TRAVIS AIR FORCE BASE, Calif. – “I think I was about halfway through writing an apology letter to my mom for what was to be my suicide when I made the decision to call the mental health clinic. In my mind, I saw my sadness as something like a virus, something infectious. And I knew that were I to follow through with my plan to end my life, my pain wouldn’t have gone away—it would’ve just spread.”
The patient, whose name they requested be omitted in this article for privacy reasons, is not someone one would typically look at as sad. The caricature of a sad person—mopey, slow and tearful—exists nowhere in their outward appearance. Not only that, they appear to anyone else as a person in good health, whose present life could most readily be described as ideal and whose future shows no indication of being anything to the contrary.
“Sometimes, I like to think I was just left out in the sun too long as a baby,” the patient said, laughing. “I’ve been explained the whole psychosomatic deal behind severe depression probably a hundred times and I just don’t have the mind for it.”
That “whole psychosomatic deal behind severe depression” is what workers at Travis Air Force Base, California’s mental health clinic specialize in.
Dr. Joy Lere, a licensed clinical psychologist working at the clinic, said depression is a multi-faceted issue with a multitude of very complex, very personalized factors that have real physiological, biological, and even, in some cases, genetic factors that can predispose and contribute to someone experiencing certain symptoms.
“If you were to hear someone be told to ‘walk off’ a broken leg, you begin to understand the problems with treating depression with ‘well, why don’t you just cheer up,’” she said. “If depression was a choice, there would never be a need for anyone to come (to the clinic) in order to receive help for it. Nobody wants to be depressed, and to buy into the notion that it’s something a person can simply will themselves into, or out of, can become a significant roadblock to them reaching out for treatment.”
A research project done at the RAND Corporation, a nonprofit global policy think tank, found that untreated mental illness correlates with attempted suicide within the military. The Department of Defense’s 4th Quarter Suicide Report for 2017 also reported 504 active duty and reserve suicide deaths that year, an increase from 482 in 2016.
For the patient, these findings are troubling, though not surprising.
“I think a large part of it is this tendency we as military members have in seeing treatment as this thoroughfare to being discharged or as an admission of weakness,” they said. “The power stigma has and, in a lot of ways, does cause a huge, invisible wall to be built around the clinic. It’s those who’ve actually taken those steps and been helped by their staff who see it as the immensely helpful resource that it is.”
Lt. Col. Michael Detweiler, 60th Medical Operations Squadron mental health flight commander, likewise has no trouble tearing down that wall.
"We're not here to kick everybody out," he said. "I wouldn't last long in the Air Force if I made it my life's mission to kick everyone out. My job and the reason I wear this uniform is to help get people back to duty ASAP. Most of our day-to-day patients are just normal, high-functioning individuals struggling with abnormal life events. They come in temporarily, we help them use their strengths to overcome their challenges, and send them back to complete the mission. If they didn't tell you, you'd never know they ever came to Mental Health."
The military has, over the years, learned more in the way of mental health and has increased the level of care available to those with mental illness while also making a concerted effort to de-stigmatize treatment.
Personalized care is a must in the mental health field because no two patients are at the same spot emotionally or perhaps even experience emotions in the same way, said Lere.
“What it all comes down to, more or less, is that initial step of walking into our clinic,” said Lere. “There is so much courage in just that simple act. The word ‘therapy’ has a lot of emotions attached to it, but it’s really just about having an open and honest conversation about how and what and why you’re feeling, and I think everyone, no matter how well-off they seem or feel, could benefit from taking a step back and finding kinder ways to treat themselves.”
For the patient, finding that kinder way to treat themself came just in time.
“In the end, I did send that letter to my mom,” they said. “But instead, it was just a bunch of reasons why I’m happy she’s in my life. I guess there are two ways to make your mom cry—I’m just glad this was the way I did.”