Huffington (Issue #64-65)

SPECIAL DOUBLE ISSUE

SEPTEMBER 1-8, 2013

INVISIBLE CASUALTIES The Struggle Against Military Suicides

BY DAVID WOOD

FEATURING

THE SURVIVORS

WARNING SIGNS

GETTING HELP

Contents HUFFINGTON 09.01-08.13

DOUBLE ISSUE

Enter POINTERS: Crisis in Syria ...

Zimmerman’s Request JASON LINKINS: Looking Forward in Angst Q&A: Taylor Schilling HEADLINES

ON THE COVER: SIMON WATSON/GETTY IMAGES; COSTI/STOCK.XCHNG (SKY); ASIFTHEBES/STOCK.XCHNG (BIRDS); PIOTRMATLA/STOCK.XCHNG (TREES); DODODRONT/STOCK.XCHNG (RIVER); KRAPPWEIS/STOCK.XCHNG (CLOUDS); THIS PAGE: COURTESY OF MIKE MCMICHAEL

INVISIBLE CASUALTIES

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Voices KIRK DOUGLAS: On Rejection IRIS HIGGINS: An Apology to All of My Weight-Loss Clients QUOTED

Exit LIFESTYLE: 7 (Totally Normal) Things That Happen to Women During Sex STRESS LESS: Be More Productive With These Apps By Your Side STYLE: Step Into Fall in Style TASTE TEST: Will Expensive Rum Make Your Mojito Better?

‘You Are Burnt to the Ground’

IT’S OK TO CHANGE

By david wood

By dR. CRAIG BRYAN

THINGS FALL APART

second life

By david wood

By david wood

TFU FROM THE EDITOR: Just Ask ON THE COVER: Photo Illustration

for Huffington by Troy Dunham

LETTER FROM THE EDITOR

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Just Ask N THIS WEEK’S issue, we launch “Invisible Casualties,” a month-long series that examines the ever-growing — but not widely discussed — issue of suicide in the military. Since 2000, the rate at which troops are being hospitalized for mental-health illness has risen a startling 87 percent.

David Wood spent months speaking to military members and veterans, their family members and mental-health experts to answer the question: How do we help?

ART STREIBER

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We meet former National Guard Lt. Mike McMichael, who shares the harrowing story that edged him closer to seriously considering suicide — a story that could have had a different end had his wife, Jackie, not intervened. “[Suicide] was the only thing that was going to make things right,” McMichael says of his plan to drown himself in the river outside his home. Until one day, Jackie sat him down and said, “You’re not gonna talk like that

Join the conversation on Twitter and Facebook

LETTER FROM THE EDITOR

anymore,” helping to set him on the path toward recovery.

Thousands of others have not been so fortunate — each day, approximately 22 veterans commit suicide. The stigma associated with suicide, coupled with a national shortage of mental health care providers, prevents large numbers from seeking help.

David confronts this reality, speaking to relatives of military members and veterans who died by suicide. These mothers, fathers and grandfathers of veterans from Iraq, Afghanistan and beyond share their stories in a powerful photo and audio feature in the pages ahead, which we’re calling “Second Life.” As one put it, they are members of a group you’d never want to be part of.

“Invisible Casualties” will also feature a series of brief profiles of veterans who almost committed suicide or seriously contemplated it, then pulled back. And on The Huffington Post, you’ll be able to see a new blog post from a veteran, family member, military member or therapist every weekday in September.

Elsewhere in the issue, the

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legendary Kirk Douglas reflects on his experiences with rejection, and how they shaped his character, and his relationship with his son. Even after a long and fruitful acting career, a rejection later in life “still hurt.”

“Yet, for me, it was a valuable lesson,” he continues. “Some-

The stigma associated with suicide, coupled with a national shortage of mental health care providers, prevents large numbers from seeking help. times what you think you want is not what you really need.”

And as part of our continuing focus on reducing everyday stress, we present seven apps that will give you the tools to live a healthier life at home and at work.

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NO ‘SLAM DUNK’

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President Obama said this week that the Syrian government is responsible for a chemical weapons attack on civilians near Damascus. “We have concluded that the Syrian government in fact carried these out,” he said on PBS. “And if that’s so, then there need to be international consequences.” However, U.S. intelligence officials have said that the connection between the attack and Syrian President Bashar al-Assad or high government officials is “not a slam dunk.” U.S. Secretary of Defense Chuck Hagel confirmed earlier in the week that the U.S. is ready to take military action if Obama gives the orders.

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EX-JPMORGAN TRADER ARRESTED

Javier Martin-Artajo, a former trader at JPMorgan Chase in London, was arrested in Madrid Tuesday for allegedly hiding $6 billion in losses by fudging bank records. The United States had filed criminal charges against him earlier this month. Martin-Artajo denied the charges and said he will fight any request for extradition, the AP reports.

‘WHALE OF A FIGHT’

House Speaker John Boehner (R-Ohio) said this week he wants spending cuts that exceed the increase in the debt ceiling needed when the Treasury Department hits its borrowing limit in mid-October. He promised a “whale of a fight” over the issue. “The president doesn’t think this is fair, thinks I’m being difficult to deal with,” he said. “It may be unfair, but what I’m trying to do here is to leverage the political process to produce more change than what it would produce if left to its own devices.”

ZIMMERMAN WANTS FLORIDA TO PAY

George Zimmerman, who was found not guilty this summer in the killing of Florida teenager Trayvon Martin, wants to recoup some of his legal fees. Zimmerman’s lawyer told the Orlando Sentinel that he will ask the state to pay up to $300,000 in legal bills. State law allows defendants who win a trial to get back money for costs related to the case, such as expenses for expert witnesses, the paper reported.

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MILEY JUMPS THE SHARK

Miley Cyrus, once known for her role as the adorable Hannah Montana, shocked audiences Sunday night with a raunchy performance at the MTV VMAs. The 20-year-old entered the stage in a leotard and later stripped down to latex underwear while grinding against singer Robin Thicke.

MSNBC host Mika Brzezinski denounced the performance as “disgusting and disturbing,” and E! Online tweeted, “Raise your hand if you feel personally victimized by Miley Cyrus’ #VMAs performance.” Rihanna’s blank expression during the act said it all.

BEAR HUG

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Francesca Schiavone just could not get into the game against powerhouse Serena Williams during the first round of the U.S. Open on Monday. After losing eight games and facing another break point, she unexpectedly walked over to a ballperson and gave him a big hug. The 33-yearold Italian managed to win only one game against Williams, ranked the No. 1 women’s tennis player in the world.

THAT’S VIRAL 23 SIGNS YOU’RE SECRETLY AN INTROVERT

A selection of the week’s most talked-about stories.

HEADLINES TO VIEW FULL STORIES

NAKED BREASTFEEDING YOGA MOM WAS FOR REAL

YOU’RE PROBABLY DATING A SOCIOPATH

*NSYNC’S PISSED AT JT FOR THE VMAS PERFORMANCE

WHAT ARE THE CHANCES?

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IMPEACHMENT FANTASIES FILL OUT THE DULL LAST DAYS OF AUGUST DLE HANDS are the devil’s playground, especially during these dog days of summer where the “news” is supposedly “slow.” And so it really shouldn’t be all that surprising that the hot

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new thing among the people who have twiddled their thumbs nearly to death is a fresh load of pipinghot blather over maybe, you know, impeaching President Barack Obama. And I have to admit, what the idea lacks in merit, it more than makes up for in being sort of exciting, in the way that daft people launching homemade flying ma-

President Obama answers national security queries in the East Room of the White House on Aug. 9.

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The recent uptick in impeachment prattle can basically be attributed to a number of factors. First, the whole “August doldrums” phenomenon. Congress is out of session, members are occasionally encountering the low-infos at town hall meetups, and eventually some gobemouche inspires someone to muse half-heartedly on the prospects of deposing the Kenyan-Muslim usurper with the Constitutional nuke. Bored reporters, gambling that “impeachment” will be a fertile search term, let the stories leg out, and eventually we get a nice “trend piece” triad, which officially makes impeachment a Thing.

The second factor involved here is that this is just the natural course of life when you leave a bunch of legislators, unhappy with an election result, all alone with nothing but their lack of a cogent policy strategy and their own nihilism to keep them company.

But the thing about impeachment is that you kind of have to have a crime of some sort with which to work. Back in the early part of this year, the IRS’ kerfuffle seemed like it might do the trick.

The use of the taxman to bedevil

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What the idea lacks in merit, it more than makes up for in being sort of exciting, in the way that daft people launching homemade flying machines off of a cliff can be exciting. one’s political enemies is, after all, the stone-ground essence of an impeachable offense. But as actual facts emerged, the whole “White House directed the IRS to crush the Tea Party” eventually became, “Someone at the IRS had what sounded like a good idea to improve workflow that ended up being a stupid idea.” And the “targets” of the stupid idea ended up being organizations of all sorts of political persuasions.

No one in Washington was particularly inclined to argue in favor

Republican Congressman Kerry Bentivolio’s desire to have Obama impeached goes against U.S. law, historical precedent and good reason.

Enter of the IRS’s management schemes, so it became hard to finger anyone for outright villainy. The “Douglas Shulman visited the White House 157 times” story ended up getting debunked in rather embarrassing fashion. The evidence that the White House stood at the helm of IRS scrutiny never emerged.

Eventually, Obama critics were left to argue that the president was secretly a master “bureaucrat whisperer,” and then that largely whimpered out as well.

For August’s august impeachment fanatics, however, the lack of a compelling reason to impeach isn’t really an obstacle. Take Representative Kerry Bentivolio (RMich.), the dyed-in-the-wool head case who ended up in the House of Representatives because he was willing to be the first and loudest guy to crawl into the crater left by former Michigan Rep. Thaddeus McCotter’s career implosion.

Per Andrew Kaczynski: “I went back to my office and I’ve had lawyers come in,” the congressman continued. “These are lawyers, PhDs in history, and I said, ‘Tell me how I can impeach the president of the United States.’”

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The Michigan congressman then explained to the audience that someone couldn’t impeach the president without evidence.

“Until we have evidence, you’re going to become a laughingstock if you’ve submitted the

Bored reporters, gambling that “impeachment” will be a fertile search term, let the stories leg out, and eventually we get a nice “trend piece” triad, which officially makes impeachment a Thing. bill to impeach the president because number one, you’ve got to convince the press,” he said.

“There are some people out there no matter what Obama does he’s still the greatest president they’ve ever had. That’s what you’re fighting.”

I was not a fly on the wall of these important state discussions, but I am imagining a situation

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Enter where Bentivolio asked a bunch of lawyers to package him up an impeachment, those lawyers gamely attempted to explain how “laws” work, and Bentivolio came away convinced that the media would be just too gosh darn corrupt to accept his argument that Obama should be removed from office just because he had a bunch of superstrong feelings about it.

Bentivolio may be a bit of an extreme case, but the fact is that while many of his colleagues haven’t arranged an encounter session with legal professionals, they nevertheless lament their inability to impeach based on the lack of Senate votes — not the absence of evidence necessary to making a case. Representative Blake Farenthold (R-Tex.), citing the fact that his constituents are always asking him about impeachment, basically made this case at a recent town hall meeting: According to Farenthold, there are probably enough votes in the House for a successful impeachment but not enough in the Senate for a conviction. He didn’t cite any charges that would have to be brought.

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The lingering question of course, is whether or not such “charges” need to have actual merit behind them for them to be brought.

Farenthold cited the failed effort at impeaching President Bill Clinton, arguing that in its failure, the impeachment was harmful to the country.

“What message do we send to America if we impeach Obama and he gets away with what he’s impeached for and he’s found innocent? What do we say he did is ok,” Farenthold said.

I mean, give the guy some credit: He’s totally gamed out every part of the impeachment process

Rep. Blake Faraenthold (R-Tx.) believes a failed impeachment may be bad for the country, citing the attempted impeachment of President Bill Clinton in 1999.

ALEX WONG/GETTY IMAGES

Enter except for that nagging little detail that you actually have to have — you know ... a reason to impeach, beyond “I think it would be fun.”

Will a reason develop? Well, you know, Sen. Tom Coburn (ROkla.) is really worried that the Obama administration is getting “perilously close” to the standard for impeachment, saying at a town hall meeting at Muskogee, Okla., “I think there’s some intended violation of the law in this administration, but I also think there’s a ton of incompetence of people who are making decisions.”

Now, Coburn’s concerns are filtered through the fact that he and President Obama have, over the course of their careers, become oddball BFFs — indeed, half of the reason anyone pays attention to what Coburn says is due to the fact that he and the president have this weird relationship. (And the thing is ... I trust this completely! I absolutely believe that this is how these two guys, with their under-appreciated mordant streaks, demonstrate their affection for one another.)

Coburn went on to say, “Thank goodness it doesn’t have to happen in the Senate until they’ve brought charges in the House.” But the lin-

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gering question of course, is whether or not such “charges” need to have actual merit behind them for them to be brought. Reading between the lines of those musing on the possibility of impeaching the president, you get the strong sense that the precipitating event won’t be a scandal, it will simply be the GOP achieving a Senate majority.

From there, it becomes an exercise of throwing stuff at the wall in the search for something that sticks.

And maybe not even that. As Jonathan Chait points out, “Still, it is noteworthy how many conservatives take the basic moral logic of Obama’s impeachment for granted.” That goes for the legal logic as well.

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Sen. Tom Coburn (R-Okla.) thinks the Obama administration is approaching the standard for impeachment, but he also blames “a ton of incompetence of people who are making decisions.”

Q&A

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Taylor Schilling on Playing a Role of White Privilege “Immediately by the color of her skin... she’s elevated... as Piper gets to know the other people she’s incarcerated with, she sees how arbitrary that is, and how horrific that is.”

Above: Schilling at the premiere of The Lucky One in London, England. Below: Yael Stone (right) and Schilling, who plays Piper Chapman in the Netflix series, Orange Is the New Black.

FOR THE FULL INTERVIEW, VISIT HUFFPOST LIVE

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The Week That Was

SALAH AL-ASHKAR/AFP/GETTY IMAGES (WARPATH); AFP/GETTY IMAGES (50); AP PHOTO/J. SCOTT APPLEWHITE (THE HOSTAGE TAKERS); AP PHOTO (KERRY: IT WAS CHEMICAL)

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08.28.13

08.27.13

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New Delhi, India 08.22.2013 An Indian villager takes a smoke break during a protest in New Delhi. The demonstrators were demanding pension for elderly poor citizens in the city.

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Las Vegas, Nev. 08.18.2013 Lighting flashes behind an air traffic control tower at McCarran International Airport. The storm was one of many that prompted the National Weather Service to issue multiple severe thunderstorm and flash flood warnings in the area.

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Yogyakarta, Indonesia 08.22.2013 Javanese dancers prepare for a performance at Ratu Boko Temple. Every full moon, the art and culture community Saptagama conducts cultural shows featuring dance from Kertaton Yogyakarta and performances from the palaces of the archipelago.

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Rye, England 08.21.2013 A warbler is weighed at a ringing hut on a private reserve in East Sussex.

The reserve is tracking the warblers’ migrating patterns on their route back to Africa.

The information gathered, including age, weight and sex, allows for monitoring of long-term population and global migration patterns.

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Moscow, Russia 08.18.2013 Gaetan Saku Bafuanga Baya of France participates in the men’s triple jump final at the World Athletics Championships in Luzhniki stadium.

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Jammu, India 08.23.2013 An Indian nomadic herder leaps into the flooded waters of the Tawi River. The states of Jammu and Kashmir have been experiencing extremely humid conditions with temperatures soaring above 95 degrees Fahrenheit and 95 percent humidity.

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Edinburgh, Scotland 08.24.2013 Participants take part in the world-famous Tough Mudder competition at Dalkieth Country Estate. Tough Mudder is a military-style endurance obstacle course of 10-12 miles designed by British Special Military Forces.

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08.25.2013 Firefighter Corey Adams of the U.S. Fish and Wildlife Service observes the Rim Fire outside of Yosemite National Park, which approximately 4,500 firefighters are fighting to contain.

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London, England 08.23.2013 Selina Chin tests out her costume for Notting Hill Carnival. Europe’s largest street fair, the carnival was first held in 1964 by the Afro-Caribbean community.

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Bath, England 08.23.2013 A child explores Colourscape on the front lawn of the Holburne Museum. The music festival sees the return of the Colourscape Moonorooni structure, a labyrinth of inflatable, interconnected chambers flooded with colored light, forming a walk-in sculpture of color, light and sound.

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Srinagar, India 08.22.2013 Purple paint is sprayed on a protester in the Kashmiri city of Srinagar.

Police detained dozens of government employees during the protest demanding regularization of contractual jobs and salary raises.

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Manila, Philippines 08.19.2013 Commuters get stuck as floodwaters fill the streets of Manila, a result of unceasing rains that forced a city-wide shutdown and caused evacuations in coastal and mountainous regions.

Tap here for a more extensive look at the week on The Huffington Post.

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KIRK DOUGLAS

On Rejection

ACTORS ARE OFTEN described as “people who love rejection.”

That’s not true. Every year hundreds of young boys and girls come to New York or Hollywood with dreams of becoming an actor and having their name in lights.

Portrait of actor Kirk Douglas with his back against an enormous, fallen tree trunk, circa 1945.

Voices They never expect to meet with rejection. “Too fat! Too thin! Too loud! Too soft!” Most of them go home. I stayed.

I was excited about my first acting venture. My agent sent me to the apartment of Mae West. Most young people today don’t remember her. She was a diva who traveled all over the world in a stage show with six adoring males. At the appointed time, 7 in the evening, I went to her apartment and was ushered into the living room.

I found about 10 good-looking guys also waiting for the audition.

Mae West sashayed down the staircase. She was, surprisingly, a small woman walking on dangerously high heels. She looked around at the applicants. I was the first one to be rejected.

Finally, I got an audition for a small part in a Russian play with an all-star cast. My part was to be a young Russian soldier who was getting ready to go to war. He is saying goodbye to the trees around his house. In the middle of the stage, facing the audience, he cries out to the trees, “YAHOO!!” I didn’t get the part. However, as a small consolation prize, they still gave me a job. When the actor who got the part for which I was rejected called

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out “YAHOO!!”, I was his echo. I stood offstage and murmured, “yahoo!” softly from the wings.

I withstood many more rejections, but finally I got a part in the play The Wind Is Ninety. The New York Times critic said, “Kirk Douglas was nothing short of superb.” That night in bed I poked my wife in her ribs, “Nothing!

Why did he say ‘nothing’? Why didn’t he just say, Kirk Douglas

Mae West sashayed down the staircase. She was, surprisingly, a small woman walking on dangerously high heels. She looked around at the applicants. I was the first one to be rejected.” was superb?” It takes me a long time to get over rejection.

Fast forward two decades. I was the father of a college-age son, Michael. Now every Jewish father wants his son (and now his daughter) to become a doctor or a lawyer. When Michael entered college in Santa Barbara he was going to be a lawyer. I was happy.

But after a month at school he told me he was going to be in a play. I

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Voices was surprised. It was a small part in Shakespeare’s, As You Like It. I drove up from LA to see it. He only had a few lines. After the performance, he asked me, “How was I, dad?” I said, “Michael, you were awful. I couldn’t understand a word that Shakespeare had written for you.” I thought my rejection of his performance would end any interest he had in becoming an actor. After a few months, I got call from him, “Dad, I’m going to do another a play.” I thought, My God, doesn’t this guy ever learn?

But I went up to see it. It was a two-character play. After the performance he asked again, “How was I, Dad?” “Michael,” I said, “you were very good.”

Michael never asks me for anything. I went up to visit him in Santa Barbara; he was living in a ramshackle building. He insisted that I use the cot and he slept on the floor. During the night, I relieved myself outside over the porch. In the morning, I walked over to the toilet in another ramshackle building. I went in and there was a naked girl leaving the toilet with a cheery, “Good morning!” Of course, Michael never became a lawyer and embarked on a career as a professional actor. At

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But even as old as (apparently) I now was, rejection still hurt. Yet, for me, it was a valuable lesson. Sometimes what you think you want is not what you really need.” the beginning, he suffered through the rejection that all actors experience. How they handle that rejection determines whether they ever have a career. Finally, he landed a part with Karl Malden on a TV series, The Streets of San Francisco.

That was his first big break.

Some years earlier, I’d read a book that I loved, One Flew Over

Jack Nicholson in an iconic scene from 1975’s One Flew Over The Cuckoo’s Nest.

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the Cuckoo’s Nest, by Ken Kesey. I was enchanted by it. I thought the leading role, McMurphy, was perfect for me. I bought the rights to the book, but I had a lot of trouble getting a studio interested in it as a film. So I hired a writer and we turned it into a play. I went to New York and performed it on Broadway for six months. The

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Dad, you always say I never asked you for anything but you gave me a lot. Love, Michael.” critics weren’t excited about it, so I went back to Hollywood to make it into a movie. I tried for years.

No studio wanted to do a movie about an insane asylum. I didn’t know what to do. I was so eager to play the part of McMurphy.

Michael Douglas (left) and his father Kirk arrive at the Vanity Fair Oscar Party in 2012.

Voices Michael was doing very well.

He just finished shooting The Streets of San Francisco. One day, he said to me, “How is it going with Cuckoo’s Nest”?

“Nobody wants to do it.”

There was a long pause, and then he said, “Dad, can I try to do something with it?”

I looked at him and thought, I have been trying for years to get this produced. What can he do with it?

But I said, “Okay, you can try.”

Within a year he got the money, a director and was casting the picture. I was very proud of him, but I was so happy because now I would have the chance to play the coveted role of McMurphy.

I went to visit him. “Michael,” I said, “I’m so proud of you! Who’s your director?”

“You wouldn’t know him.”

“But who is he?”

“He’s a foreigner. Milos Foreman.”

“I know Milos! I met him in Prague. He knows me!”

“Well, he thinks you’re too old for the part. He wants Jack Nicholson.”

Now I paused, for a long time.

Finally I said, “Who’s he?”

I was happy that Michael put

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it all together but I was so disappointed that I would not be playing McMurphy. I was secretly anxious to see how badly someone else would muck up my part.

I saw the movie for the first time at the premiere. Despite my personal feelings of rejection, I had to admit it was a great movie. Jack Nicholson was brilliant!

But even as old as (apparently) I now was, rejection still hurt.

Yet, for me, it was a valuable lesson. Sometimes what you think you want is not what you really need. At this point in my life, Michael’s success was more important to me than my own.

Michael has gone on to a tremendously successful career. And he didn’t need any help from me. On my birthday, he gave me a beautiful new car. I sat in the driver’s seat and I saw a note on the wheel. I recognized Michael’s handwriting: “Dad, you always say I never asked you for anything but you gave me a lot. Love, Michael.”

What is the opposite of rejection? Acceptance.

Not just from others — from yourself.

Kirk Douglas is a retired actor, film producer and author.

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IRIS HIGGINS

An Apology to All of My Weight-Loss Clients

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WORKED AT A POPULAR weight loss company for three years. I loved my job there. I LOVED my clients. I loved making a connection and sharing my knowledge.

And I learned a lot about nutrition, about dieting and weight loss and what works and what doesn’t. My job was to be a weight loss consultant, and I learned that job very well. I can design a 1,200 calorie meal plan, tell you which activities are most likely to make the number on the scale go down, and how many carbs are in a cup of rice. I can talk the diet game like it’s my business... because it was. Volumize with vegetables. Don’t

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Voices go too long in between meals. Start with a bowl of broth-based soup.

Are you drinking enough water?

Did you exercise enough? Did you exercise too much? Let’s look at your food journal.

This is not an anti-weight loss company post (although I could write that too). It’s a letter to each and every woman that I unknowingly wronged. My heart is beating a little bit faster as I write this, and so I know this needs to be said. The words have been playing in my head for months. Sometimes it just takes time for me to get up the courage to say the right thing.

So here goes: Dear Former Weight Loss Clients (you know who you are): I’m sorry.

I’m sorry because I put you on a 1,200 calorie diet and told you that was healthy. I’m sorry because when you were running 5x a week, I encouraged you to switch from a 1,200 calorie diet to a 1,500 calorie diet, instead of telling you that you should be eating a hell of a lot more than that. I’m sorry because you were breastfeeding and there’s no way eating those 1,700 calories a day could

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have been enough for both you and your baby. I’m sorry because you were gluten intolerant and so desperate to lose weight that you didn’t put that on your intake form. But you mentioned it to me later, and I had no idea the damage you were doing to your body.

I’m sorry because I think I should have known. I think I should have been educated better before I began to tell all of you what was

I’m sorry because when you were running 5x a week, I encouraged you to switch from a 1,200 calorie diet to a 1,500 calorie diet, instead of telling you that you should be eating a hell of a lot more than that.” right or wrong for your body.

I’m sorry because I made you feel like a failure and so you deliberately left a message after the center had closed, telling me you were quitting. I thought you were awesome and gorgeous, and I’m sorry because I never told you that. I’m sorry because you came in telling me you liked to eat organic and weren’t sure about all the chemicals in the food, and I

CULTURA/LIAM NORRIS/GETTY IMAGES

Voices made up some BS about how it was a “stepping stone.” I’m sorry because many of you had thyroid issues and the LAST thing you should have been doing was eating a gluten-filled, chemically-laden starvation diet. I’m sorry because by the time I stopped working there, I wouldn’t touch that food, yet I still sold it to you.

I’m sorry because it’s only years later that I realize just how unhealthy a 1,200 calorie diet was.

I stayed on a 1,200-1,500 calorie diet for years, so I have the proof in myself. Thyroid issues, mood swings, depression, headaches... oh and gluten intolerance that seemed to “kick in” after about a month of eating the pre-packaged food. Was it a coincidence? Maybe.

I’m sorry because you had body dysmorphic disorder, and it was so painful to hear the things you said about yourself. You looked like a model, and all of my other clients were intimidated by you, asked me why you were there because clearly you didn’t need to lose weight.

And yet you would sit in my office and cry, appalled that a man might see you naked and be disturbed by the fat that didn’t actually exist. I’m sorry because you should have been seeing a therapist, not a

IRIS HIGGINS

weight-loss consultant.

I’m sorry because you were young and so beautiful and only there because your mother thought you needed to lose weight. And because there were too many of you like that. Girls who knew you were fine, but whose mothers pushed that belief out of you until you thought like she did. Until you thought there was something wrong with you. And the one time I confronted your mother, you simply got switched to a different consultant.

I think I should have made more of a stink, but I didn’t. I’m sorry

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Voices because you were in high school and an athlete, and I pray that you weren’t screwed up by that 1,500 calorie diet. Seriously, world?

Seriously? A teenage girl walks in with no visible body fat and lots of muscle tone, tells you she’s a runner and is happy with her weight... but her mother says she’s fat and has to lose weight and so we help her do just that. As an individual, as women, as a company, hell, as a nation, we don’t stand up for that girl? What is wrong with us? There ain’t nothing right about that. Nothing.

I’m sorry because every time you ate something you “shouldn’t” or ate more than you “should,” I talked about “getting back on the bandwagon.” I cringe now every time someone uses that phrase. When did the way we eat become a bandwagon? When did everyone stop eating and become professional dieters? I’m sorry because I get it now. If you’re trying to starve your body by eating fewer calories than it needs, of course it’s going to fight back. I used to tell you that then, when you wanted to eat less than 1,200 calories a day. The problem was, I thought 1,200 was enough. I thought that was plenty to sup-

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port a healthy body. Why did I believe that for so long? I’m sorry because I wasn’t trying to trick you or play games to get your money. I believed the lies we were fed as much as you did.

And it wasn’t just the company feeding them to me. It was the doctors and registered dietitians on the medical advisory board.

It was the media and magazines confirming what I was telling my

I’m sorry because you came in telling me you liked to eat organic and weren’t sure about all the chemicals in the food, and I made up some BS about how it was a ‘stepping stone.’” clients. A palm-sized portion of lean chicken with half a sweet potato and a salad was PLENTY. No matter that you had “cravings” afterward. Cravings are a sign of underlying emotional issues. Yeah, sure they are. I’m a hypnotherapist with a past history of binge eating disorder. I KNOW cravings are a sign of underlying emotional issues. Except when they’re not.

Except when they’re a sign that

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Voices your body needs more food and you’re ignoring it. Then they’re a sign that your 1,200 calorie diet is horseshit. Then they’re a sign that you’ve been played.

And that’s mostly why I’m sorry. Because I’ve been played for years, and so have you, and inadvertently, I fed into the lies you’ve been told your whole life. The lies that say that being healthy means nothing unless you are also thin. The lies that say that you are never enough, that your body is not a beautiful work of art, but rather a piece of clay to be molded by society’s norms until it becomes a certain type of sculpture. And even then, it is still a work in progress.

I owe you an apology, my former client and now friend, who I helped to lose too much weight. Who I watched gain the weight back, plus some. Because that’s what happens when you put someone on a 1,200 calorie diet. But I didn’t know. If you’re reading this, then I want you to know that you have always been beautiful. And that all these fad diets are crap meant to screw with your metabolism so that you have to keep buying into them. I think now that I was a

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I helped you lose weight and then gain it back, so that you thought we were the solution and you were the failure.” really good weight loss consultant. Because I did exactly what the company wanted (but would never dare say). I helped you lose weight and then gain it back, so that you thought we were the solution and you were the failure.

Voices You became a repeat client and we kept you in the game. I guess I did my job really well.

And now I wonder, did I do more harm than good? When I left, you all wrote me cards and sent me flowers. I still have those cards, the ones that tell me how much I helped you, how much I cared. But I’m friends with some of you on Facebook now, and I look at your photos and you look happy. And beautiful. And not because you lost weight since I saw you last. But because I see YOU now. You. Not a client sitting in my chair, asking for my assistance in becoming what society wants. But you, a smart and lovely woman, who really doesn’t need some random company telling her there’s something wrong with her.

So I’m sorry because when you walked in to get your meal plan, I should have told you that you were beautiful. I should have asked you how you FELT. Were you happy? Did you feel physically fit? Were you able to play with your kids? There were so many of you who never needed to lose a pound, and some of you who could have gained some. And maybe sometimes I told you that.

But not enough. Not emphati-

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cally. Because it was my job to let you believe that making the scale go down was your top priority.

And I did my job well.

I am sorry because many of you walked in healthy and walked out with disordered eating, disordered body image, and the feeling that you were a “failure.” None of you

You looked like a model, and all of my other clients were intimidated by you, asked me why you were there because clearly you didn’t need to lose weight.” ever failed. Ever. I failed you. The weight loss company failed you.

Our society is failing you.

Just eat food. Eat real food, be active, and live your life. Forget all the diet and weight loss nonsense.

It’s really just that. Nonsense.

And I can’t stop it. But I can stop my part in it. I won’t play the weight loss game anymore. I won’t do it to my body, and I won’t help you do it to yours. That’s it. End game.

Iris Higgins is a certified hypno­ therapist and women’s health coach.

CLOCKWISE FROM TOP LEFT: CHRIS PIZZELLO/INVISION/AP; YASINGUNEYSU/GETTY IMAGES; GETTY IMAGES/LONELY PLANET IMAGES; ANDREW HARRER/BLOOMBERG VIA GETTY IMAGES

Voices

QUOTED

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“ Looking forward to the day when Facebook is looked back on like water beds, bell bottoms, and disco. Fad.”

— HuffPost commenter whoshooter,

“ I’m on the verge of dying.”

on “Facebook Status Ends With A Really Awkward Twist”

— Mike Tyson

revealed his ongoing battle with drug addiction in a press conference last Friday

“ You say you want to reach out, you say you want to have a new message...

This is not the way to do it.”

— Colin Powell, on Republicans’ pursuit of strict voter identification laws

“ You’re only afraid of oversight if you know you’re doing wrong.”

— HuffPost commenter Mitchell_Horton, on “NYC Council Overrides Bloomberg Vetoes On NYPD Oversight Bills”

Voices

“ There’s nothing you can do with a foam finger that you can’t air on MTV.”

CLOCKWISE FROM TOP LEFT: JASON LAVERIS/FILMMAGIC/GETTY IMAGES; JEFF KRAVITZ/FILMMAGIC FOR MTV/GETTY IMAGES: AP PHOTO/MSNBC; DOMINIC CHAVEZ/THE BOSTON GLOBE VIA GETTY IMAGES; DANIEL ALLAN/ GETTY IMAGES

— James Van Der Beek

on Twitter, referring to Miley Cyrus’ controversial performance at the VMAs

“ The only thing that will stop a bad guy with a gun is a good woman with heart.”

— HuffPost commenter kay360,

on “Kendra McCray And Antoinette Tuff Reunite After School Gunman Incident”

QUOTED

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“ Obviously, the numbers are bad right now.”

— MSNBC’s Chris Hayes,

in an interview with the New Yorker regarding his struggling 8 p.m. show

“ I have to respect a parent who doesn’t try to explain away horrible actions like these.”

— HuffPost commenter Ratso45,

on “Jerry Remy, Red Sox Broadcaster, Blasts Son, Jared, Charged With Murder Of Jennifer Martel”

INVISIBLE CASUALTIES In 2012, the U.S. Department of Veterans Affairs (VA) named September National Suicide Prevention Month, in an effort to demonstrate “support for Veterans in crisis and help raise awareness of the VA mental health services Veterans have earned.” To keep the momentum of that effort going, this September, The Huffington Post is dedicating a special series to that effort. “Invisible Casualties” shines a spotlight on suicide prevention within the military, focusing on those who have successfully overcome struggles with substance abuse, depression and war trauma. The series features original reporting, video and audio, and the work appears on both our website and in Huffington, throughout September. To see all the articles, blog posts, audio and video in the series, tap here.

And please, if you or someone you know needs help, call the national military and veterans crisis line, 1-800-273-8255, or send a text to 838255.

09.01-08.13 #64-65

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‘ You Are Burnt to the Ground’ WAR’S COLLATERAL DAMAGE

BY DAVID WOOD

T

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WASHINGTON

THE GOOD NEWS: most people with military service never consider suicide. Contrary to popular perception, there is no “epidemic” of military-related suicides — even though President Barack Obama used the word in a speech this summer at the Disabled American Veterans Convention. Among those few whose lives do spiral down toward darkness and despair, the vast majority never take that irrevocable step.

The bad news: the number of military and veteran suicides is rising, and experts fear it will continue to rise despite aggressive suicide prevention campaigns by the government and private organizations.

The Pentagon and Department of Veterans Affairs (VA), already struggling to meet an increasing demand from troops and veterans for mental health services, are watching the suicide rates, and the growing number of those considered “at risk” of suicide, with apprehension.

“It really is extremely concerning,” said Caitlin Thompson, a VA psychologist and clinical care coordinator at the national crisis line for the military and veterans.

The warning signs of an approaching wave of suicides are unmistakable.

— While the rate of suicides has traditionally been lower for the military ranks than for civilians, that trend has begun to reverse.

— The number of suicides among active-duty troops of all services

remains relatively low, at 350 last year, Pentagon data show. But that number has more than doubled since 2001, while in the Army’s active-duty ranks, suicides have tripled during the same period, from 52 soldiers in 2001 to 185 last year.

— Roughly half of active-duty troops who die by suicide never served in Iraq or Afghanistan. But there is growing evidence that war trauma weighs heavily on those who did. In one indication of deep emotional stress, the suicide rate among U.S. troops deployed to Iraq between 2004 and 2007, a period of intensified fighting, jumped from 13.5 to 24.8 per 100,000, according to a report issued in 2009 by the Army surgeon general.

— Some 8,000 veterans are thought to die by suicide each year, a toll of about 22 per day, according to a 2012 VA study. The VA acknowledged the numbers

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might be significantly underestimated because they’re based on incomplete data from 21 states, not including Texas or California.

Even so, the data documents an increase of nearly 11 percent between 2007 and 2010, the most recent year of data in the study.

— The population of veterans over 50 — more than two-thirds of all veterans — is swelling with aging baby boomers. Mostly men, they are considered more at-risk of suicide because they tend to be socially isolated, struggle with physical or mental deterioration, and possess easy familiarity with firearms.

The suicide numbers are rising despite a determined push by the Pentagon and the VA to connect troops to a proliferation of resources. These range from immediate crisis intervention, to specific therapy for post-traumatic stress disorder and other forms of trauma, to broader mental health services, peer mentoring, resiliency training, and financial and relationship counseling. VA specialists scour hundreds of places, from NASCAR events to American Indian reservations, for veterans in need. There is such a drive to

provide resources that even the Pentagon can’t say how many programs it has or what they cost.

Suicide numbers aside, there are many reasons to anticipate trouble. Vietnam veterans have gone largely untreated for post-

Some 8,000 veterans are thought to die by suicide each year, a toll of about 22 per day. traumatic stress disorder, and many have buried those emotional wounds by drinking or overworking, said Tom Berger, executive director of the Veterans Health Council of Vietnam Veterans of America. As these veterans age into retirement, symptoms of anxiety and depression often emerge.

Mental stress within the military is already high. A new study by the Armed Forces Health Surveillance Center found that mental disorders are the leading cause of hospitalizations for active-duty forces. The rate at which troops are being hospitalized for mental health illness, it says, has risen 87 percent since

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2000. Those who have been hospitalized have a “greatly elevated” suicide risk, the study found.

Experts such as David Litts of the National Action Alliance for Suicide Prevention believe the stress on the force will continue to rise — even with the pace of combat deployments declining.

One of many reasons for this, Litts said, is that the military is shrinking because of budget reductions, cutting short anticipated careers and disrupting family plans. “A lot of people will be pushed to leave active duty who weren’t planning on it,” said Litts, noting that separation from friends and isolation are key risk factors for suicidal behavior.

The raw numbers of suicides are relatively small: the 350 active-duty suicides last year occurred in a total active-duty force of 1.4 million. Even the estimated 8,000 veteran suicides a year is a small percent of the 22.3 million American veterans.

But any suicide is a tragic loss, crushing to those left behind.

“You are burnt to the ground,” said Kim Ruocco, whose husband, Maj. John Ruocco, a Marine Cobra gunship pilot with 75 combat missions in Iraq, died by suicide in 2005.

WARNING SIGNS SOMEONE MAY BE AT RISK OF SUICIDE

HUFFINGTON 09.01-08.13

People at risk of suicide display warning signs.

It’s important to learn these signs, be alert to them and know what to do next. Most suicides come during an acute but temporary crisis.

Helping someone through a crisis may save a life.

Ask if the person is feeling suicidal. Show that you care. Offer to take that person to get help.

If you have concerns about yourself or someone else, please call the national crisis line for the military and veterans at 1-800-273-8255, send a text to 838255, or open a chat line at the website. It’s staffed 24/7 by mental health professionals, and it’s free and confidential.

EXPERTS SAY THAT PEOPLE WHO MAY BE AT RISK OF SUICIDE OFTEN:

• Appear sad, depressed, anxious or agitated.

• Express hopelessness or say they lack reasons to live.

• Are unable to sleep, or sleep all the time.

• Are withdrawn from friends, family and society.

• Feel trapped or in unbearable pain.

• Have frequent and dramatic mood changes.

• Feel excessively guilty or ashamed, or feel they have been a failure and that their family and friends would be better off without them.

•Abuse drugs or alcohol.

A PERSON THINKING ABOUT SUICIDE MAY:

• Put his or her affairs in order, tie up loose ends and/or make out a will.

• Seek access to firearms, pills or other means of harming oneself.

• Give away prized possessions.

• Call or visit family and/or friends as if to say goodbye.

SOURCES: DEFENSE DEPARTMENT SUICIDE PREVENTION OFFICE, VETERANS CRISIS LINE, DEPARTMENT OF VETERANS AFFAIRS, NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION

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‘I TURNED MY LIFE AROUND’ Recruits are screened for psychological problems and are trained to endure stress. Active-duty troops tend to be more physically fit and more purpose-driven, with far lower rates than civilians of drug and alcohol abuse. They have access to virtually unlimited medical and mental health care. They are all under close supervision, hard-wired into a buddy system and command structure.

For decades, these troops seemed to be sheltered from much of the stress, loneliness and emotional storms of civilian life — reflected in a lower incidence of suicide in the ranks.

But the rising military suicide rate today indicates something fundamental has changed.

Combat trauma certainly is one driving factor. For 25-year-old Andrew O’Brien, an Army grunt who fought in Iraq, it was the sight of the remains of American bodies, after a convoy had struck an IED, that burned into his memory and caused nightmares that eventually drove him to attempt suicide. With the help of family

and a fellow veteran, he said, “I turned my life around.”

A detailed study of troops’ mental health in Iraq by the Army surgeon general, published in 2008, found that three-quarters of young male troops, privates, specialists and sergeants saw someone seriously injured or killed; more than half were attacked or ambushed; 70 percent experienced an IED explode near-

The rate at which troops are being hospitalized for mental health illness has risen 87 percent since 2000. by; and 88 percent received incoming fire. One in five reported being “bothered by thoughts that you’d be better off dead” during the previous four weeks.

Some experts believe that constant exposure to weapons and carnage of war can make the idea of suicide less unthinkable. “We know what death looks like and we’re comfortable with it,” explained a former Special Forces officer who served multiple com-

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INVISIBLE CASUALTIES

bat tours in Iraq and Afghanistan.

Even those troops who never experienced direct combat, researchers are realizing, are nonetheless experiencing the consequences of the damage war can inflict.

The study by the Armed Forces Health Surveillance Center found that for all the military personnel medically evacuated from Iraq and Afghanistan between 2001 and 2012, the most frequent diagnosis was not physical battle wounds but “adjustment reaction,” a category that includes grief, anxiety, depression, post-traumatic stress and other mental disorders.

“We start off with a very healthy population,” said Army Col. William Corr, a physician with the center. “Stress does cause people to become ill.”

In considering the mental toll of war, “we usually think about infantrymen, guys shooting other people, but we are also seeing some problems among non-combatants,” said Craig Bryan, a clinical psychiatrist and suicide expert at the University of Utah, where he is associate director of the National Center for Veterans Studies. Bryan has led numerous research projects on mil-

For 25-year-old Andrew O’Brien... it was the sight of remains of American bodies, after a convoy had struck an IED, that burned into his memory and caused nightmares that eventually drove him to attempt suicide. itary suicide and has served on active duty, deploying to Iraq in 2009 to treat troops for traumatic brain injury and combat stress.

He cited the experiences of Air Force personnel who receive and process the war dead at Dover Air Force Base in Delaware. War trau-

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ma, he said, does affect “all those other career fields who see the consequences of war even if they are not directly involved.”

“We are realizing now that a lot of service members and vets see things and experience events that are not necessarily life-threatening situations but that disrupt their sense of security, what is right and wrong — and that creates tremendous inner conflict,” Bryan said.

A gradual change in the military culture has also raised stress within the ranks, experts believe.

Frequent deployments have increased the isolation of those left behind. At the Army’s Fort Drum in New York, for instance, it was not uncommon after 9/11 for two of the 10th Mountain Division’s three infantry brigades to be gone at the same time, leaving the post a virtual ghost town.

At military posts across the country, many families have chosen to move into nearby civilian communities. More spouses find work outside the military and many send their kids to civilian schools. Under congressional mandate, underused bases have been shuttered and their military

Dr. Craig Bryan, director of the National Center for Veterans Studies at the University of Utah, served in Iraq in 2009 and has led numerous research projects on military suicide.

families sent elsewhere. Social media has made it easy to connect to the world beyond the military.

All of this disrupted what in the 1980s and 1990s was a comfortable, insular existence. Life in places like Camp Lejeune, the Marine base in North Carolina, and the Army’s Fort Benning in Georgia often resembled small towns of the 1950s, with children walking to Defense Department schools, housewives gathering for coffee, families maintaining manicured lawns, and crime and drugs staying mostly outside the main gates.

“Service people used to live in their own world, and I don’t mean that negatively,” said Jacqueline Garrick, a retired Army officer who directs the Pentagon’s suicide prevention programs. “There was

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a protective factor to being in the military, very strong social support, a closed network.”

Now, military communities are vulnerable to the same social ills that afflict civilians. The divorce rate inside the military has risen steadily — for enlisted troops, from 2.9 percent a year in 2000 to 4.1 percent in 2011. Drug and alcohol abuse rose as well through the decade; in 2011 alone, the Army sent 24,000 soldiers to substance abuse programs. The number of those in the active-duty force who tested positive for heroin jumped from 45 in 2005 to 194 in 2011.

“We are not insulated from those things,” Garrick said. “There is not a bubble around our military people, so that the issues of everyday life of America are the issues of everyday life in the armed forces. We are less immune than we used to be.”

Whether the military’s suicide rate has now passed the civilian rate is a matter of dispute among researchers. The numbers are inconclusive, said Gregory K. Brown, a clinical psychologist and suicide researcher at the University of Pennsylvania. “Let’s just say it’s a lot.”

This shift inside the military community is causing defense officials to broaden their suicideprevention campaigns to include servicemen and women who may be struggling with mental health issues, substance abuse, family dysfunction, financial problems and other issues that can be difficult to manage, but do not neces-

Constant exposure to weapons and carnage of war can make the idea of suicide less unthinkable. sarily lead to suicide.

Many of the suicide prevention measures undertaken in the past few years, such as the highly successful national crisis line for the military and veterans, have saved lives in cases where a soldier or veteran literally has a gun to his or her head. Counselors at the crisis line are adept at talking down callers and getting them help.

Experts now acknowledge that intervention also is needed well before that point. The Pentagon’s Garrick explains this using an analogy of a mountain in winter.

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FREE, CONFIDENTIAL HELP FOR THOSE AT RISK OF SUICIDE If you or someone you know is at risk or is considering suicide, free and confidential help is available. The most important thing you can do for someone at risk is to get them help.

• Active-duty personnel of all services, veterans, those in the Army Reserve and National Guard, and their friends and family members can call the national crisis line for the military and veterans at 1-800273-8255. It’s staffed by mental health professionals, and it’s free, confidential and available 24/7. You can also start an online chat from the crisis line website, or a conversation by text at 838255.

• Marines — both active and reserve — and their families can speak to a Marine veteran for any kind of help through the DSTRESSLINE. It’s free, anonymous and available 24/7 by calling 1-877-476-7734 or setting up a chat via the website.

• To access the many resources of the Department of Veterans Affairs, including finding a suicide prevention coordinator near you, tap here.

• To access a portal for active-duty, Guard and reserve troops, tap here to get to a range of resources, including online, telephone and face-to-face counseling.

• To find a therapist, visit the HelpPRO Therapist Finder.

• To find a support group for suicide survivors, visit the Tragedy Assistance Program for Survivors and the American Foundation for Suicide Prevention.

TO FIND MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AND TREATMENT, VISIT:

•S ubstance Abuse and Mental Health Services Administration •M ilitary Pathways, an anonymous mental health and alcohol education screening program •A fterdeployment.org, an all-purpose resource for active-duty personnel, veterans, families (kids and teens, too) and health care providers on issues ranging from post-traumatic stress and anger to those involving work, finances and substance abuse. You can also join a workshop, participate in research, take selfassessments and find additional resources.

OTHER RESOURCES:

• Tap here to learn what kind of support is available for homeless veterans.

• Visit MakeTheConnection.net to meet veterans from your service and find out how they coped with behavioral health issues.

MOBILE APPS:

• Breathe2Relax — a portable stress management tool to reduce stress and calm the “fight or flight” response.

•T 2 Mood Tracker — a diary to record emotions and behaviors on six pre-loaded scales (PTSD, stress, brain injury, depression, anxiety and general well-being).

• PTSD Coach — an app that discusses traumatic stress and how to manage symptoms, and helps users find professional care and crisis support.

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“Life is a slippery slope, and at the top are snowflakes,” she said.

“Coming down the mountain are snowballs, and at the bottom is the avalanche zone where you can be buried alive. The question is, how do we deal with the snowflakes so they don’t become snowballs and avalanches?”

Shifting suicide prevention resources to this larger at-risk group “ultimately will save many more lives,” said Yeates Conwell, a psychiatry professor at the University of Rochester who has done seminal research on suicide prevention and is also co-director of the school’s Center for the Study and Prevention of Suicide.

Intervening early with the atrisk population, he said, might mean early identification and treatment of mental health issues, ensuring that injured troops get the best rehabilitation so they can manage independently. The efforts can help to secure firearms at home and connect struggling soldiers and veterans with peer counselors who have had similar issues.

“What we know about suicide in older adults is that it is a complicated act” that may include

Defense Suicide Prevention Office Acting Director Jacqueline Garrick stresses that suicide prevention efforts need to start early.

many factors, but “is always associated with diagnosable psychiatric illness,” Conwell said. “And by far the most common illness associated with completed suicides is clinical depression.”

The problem, of course, is connecting the copious resources of the Pentagon and the VA with the troops, veterans and families who need them.

FIGHTING THE STIGMA For a variety of reasons — some say they just don’t trust the VA — many veterans under stress don’t get help. Fewer than half of all the nation’s 22.3 million veterans are enrolled with the VA, officials said.

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Those who do try to get help often find that the nationwide shortage of mental health care professionals translates into long lines and long waits for appointments.

“We’re still having trouble getting in to the VA,” said Jackie McMichael, whose husband, Mike, has struggled with traumatic brain injury and suicidal thoughts since his return from Iraq in 2005. “Everybody has trouble getting appointments for mental health counseling.” In a crisis, she takes Mike to the emergency room. But for routine counseling, “you get them for months down the road.”

Even as demand is rising, there are not enough therapists trained in both military culture and suicide prevention to meet demand, said Litts, a former Air Force colonel who designed the military’s initial suicide prevention programs and now manages the National Action Alliance for Suicide Prevention.

“It’s a safe bet that in most communities, there is a shortage of [mental health care] providers that have been trained as well as they should be to assess and manage suicide risk,” he said.

The Department of Veterans Af-

fairs recently hired 1,600 additional mental health care providers. But, Litts said, “there are only so many mental health professionals who are good and who are ready to leave their jobs and go to work for the VA. And if they pull 1,600 qualified professionals out of civilian communities, you’ve just taken 1,600 people who might have treated veterans in the community, where most veterans get their care. It’s a zero-sum game.”

As Rep. Jeff Miller (R-Fla.), House Veterans’ Affairs Committee chairman, put it recently, “[L] ack of access to VA mental health care services remains a deathly serious problem for the department — one that past staffing and budget increases as well as numerous mental health summits have failed to solve.”

Providing mental health care is “a huge challenge not only for the VA, but health care systems across the country — we are not always there when people need us,” Jan Kemp, director of suicide prevention for the VA, said in a recent VA webinar. “Sometimes we are difficult to get to and there are long waiting lines and delays in getting services.”

Once veterans do get mental health care from the VA, “we do

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a pretty good job,” Kemp said in an interview. “What happens to people we don’t provide care to, we are trying to figure it out,” she said, adding that “they are at higher risk.”

Within the military as well, long waits for mental health care are legendary. An Army task force on suicide prevention in 2010 warned of a shortage of therapists to meet the growing demand for behavioral health care. “Although there has been some expansion in the number of behavioral health providers

in all of the Services, timely access to quality behavioral health care for ServiceMembers continues to be a challenge,” the report said.

And despite efforts to erase the stigma of seeking mental health care, many say the military culture is resistant to change. Soldiers wounded physically or psychologically tend to be cut from the herd.

“If a soldier has a mental health issue and fellow soldiers learn about it, then confidence is broken and military careers unquestionably are harmed,” said Dan Williams, an Iraq war veteran who said his unit ridiculed him when he sought help for what was even-

“[L]ack of access to VA mental health care services remains a deathly serious problem for the department,” according to House Veterans’ Affairs Committee Chairman Jeff Miller.

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tually diagnosed as a traumatic brain injury from an IED blast.

In a new survey by the advocacy group Iraq and Afghanistan Veterans of America, 43 percent of Iraq and Afghanistan war veterans who responded said they did not seek mental health care because of a perceived negative impact on their careers.

“We have had massive education campaigns” against the problem of stigma, said Charles W. Hoge, a staff psychiatrist at the Walter Reed National Military Medical Center in Bethesda, Md. “Has stigma changed since the start of the war? The answer appears to be no,” he said at a 2012 conference on traumatic stress. “We have not seen much of a dent in stigma over time.”

Others say attitudes within the ranks about mental health care have changed. “The overwhelming number of patients I’ve seen for suicide risk have gotten help and gone on with their careers,” Navy Cmdr. Andrew Martin, a clinical psychologist, said in an interview.

But, he acknowledged, “some of the people we most want to get help sometimes don’t.”

National Guard, reservists and

veterans face the additional barrier of isolation: they often live far from military health care facilities, are cut off from peers and mentors, and are less likely to know about available resources. It’s also more difficult to keep track of them.

Vietnam-era veterans, in particu-

“ We can provide the greatest clinical care, but if the veteran is unemployed and living on the street, he or she is probably not going to get better.” lar, are often distrustful of the VA — a legacy of that generation’s suspicion and anger at the government — and many have never sought VA health care. Tragically, about 90 percent of military service members and veterans who die by suicide had some undiagnosed or poorly diagnosed mental health problem, according to Caitlin Thompson, the VA psychologist and clinical care coordinator at the crisis line for

★

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INVISIBLE CASUALTIES

the military and veterans. The VA cannot compel veterans to come in for help — even if counselors know where to find them.

Finding veterans and identifying struggling troops in time, and matching them with the right resources, is a major concern of suicide prevention officials at the Pentagon and the VA. The rising suicide numbers, they acknowledge, are evidence that a greater effort is needed.

That’s why the Pentagon’s Office of Suicide Prevention is engaged in a massive effort to determine exactly what programs exist, how much is being spent on them and how they can be more efficiently coordinated. Garrick, the office director, said she has asked each of the military services this summer to report how many suicide prevention programs they have, what they do and what they cost. Answers aren’t in yet, she said.

Many are convinced that the answer lies in part outside the Pentagon and VA, out in the communities where people live.

Across the country, there are fledgling efforts to tackle this idea in two ways: train veteran volun-

“ If a soldier has a mental health issue and fellow soldiers learn about it, then confidence is broken and military careers unquestionably are harmed.” teers to act as peer counselors to troops and other veterans in need, and more closely coordinate with community-based health care providers, including nonprofits.

‘SOMEONE THAT CARES’ At the Philadelphia VA Medical Center, the concept of reaching those at risk of suicide — before they are in crisis — is driving the suicide prevention effort beyond the traditional counseling and therapy for specific mental conditions.

“To us, this is a very small piece of the puzzle of getting better,” said Dr. David W. Oslin, a psychiatrist and chief of mental health at the Philadelphia VA. “We can provide the greatest clinical care, but if the veteran is unemployed and living on the street, he or she is

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CHRIS HONDROS/GETTY IMAGES

INVISIBLE CASUALTIES

probably not going to get better.”

The Philadelphia VA’s work on suicide prevention, although not labeled as such, now includes programs for housing the homeless, pain management, employment, and outreach to veterans in legal jeopardy.

Under prodding from the White House, the VA this summer organized dozens of meetings with community mental health organizations to figure out better ways to serve its communities. At a gather-

ing at the Philadelphia VA in midAugust, local activists and mental health workers brainstormed about new ways to find and connect veterans to their resources.

“It’s not just what we can do in this hospital, it’s what we can do in the community to help veterans get better,” said Dr. David W. Oslin, director of mental health services at the center.

But the fact is, community programs are often underfunded and disconnected. At the Philadelphia meeting, two officials of the city’s Department of Behavioral Health, which has an impressive array of

Iraq War Veteran Robert Wake speaks with physical therapist Nicole Bormann at the VA Medical Center in St. Louis before beginning a counseling session.

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INVISIBLE CASUALTIES

suicide prevention programs and outreach, said they had no veteranspecific programs, did not routinely look for veterans to connect with the VA, and really had no idea where to send veterans in need.

“There are so many resources and different organizations, and one person calling one organization isn’t going to get a fraction of all the help that’s out there,” said Valerie Glauser, a family therapist in suburban Philadelphia. “There is no community clearinghouse for all types of veteran support for those of us who work in behavioral health.”

After hours of discussion, the group came up with two solid plans: spread the word about VA programs in new ways — such as posters on buses and job fairs — and train volunteer veterans for peer counseling.

With all these campaigns and programs, the most effective suicide prevention tool often seems to be an individual — a family member or a friend — who makes the effort to be available.

Army Sgt. Maj. Joseph Sanders, now 48, twice attempted suicide when depression, illness and anxiety sent him into what

seemed like a bottomless pit with no other way out.

One time he put a bullet in his revolver, and when he pulled the trigger it clicked on an empty chamber — a shock that brought him to his senses. The second time he ran his car engine in a closed garage before suddenly realizing how much he had to live for.

At 1 a.m. he banged on a friend’s door to ask for help.

“All it takes,” he said. “You always have someone to turn to, someone that cares.”

His friend took him that night to a military chaplain and then to a suicide prevention officer. “We worked up a safety plan, and they said, ‘You go on home now and we’ll call in the morning to make sure you’re okay, and we’ll call you in the evening and continue checking on you until everything is okay and you’re not feeling as stressed.’”

“Well,” Sanders said.

“That was quite effective.”

HuffPost reporter and Pulitzer Prize-winner David Wood (left) explains the thinking behind the “Invisible Casualties” series.

INVISIBLE CASUALTIES

Things Fall Apart PUTTING A BROKEN VETERAN BACK TOGETHER

BY DAVID WOOD

PHOTOGRAPHS BY JEREMY LANGE

A INVISIBLE CASUALTIES

DURHAM, N.C.

A STORY MIKE MCMICHAEL’S grandma told him when he was young probably saved his life. But that was years after he had grown up to be a National Guard infantry officer, been knocked unconscious by an IED blast in Iraq and come home after a long combat tour with brain injuries the Army never diagnosed.

It was after worsening tremors and memory lapses forced him to quit the military, and after blackouts and violent rages cost him his civilian job and nearly drove away his wife, Jackie, and their four young children.

It was when he felt he’d failed as a warrior and failed as a dependable wage earner and failed as a husband and dad. When suicide began to look like the only option left, it was then that he remembered the story his grandma had told him. She’d been a nurse, and the story went like this.

Many years before, a man in his prime unaccountably had fallen on such hard times that he came to believe suicide was the only way to end his pain. He put a shotgun under his chin and pulled the trigger. The blast blew off his face and part of his brain, but it left him alive and breathing.

For the rest of his life he sat in a chair, unable to speak, alone with his thoughts. Inside, the young Mike imagined, he was silently screaming.

“How did things get so bad in his life that he thought that was the answer?” Mike wondered.

In Mike’s own darkest moments, when thoughts of suicide were banging up against his zest for life

and love for his family, the story weighed on him. He hesitated, perfecting the suicide plan but putting off the decision. “I didn’t want to be that guy,” he explained.

“That’s what drug it out.”

So far, at least, Mike, now 39, has triumphed over his demons.

But it’s been close. He is a stocky, well-muscled man whose commanding presence, friendly, backwoods demeanor and liquid Carolina diction camouflage a world of hurt and struggle.

For too long, Mike got no help.

For too long, professional help was out of reach. For too long, he resisted what help there was.

In that, he is like too many others, military men and women who remain at risk of suicide.

Invisible casualties, they are

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INVISIBLE CASUALTIES

combat troops afflicted with brain injury and war trauma. They are victims of military sexual trauma.

Aging veterans living alone with deteriorating bodies and minds.

The physically wounded who’ve become addicted to painkillers, and people whose lives are temporarily derailed by the death of a loved one, illness, job loss, homelessness or the breakup of a close relationship.

Follow any case of attempted or completed suicide far back enough and you will find one missed opportunity after another. Mental

illness remains difficult to recognize, difficult to acknowledge.

Asking for help is hard; many troops remain convinced that seeing a counselor will damage their career. There is a national shortage of mental health care providers. Many find it impossible to sort through the hundreds of programs the military and the Department of Veterans Affairs (VA) offer to individuals and families.

Researchers are now looking at suicide factors that can be detected long before a crisis — at traumatic brain injury, for instance, the wound that changed Mike McMichael’s life. Since 2000, a quarter

A family portrait of the McMichaels taken on the Tar River while Mike was on leave in October 2004.

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INVISIBLE CASUALTIES

million troops have been diagnosed with TBI, and many more injuries — like Mike’s — went undiagnosed because the military didn’t start battlefield testing until 2007.

Recent studies have conclusively linked traumatic brain injury to suicidal behavior. But for too many, the military’s improved screening and treatment for mental health issues have come too late. Indeed, Mike’s trajectory is a common and troubling case, a roadmap of how things go wrong.

UNDIAGNOSED AND UNTREATED Drawn early to military service, Mike enlisted in the National Guard in 1995 while working for a local power company in Raleigh, N.C. He rose quickly through the civilian and military ranks, getting regular promotions and pay increases at the power company and being selected to become an officer in the Guard.

When war came, Lt. McMichael was a platoon leader in Charlie Company, 1st Battalion 20th Infantry, North Carolina National Guard, and found himself in Iraq’s

Were you ever in fear of your life? Check.

Felt hopeless, check.

Ever see bodies, check; ever see civilian injuries, check. Anxious and sleepless, check.

Saladin Province north of Baghdad, where the insurgency was escalating and IEDs were killing with unnerving regularity. A natural leader, Mike was promoted to become the company executive officer, a position in which he felt directly responsible for the lives of 174 North Carolinians. His radio call sign: ManDog Five.

He had several near misses with IEDs, but in late November 2004, two 155-mm artillery shells wired together with a cell phone detonated when insurgents dialed the number from a safe distance. The blast blew his unarmored Humvee off the road; Mike was unconscious for five minutes or more. When he came to, he couldn’t hear or see or feel anything, but gradually his blindness opened to tunnel vision and a bit of his hearing came back.

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He could hear moaning and someone shouting, “MadDog Five’s hit!” but it turned out everyone was okay. At least no one was dead or had limbs torn off.

“The way it was, when you got hit like that, you got out of the wreckage and said, ‘Whew! We made it!’ If you weren’t bleeding, pretty much you went on and continued with the mission,” he explained. “There was no going to get a head scan or anything like that.”

With two weeks left before the battalion was due to rotate home, Mike did what countless other troops have done with a concussion: nothing. His head hurt horribly every day, but he felt deeply responsible for his soldiers and — like many combat leaders — he took personal responsibility for their lives. “I had to get those 174 dudes back home safe. Even though my head hurt so bad I couldn’t sleep,” he said.

“What I’m trying to say is that there was no system to help the macho soldier who’s not going to do anything unless he’s bleeding out,” Mike said. “I knew a concussion ought to be checked out. I didn’t know you would possibly have a

brain injury.” Or that complications from that injury would eventually drive him toward suicide.

When Mike and his soldiers were being processed off active duty at Fort Bragg in North Carolina, they were anxious to get home to their wives and kids. At one point in what seemed like an endless bureaucratic process, Mike filled out a questionnaire about his combat experience and handed it

Mike and his wife, Jackie, who he credits with his recovery.

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The new diagnoses of TBI that occurred anywhere U.S. troops are located climbed steadily over the past decade.

35k

Brain Injuries 30k

25k

20k

15k

10k

‘WHERE’S THE OLD MIKE?’ Mike kept up with the National Guard one weekend a month, and took back his old job as lineman for the local power company. Out of some kind of misplaced pride, he didn’t admit his problems to anyone. “I had guys that lost legs; what’s wrong with me that I can’t

2012

you’re high on life for a while. That’s the drug that keeps you going.”

2011

SOURCE: DEFENSE AND VETERANS BRAIN INJURY CENTER, DEPARTMENT OF DEFENSE

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

to a doctor behind a window. She nodded and set it aside. Neither he nor the Army ever followed up.

Looking at a copy of that form years later, Mike realized he had checked every indicator of severe post-traumatic stress disorder on the sheet: Were you ever in fear of your life? Check. Felt hopeless, check. Ever see bodies, check; ever see civilian injuries, check. Anxious and sleepless, check. And so on.

“If you look at this thing you’d know, this dude is gonna have trouble and needs to talk it out,” Mike said. No one pulled him aside for PTSD counseling, nor was there any screening for traumatic brain injury as there is today.

There was a point where he could have said, yes, I think this is wrong with me, check me out before I go. But you knew, Mike said, “that if you checked yes, I was in a blast and my head still hurts, you’re probably going to be in a medical hold battalion forever. And it’s gonna be that much longer before you ever see your family.”

So home he went, undiagnosed and untreated. In those first months, he said, “You are kind of over-stimulated from all the choices,

A Spike in Traumatic brain injury

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Among active-duty troops, the war years have seen a persistent rise in suicides.

35k

30k

All-Active Duty 25k

20k

Army

15k

Marines 10k 2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

Active-duty troop suicides per 100,000 15

10

5 0 2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

handle this, there isn’t anything really wrong with me. I didn’t want to show weakness,” he said. He’d get together with his Guard buddies and the subject of mental stress never came up — even though, he found out later, they were all having the same issues. They just wouldn’t admit them to each other.

Mike’s trouble started slowly at first. Memory lapses. Fits of pointless anger. Anxiety attacks that left him gasping on the floor. Occasional screaming nightmares. He couldn’t shake the memory of his convoy getting ambushed outside Baghdad; a fuel truck had caught fire and Iraqi bystanders burned to death. He was in charge, responsible for getting his guys out of a trap. In his tortured dreams he could see other Iraqis screaming, faces contorted, shaking their fists at him, as he pushed the convoy forward past the wreckage.

All this got bad one night close to Christmas 2005, when he’d been home a year. Something threw him into a black fury. He punched holes in the wall, tipped over the Christmas tree and ripped up furniture while his wife, Jackie, and their boys scampered

an alarming rise

NOTE: DOES NOT INCLUDE NON-ACTIVE NATIONAL GUARD AND RESERVE PERSONNEL. COMPARABLE U.S. CIVILIAN POPULATION SUICIDES, ADJUSTED FOR AGE, SEX AND RACE, AVERAGE 2001-2006: 19.1 PER 100,000.

SOURCE: 2011 DEPARMENT OF DEFENSE SUICIDE EVENT REPORT

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away and hid. Jackie frantically dialed 911. It took an hour. “I kept calling, begging them to hurry. I told them I have babies here, he will kill us and not even remember it the next morning,” she said.

The sheriff’s deputy who arrived went for his gun when Mike burst from the house — bloody from busting his hands on screws and splinters — brandishing what looked like a weapon (it was a broken piece of chair). The officer had his service revolver out, but he himself was a Vietnam combat veteran who had been through this kind of emotional

turbulence and had gotten help.

“I need you to get down on the ground now, sir,” he told Mike, and Mike obeyed. He got Mike into his squad car, and rather than throwing him in the county lockup, where his violent rage could break out again, he delivered him to Mike’s mother, who kept him safe overnight.

In the morning, Mike found the officer’s card in his pocket.

Next time, call me, it said in a scrawl on the back. Anytime you need to. Anytime.

He told Mike later that any cop who wasn’t a veteran and didn’t know what was going on might have shot him, and been justified in doing so.

Mike enlisted in the National Guard in 1995. He is seen here on duty in Iraq.

“I had guys that lost legs; what’s wrong with me that I can’t handle this, there isn’t anything really wrong with me.

I didn’t want to show weakness,” — said Mike,

pictured here with his dog.

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INVISIBLE CASUALTIES

Mike spent several days in a civilian mental health care hospital, and doctors began trying different medications to calm him down while also trying to keep him alert enough to work. Nothing helped.

At one point months later, Mike dug out a refrigerator magnet he’d been given with the phone number of Army OneSource, a portal for medical, mental health and family support resources. He dialed the number and eventually was put in touch with a civilian psychiatrist.

But he felt she had no experience with the military or an understanding of military culture, and after a while Mike stopped seeing her.

His first brush with suicide had come earlier that year, in the spring of 2005. Jackie discovered Mike had lost his ability to manage money; he’d been on thousand-dollar shopping sprees at Target, bringing home “junk.” She took away his checkbook and credit cards. His angry outbursts continued. He was back with his National Guard company once a month, but found he could no longer lead his men. He’d stand in front of them without being able to think what to do or say.

“I didn’t own up to the fact that

“ ... there was no system to help the macho soldier who’s not going to do anything unless he’s bleeding out.” something was wrong with me, and ask ‘em to check me out and get medicaled out,” he said, referring to the process of getting a medical separation from the Guard.

Ashamed, he resigned his commission, “the hardest thing I have ever had to do.”

At work, he found his hands trembled so hard it was dangerous for him to handle 14,000-volt power lines. He was given other duties. Once a happy, popular and fast-moving lineman, now he was a shadow of his former self.

He had disabling anxiety attacks.

“Where’s the old Mike?” his bosses would ask him. “We want the old Mike back!” Eventually he was fired, ashamed and terrified to tell Jackie he had failed again.

SCREW RESPECT The McMichaels’ house in rural Franklinville, along the banks

★

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INVISIBLE CASUALTIES

of the Deep River, a short drive from Durham, is filled with photos of Mike in happier times.

“The old me,” Mike said. “I could see it in my face, a happiness and some sparkle. Strong innocence. And seeing Jackie’s face, so happy and innocent of how bad a man can get after you marry him. And I wanted so bad to have that innocence again for me to provide that to her.”

“But I wasn’t the same guy, and I didn’t understand it,” Mike said.

One day he learned in a phone

call that three of his former soldiers, men he’d been with in battle, had died: one by heart attack, one in a car accident. The third, Mike said, died of a drug overdose.

“It broke me,” Mike recalled.”I was kind of drowning.” Suicide “was the only thing that was going to make things right. I felt so worthless, it just seemed like the right answer,” he said. The plan was to drown himself in the Deep River, so swift it once powered textile mills. He kept fiddling with the mechanics of it; he’d have to wait until the river flooded after a heavy rain and figure out how to knock himself unconscious.

Mike with his son on the day he left for Iraq in December 2003.

After war, a lifetime of struggle

69.3%

22

PERCENTAGE OF ALL VETERAN SUICIDES ARE OVER AGE 50

20

16.5%

18

60-69

50-59

2010

2009

2008

2007

2006

2005

2004

2003

“The problem was trying to find a way that would definitely do it and look like an accident,” Mike said. “Never thinking about what it would look like to my family.”

Jackie is a lively brunette with a master’s degree in counseling and a growing family, and during this time she was frantically looking to get Mike help. But she couldn’t find it. One day she phoned the local Vet Center, a drop-in place with peer counselors that is funded by the VA but free of its bureaucracy. She asked if she could bring in her husband because he needed help quickly. No, she says she was told, he has to come in himself.

He has to ask for help.

He’s uncomfortable asking for help, she said. He says, guys have lost their legs, help should go to

2002

80+

2001

14.2%

16 2000

70-79

20%

1999

18.6%

PHOTO OR ILLUSTRATION CREDIT TK

Estimated count of veteran suicides per day:

SOURCE: DEPARTMENT OF VETERAN AFFAIRS SUICIDE DATA REPORT 2012

“ ... when you got hit like that, you got out of the wreckage and said, ‘Whew!

We made it!’ … There was no going to get a head scan or anything like that.” them first, what’s wrong with me that I can’t handle this? Sorry, she was told. We can’t help anybody who isn’t ready to come in.

When Mike started talking again about suicide, she realized it was up to her to stop it, to push aside her fear of confronting him. Until then, she’d tried to respect his decisions.

Screw respect, she told herself.

“You’re not gonna talk like that anymore,” she told Mike in a serious sit-down. “Don’t threaten

★

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INVISIBLE CASUALTIES

us with that. Because I know the plan and it’s a good plan and I know you mean it.”

Later, she explained, “I felt if I had not taken that threat seriously, it would only have escalated, and he’d been through so many bouts of anxiety and depression and desperation that he could have easily gone and done something.”

She dragged Mike off to the Durham VA Medical Center. It was 2008, almost four years after he was blown up in Iraq. His TBI finally was diagnosed. Doctors listened. Mike got counseling, medication. He took part in a 10-week program for veterans with PTSD at the Salem VA Medical Center, where veterans use role-playing to re-live traumatic combat experiences in which they feel they failed.

“You’ll have guys telling you, ‘Dude, it’s okay, you did the best that could be done there, it’s okay to let it go,’” Mike recalled.

“It’s a fantastic program,” Mike said. “I’d always said, don’t ever take me to the VA. But I’ve had amazing experiences with the VA. Every once in awhile I call to thank them for saving my life.”

‘MY HUSBAND IS A HERO’ Of course, it hasn’t been easy, and the McMichaels’ future is uncertain. Today, almost nine years after his wartime experiences derailed the life that he and Jackie had imagined, Mike is still in a fragile state.

He is unable to handle financial transactions, and still struggles with memory. He regularly sees therapists and doctors, even acupuncturists. He does yoga for exercise and relaxation. His medications seem to be keeping him in balance.

Jackie taped pictures of Mike at eye level around the house so that their son, born just two weeks before Mike’s deployment, would recognize him.

the risk factors

915

57%

Were under age 25

ACTIVE-DUTY NON FATAL SUICIDE ATTEMPTS IN 2011:

64%

Had a known behavorial health disorder

241

Air Force

46%

86

Had a known failure of an intimate or spousal relationship

Navy

75%

156

Were male

Marines

64%

432

Involved misuse of prescription drugs

Army

301

ACTIVE-DUTY FATAL SUICIDES IN 2011:

59%

Had no history of deployment to Iraq or Afghanistan

Of those who did deploy, percent with no direct combat experience

SOURCE: RAND REPORT, THE WAR WITHIN: PREVENTING SUICIDE IN THE U.S. MILITARY

Disability compensation payments from the VA keep the family afloat financially, but only just.

The future they’d imagined, one of promotions and pay raises, is gone.

Jackie has moved away from her role as wife and settled into a role she describes as more of a manager

82.9%

of her husband, one “which is uncomfortable for me,” she allowed.

Mike’s headaches are constant and occasionally erupt into blinding migraines that drive him to his knees. Jackie has fought with doctors who’ve changed his medications and not told her.

“My brother used to say, ‘Why do you stay with him?’” Jackie said one day. “Because the man I married

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wouldn’t give up on me. My husband is a hero and he feels immense pride at what he did over there.”

Still, she said in a quiet moment, being in the military “you give up so much. I try not to think about it in terms of sacrifice.”

As with many who’ve considered suicide, there’s no single, overpowering factor that keeps Mike back from the abyss. No head-smacking insight. No one wrestled him to the ground and took him in handcuffs to the VA. Nothing that dramatic.

Instead it is the constant and steady presence of his wife, friends and other veterans. And his kids.

The patient work of doctors and therapists at the VA and elsewhere who help Mike deal with pain and frustration. And — crucially important to those at risk of suicide — the absence of guns in his house. Quick access to firearms is the number one factor in suicides among service members and veterans. Sixty percent of military suicides in 2011 were by firearm, according to the Defense Department’s most recent annual report.

Jackie, Mike believes, saved his life. He owes her, and their four

“ My brother used to say, ‘Why do you stay with him?’” Jackie said one day.

“Because the man I married wouldn’t give up on me.

My husband is a hero…” children, big time. “It’s been rough for me, but nothing compared to what I put them through,” he said.

“What they’ve seen dad go through ... I apologize to them, because they never know which dad they’re going to get. I can go off like that! And sometimes I don’t realize it until I see the

★

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“ Instead of those namby-pamby little briefings they give you when you come home...

You need people who’ve been there, done that, who can say, ‘What you’re feeling is normal...’ ” scared look on their faces. It shakes them to the core.”

Mike has thrown himself into helping other veterans by organizing a group of retired service members who act as peer counselors for veterans in need. That’s the missing link, he believes, between veterans struggling with mental health or any other issue, and the resources of the VA. It should be veterans and their spouses who brief returning troops, he says. They can point out the things they did wrong, the problems they had, and how to avoid those problems and get help. “Instead of those nambypamby little briefings they give you when you come home,” he said, referring to the briefings he got at Fort Bragg. “You need people who’ve been there, done that, who can say, ‘What you’re feeling is normal, it can happen

and you’re not alone, and here’s where I found some help.’”

“We gotta do something,” he said. “The suicide rates just keep going up and up.”

Even as he is immersed in helping other veterans — he is chairman of the veterans advisory council at the Durham VA — Mike struggles to manage his own demons. He and Jackie have worked out ways to de-escalate arguments and she has made accommodations to his impaired ability to plan, manage money, even drive.

Sometimes, though, Mike’s headaches get so bad that he tells Jackie, “I don’t know how long I can live with this kind of pain.”

Ask Jackie how Mike is doing and her answer is simple.

“He is maintaining.”

David Wood is the senior military correspondent at The Huffington Post and the winner of a 2012 Pulitzer Prize in National Reporting for his series “Beyond the Battlefield.”

★

INVISIBLE CASUALTIES

second life

THE TRAGEDY OF SUICIDE is not only the loss of an individual but the profound grief that is left behind. We asked relatives of military members and veterans who died by suicide to tell their stories. They are men and women who are, as one put it, members of a group you never want to be part of. They hope their stories will help other suicide survivors find comfort, and will convince those at risk of suicide to seek help now.

DANNY WEISS

RICHARD STUMpf

JEFFREY SVOBODA

Benjamin t. Miller

INVISIBLE CASUALTIES

DR. CRAIG BRYAN

It’s ok to change

F

OUR YEARS AGO this month I returned from Iraq, which was sort of my last big mission as a military psychologist before “becoming a civilian.” As a psychologist I was interested in trauma and suicide long before my deployment, but there’s something very different about listening to a soldier tell the story of his buddy’s death while he’s still lying in a hospital bed having fragments of metal removed from his leg as compared to hearing the same story in your clinic in the U.S. two years after the fact. It was also in Iraq that I first stood over the body of someone who had died

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It was ... in Iraq that I first stood over the body of someone who had died by suicide, feeling a mixture of helplessness, grief, and anger; an experience that had, for me as a suicidologist, been merely an intellectualized concept. by suicide, feeling a mixture of helplessness, grief, and anger; an experience that had, for me as a suicidologist, been merely an intellectualized concept. Four years ago, psychiatric disorders and suicide became personal to me.

Suicide is the fatal outcome of psychological injury. I should stress, however, that not all psychological injuries sustained by military personnel and veterans occur during deployments. For many of the service members and veterans I’ve worked with, the psychological injuries occurred during childhood at the hands of an abusive or demeaning parent; for others it was sustained within the context of a recent breakup or a financial crisis. Indeed, more than half of service members who die by suicide never deployed or saw

combat. The good news is that we have very effective treatments for the full range of psychological injuries that lead to suicide. The bad news is that very few service members or veterans will receive them.

Clinic-based mental health services have been expanded dramatically for service members and veterans over the past decade across both the public and private sectors. Mental health treatment is arguably more accessible and affordable for service members and veterans now more than ever, due in large part to community mental health professionals and agencies offering free or significantly reduced-cost services. Although admirable, these efforts are not enough, and too many psychological injuries remain untreated.

One of the primary problems is that the expansion of mental health services has largely occurred in traditional, clinic-based settings

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INVISIBLE CASUALTIES

that are unlikely to be accessed by most service members and veterans due to pervasive mental health stigma. Only a very small proportion of service members who die by suicide (16 percent) visited a mental health care professional within the month preceding their deaths.

Despite our decades-long battle with mental health stigma among service members and veterans, we have yet to see much success, primarily because we have failed to consider the issue of mental health treatment and stigma from within the context of the military culture.

In the military, we value strength, mental toughness, elitism, and self-sufficiency, but the culture of mental health is deficiencyoriented and values emotional vulnerability, which contradicts the core identity of many service members and veterans. We mental health professionals need to adopt a multicultural approach to working with service members and veterans, and to change how we deliver our services to better fit with military cultural norms, instead of asking service members and veterans to abandon their identities and conform to our standards.

From my perspective as a mental health professional, an even bigger tragedy is the realization that when service members and veterans do overcome mental health stigma and access care, they are still unlikely to receive the best treatments available. This is not a DOD or a VA problem; this is a problem of our mental health care system as a whole in the U.S., which continues to perpetuate the myth that all psychological treatments are equally effective, and that any treatment is better than no treatment. What we actually know, however, based on decades of research, is that trauma victims who receive prolonged exposure (PE) or cognitive processing thera-

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INVISIBLE CASUALTIES

In the military, we value strength, mental toughness, elitism, and self-sufficiency, but the culture of mental health is deficiency-oriented and values emotional vulnerability, which contradicts the core identity of many service members and veterans. py (CPT) for PTSD are three to four times more likely to experience full remission from PTSD. These better outcomes occur regardless of the trauma, whether rape, violent assault, or combat. Early findings further suggest that PE and CPT reduce suicidal ideation among military personnel with PTSD. And just within the past month, preliminary data presented at the American Psychological Association’s annual convention indicate that brief cognitive behavioral therapy (BCBT) for suicidal military personnel contributes to a 50 percent reduction in suicide attempts and significant reductions in PTSD symptoms as compared to traditional mental health care approaches. In short, some treat-

ments work better than others, and are more effective at helping service members and veterans.

For many of us, the service members and veterans who are suffering from these psychological injuries are family members and friends. And some of them are dying from their injuries. Improved access to mental health care without improved quality of care will do little to prevent suicide among service members and veterans. As mental-health professionals we must therefore commit ourselves individually and collectively to learning and using these better treatments that we know can help service members and veterans live lives that are worth living.

It’s okay for us to change.

Craig J. Bryan is an associate director at the National Center for Veterans Studies.

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LIFESTYLE

7 (Totally Normal) Things That Happen to Women During Sex

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BY CATHERINE PEARSON

ONE ARE THE DAYS when people thought women were inherently squeamish about sex.

And good riddance. It’s so obvious, it seems silly to even say it, but women are every bit as interested

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in having sex as men — and just as comfortable with the nitty gritty.

(Many of them even want it more.)

But sometimes, things happen during sex that can take even the most sexually confident of us aback. There are sounds, and smells and feelings that make us stop and think ... “Uh, what just happened?”

“Is that normal?”

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So we asked a team of sex-health experts to spill: What are some typical things that happen to women during sex, but that you never really hear people cop to or wonder about? And what, if anything, do they mean? Here’s what they said.

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YOU’RE DRY Dr. Mary Jane Minkin, an ObGyn with Yale University and spokesperson for FirstResponse said that it’s very common for women to become (or stay) dry or irritated during sex. In fact, Women’s Health reports that roughly one-third of young women say they experience vaginal dryness. But lubrication is one of the keys to a pleasurable, comfortable sexual encounter.

The best way to get there, according to Minkin? Good ol’ fashioned foreplay. “Vibrators can help,” she added — and there are plenty of personal lubricants on the market.

YOU’RE DISTRACTED Sometimes when you’re having sex, you’re totally in the moment, incapable of thinking about anything else. Other times, you’re thinking about approximately 12 million other things. “Women report that they’re pretty easily distracted by what is happening in their life,” said

There are sounds, and smells and feelings that make us stop and think ...

‘Uh, what just happened?’

‘Is that normal?’”

Resnick Anderson. “They wonder if something is wrong with them.

‘Why am I thinking about that?

Why am I not able to focus?’”

Sometimes, it is what it is, she said. In other words, women shouldn’t beat themselves up if other elements of their lives creep into the bedroom. But if distraction becomes a frequent issue, there are mindfulness interventions women can try — most of which they practice on their own — that can make

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them feel more connected and focused, Resnick Anderson said.

YOU HAVE ‘THE MOMENT’ No, not an orgasm, but that moment — seconds or minutes after sex begins — when you just somehow know how the rest of the encounter is going to play out for you, good, bad or otherwise.

“When I mention it to women, they say, ‘How did you know?’” said Kimberly Resnick Anderson, director of the Summa Center for Sexual Health in Ohio.

When it comes to sex, women often start in a state of “sexual neutrality,” she explained. “Sometimes, you start engaging in sexual activity and right away, you think, ‘This is going to work.’” Other times, you sense that what’s coming next will be nice, or fun, but that you won’t quite get there. Women are pretty intuitive about whether they’re going to be able to achieve orgasm, Resnick Anderson said.

YOU FEEL LIKE PEEING “If during certain sexual positions, like doggie-style, you [have] a need-to-pee feeling, it’s completely normal,” said Amy Levine, a sex coach and founder of Ignite Your Pleasure. “Those sensations are

usually from G-spot stimulation, which can lead to female ejaculation. Ejaculate comes out of the urethra and is clear and odorless.”

That said, it is entirely possible — and not atypical — for women to pee and orgasm at the same time.

Some women find they pee a little when they laugh, sneeze or orgasm,

Women are pretty intuitive about whether they’re going to be able to achieve orgasm.” particularly after giving birth. It’s also easy to confuse the feeling of an impending orgasm with the urge to pee. “Women who do not experience urinary incontinence at other times, but feel the urge to pee when approaching orgasm, may be getting confusing messages from very sensitive parts of their bodies,” Go Ask Alice explains. If fears about going to the bathroom during sex are going to hold you back in any way, Levine recommends simply going before you get started.

YOU SCREAM Sure, there’s often a performance aspect to screaming during sex. A small 2011 study (focusing solely on

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heterosexual women) found that 66 percent moan during sex to speed up their partner’s climax, while 87 percent did so to boost their partners’ self-esteem, CNN reports. But making noises can be a great way to be clear about what you want in bed, and “there are many women who need to be vocal to help themselves achieve orgasm,” sex educator Patty Brisben told CNN. “There is a difference between faking it like a screamer, and being in the moment and expressing how you’re feeling, which can increase sound,” agreed Levine. Some women are quiet during sex, others are loud — it’s as simple as that.

YOU GET A HEADACHE A sex headache is usually a dull ache in your head or neck that builds as sexual excitement mounts, or it can be a more sudden pain, often accompanying orgasm. Most are nothing to worry about, the Mayo Clinic says, but sudden-onset ones may be a sign of something serious.

Minkin cautioned that “in rare situations, some women have a severe headache at the time of intercourse, which is possibly related to changes in blood pressure. If you do have it, you’re not crazy, but do mention it to your healthcare provider.”

YOU FART Vaginal flatulence is not actually the same thing as passing gas — it’s just air being released through the vagina — but it does make a very similar sound. Dubbed “queefing,” it occurs when air gets trapped in the vagina. There isn’t any way to prevent it, avoiding certain sex positions may help, whereas switching positions several times may increase the chances of it happening.

Better yet, just don’t sweat it.

“Sex can be awkward — we queef ... bump body parts and miss the mark,” said Levine. “It’s completely natural for it not to be seamless, and your best bet is to laugh it off and keep going.”

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STRESS LESS

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Be More Productive With These Apps By Your Side

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BY CAROLYN GREGOIRE

Exit HEN IT COMES to productivity, technology is a doubleedged sword. For every technological time-saver, there’s a new distraction that sweeps in to steal the precious time you just saved. Unfortunately, our smartphones may be doing as much harm as good: A recent British survey estimated that we spend roughly 23 days a year looking at our phones, and it’s safe to say much of that time isn’t exactly helping us get more done.

Although unplugging can sometimes be the best way to boost productivity, a smartphone can be an incredibly helpful tool for simplifying tasks and organizing your work and personal life — if you have the right tools.

From the note-saving app that’s been called “last notebook you’ll ever need” to a brain-mapping tool to guide your most productive brainstorming session ever, ahead, find seven apps that will help boost your productivity — and streamline your life.

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CLEAR ($1.99)

Called “The iPhone’s most beautiful to-do list app” by The Verge, Clear is a productivity app for those who care about aesthetics just as much — if not more — than functionality. But it’s also incredibly user-friendly: Just swipe to check an item off the list, and simply shake your phone for the option to email your list. The user can also create separate lists for work, shopping, personal goals and more.

Gizmodo deems it “perfect for busy people.”

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EVERNOTE (FREE)

Sync all your notes, clippings, to-do lists and reminders across devices with Evernote, the highly-rated productivity app that makes it to the top of many reviewers’ lists. The app conserves time and energy by saving all your files, photos, reminders, to-do lists, tweets and more in one app accessible from all your platforms. Email notes to yourself or others, and search within notes for easy access to any information.

“Evernote is the last notebook you’ll ever need,” Social Media Today wrote.

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POCKET (FREE)

Formerly known as Read It Later, Pocket can be used to save articles, videos and web pages that you don’t have time to read but want to return to later. Like Evernote, the app syncs across platforms for easy access and streamlined link-saving.

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CNET gave the app a five-star review, writing: “If you’re looking for a bookmarking tool that syncs across devices, then look no further. Better than Instapaper and other competitors, Pocket is the app to beat in the category.”

MINDNODE ($9.99)

Before you dismiss the idea of mind-mapping as something out of The Matrix, try the brainstorming tool MindNode. The iPhone and iPad app could lead you to some of your best ideas in less time by allowing you to organize projects and concepts in a vibrant graphic.

“The theory is that these large, pictorial networks mirror the way our brains work, making it easier to spot connections and insert new ideas,” a Forbes article explains.

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MAILBOX (FREE)

If just looking at your overflowing Gmail inbox makes your pulse quicken, the iPhone app Mailbox is your new best friend. The app helps you tackle that mounting inbox — with the goal of getting down to the elusive “inbox zero” — with convenient labels for all your unread emails and a feature that allows you to instantly swipe messages to archive or trash.

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“Mailbox largely fixes a problem most of us have with email: quickly getting rid of the junk we don’t want, and saving the stuff we do for later,” writes Business Insider. “You’ll want to give it a try.”

CHECKMARK ($4.99)

You’ve written on at least five to-do lists that you need to pick up your dry cleaning, but can never seem to remember at the moment you’re actually walking past the dry cleaner. Of course, there’s an app for that. Try Checkmark, which can set up reminders based on time and location. Users can create repeat notifications, or snooze reminders to save for next time.

“While Apple’s built-in Reminders app does locationbased tasks pretty well, Checkmark makes it dead simple,” LifeHacker raves.

CLOUDON (FREE)

Recommended by Mashable for boosting work productivity, CloudOn allows you to use Microsoft Word, Excel and PowerPoint to create documents on the go using your iPhone, iPad or Droid. Users can sync with Box, Dropbox, Google Drive and SkyDrive accounts, and also email files to contacts directly from mobile devices, so you don’t have to wait until you get to a computer to add that attachment.

“If you find yourself in a pinch needing to work with Microsoft Office files, the free CloudOn app might be just what you’re looking for,” writes TIME TechLand.

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BEAUTY

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Step Into Fall in Style With These Runway Trends

BY DANA OLIVER

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AS YOU PREPARE to transform your wardrobe to take on the cool, crisp air of autumn, don’t forget about your beauty routine.

The Fall 2013 runways are a great source of inspiration for hair, makeup and nail looks.

However, with outrageous styles like these stealing the spotlight, we know that it can be a bit hard to decipher what can actually work in the real world.

So we’ve rounded up six of this season’s biggest runway beauty trends that are fashion-forward, yet practical. Check them out below, and tell us which ones you’ll be wearing.

BIG HAIR, DON’T CARE. Marc Jacobs, Kate Spade, and Diane Von Furstenberg showcased their luxe fall designs on models sporting larger-than-life hair.

While these voluminous strands were exaggerated for the runway, you can easily recreate this look at home. Use hot rollers to enhance your natural texture, then gently tease with a hair brush and spritz on the extra hold hairspray.

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BEAUTY

02 DENIM EYES. This modern take on the classic smokey eye (as seen above at Thakoon) fuses rich shades of blue and purple with flecks of gold. To keep it 9-to-5 friendly, apply the indigo eyeshadow color close to your lash line and finish with a few coats of mascara on the top lashes.

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MATTE MANIS. Take a cue from this black matte manicure spotted backstage at Karen Walker and dress up your fingertips in this season’s hot nail polish trend. A smooth finish will look great against any nail color, from nude to obsidian.

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BUSHY BROWS. Don’t get us wrong. This isn’t an excuse to give up eyebrow grooming. Instead, you should ease up on the excessive tweezing, threading and waxing to achieve face-framing bold brows. If you weren’t born with naturally thick eyebrows, use a black-brown powder and angled brush to get the look.

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THE LOW PONY. On bad hair days, you can always turn things around with a ponytail. And this close-tothe-nape cognac version we saw on Alexander Wang’s fall runway is sophisticated yet edgy.

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CHOCOLATE KISSES. We are obsessed with the dark, stained lip colors models donned at 3.1 Phillip Lim’s runway show. The reddish-brown hue looks amazing on every skin tone and pairs perfectly with fall’s must-have accessory, the leather jacket.

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Will Expensive Rum Make Your Mojito Better?

BY JOE SATRAN

TASTE TEST

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TASTE TEST

Exit WELCOME TO ANOTHER edition of our recurring series of Cocktail Taste Tests, which aim to figure out when expensive liquor makes a difference. This time, we gravitated toward mojitos, one of the most fun drinks in the universe — and the perfect drink for summer heat.

We mixed up a bunch of mojitos, all using the same recipe (which you can find ahead) but with different brands of rum,

ranging widely in price. We had a couple dozen HuffPost writers and editors taste all 11 samples blind and give their feedback to us. (Samples of all the rums, save Bellows, were provided to us by their distillers, but, as always, our judgment was in no way affected by the brands’ participation.) Ahead, find out which brands of rum we thought were just right.

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From left to right: Flor de Cana ($15 for 750 mL), Banks 5 Island ($28 for 750 mL ), Don Q ($14 for 1 L ), Brugal ($21 for 750 mL), Cruzan ($13 for 750 mL), Rhum Clement ($27 for 750 mL), Caliche ($24 for 750 mL), Appleton ($17 for 750 mL), Mount Gay ($19 for 750 mL), Bacardi ($17 for 1 L), Bellows ($9 for 1 L)

PHOTOGRAPHS BY DAMEN DAHLEN

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Dentist Wants to Clone John Lennon Using His Molar Tooth

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Family Moves to Woods, Complains About...

Living in the Woods

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INTRODUCING ‘LIQUID LAPDANCE’ PANTS

City in South Carolina Plans to Exile Its Homeless Population

Someone BBQ’ed One of the Queen’s Swans

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Sea Turtles Are Eating Plastic at Record Rates Amid Surge in Pollution

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Report: We’re Worse Off Now Than at the End of the Recession

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MOHAMED MORSI PERFUME?!

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Transgender Americans’ Struggle With Health Coverage Even Worse Than Iranians’

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George Zimmerman Went Shopping for a Shotgun

Editor-in-Chief:

Arianna Huffington Editor: John Montorio Managing Editor: Gazelle Emami Senior Editor: Adam J. Rose Editor-at-Large: Katy Hall Senior Politics Editor: Sasha Belenky Senior Food Editor: Kristen Aiken Senior Voices Editor: Stuart Whatley Pointers Editor: Marla Friedman Quoted Editor: Gina Ryder Viral Editor: Dean Praetorius Creative Director: Josh Klenert Design Director: Andrea Nasca Photography Director: Anna Dickson Associate Photo Editor: Wendy George Senior Designer: Martin Gee Infographics Art Director: Troy Dunham Production Director: Peter Niceberg AOL MagCore Head of UX and Design: Jeremy LaCroix Product Manager: Gabriel Giordani Architect: Scott Tury Developers: Mike Levine, Sudheer Agrawal QA: Joyce Wang, Amy Golliver Sales: Mandar Shinde AOL, Inc. Chairman & CEO:

Tim Armstrong

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