Lingering casualties of war
Even before his twin brother committed suicide in December 2010, former Army Staff Sgt. Earl Granville never liked the holidays.
While getting ready for a party at his girlfriend's workplace, Earl received a call from his mother telling him the news, Staff Sgt. Joseph Granville was dead by his own hand.
It hit him like a brick, throwing him to the floor in a flurry of shock and disbelief and, while the event deepened his aversion to the holiday season, he said the event brought his family closer than ever before.
"We still exchanged gifts but we were more glad to be with each other than ever before," Earl said.
Earl Granville, believed Joe had a "touch" of post-traumatic-stress disorder, a condition behind a deadly epidemic sweeping the nation.
Today, the Department of Veterans Affairs estimates that one veteran commits suicide every 80 minutes.
Iraq and Afghanistan veteran suicides represent 20 percent of total suicides in the United States, though only one percent of Americans have served in either war.
The Department of Defense has made it a top priority to identify and prevent suicides, but the numbers are stark.
Suicides among active-duty servicemen and women increased by 87 percent from 2001 to 2011, the Department of Defense reports.
Within the Army alone, there has been a more than 200 percent increase in the 10-year period, from 52 suicides in 2001 to 165 in 2011. In the first seven months of this year, the Army reported there have been 66 confirmed active-duty suicides, with 50 remaining under investigation.
Dr. John McGrail, a former Coast Guard officer and clinical hypno-therapist, said military culture tends to impede motivation to receive help. He said soldiers expect themselves to "suck it up" when troubled and avoid help, believing it to be a sign of weakness.
"Given our society's and the military's culture and traditional attitude toward seeking help for mental heath issues, many of these men and women are both afraid to seek help, and are surrounded by people back home that simply cannot comprehend what it is they are going through," Dr. McGrail said. "Eventually it becomes such a burden that they see no alternative but to end their own lives."
Psychiatrist David Reiss, M.D. said even minor PTSD, if left untreated, could be severe. Since anxiety and hyper-arousal are common symptoms of PTSD, sleep deprivation is common.
"If you take someone who is sleep-deprived they're going to be unhappy and depressed," Dr. Reiss said. "It's something that needs to be treated immediately."
Earl Granville credits counsel with putting his life back together.
While overseas, Earl lost his leg to an improvised explosive device that killed five of his comrades.
With his life upended, he began talking to a counselor - in complete contrast to the "macho idealism" he had come to expect from his time in the military. After the first time he spoke with a counselor, he began to feel like he had been "freed."
"Just the simple act of talking can make you feel so much better," Earl said. "Even on days when I felt OK I still would go and talk about anything. It helped me get through my injury and Joe's death."
One of the key symptoms of PTSD is avoidance, where those suffering begin to avoid stimuli and situations that arouse stress, said Dr. Matthew Dooley, a psychologist and expert on PTSD at the Wilkes-Barre Veterans Association Medical Center. Some sufferers avoid contact with others entirely, at severe cost to their social functioning and self-esteem, he said.
One of the ways Dr. Dooley treats PTSD is by teaching patients muscle relaxation and breathing techniques and gradual exposure therapy.
Gradual exposure therapy for a patient with a fear of spiders, for example, would involve gradually exposing the patient to more and more spiders over several weeks. With gradual exposure, the fear of the stimulus washes away, building acceptance and familiarity.
Treating post traumatic stress disorder is more complicated, primarily due to difficulty lies in isolating the distressing stimulus, which typically varies from patient to patient, Dr. Dooley said. Still, he stressed, the only way to make any progress is to "take the first step" and seek help.
"We can't do anything unless the person suffering recognizes their need for help," he said. "This isn't something that they can conquer on their own."
When Joe Granville came back from Iraq in 2006, there was a change in him, Stephanie said. It was small, but obvious. When Earl lost his leg in Afghanistan, Joe began a "downward spiral."
"He wanted to go back to war and find the ones who did it," Stephanie said. "He wanted revenge."
Joe signed up for redeployment but when he received the letter stating he would have to wait out the latest rotation he came back to the house in tears.
"I think he needed to be there," Stephanie said. "He was a through-and-through leader and he needed to be there for his troops."
After Joe died, Stephanie stayed in bed for four months.
"Then my mother came into my room and told me I needed to get up, I have children to take care of, who need me," Stephanie said. "She said I was letting myself die in that bed."
Determined to make a new start, she packed up and moved to a new house. Still, she said, he will always be there with her, she said, in the loves of her life - her children.
"They have his eyes," she said. "They are exactly his eyes."
Nearly two years after Joe's death, it is a Sunday routine to visit his grave with her three children to plant flowers, clear debris and talk about the man they will always love.
Her two oldest Jonathan, 7, and Emily, 4, like to sit on either side of his grave and remember their father, debating whom he took to the most exciting event. At home, Jonathan runs around wearing his father's headgear, his backpack and, sometimes to Stephanie's chagrin, his gas mask.
She remembers Joe as a man of action, a "hothead" at times, but always "a good man."
She still gets angry at Joe, but over time she believes her anger will fade. She is sure she will never stop missing him.
Neither will Earl, who said he doesn't get a chance to visit his brother's grave as often as he would like. Though they were twins, Joe was his older brother.
"It was like losing a part of me," Earl said. "He was not just my war brother but twin brother. I took it pretty rough for awhile."
The loss of Joe motivated Earl to take action to prevent further suicides by pursuing a degree in counseling at the University of Scranton. With the reluctance of many veterans to seek counseling, he believes a few words of encouragement from a fellow veteran may be the call to action they need.
"(Counseling) made me a better person," Earl said. "It isn't something that can happen overnight. You need to make it your personal mission to go to every session whether you want to or not. I wish that Joe had done more with this. I'll always think about whether he would still be here, but there are others that are still here and could use the same help."
Contact the writer:
email@example.com, @jkohutTT on Twitter