Tag Archives: mental health care

Try to Understand: The Kindest, Noblest, & Best Thing You Will Ever Do

grant and sherman

Grant and Sherman

Friends of Padre Steve’s World,

The great American Civil War general William Tecumseh Sherman once said of his relationship with Ulysses S. Grant, “Grant stood by me when I was crazy, and I stood by him when he was drunk. Now we stand together.” Having been both crazy, and at times drunk, I can relate to both men, both of whom also often suffered from severe and often disabling depression at different points in their lives.

Yesterday I wrote an article about depression and I decided to follow it up with another on the same subject. Yesterday I mentioned the late Iris Chang and her comments about how depression is not rational, and C.S. Lewis who talked about how mental pain is harder to deal with than physical pain. During my worst phases of depression in the years after I came back from Iraq, I fought every day to find something to hold onto, something to keep me from ending my life. If you have never experienced real depression, the kind that slowly eats away the very fabric of your being, you might not understand. In fact it was something that I really didn’t understand until I went through years of it.

Depression is far different than being sad. It is like the difference between having a cold, which you know should pass, and having an insidious cancer which even if it goes into remission lurks for another chance to strike again.

I think that Elizabeth Wurtzel, the author of the book Prozac Nation, hit what I am describing on the head, “That’s the thing about depression: A human being can survive almost anything, as long as he sees the end in sight. But depression is so insidious, and in compounds daily, that it’s impossible to ever see the end.”

In a similar manner, J.K. Rowling, the author of the Harry Potter books noted, “Depression is the most unpleasant thing I have ever experienced. . . . It is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened feeling, which is so very different from feeling sad. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different.”

I have to agree with both of these writers, depression is the worst. I can live with insomnia, and night terrors, even with anxiety, but depression is the worst, it never seems like it will end. I was fortunate that I got through my most difficult times, including a period just over a year ago where I was nearly suicidal after very bad treatment in the Mental Health Department at the local naval medical center. It took the intervention of my former commanding officer, a doctor named David Lane, who had just been selected for promotion to admiral to get me the help that I needed, but not everyone has that kind of ace in the hole. I wouldn’t have thought of asking him, but his Command Master Chief, and my friend Ed Moreno, intervened, told him of how bad I was doing and that made all the difference. Ed didn’t try to fix me, he just stood beside me and when I needed help, he came through as a friend, and he is still a friend. That is what friends do.

I still struggle, sometimes with depression, but more often the nightmares and night terrors associated with my PTSD. Last night my wife woke me up when in one of my high definition nightmares I was thrashing around trying to defend myself from an enemy insurgent in Iraq. Now mind you, I was never in a close combat situation, but I took part in a number of missions where we didn’t know who the good guys or bad guys were and I was unarmed. But I can live with that, depression without end is far different.

In my worst times I had a lot of people tell me what I needed to do to get out of being depressed. Most were well meaning but didn’t have a clue as to what I really needed. I didn’t need someone to fix me. I didn’t need a checklist of things to make me well. I didn’t need to pray more, or read my Bible more. I didn’t need to work ungodly numbers of hours in ICUs where lives of people were hanging in the balance… all I needed was people who would say I love you, I care for you, and I value you for who you are, not what I want you to be, and will be there for you no matter what, or maybe, let me buy you a beer. Thankfully, there were a few people who did all of those things, and they have been there for me since I emerged from that darkness.

As for the others, who seemed more like “Job’s helpers” it is sometime embarrassing to come across them. Of course I am polite and I do not avoid them. That being said, once you have gone through this, you can see just how uncomfortable that they are to be around you. So those encounters tend to be brief and uncomfortable, as Job’s helpers quickly move along to avoid the awkwardness of the situation. The interesting thing is now I am perfectly fine with their discomfort.

I think that some of the best advice for those who live with, work with, or are friends with a person struggling with depression was written by English comedian Stephen Fry, who said, “Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.” That is empathy in action.

I have a number of friends; classmates, and other people I have served with in the military who this very day just hope to stay alive, to find something to live for. The depression that they feel is often overwhelming. They are wonderful, talented and gifted people, people who have a strong amount of empathy for others, but they are enveloped by a darkness and fog which makes it hard for them to see any sign that the depression will ever lift. I have been there, and now I try to be there for them. For me it comes back to what Sherman said about Grant, If I don’t stand with those who suffer from depression after what I have been through, what good would I be?

Peace

Padre Steve+

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Filed under faith, healthcare, mental health

A Good Day to Speak Truth to Power and to be Listened to

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I have been writing about my recent experiences in trying to get help for my own issues dealing with PTSD as well as my frustration with a military mental health system that is, at least in my view, floundering.

That effort over the past month or so has been quite painful, at times humiliating and dehumanizing, and frankly driven me into a depressed and nearly suicidal fog, from which I am slowly emerging.

Today was a good day. Not just for me but maybe for all of those seeking help at our local Naval Medical Center. Instead of being blown off and shunted aside by providers as well as mid and high level administrators I was able to have a long, nearly forty-five minute phone conversation with the Admiral who commands that facility as well as every Naval Medical facility on the East Coast and Europe, with the exception of the Bethesda-Walter Reed complex in Washington DC. Bottom line up front; it was a very good and positive experience for me that I believe will help others get better care.

I have to say up front that I was terrified about asking to talk to him. One of the people on his staff told me that “it would not be a good thing for me to talk to him.” When I heard that comment my heart sank. I didn’t know what to do, I was perplexed because most commanders of Medical facilities in the Navy that I have worked for actually did want to hear about negative experiences of the people that are their customers, most because they care, but if nothing else because they want to make sure that they pass the Joint Commission accreditation that their facilities get every few years. So I wondered if the Admiral actually knew what was going on, at least in regard to the Mental Health Department and the experiences of people like me.

My last Command Master Chief, who read some of my very angry posts on a social media site suggested that I call my former Commanding Officer, a man who helped me a lot, cared about me and who is soon to become an admiral. I finally worked up the courage to call him, not out of fear, but because I felt like I might be bothering him, and would not be worth his time. I left his command a year ago and frankly I thought why should someone moving up in an organization be bothered by the problems of a former subordinate.

However, he was both concerned and helpful. He did not just listen but he took action by contacting the Admiral here. He told him that he knew me and that he knew that it was my desire to make sure that people get the help and care that they need, that I wasn’t just complaining or seeking special treatment.

Yesterday the admiral called me, of course my phone went directly to voice mail so I missed the call, but his message, and the tone of his voice conveyed a sense of care and concern. I called back and got his voice mail. So this morning I called again and was able to share my heart, in a very respectful way with him. He listened and seemed to be attempting to formulate some kind of positive response that would actually help people. He wants to get answers and he told me that he wanted those that come to that facility to be treated as he would want his grandparents treated.

As I said we talked for forty-five minutes and he listened. I have no doubt, within the very real fiscal constraints faced with current budget cuts and the still looming threat of sequester that he will do his best to improve and change the system that is within his control. He also did something that I have never experienced before from a superior officer, he called me “sir” a number of times. I am not used to that and I don’t think that I have ever in all of my reading of military history recall an Admiral or General calling a subordinate “sir.” I was blown away.

That system appears to be undermanned, under-budgeted and overwhelmed. It is struggling and as it struggles, as it reacts to criticism from the media, politicians and advocacy groups, it resorts to protecting itself as any bureaucracy does in such a situation. The Admiral realized this and he encouraged me to call him again on his office number if I see things that he can help. That was very encouraging. I don’t think that I will have to ask him to intervene on my part, but I have an open door to use this relationship to help others.

All that being said, most people do not have the connections that I have in the system, nor are they willing to take the risks to rock the boat. The stigma is great and personal risk can be or at least seem too great to make the effort, so most people just give up. After all the bureaucracy can be unbending and even vindictive in the way that it rebuffs those that try to raise issues. They resist change and try to keep bad news from enquiring superiors. Bureaucracies and those who faithfully serve them do just that. It is part of who and what they are; be they military, other government, business or ecclesiastical organizations. Admiral Alfred Thayer Mahan wrote:

“It [the bureaucracy] tends to overvalue the orderly routine and observance of the system by which it receives information, transmits orders, checks expenditures, files returns, keeps the Service the touch of paper; in short, the organization has been created for facilitating its own labors.”

However, when I first collapsed after Iraq, I decided that I could not be silent and have “sky-lined” myself which probably will not help me get promoted, not that care anymore. I am sure that being so public about my struggles with PTSD, Moral Injury and even my crisis of faith, which left me an agnostic for a couple of years, while serving as a Chaplain in adult and pediatric Intensive Care Units has marginalized me in the Chaplain Corps. I don’t know that for a fact and would hope that it is not the case, but it is the feeling that I get when I deal with most Chaplains.

All of that said, the past few weeks have been some of the most difficult since my return from Iraq. I personally find no pleasure in being anxious, depressed or feeling suicidal and getting even less sleep than my chronic insomnia normally allows.

At least I was listened to, and I really did get the sense that the Admiral that I was able to have such an honest conversation with today, does really care and wants to help improve the system and change the culture.

But that is the thing. This is a systemic and cultural problem, not just in the military or the Veterans Administration, but in society as a whole. In our desire for efficiency, supposed effectiveness  measured by profits and the bottom line; we have forgotten to care about people. Sadly that is statistically verified in poll after poll by people from all parts of the political spectrum. People don’t trust the government, they don’t trust big business, they don’t trust health care systems, they don’t trust the police, they don’t trust the banking and insurance industries and they certainly don’t trust the church or religion in general. Can I get an amen?

Thank you…

But our culture has to change, we have become so materialistic and embrace the most crass forms of predatory Capitalism and Social Darwinism, even in church, that people don’t matter, especially the poor and those with no voice or power, especially those who volunteer to serve the nation and come back broken in body, mind and spirit.

Joshua Chamberlain the hero of Little Round Top at Gettysburg spoke years after the Civil War something that should be a warning to us about how we treat people. Of course Chamberlain was talking about the horror of war, but it can apply to anyone, anywhere:

“But we had with us, to keep and care for, more than five hundred bruised bodies of men–men made in the image of God, marred by the hand of man, and must we say in the name of God? And where is the reckoning for such things? And who is answerable? One might almost shrink from the sound of his own voice, which had launched into the palpitating air words of order–do we call it?–fraught with such ruin. Was it God’s command that we heard, or His forgiveness that we must forever implore?”

His question is as operable today as it was then. There has to be a reckoning somewhere for destroying peoples lives, and further traumatizing them when they seek help, otherwise there is no justice nor anything that resembles a loving God.

We have to start valuing people, regardless of their social status, their race, religion, sexual preference, disability or even their alma mater. If we don’t start caring for people as human beings, then why bother with anything else? It is either about humanity or its not. Those who are comfortable cannot turn a  blind eye thinking that these issues don’t affect them, because they will.

So in spite of being unpopular in some circles I take the personal risk to speak the truth the best and most honest way I can to anyone that will listen. I have to do it, for those that feel that they have no voice, as well as those who I have known who have lost their lives after giving up on the system. I owe it to them. It is now my mission in life and I do that I can both inside the system and outside of it to speak out for those who need it.  I guess I have become something of a liberal social activist, not that there is anything wrong with that.

I can be as persistent and irritating as Mustard Gas; I am doggedly determined to speak out for those that do not feel that they matter or have a voice; and I will stay in the fight until I can’t fight anymore. As Paul Tillich said “It is my mission to comfort the afflicted and to afflict the comfortable.”

I admit that sometimes it is like tilting at windmills, but this week, two men who have the position to influence the system took the time to listen and just maybe at least at some level things will begin to change. I am grateful tonight, maybe I will sleep well…

Peace

Padre Steve+

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Filed under faith, healthcare, mental health, Military, PTSD, suicide, US Navy