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Walter Armstrong Walter Armstrong

The Fort Hood Shooter’s Untreated PTSD: A Veteran’s Suicide Note Tells How It Feels

PTSD carries a high risk of substance use disorder and is scandalously undertreated in soldiers and veterans.

5 Substance

In the aftermath of yesterday’s Fort Hood shooting, some details of the background of the gunman, Army Specialist Ivan Lopez, are emerging. Lopez was said to have self-reported traumatic brain injury (TBI) when he returned from Iraq in 2011.

In addition, it seems certain that Lopez was suffering from post-traumatic stress disorder (PTSD). He had recently been transferred to Fort Hood in order to be evaluated for PTSD. It is now 2014. For almost three years, then, his mental health problems likely went untreated or inadequately treated. [UPDATE: Lopez reportedly had already been diagnosed with depression and was prescribed a number of medications, including the anti-insomnia drug Ambien, which has a record of causing weird behavior but not mass murder.]

Many soldiers with PTSD who are no longer on active duty, like many veterans, use illegal drugs or alcohol to self-medicate. Some are addicted to opiate painkillers. The rate of substance-related problems is much higher than average (estimated at 21-43% for people with lifetime PTSD, compared with 8-25% in those without PTSD), as is the rate of suicide. They live in a state of crisis, but when it comes to accessing even the most basic treatment and care, they’re forced to jump through a long series of bureaucratic hoops. Even then, mental health services are grossly underfunded.

After serving their nation in battle, this is often what they come home to.

Last year the parents of a veteran who fit this pattern in every detail wrote an account for The New York Times of what their son had gone through between 2007, when he returned home after serving two tours in Iraq, and last June, when he took his own life. They included the suicide letter he left behind, which detailed the many obstacles he had faced in trying to access treatment from the Veteran Affairs system. His parents wrote:

We also found a cover letter he had written as part of his disability benefits claim, describing his many physical and psychological ailments. It was not until we read the letter that we truly understood the immense scale of his illnesses. He described his post-traumatic stress and traumatic brain injury symptoms in these words: “unrelenting depression and a generally joyless existence,” terrifying nightly panic attacks, and “unbearable anxiety and fear in any situation in which I don’t have complete control of the surroundings.” In addition, he wrote, he had a “constant bombardment of violent thoughts and images.”

“His physical symptoms included acute and chronic pain from fibromyalgia, which was so “grinding” that at times he could barely move; chronic fatigue so severe that “just holding my head upright requires more effort that I can bear”; excruciating headaches that could “easily be enough to strike an entire day from my calendar”; and an extreme case of irritable bowel syndrome that “literally controlled my schedule.” He was so embarrassed by these medical issues that we did not know until after his death that the hugs we gave him for comfort actually hurt him physically.

Army Specialist Lopez reportedly did not leave a suicide letter—only his tragic actions.