First Sgt. Landon Jackson left the hospital last year with a mission: To assist other Soldiers, to get them help for post-traumatic stress and depression, and to make visiting behavioral health as commonplace as a visit to primary care for a twisted knee or upper respiratory infection. He didn’t want anyone else making the same mistake he did. He had been so embarrassed by his nightmares and anxiety and rages, and so worried for his security clearance and career in explosive ordnance that he had very nearly destroyed his family and ended his life.
His recovery was long and hard, and his family is still healing. But along the way, he discovered that the more he talked about his combat trauma and his symptoms, the better he felt, so he talked and he talked and he talked. He told his Soldiers everything, and then he started giving speeches at EOD events and graduations, sharing his story with others. To his surprise, many Soldiers responded, opening up about their own struggles. He realized that as a senior noncommissioned officer he was in a unique position to make a difference.
“My main focus is to get leaders in the military comfortable and open about discussing behavioral health concerns, for themselves and for their Soldiers,” Jackson said. “Everybody has their right to their own privacy about their medical stuff, of course. You don’t have to talk about everything. But I think the more open you are, the more it’s going to encourage your Soldiers to get help for themselves. I’d tell my Soldiers what medications I’m on if I thought it would help them. That was one of the main concerns: If I’m on this medication, can I handle explosives? Well, I’m on these and I’m still quite capable of doing my job of handling explosives.”
Scared for your career? Get help anyway
He got help, went back to work and everything turned out so much better than he expected. But Jackson acknowledges that he’s in something of a unique position: His current unit, the 55th EOD Company, is nondeployable, and he has access to some of the military’s premier behavioral health services at Fort Belvoir, Virginia. Its hospital, the Fort Belvoir Community Hospital, is something of an extension of Walter Reed National Military Medical Center and home to cutting-edge therapies and treatments. If he had been up for another deployment, he admits that it probably would have been difficult to remain the unit first sergeant. He would most likely have been pulled from that deployment, which probably would have been detrimental to his mental health anyway.
“You might go to the doctor and they might realize you have some very serious stuff going on and they might recommend you don’t do the job while you’re working on stuff. You might have to look at reclassing to another job or getting out of the military. It’s better to find that out now instead of trying to keep pushing on and end up at a point where you’re suicidal” Jackson pointed out. He had already lost his family and was about to take his own life when he finally reached out, fully expecting to lose his job. But, he figured, “it’s better to go get help … and live than the alternative.”
Talk about getting help
Things have gotten better for Jackson, and a year after his hospitalization, he’s on a crusade to tell his story. He’s found that senior NCOs and officers are among the most reluctant to get help. Like him, they tend to push their own troubles aside and focus on caring for their Soldiers. When he attended an outpatient program at Fort Belvoir, he was shocked to discover he was far from being the senior Soldier in his therapy group, and he wants other Soldiers and leaders to know that they’re not alone and they can come out on the other side. Get help, he urged, but also talk about getting help. That’s especially important for leaders to do.
“Everybody has their right to their own privacy, of course. You don’t have to talk about everything. But I think the more open you are, the more it’s going to encourage your Soldiers to get help for themselves. … I know there’s a lot of military leaders who go to behavioral health and get counseling, but there’s very few who talk about it. That’s great for them … but it’s not doing anything for their Soldiers. … They know you go. That’s no secret. When you don’t talk about it, they’re like, ‘Oh, this is something we’re not supposed to talk about,’” he said, applauding senior NCOs and leaders who wear their uniforms to behavioral health, and who openly go to regular behavioral health offices instead of privately visiting executive medicine.
That can set a dangerous precedent. At a time when far too many Soldiers still feel a stigma when it comes to behavioral health, whether it comes from their commands or exists only in their own minds, any encouragement can make a life-saving difference.
Visit primary care
Going to behavioral health is hard. It’s intimidating, admits Army veteran and U.S. Public Health Service Lt. Cmdr. Robert Burns, a clinical psychologist at Belvoir Community Hospital and Jackson’s doctor. However, going to the doctor for a strained knee or a headache is easy. And many troops who are suffering mental anguish do have physical symptoms. The answer, Burns said, is in assigning more psychiatrists and psychologists to primary care clinics, something the Army is starting to do. It’s then very easy for the attending physician to pick up on some symptoms of depression and say, “Wait here for a few more minutes. We have someone else we want you to see.”
“You can do a lot with a couple of sessions in primary care, and they’ll never have to come up to specialty care,” said Burns. Besides, he and Jackson agreed, going to counseling shouldn’t be any different from having that knee checked out.
Watch your sleep
One of the biggest physical indicators that a Soldier is in distress, Burns continued, is sleep. “When sleep starts to be affected, you probably should start noticing and getting somebody some assistance. … Once sleep goes down everything else kind of devolves from there. When they’re not sleeping, my guess is they’re also showing up to work late or missing formation. They’re not doing morning PT. So there’s a lot of things that in everyone else’s mind they’re probably thinking, ‘He’s a slacker. He’s just lazy.’
“Sleep is probably the easiest identifier that someone is having a difficult time. … They may be thinking about stuff. They may be anxious. They may be depressed. That keeps them awake at night. … They ruminate and then the next day they have problems. … A couple of days? … That’s OK. I think after a week of limited to no sleep you’d probably see signs of something going on.”
Keep an eye on others, even leaders
Sometimes those symptoms will be so obvious that an in-tune battle buddy or sergeant might notice something’s wrong even sooner. The real worry is for those Soldiers who keep everything so close that no one realizes there’s a problem.
“Those are the tough ones because if they’re isolating, people just think they’re quiet or shy,” said Burns. “Maybe they wake up and do their job and they’re quiet and there’s no problems, and then they go home and they’re not partying. They’re just isolating. Maybe nobody knew they just broke up with their girlfriend or maybe so and so died and they’re having a rough time, but they’re able to do their job and they’re not causing any problems. They go completely under the radar.”
This can also be true of senior Soldiers. “They don’t have a lot of people they can turn to,” continued Burns. “They don’t want the younger people, the people they supervise, to think they’re weak.”
In the week or two before Jackson hit bottom, he remembers being quieter than normal and spending a lot of extra time in his office, but not enough that his behavior stood out. After all, he’s a first sergeant. He spends a lot of time in his office doing paperwork so no one really noticed a difference. No one thought to look for one. He was a first sergeant, invincible. He had a temper, but everyone assumed he was fine.
“Sometimes those signs are there, but you don’t realize it until afterward,” he explained, noting that in his experience, they’re often more subtle than those described in suicide prevention training. “I think the best thing that leaders in the military – not just leaders, but military members – can watch out for is the changes in personality, but also know what they have going on in their lives: finance issues, marriage issues, job issues, people who have been amazing Soldiers who just max on everything and they have an injury that ends their career. You’ve got to really watch that. Sometimes really star performers, if they fail at one thing … they don’t know how to deal with it.”
Know and support your Soldiers
The experience was a good lesson for Jackson’s commander too, to stop, to listen more, to gather as much information as possible, to not jump to conclusions. Capt. David Watkins, then the 55th’s company commander, was extremely supportive, Jackson said. Watkins not only made sure his job was safe, he visited him in the hospital constantly.
“It felt like the natural thing to do, the right thing to do,” said Watkins. I just felt, he’s my right-hand man and I wanted to make sure that he’s OK. … I wanted him to get better. I wanted him to get the help he needed. One, it helps me do my job, but in the end, I think he became a friend and he was someone that I was concerned about.
“The services are there,” he advised other commanders. “You need to understand what is truly available … and how to use those services before it’s too late.
Spouses also have a critical role when it comes to post-traumatic stress and depression. They’re often the first to notice that something is wrong. They’re the ones who must somehow cope with husbands and wives so different that they might as well be strangers. Jackson’s wife, Sarah, couldn’t do it anymore. His road rage and anger outbursts escalated until their kids were terrified of him. She finally ordered him out of the house until he finally agreed to get help.
Other spouses now regularly turn to her for advice: “Basically, whenever anyone asks me, now that I do know some resources and we had to figure it out the hard way, I always just try to say, ‘they are hard to find sometimes, but they are trying to improve those things. You just have to find them. You have to make those right connections. Keep asking around.’ I always say, ‘Us spouses have to stick together.’ Find spouses who you can trust, who you can relate to and you feel like you can talk to. Or go to counseling. Spouses are a great resource … because no one understands it as much.
“Have your husband know that they can reach out for help and it doesn’t mean their career is going to be over. It really doesn’t anymore. … If someone like my husband, who is a first sergeant and has all of these responsibilities and is in as dangerous a job as he is, if he can reach out and get help … that should show people,” she continued, adding that she too had fully expected her husband’s career to be over. But even that would have been better than the way they were living.
A possible answer
“I think the best way to prevent suicide is we have to prevent it earlier on. … I’m talking like weeks and months and even years before,” Jackson said – before the nightmares, the flashbacks, the anxiety, the depression are fully ingrained.
It’s like any illness, Burns explained: If you ignore minor symptoms early on, there’s a good chance that they’ll get worse and worse, but if you take care of yourself, your cold might not turn into a raging case of pneumonia. You might need antibiotics and steroids and inhalers and even hospitalization instead of rest and chicken soup. Similarly, if a Soldier asks for help after just a few nightmares, he or she might be fine after a handful of counseling sessions.
“Unfortunately, we don’t get people coming in when things are going well,” said Burns. “We get people coming in when things have hit rock bottom and we’re trying to pick up the pieces. … At that point, it takes a lot more time to work through it.”
Editor’s note: Jackson is set to retire from the Army this month. He recently completed a degree in emergency management and hopes to work in disaster response at the local, state or federal level. He has also founded a peer-to-peer suicide prevention group for EOD Soldiers, After the Long Walk. Sarah is working as a teacher’s aid while pursuing a degree in legal studies. Recently, Jackson and his wife announced they have separated and plan to divorce – their children remain their top priority.
For more information about suicide, read, “The ones they left behind,” “Suicide: recognizing the warning signs” and “What parental suicide means for children.” Learn more about preventing suicide at Army Suicide Prevention Program, Military OneSource (800-342-9647) and the National Suicide Prevention Lifeline (800-273-8255).