issue slip through the cracks as so many interpersonal issues affecting soldiers do.

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