July 2021
A mother’s warning about PTSD and moral injury

On March 17, 2021, about 6:30am, my life ended. With one small sound, my whole world completely imploded.

I was at my 26-year-old son's house. He'd barricaded himself inside. My brother and I were trying to figure out how to get to him without escalating the situation. He was in a dissociative state, not himself even slightly, and we couldn't reach him either mentally or physically. Then he stopped talking at all.

Shortly after, there came a small, abrupt sound that I knew to be a gunshot. I felt my heart shattering, even as I ran to where he was sequestered. Knowing the situation could no longer get worse, we yanked him out of the “foxhole” he’d made for himself and began to work him. My brother, a medic, got him breathing again, but we both knew it was just a physical response. HE was gone. My handsome, smart, capable, amazing, firstborn son. One of the most incredible men I've ever known. Gone.

That devastating morning began my pilgrimage into learning about PTSD and moral injury. No one in our family was truly educated about mental health issues. I've spent 20+ years in various capacities of law enforcement; my brothers, roughly the same as firefighters. First responders are taught “signs” of suicidal behavior. My son exhibited not a single one. As I've unwillingly embarked on this journey I never wanted, never dreamed I would take; I've learned that there were, in fact, signs for us to see — if only we’d known they were signs.

A good life, except

Shortly after high school, my son began his journey to become a US Army Infantryman. He was assigned to the 101st Airborne. At 19 years old, he deployed to Afghanistan. He was a sniper, leading a scout team that saw much combat. When his unit returned, the Army sent them to “counseling”; where guys who’d previously been drilled to be emotionless were expected to talk openly about what they'd experienced. It didn't go well. But although he refused to talk much about deployment, he seemed fine.

My son was incredibly strong and well adjusted. Upon his transition to inactive duty, he came home to the town he loved, where he was born and raised. He was happy; engaged in his life and family, accomplishing his goals. He hired on at the same fire department as his uncle. But he'd gone full circle — from responsibility for eliminating “bad guys” to responsibility for saving them, allowing police to deal with their transgressions. It didn't occur to anyone how difficult a mental transition that might be.

He married the love of his life. They had two perfect, adoring kids. He had an extremely close, loving family; he was living the life he'd always wanted. But slowly, struggles began. He occasionally “freaked out” (a dissociative state, I learned), becoming very angry, doing and saying things that he normally never would. He’d threaten suicide and/or violence, then drive off by himself; coming back within a few hours, remembering none of it, and back to normal.

Obviously, it was a sign that something was wrong. We talked with him, but not remembering the incidents, he didn't believe there was truly a problem. After his post-deployment experience, he saw counseling as useless. Nonetheless, we arranged a meeting for him with someone who could help, and things improved for a while. Truthfully, though, we didn't know what we were doing, where to even begin, or how to convince him he needed help. He was a hard worker, his family’s sole provider. He always had another shift or something else “more important.” He put his own wellbeing on the back burner. 

“I can handle it”

He didn't take what was happening seriously enough. He knew he was strong and could handle it. I never doubted that he could manage alone but thought getting help would make it easier. No one, including him, expected it to get so bad, and certainly not as suddenly as it did.

The week leading to his death was a difficult one. There was an Army anniversary that he wouldn’t discuss, bad calls, long, tough shifts at work, significant sleep deprivation, and other emotional stressors. Alone, any would have, and previously had, been manageable; but having them all coincide created the perfect storm.

He went into another dissociative state. This one lasted nearly 24 hours, culminating in his death. It was very different. He came out of it long enough for a couple brief communications that were him before going right back in. During those few brief periods of “him,” he did remember. He indicated he “needed help,” he said twice he “didn't want this,” that he’d “been taken over” and “tried to stop it.” But this time, the dissociative state was so deep, its grip so tight, that he couldn't overcome it long enough to ask for the help he finally knew he needed.

That awful morning, he was still dissociated, blatantly not himself. Later, digesting those few lucid communications led me to understand that he’d sacrificed himself to protect his family. Realizing when he was “taken over” he couldn’t regain control, knowing his own capabilities, he refused to risk hurting someone he loved when he wasn’t himself. He had a strong relationship with God, was steadfast in his faith. He was never afraid to die, knowing with absolute certainty where he was going. He’d always made it his mission to protect his loved ones from everything. His family was his entire world, he'd do anything to protect us all. Ultimately, he did.

In the days immediately following hisdeath, I grudgingly agreed to counseling. I was certain it would be a monumental waste of time. Nothing could help me. I was inconsolable and completely broken. But I wanted to understand, so I tried. And I learned.

A developing brain

That first appointment came with an enormous light bulb. The counselor explained how the human brain doesn't fully develop until the mid-late 20s. She clarified that it wasn’t emotional maturity, but rather actual, physical maturity; some of the pathways in the brain aren't fully formed until then. So, what did this mean? ell, for us it meant that my 19-year-old son and his un-fully-developed brain had gone to war and done his job. He eliminated enemies. It was justified. It was righteous. And it was fine — until it wasn’t. The problem arises when the brain matures.

This illuminated why he was fine initially and only as he entered his mid-20s did problems begin. When the brain matures, it can lead to “moral injury,” which “… involves psychological and spiritual wounds that result from experiences that conflict with one’s deeply held beliefs of right and wrong. This is not a mental disorder,” says Dr. Katinka Hooyer in her documentary film on the subject, Almost Sunrise.

For my son, it meant that while he had done what was necessary, he began to see the enemies he'd eliminated as fathers, sons, brothers, grandsons, uncles, etc. He related to all those roles, because he held all those roles. This led to his moral injury. While consciously knowing he'd done nothing wrong, his subconscious was at war within him, trying to reconcile his actions with his beliefs, with what was important to him. He didn't know about moral injury, had no foundation from which to recognize what was going on inside him.

I, like him, knew none of this. None. I would guess that most people don't. If I'd had any idea that this was possible, I would never have allowed myself, or him, to believe that being strong enabled him to handle it. If I’d known that it wasn't an ordeal to “deprogram” soldiers returning from deployment through trauma treatment, using EMDR therapy, and prevent this problem, I wouldn’t have rested until my son had done it. Even though the Army didn't offer it. Even though the VA didn't offer it. It would have changed everything.

But no one said anything. There’s information about it on the VA’s website, but no one ever mentioned it. How would someone know to watch for it if they didn’t know it even existed?

Moral injury and PTSD aren’t limited to the military. First responders experience it too. But so can anyone. I'm far from being an expert on any mental health issues, but I can relay what I've learned. I can relay how our family got here. 

My son loved to help others. Through his story, I hope is that he can continue to do so. I pray that something in these words will stick with you, help you recognize signs, enable you to realize the danger, and spur you to take action.

Take it seriously

Don't assume that the lack of “traditional” suicidal signs means someone is okay. Do NOT ignore “weird things that seem to resolve themselves. They don't. Be diligent in looking for anything abnormal — and be honest about what you see. If you're unsure whether something might be, or lead to, trouble — address it. Don’t wait. Don't tread lightly for fear of angering someone. Speak up, force the issue, do whatever it takes.

Please be proactive. There is help — you just have to know about it. Tell everyone you know. Talk about this. Educate yourself. Educate others. Make this common knowledge. It’s now painfully clear that we must take the initiative. It’s not something to hide from or pretend doesn’t exist – because it does. It isn’t something that only happens to “other people.” Just ask me. I know. DO. NOT. BE. SILENT.

Resources

Almost Sunrise, documentary about PTSD and moral injury. Available for rent/purchase on Amazon.

Direct link to the film’s discussion on moral injury

National Center For PTSD: ptsd.va.gov

Veterans Crisis Line: 1-800-273-TALK (8255), option #1

Prescott Vet Center: 928-778-3469 or DSVT.az.gov

Start Moving-On Counseling and Trauma Therapy: 928-910-5145 or startmovingon.com

Mighty Oaks Foundation: mightyoaksprograms.org

Gary Sinise Foundation: garysinisefoundation.org

Mission 22: mission22.com

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