Regressive Disease Attacks the Mind, Body & Soul

In the spring and summer of 2014, another viral social media trend was born. People around the world began recording or streaming themselves dumping buckets of ice and cold water over their head, and then challenging others to do the same. The trend has been performed each summer ever since, with participants ranging from community gatherings and individuals in their backyards to celebrities like Oprah Winfrey, Bill Gates, Lebron James and Cristiano Ronaldo. The trend also had a purpose: to raise awareness and encourage donations toward fighting and finding a cure to amyotrophic lateral sclerosis or ALS. But for Therese Kambach, a 57 year-old woman of Warrenton, Virginia, that awareness came too late. It was a dark and stormy evening in 2010--your typical setting to proceed something bad--when a large storm with the risk of tornados came through the area. When it had passed, Therese heard the voice of her best friend, Cheryl, who was the same age and lived in Greenbelt, Maryland. The two had been best friends since they were kids and, after the storm had past, Cheryl was calling to make sure everything was okay. Therese immediately knew that something was terribly wrong. “Cheryl developed a very noticeable slur in her speech,” she said. “At first, the doctors thought she had a stroke, but she had no other stroke symptoms. I often had to ask her to repeat herself. But when she learned the doctors wanted to test her for ALS, she learned all she could about it, and prayed with all her heart that the test would show she did not have ALS.” [caption id="attachment_732" align="alignleft" width="316"] Therese Kambach, right, with Cheryl on her wedding day. The two had been best friends since childhood.  [/caption] Also known as Lou Gehrig’s disease, ALS is a progressive neurodegenerative disorder where the nerve cells in the brain and spinal cord that control muscles gradually die, resulting in the muscles weakening throughout the body. This leads to paralysis and seriously inhibits the patient’s ability to communicate.    ALS, which is rare and affects approximately 30,000 people in the United States with no known cause, is the traumatic change in life that no one either expects or wishes to face. When her diagnosis was confirmed, Cheryl--who had also battled and defeated breast cancer not long before--was terrified for herself, worried about her ailing husband Frank and who would take care of him and, like her best friend, was angry that the future she had hoped for would never happen. Patients who receive the ALS diagnosis are initially given an estimated 2-5 years before the disease kills them, and are advised to get their affairs in order. “Everything about ALS is bad,” said Therese. “It's hard to determine what is the worst experience. Early on, it’s probably the loss of independence. One needs help walking, using the bathroom, bathing. Later on, the inability to communicate is probably the hardest part. The patient becomes trapped in a body that refuses to do what the brain tells it to do, but doesn’t lose touch with reality. The disease robs a person of independence, comfort, means of communication, ability to eat and ultimately the ability to breathe. During the journey, the victim of ALS tires easily (due to less oxygen taken in with each breath) and experiences stabbing pains throughout the body. They come and go at random times with no warning, and there’s little anyone can do to relieve them.”   The disease can also have different, heavy affects on the mind. Patients can experience frontotemporal dementia, which can change how the victim thinks, communicates, behaves or makes decisions, and can even lead to aggression. Another condition they may experience is called pseudobulbar affect, which causes them to display outward expressions of emotions that they are not really feeling. Patients can burst into sudden episodes of laughing or crying without warning. The diagnosis of ALS is also emotionally devastating for both the patient and their loved ones. All must adjust to a new way of life with the disease. Without a job to go to every day, shopping, outings, and housework, one's days and nights become one. There were the doctors appointments and places one can go in a wheelchair if one has a vehicle to transport the patient in the wheelchair. Eventually, and all too soon, moving from the wheelchair to car and back becomes an exhausting adventure for both the ALS patient and the person helping. These traumatic changes and the symptoms of the disease can cause patients to fall into isolation, withdrawing from social interactions and situations, which can lead to anxiety and depression. Symptoms of depression in ALS patients is even more difficult to identifiy due to the disease's affect on the mind and the patient's ability to express emotions. According to Therese, the worst thing a friend or family member can do is avoid the ALS patient because he or she is afraid or feels inadequate to handle what is happening. This causes an ALS patient incredible grief even if the patient says he or she understands. Usually, ALS patients do understand, but time is short for them so words that need to be said and feelings that need to be expressed may go unsaid or unexpressed. Cheryl's own brother went with her to the first couple of doctors appointments, but then avoided her as the disease progressed until Therese called him to say that if he wanted to see her alive, he'd better get over to the apartment. Her sister didn't show up until a couple of hours before she passed. This caused Cheryl great and unnecessary pain during a time when every day was filled with suffering. “I was heart-broken,” Therese said. “We had always hoped to grow old together. Then I researched ways to help.” According to Therese, the best thing to do to help alleviate some of the trauma all around is to be present for your friend or family member, and listen to them. Do research and offer to help in any way. This may involve help with bathing, personal hygiene, household chores, yard work, transportation, shopping, etc. In addition, encourage the patient to take advantage of any support, programs, or ALS-specific devices as soon as the patient becomes eligible. In the beginning, Cheryl was loaned a text-to-speech machine so that she could type what she wanted to say. When she lost the use of her hands and couldn’t type, Therese made a speech board so that all Cheryl had to do was point to words, but she would tire easily and become frustrated. As the disease progressed and she couldn’t move her arms, they resorted to yes and no questions where she could give a thumbs up or down to answer, or blink yes or no.      With advancements in technology and the help of their caregivers and loved ones, many ALS patients are able to manage the symptoms and to live fulfilling lives. Some have even gone on to do great things in arts and sciences. Jason Becker was a rising guitarist when he was diagnosed in 1990. Tony “Temp One” Quan, an iconic graffiti artist out of Los Angeles, was diagnosed in 2003. Both are completely paralyzed and require 24-hour care, but that hasn’t stopped them from their work. They use eye-tracking technology that allows them to draw, type and speak simply by moving their eyes. Becker released a seventh solo album this past December. And, of course, there’s the acclaimed physicist and cosmologist Stephen Hawking.      Though she had no aspirations of releasing a metal album or study the stars, ALS didn’t not stop Cheryl from living the rest of her days as best as she could. Experiencing and sharing love became her primary work, and she did everything she could to make her ALS journey as easy as possible for both her and her husband. She set all her affairs in order while she was still able to sign her own name. She learned about all the resources available to those with ALS and, with Therese’s help, moved to an apartment in Stafford, Virginia, where it was easy for both her and Frank to move around. When the funds from her retirement plan became available, she even planned and paid for her funeral, her husband Frank's funeral and Jerry's (Frank's brother) funeral so all Frank had to do when she died, was call the funeral home. On Christmas Eve, 2012--after she had passed--her husband Frank returned home to find a Christmas ham that had been ordered and delivered to his front door...from his late wife. “Cheryl was a very faith-filled person,” said Therese, “and she lived for visits from family and friends. She, more than almost anyone I know, radiated love. She prayed a lot, but she was a doer. Not actively being involved in people's lives was very hard for her. She accepted that there was no cure, but she fought hard to live every moment she could. I would say visits and prayer helped her, but she really had no choice but to go through it.” “Prayer and the courage Cheryl demonstrated also helped me,” Therese continued. “Watching her suffer certainly made it easier to accept her passing, and knowing she was free also helped.” [caption id="attachment_733" align="aligncenter" width="350"] Cheryl Parkes-Ray
April 25th, 1961-December 10th, 2012[/caption] If you have a friend or loved one who is struggling through this horrible disease, you can find information and resources through the ALS Association and Team Gleason. Consider the Online M.S. in Psychology, M.S. in Counseling or the Psy.D. in Clinical Psychology if you want to build the skill set to help ALS patients and their families through their difficult journeys.  

Remembering the Virginia Tech Shooting

The small town of Blacksburg in Southern Virginia was, at one point, only that: a small town, nestled along the New River Valley. The trip from the cities of the north will lead you witnessing the significant change of scenery as you cruise down I-81, from cityscapes to treelines, from city streets to nature trails, from Smithsonian Museums to the Blue Ridge Mountains, from the boisterous white noise of a congested population to the melodies of the rural countryside. And, of course, it will lead you to the spirited Hokie Nation. But this little Virginia gem was not brought under the eyes of the new millennium by its quaint charm. It wasn’t Blacksburg’s or Virginia Tech’s spirited community or the university’s technological innovations or successes in science and agriculture, nor was it Beamer Ball that brought it under the spotlight of the world. It was a 23-year-old English major from northern Virginia, and the 32 people he murdered on campus that brought the spotlight to Virginia Tech and an issue that continues to be debated to this day. The beautiful campus and its community was eternally scarred by the violence of that April day of darkness fourteen years ago. Today, there is still a certain, strange air carried on the winds throughout campus that leaves one keeping an eye open and scanning their surroundings, and there’s rarely a day where students do not pass or visit the memorial at the top of the drillfield in front of Burruss Hall: 32 stones for the 32 taken from us too soon. April 16th always brings back the pictures of that tragic day: students evacuated from campus, huddled together in a circle at a local church; sheriff officers carrying survivors from the scene by their arms and legs; tearful mothers holding tight the child who just left their nest for the first time; other mothers searching frantically among the large crowds of bloodied faces for their children, praying that they are not one of the many carried away in body bags; President Bush, a father himself, addressing the university, seeking to comfort a confused, sorrowful student body of 25,000; Resident Poet Nikki Giovanni absorbing all that sorrow into her pen and converting it into prose of flourishing inspiration as she cries out, “We Are Virginia Tech!” The date also brings back to remember the student and shooter Seung Hui Cho, who was described as an isolated individual preferring to be by himself. He hardly spoke in class and, when he was called to do so, he spoke barely above a whisper. The content of his written assignments and projects at Virginia Tech caught the concerning attention of his professors, and the videos and manifesto he sent to NBC left people anxiously asking questions about his mental stability. What could have led him to commit such a seemingly random act of carnage? What could have been done to stop it? School shootings have been well covered and documented over the last several years. As a result, studies have shown that there are a number of common risk factors that can indicate if someone is at risk of harming themselves and/or others. Risk factors commonly associated with school shooters include creating or engaging in content--writings, drawings, etc.--depicting violence or violent fantasies, difficulty controlling anger, suicidal and homicidal ideations, social isolation and social deficits, victim/martyr self-concept, paranoia and interest in other shooting situations. “I think those are very good starting points,” said Dr. Suzanne Hollman, Academic Dean and Director of Divine Mercy University’s Psy.D. Program, in an interview on EWTN after the shooting at Stoneman Douglas High School in Parkland, Florida. “The research right now is all over the place. But what we do know is that all of these things are risk factors. All of these things can predispose someone to making a decision or planning something that dramatic. A lot of it stems from social isolation--not being seen in the world--and then trying to find these mechanisms to ensure that they are noticed.” After the attack, Virginia Governor Tim Kaine assigned an independent panel to review the events leading up to the tragedy and how they were handled. The panel was also charged with developing a profile and investigating the life of Cho leading up to April 16th, including his mental health records, which showed that Cho displayed all these red flags during his last two years at the university. But the panel didn’t just shed light on the indicators that developed during his final two years. The panel discovered other details in Cho’s life that could also have been contributing factors.    According to their review, Cho was a shy boy who rarely spoke and, when he moved with his family from South Korea to the United States, he became more withdrawn. He allegedly resented the pressure of speaking in public, and would avoid speaking both at home and at school. When called to speak--particularly if his family had a visitor--Cho would freeze on the spot and grow incredibly anxious. He would become pale, develop sweaty palms, and in some cases, begin to cry and resort to nodding yes or shaking his head no.     Cho’s parents tried to urge him to become more involved in different activities and local sports because they worried he was becoming more isolated and lonely. On the other hand, transportation to any event in general was a challenge in itself, as Cho’s parents worked long hours during the week and were not able to take him or his sister to any extracurricular activities. His father was stern on matters of respect, which is something the two would argue about. According to one of the records reviewed by the independent panel, Cho’s father would not praise his son, and one of his writings later included a father-son relationship where the father was always negative. Eventually, Cho’s parents decided to “let him be the way he is” and not force him to interact and talk with others. Doing so may not have been in their son’s best interest. Extreme social deficits is not just a key indicator of a serious mental health issue. According to 2018 Divine Mercy University Psy.D. graduate Amanda Aulbaugh Faria’s dissertation entitled “Mass School Shooters: Psychosocial Characteristics in the Lives of the Perpetrators,” it’s also a common characteristic among school shooters. Nine out of the nineteen school shooters that Faria studied had significant social deficits. One shooter was quiet, was disliked by her peers, walked around by herself and did not participate in class at school. Another shooter suffered significant social anxiety and was seen as “odd, goofy or weird.” Twelve of the nineteen studied also displayed antisocial characteristics. “The negatives have already been identified,” said Dr. Paul Vitz, Divine Mercy University Senior Scholar and Professor, who has recently begun researching school shootings and their perpetrators, from elementary school to high school. “They were depressed, or they came from dysfunctional families, or they were all obsessed with violence. They had a variety of negative characteristics.” In his own research of school shooters, Dr. Vitz found that one thing common among the shooters is not merely a variety of negative risk factors, but also a lack of positive things in their lives. “None of them seemed to have a goal in life,” he said. “None of them wanted to be a star musician, no one wanted to be an athlete, none of them talked about being businessmen or have success at college. Second, none were involved in any pro-social organizations. None were in scouts or 4-H. None were in a civic society or were helping the poor, none were involved with any of the virtues or active in any faith.” In Faria’s study, many of the shooters were involved with different activities as younger children, but as they grew older into middle school and high school, they began to withdraw from social activities. Others, including Sandy Hook shooter Bill Lanza, had no social interests or did not engage in any social activities from the beginning. “It isn’t just the overwhelming presence of many negatives,” continued Vitz. “It’s the absence of the positives too.” A second factor discovered was that Cho, who had been receiving psychiatric treatment prior to attending Virginia Tech, stopped his treatment before moving to Blacksburg, and the university had no knowledge of his mental health history. According to the panel report, Cho’s middle school teachers noticed suicidal and homicidal ideations in his writings after the 1999 Columbine shootings. On their recommendation, Cho received psychiatric counseling and medication for a short time, and special accommodations were made to help Cho achieve top scores and honors in his coursework all through high school. “Cho exhibited signs of mental health problems during his childhood,” the report reads. “His middle and high schools responded well to these signs and, with his parents' involvement, provided services to address his issues. He also received private psychiatric treatment and counseling for selective mutism and depression.” By the time Cho was preparing to leave home for college for the first time--entering as a business major before making the switch to English--neither he nor his high school revealed that he had been receiving special education services as an emotionally disabled student. As a result, no one at Virginia Tech ever became aware of his pre-existing conditions until it was too late, leaving him to carry on without the critical helped that assisted him to cope and flourish. Since that tragic day in 2007, colleges and universities across the country have taken steps to both help those individuals with anxiety and mental issues. Many have added mental health professionals and university police officers to their campuses; faculty and staff members are being trained on how to spot worrisome behavior and reach out to those students in a preventative manner. Virginia Tech even became the first campus in the nation to be certified by an independent non-profit organization that established rigorous national standards for emergency planning.   A question still lingers: is it enough? That question may never have an answer. But it’s the reverberation of gunshots that still faintly linger in the winds of Blacksburg, and in the tears that stain the 32 stones in front of Burruss Hall that pushes us to keep trying and keep innovating ways to help our mentally ill and, in doing so, trying our hardest to prevent another April 16th. If you’re passionate about helping those who have witnessed or suffered serious trauma, or if you want to help those with serious mental illness, consider the M.S. in Psychology, M.S. in Counseling or Psy.D. in Clinical Psychology at Divine Mercy University.   Work Cited: “Mass Shootings at Virginia Tech, April 16, 2007, Report of the Review Panel”. Presented to Governor Tim Kaine, Commonwealth of Virginia, August 2007. https://scholar.lib.vt.edu/prevail/docs/VTReviewPanelReport.pdf Faria, A. A. Mass school shootings: Psychosocial characteristics in the lives of perpetrators (Doctoral Dissertation). Divine Mercy University, 2018. Available from ProQuest Dissertations & Theses Global. (2100701144). Retrieved from https://search.proquest.com/docview/2100701144?accountid=27532 Friedman, Emily.  “Va. Tech Shooter Seung-Hui Cho's Mental Health Records Released.” ABC News, 19 Aug. 2009, https://abcnews.go.com/US/seung-hui-chos-mental-health-records-released/story?id=8278195 Hausman, Sandy.  “Lessons Learned at Virginia Tech: What Went Wrong?.” WVTF, 13 Apr. 2015, https://www.wvtf.org/post/lessons-learned-virginia-tech-what-went-wrong#stream/0 Langman, Peter. School Shooters: Understanding High School, College and Adult Perpetrators. Maryland: Rowman and Littlefield Publishers, 2015. O'Meara, Eamon. “Virginia Tech shooting may have changed how mental health was treated.” ABC WDBJ7, 14 Apr. 2017, https://www.wdbj7.com/content/news/Virginia-Tech-shooting-may-have-changed-how-mental-health-was-treated-419513643.html Potter, Ned and David Schoetz, Richard Esposito, Pierre Thomas. “Killer's Note: 'You Caused Me to Do This'.” ABC News, 7 Apr. 2007, https://abcnews.go.com/US/story?id=3048108&page=1

Honoring St. Patrick With Moderation

When we look at the calendar and see that St. Patrick’s Day is right around the corner, many of us may salivate knowing that our local pubs and bars will be decorated and playing Celtic music, with Guiness and green beer flowing endlessly like the great falls of some romantic Irish waterfall, and when the day comes, we celebrate even more the week before and the week after the holiday. And then the following morning you find yourself staying in bed sick. Most of the adrenaline in your body has vacated the premises, leaving only a small amount to get you to roll around under the covers in desperate search of a position that will calm the heavy throbbing in your head, or to get up and rush to the bathroom or the nearest trash can to vomit. It’s highly doubtful that St. Patrick--one of the most popular and highly recognized Catholic saints in the world--would’ve expected that kind of celebration of his feast day. Born in Roman England, he first entered Ireland as a captive of pirates as a fourteen-year-old, and wasn’t able to escape and return to England until he was twenty. [caption id="attachment_645" align="alignleft" width="240"] St. Patrick often used a clover when teaching about the Holy Trinity.[/caption] In his memoir, The Confession of St. Patrick, he describes experiencing a vision that prompted him to study for the priesthood. He was eventually ordained a bishop and, in the year 433, was sent to preach the Gospel in Ireland. Throughout his 40-year stay in Ireland, he converted thousands of people, built churches throughout the country, and performed many miracles up to his death on March 17th, 461. Approximately 33 million people celebrate St. Patrick’s Day each year, and with his feast day falling within the season of Lent, Catholics and Christians are able to set aside their Lenten restrictions and are able to indulge in whatever they gave up, e.g. if they gave up snacks and stout. The day also became a celebration of not only the holy man, but also Irish heritage, culture, history and traditions around the world. According to Wallethub, over 55% of Americans plan to celebrate St. Patrick’s Day and are expected to spend a collective estimate of $5.6 billion. “For some, any reason to drink more is a good enough reason,” said Divine Mercy University Associate Professor Dr. Stephen Sharp, a specialized instructor for the Addictions Counseling course (COUN 650). “But for others, it may simply be part of the ‘spirit’ of the holiday, in this case St. Patrick's Day. It could as well be Christmas, New Year (even Chinese New Year), or the 4th of July.” Today, St. Patrick’s Day is ranked the third most popular drinking day of the year. According to WalletHub, 152.5% more beer is sold and 13 million pints of Guinness consumed (an 819% increase from the rest of the year), and 32% of men admit to binge drinking on St. Patrick’s Day.    “I'm not sure we can say that binge drinkers ‘go out of their way’ to drink more when there is a social opportunity to do so,” Dr. Sharp said. “They may just simply take advantage of the socialized opportunity to celebrate using alcohol. In ways, a culture of drinking on holidays has contributed to problems created by over-imbibing.” But with greater consumption comes a greater need for greater responsibility. Seventy-five percent of fatal car crashes over St. Patrick’s Day involved a drunk driver, and 59 people were killed in St. Patrick’s Day drunk driving crashes in 2017. Between 2013-2017, 44% of people killed in drunk driving crashes during the St. Patrick’s Day holiday were between 21 and 34 years old.   “Law enforcement recognizes the patterns,“ Dr. Sharp continued, “and often has a bigger presence, and has also helped to sponsor the idea of ‘designated drinkers’ and the use of services for transportation to keep drinkers from behind the wheel of an automobile. With or without the cultural influences of alcohol consumption, those choosing to use alcohol have the ultimate challenge of drinking responsibility on these celebrated occasions.” Unfortunately, it seems to be a difficult challenge for many. Alcohol abuse is currently one of the largest public health crises in the United States, and it kills more people each year than overdoses. According to the Center for Disease Control, six people die from alcohol poisoning every day, and further research shows that alcohol consumption will only grow in 2019, even as population growth is expected to slow.     “Too much of almost anything can be harmful,” said Sharp. “Extended over-use is probably the most hazardous to your health. Our bodies are remarkably able to recover from the occasional over-drinking simply by remaining abstinent from it for a period of time.” When we don’t allow our bodies the chance to recover, our drinking may contribute to heart disease, stroke, diabetes, and other organ damage, especially the liver, which is the organ charged with keeping our bodily system clean by removing toxins. When we regularly overload our liver, we may pay the price over time. But as mentioned before, our body is a remarkable system capable of near miraculous recovery, but only when given the opportunity to do so. But the risks are not just bodily. Poor drinking habits can be destructive enough to damage our relationships that often do not recover, including those within our family. “Behavior problems resulting from alcohol use and abuse can stretch the limits of those who love us, and that we love,” said Dr. Sharp. “Moments and phases of intoxication may result in engaging in other risky and damaging behaviors and in having a lifelong impact on the quality of our life and those precious relationships. This also often takes a toll on children of alcoholic parents as binge drinking may be part of a bigger cycle, and is often an unpleasant experience for the child.”    According to Dr. Sharp, it is also widely observed that concurrent mental disorders will accompany a substance use disorder. It is not uncommon to see depression, anxiety and substance use co-occurring in an individual. “Did the anxiety appear before the depression,” he said, “and were they present prior to the onset of substance use? Or, did the substance use begin and the other mental disorders begin subsequently? The answer is that this is highly individualized in differences, distinctions, and similarities to others. It depends on the person, their history, and the narrative of their life story. “A short and simple answer is often right beneath the nose, though,” he continued, “and that is if using alcohol is creating problems in your life at any level such as work, relationships or legally, then you may have a drinking problem and should seek the help of a professional.” As we celebrate the life of St. Patrick and everything Irish in communion with each other--whether it be in person or in spirit--let us do so in safe, moderate and healthy fashion for ourselves and each other.    

Stigmas Still Scare People From Counseling

What happens when we’re confronted with a problem? What do we do when we have an issue we’re trying to fix at work or trying to solve a problem in our schoolwork?  What do we do when we can’t fix something at home--a jammed window, a dislodged door, a flat tire on the car? What can we do when we’re having difficulty figuring something out on our own? Clearly, the expected solution would be to look for help from the outside. We reach out to our supervisors and co-workers to help address issues or to help complete projects at work. We research online for do-it-yourself remedies, or hire a specialist to fix problems with our home or vehicle. We call upon our professors, tutors and academic peers to conquer the hurdles of education. In facing our most personal troubles, we typically call on those closest to us or people we trust for guidance and assistance. We lean on our spouse, family and close friends for support when facing a personal crisis or emergency; we look to our pastors and ministers for spiritual guidance, and mental health counselors to help overcome mental or emotional blockades.     Or we don’t. We may continue to go solo, taking breaks away from the task before returning to find the solutions ourselves, or we may give up and move on to different things. Still others may choose to endure or continue enduring whatever issue they’re facing, refusing to acknowledge the possibility of needing help facing the issues they face. For some, asking for help is difficult. For some us, admitting that we need help feels like a sign of weakness and uselessness, which can be detrimental to the individual, especially in the case of mental health issues.   [caption id="attachment_578" align="aligncenter" width="540"] The hit show “The Sopranos” circulates around a New Jersey mob boss’s sessions with a psychiatrist, highlighting the perception of weakness as well as the dangerous suspicions of spilling crime family secrets to outsiders.[/caption] According to the National Alliance on on Mental Illness (NAMI), millions of people face mental illness and mental health challenges in the United States each year, and the stigma that surrounds mental health--the fear and the lack of understanding, which can lead to isolation, shame, harassment, and even bullying and discrimination from others that can turn violent--can still be felt.   “When my husband asked me to keep his secret, I didn’t hesitate,” said Carolyn Ali in her New York Times piece, Alone With My Husband’s Secret. Carolyn and her husband worked to battle his depression on their own, taking care to avoid telling their families and loved ones. But the secrecy and the severity of his depression wreaked havoc on the two. As Carolyn attempted to navigate their way through the channels of the mental health system, her husband dropped out of the master’s program he was enrolled in and spent the majority of his days sleeping. When they did tell their family, he downplayed the severity of his depression and, after mustering every ounce of energy to appear upbeat through birthday gatherings and Christmas dinners, would crash for days once they returned home, utterly depleted. For Carolyn, maintaining the secret of her husband’s depression was costly for her as well. “Because it was his illness,” she wrote, “and he didn’t want to talk about it, I felt as if I had no right to talk about it either. So outside of my family and a few close friends, I didn’t talk about it with anyone. I didn’t talk about my frustrations in trying to find him proper medical care. I didn’t talk about how helpless and hopeless I felt as I tried to lift his mood. And I definitely didn’t talk about that leaden, sickening feeling I had every day after work as I pulled open the front door of my apartment: I’d check every room one by one, not knowing what I would find.” Two years after he spoke about his depression, Carlyn’s husband began to recover from his depression and, today, he is open about his history of mental illness and challenges the stigma himself, recognizing the impact the silence had on him and Carolyn, both individually and as a family. Today, the grip that the stigma of mental health seems to hold has been loosening in the U.S. A 2017 report from the Barna Group showed that approximately 42 percent of adults in the U.S. have met with a counselor at some point of their lives, and at least another 36 percent saying they’re at least open to seeing a counselor. That being said, the fear of seeing a counselor is still prevalent to this day. Dr. Benjamin Keyes is the Director of Training and Internships for the Eastern States for Divine Mercy University’s School of Counseling, Director for the Center for Trauma and Resiliency Studies, and has spent his career helping people in the U.S. and around the world recover from traumatic or stressful situations while providing organizations with counseling and training, including Charlottesville Virginia following the of the White Supremacist Rally. “The stigma of having to go see a counselor or a psychologist is the perception of being seen as crazy or psychotic,” he said. “People think this true with their family, at work or the other people they may see on the day-to-day. The reality is that there are a lot of reasons as to why people meet with counselors.” Dr. Keyes has also worked with many individuals whose jobs put them in stressful environments and situations regularly, including firefighters and members of the military and police forces. “There’s a perception of ‘going to the shrink,’” he said, “and there’s a fear that this stigma may have a negative effect on their careers or hurt their chances at promotions so they may be more inclined to avoid counseling to avoid that appearance.”     Outside the U.S., the stigma of mental health still holds an even tighter grip, causing thousands of people around the world who need treatment for mental health issues to avoid seeking treatment altogether. Mental illness has a long history of being stigmatized around the globe, from being considered a sign of demonic possession in its early history, to being seen as a shortcoming or a sign of weakness today. For instance, in Korea, the concept of mental health simply does not exist. “In Korea, there is no such thing as mental health,” said Jin-Hee, a Korean-American mental health professional in an interview with the University of Washington’s Forefront Suicide Prevention center. South Korea has one of the highest suicide rates in the world, and it’s been attributed to pressures relating to conformity for those in their 20s and 30s, loneliness, cultural dislocation, and lack of social connection for the elderly. But there’s still an aversion to accepting mental health treatment. According to Jin-Hee, depression is perceived as a sign of personal weakness instead of a clinical issue in Korea. Instead, it’s seen as a burden on a family’s reputation. “One is seen as ‘weak’ if they have a mental health issue,” she said. “People with mental health issues are seen as ‘crazy’ and the issue is something that must be overcome.” In Africa, the absence of treatment is the norm rather than the exception. In the face of many other challenges like conflict, disease, maternal and child mortality and intractable poverty, the importance of mental health is often neglected or overlooked typically due to a lack of knowledge about the extent of mental health problems, stigmas against those living with mental illness and beliefs that mental illness cannot be treated. The proportion of people with mental illness in Africa who don’t receive treatment ranges from 75 percent in South Africa to over 90 percent in Ethiopia and Nigeria.   “The stigmas are very pervasive in places like Eastern Europe and Africa,” said Dr. Keyes, “but the church in these nations and elsewhere is really making the inroads to address this, with pastors and clergy receiving education and counseling training to help their congregation and countrymen. Education goes a long way in rectifying these stigmas.” Research shows that tens of millions of people throughout the world will at some point in their life experience a mental health illness or disorder. It’s estimated that only half of those people will receive treatment, and the stigma and silence of mental health is a critical barrier that holds them back, leaving the individual without the critical help they need, and their loved ones--their spouses, siblings, parents and children--from receiving the essential support they need. “There are many different reasons people receive counseling,” Dr. Keyes said. “Some may be trying to help or save their marriage. Some may need an outlet for their anxiety while others go to address and treat depression. As counselors, we try to normalize the experience as much as possible.”   “If I could go back to that fall morning in our kitchen,” Ali said, “I would tell my husband this: ‘I know what you’re going through feels unbearable. It breaks my heart. I so desperately want to make things better. But we can’t keep this between us. We need as much support as possible to get the help you need. You are not alone.’”

Only Half of Veterans with PTSD Are Treated

Some football programs at both collegiate and high school levels have a tradition: at the end of the national anthem, when the home team scores or wins the game, a small cannon is fired at a safe distance behind one of the end zones in celebration. One evening, a young man was catching up with old colleagues and mentors during a match between his alma mater and a local rival. This young veteran had just returned from a tour in Iraq. He stood at attention and saluted the flag as the national anthem played over the speakers. The anthem ended, the cannon was fired, the players took their positions on the field and the crowd took their seats on the bleachers. But the young man remained standing, hands at his sides, frozen still, his skin pale as the echo of the cannon reverberated throughout his body, causing him to relive memories and moments from which he just returned. Post Traumatic Stress Disorder (PTSD) is a disorder that can develop after experiencing shocking, scary, or dangerous events. U.S. veterans and active duty service members make the ultimate sacrifice to protect the nation, with absolutely no guarantee that they’ll return alive or unscathed. They leave their families and friends, miss the weddings of their siblings or the births of their own children in order to step up and stand against the forces that wish to do them and our way of life harm. But, in doing so, they put themselves at risk of developing this disorder. As we honor our veterans for their sacrifice and bravery, we may forget that -- even though they survived the trenches, jungles or deserts -- not everyone returns home whole. The reality is that, despite returning to civilian life, the trauma they witnessed is never far from their minds, making their transition a greater challenge and even putting their physical and mental health in greater jeopardy.   According to the U.S. Department of Veteran Affairs, up to 20 percent of veterans who saw combat in Iraq and Afghanistan develop PTSD or major depression in a given year, as well as experienced a traumatic brain injury (TBI). Additionally, 12 percent of men and women who fought in the Gulf War have developed PTSD, and an estimated 30 percent of Vietnam veterans have had PTSD in their lifetime. Among the number of veterans who return from war with mental health issues and PTSD, only about 50 percent will actually receive the mental health treatment they need. Both active duty service members and veterans face great barriers to mental health treatment issues that make them hesitant to pursue treatment, including wait times, demographics and logistics regarding traveling distances, age and gender. “[My therapist] kinda encouraged me to get enrolled in the VA, which I had not done for five years after retiring from the military,” said Christopher Provost of Colorado while speaking with StoryCorps. “I didn’t realize how angry I was when I got out of the military. That was a big thing... in dealing with the post-traumatic stress." Provost joined the National Guard to ski and compete in biathlons -- a sport that combines cross-country skiing and target shooting. He served in both Iraq and Afghanistan, but he didn’t consider enrolling for VA benefits until about five years after retiring from the military. “I was hearing about the shortage and the backlog,” he said, “and, you know, all the amputees that weren’t getting their appointments, and, you know, people killing themselves in VA parking lots because they couldn’t get their therapy appointments. And I’m like, I’m fine. I’ve got a job, I’ve got a house over my head, I’ve got a car. I’m doing fine. They need help before me. And so I was kinda putting...I guess it was a displacement.”   According to Benjamin Keyes, Ph.D., Ed.D., Director for Center for Trauma and Resiliency Studies at Divine Mercy University, there are five symptoms of PTSD. Unstable moods and reacting to certain triggers are the most easily recognizable. “I had a friend in college,” he said, “who had just gotten back from Vietnam. Whenever we heard a helicopter approach or fly over, he would hide under a desk or do whatever he could to take cover." Other symptoms include self-isolation, hyper arousal and intrusion of consciousness, in which they are stuck on a thought or memory from the battlefields that they can’t shake or push from their minds.   “Though some cases are similar in symptom and description, all cases are different for each individual,” Devon Alonge, a Bachelor’s of Fine Arts student at George Mason University. Devon served as an armourer specialist for the U.S. Army, and deployed to Iraq in 2011. “For myself,” Alonge continued, “having been in a combat zone for six months, I deal with some issues regarding anxiety and, in some cases, claustrophobia.”   Shame is an incredibly critical factor in treating veteran PTSD. Some may feel embarrassed over their service-related mental disabilities, whereas others experience shame over needing to seek mental health treatment and are afraid of being seen as weak, or that they should still be fighting with their comrades-in-arms, but have gone home instead. When the shame is not addressed, it leaves our veterans in danger of falling into alcoholism and substance abuse, and even lead them to commit suicide. According to a study published in the Journal of Affective Disorders, veterans with PTSD have higher rates in suicide and suicidal behavior. Approximately 20 veterans commit suicide every day. “When soldiers return home from war, there is a sense of relief,” said Dr. Keyes, “But then they feel a sense of guilt about being home while others are still in the fields fighting. As they adjust to civilian life, they’ll feel that they should still be fighting in the war with the people they left behind.”   Dr. Norman Hooten has experienced this first hand. A full-time health care provider who helps veterans fight substance addiction, non-cancer related chronic pain and PTSD, Hooten served for over 20 years in the U.S. Army and special forces before retiring as Master Sgt. Norman “Hoot” Hooten, and fought in the Battle of Mogadishu in Somalia, which was later chronicled in the book and film, Black Hawk Down (Sgt. Hooten was played by actor Eric Bana in the film).   He experienced losing someone struggling with a mental health disorder when a platoon sergeant he knew early in his career committed suicide after struggling with PTSD and substance abuse. “In the military, we never want to lose people, but it becomes understandable when we lose people on the battlefield," Hooten said to the Military Times. "A generation of veterans have survived the horrors of war to come home and commit suicide. I do not want to accept this. I want to do everything I can to make a dent in this problem. Even if this is about saving one person.” It’s highly important -- and the very least we can do -- for us to ensure that necessary mental health treatments, both clinical and spiritual, are available to our vets and service members when they return home, and that starts with the relationships they build both in service and in life. Research has shown that kindling and rekindling relationships are critical to promoting change in those who are suffering and need help. These are the first stepping stones toward building hope -- especially amongst veterans who served together -- and are the first line of defense in identifying the signs of mental illness or PTSD. “Sometimes we get too comfortable not communicating with one another for a year or more because we tend to always think we are all close and fine," said Dr./Sgt. Hooten. "But that one phone call every now and then, or that meet-up for a fishing trip might make the difference in saving a life.” Divine Mercy University’s co-director for the Online Master’s in Clinical Mental Health Counseling, Dr. John West, has had the privilege of working with many veterans and soldiers returning from war who had survived traumatic events in battle, including one man whose vehicle was blown up during a firefight, breaking his back. “When I first started seeing him,” he explained, “he was completely hunched over, walking with a cane. His back was broken. His life was broken. He was just filled with despair and hopelessness.” At one of their sessions, the man brought a baseball because he loved baseball so much, and asked Dr. West to hold onto it for him. From then on, during each session of working through the trauma and adjustments, Dr. West handed him that baseball as a source of comfort while they spoke. After a few months, he began to heal, both physically and emotionally. “His whole life started to be reconstructed,” Dr. West said. “By the time we were finished -- when he had been able to move past the trauma, adjust to this new phase of his life and regain his dignity -- he was ready to move on. As he was walking out the door after our last session, he had that baseball in his hand. But he stopped at the door, looked back and tossed it to me saying ‘someone else needs this more than I do now.’”   Divine Mercy University is one of the nation’s leading graduate institutes that trains students in addressing and treating PTSD and other trauma-related disorders, with the specific mission to help patients flourish. “You can recover,” said Dr. Keyes. “Our students are trained to think about how people can flourish in their lives, and how they can help our veterans deal with emotions they suppressed while in combat zones. Having that as an overlay is a quality difference in treating PTSD.” Learn more about what you can do to help those around you suffering from PTSD or other trauma. (The Effects of Trauma)
About DMU
Divine Mercy University (DMU) is a Catholic graduate university of psychology and counseling programs. It was founded in 1999 as the Institute for the Psychological Sciences. The university offers a Master of Science (M.S.) in Psychology, Master of Science (M.S.) in Counseling, Doctor of Psychology (Psy.D.) in Clinical Psychology, and Certificate Programs.