The military’s hidden mental health crisis: spousal trauma

Army wife Melissa Bourgeois hit her breaking point five years ago when she was living at a U.S. military base in Vicenza, Italy, with her husband, Eric, an infantryman. Eric was just back from a harrowing second deployment to Afghanistan marked by frequent firefights. Filled with an uncontrollable rage, he spent his nights self-medicating at bars with his war buddies.

Eric’s anger toward his family had become explosive, and he regularly punched doors, furniture and even a concrete wall that left his hand injured. Melissa, 25 at the time, with their two small children, felt isolated in a new country where she barely spoke the language. She needed to talk to someone about her situation, but she said each time she sought mental-health care on the base, she was given Valium and sent away.

In October 2008, Eric backed Melissa into a corner and started shouting at her in front of the children, the smell of alcohol heavy on his breath. “I was hysterical, screaming,” she said. Desperate, she called a friend, who reported him to the military police for domestic abuse. The commanding officer of Eric’s company held him in the barracks for 72 hours before releasing him. When Melissa went to her husband’s platoon sergeant for help, he told her that if she was so unhappy, maybe he should just send her back home. Soon after that, Eric said, the platoon sergeant told him, “Keep your wife in line.”

In a U.S. military psychologically ravaged by 12 years of continuous war, troops’ family members, like Melissa, are the victims of a hidden mental-health crisis, missing from the public calculus of the social costs of combat and systematically denied by the institution that placed their partners — and them — in harm’s way. Interviews with military doctors, psychologists, social workers and counselors and with service members and spouses suggest that this problem is ubiquitous yet invisible.

“The military just doesn’t want to deal with wives,” Melissa said.

‘You replay it over and over’

Combat post-traumatic stress disorder (PTSD) takes a severe toll on spouses. A New England Journal of Medicine study that analyzed medical records of more than 250,000 spouses of U.S. active duty soldiers from 2003 to 2006 found that the multiple and prolonged deployments typical in Iraq and Afghanistan led to greater risk of “depressive, anxiety, sleep, and acute stress reaction and adjustment disorders” among spouses — among the anxious and depressive symptoms referred to by mental-health providers as secondary traumatic stress.

While the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) — the bible of psychiatric diagnoses — does not include secondary traumatic stress, it does recognize that PTSD can arise in family members of those exposed to violent trauma. According to peer-reviewed studies on the Vietnam War and the war in Croatia in the 1990s, prolonged caring for and exposure to a partner with PTSD is a strong predictor of developing PTSD symptoms as well.

“When something terrible happens to someone you love, it is going to affect you,” explains clinical psychologist Dr. Laurie Pearlman, who played a lead role in identifying the effects of secondary trauma. “The person comes back and your life is completely altered. You live according to their trauma. You imagine what your loved one is going through, and you replay it over and over.”

Military data show rising suicide rates and deteriorating mental health in the ranks — which is tied to a growing epidemic of domestic violence.