What does it mean to die from PTSD? These veterans' families want us to know.
By: Jessica Campbell
1 month ago
Carlos Lopez Jr. was still a teenager when he signed up for a two-year stint in the U.S. Army. Not long after, the Iraq War began, and he became one of the first American soldiers to be deployed there, fighting battles in Baghdad, Najaf, and Fallujah.
Five years active duty, three tours, and more than 37 months in “extreme combat environments” later, Carlos Jr. came home. But he “was not the same person,” according to his obituary.
Though he was still kind and loving, his family said, he was also “very aggressive.” Carlos — known fondly as “Los” to his parents, brother, and sisters — turned to an acting career as “an outlet for the combat life he endured” because it “allowed him to express his deepest thoughts.” He would go on to make his mark in Hollywood, appearing on television in the show “Operation Repo” and in military action movies including “Captain America: The Winter Soldier” and the upcoming “Bumblebee.”
Carlos also wrote, directed, and starred in the award-winning short film “PTSD: An American Tragedy,” in which he plays a veteran who returns from Iraq suffering from severe post-traumatic stress disorder.
It was a condition the young actor knew all too well. On June 24, 2018, Carlos himself “passed away of PTSD.”
“Passed away of PTSD.”
I was startled to see that phrase in Carlos’s obit. In my 13 years with Legacy, I’d read thousands of obituaries, but never before had I come across one that listed, so matter-of-factly, post-traumatic stress disorder as the cause of death.
What does it mean to die from PTSD?
For someone as young as Carlos, just 35 at the time of his death, it means dying by suicide. As reported in news stories shortly after his death, and later confirmed by his parents, Carlos killed himself after struggling with PTSD for years.
When it comes to causes of death that survivors find difficult to talk about, obituaries have long employed a secret code. If someone died by suicide or from a drug overdose, the obituary might say "died at home" or "died suddenly" or simply "passed away." However, increasingly over the past few years, families have begun to open up in obituaries, sharing painful details of their loved one’s life and death.
Often, their explicit intent is to raise awareness and prevent others from going down a similar path. In recent years, Legacy has reported on obituaries that highlight:
Carlos’s obituary was the first I came across that brought this full-transparency approach to PTSD — and, more specifically, to explicitly describe the underlying mental health issue as the “cause” of a suicide death, rather than the suicide itself.
I wondered: Was this an isolated case? Or have other families also begun using obituaries to open up about a beloved veteran’s “invisible wounds”?
It’s no secret that war is hell. Centuries of evidence documents that military combat has debilitating aftereffects not only on the bodies of veterans, but also on their minds and spirits. What we’re only now beginning to understand in depth is the lifelong toll that the trauma of war can have on military veterans.
Historically, traumatized veterans returning home from war with psychological wounds received little understanding or support. Starting with Vietnam, we began to understand differently post-war symptoms like severe anxiety, nightmares, sleeplessness, and memory lapse. We now know that these are signs of “post-traumatic stress disorder,” and that PTSD is not a sign of weakness but rather a natural response to trauma.
Post-traumatic stress disorder causes a host of mental and emotional symptoms including flashbacks and panic attacks. PTSD is often accompanied by depression, substance abuse, and/or other anxiety disorders, and people with PTSD are at greater risk of suicide or self-harm. Recent studies have shown that PTSD also takes a toll on physical health: PTSD can accelerate the aging process and people with PTSD are at greater risk of developing illnesses such as type 2 diabetes, cardiovascular disease, and dementia.
PTSD can affect anyone who has been exposed to a traumatic, life-threatening event. Because military service members are regularly exposed to violence, both directly (in combat) and indirectly (treating the wounded, for example), they are especially vulnerable.
The prolonged wars in Iraq and Afghanistan have led to millions (nearly 3 million American service members between 2001 and 2015) being deployed. Many, like Carlos Lopez Jr., have deployed multiple times. With roughly 6,800 American troops killed, and more than 50,000 physically wounded in action, the wars have taken a heavy toll.
The wars have also had a profound impact on the mental health of veterans, according to Craig Bryan, an Air Force psychologist who heads the National Center for Veterans Studies. Based at the University of Utah, the NCVS has as its mission to improve the lives of military personnel, veterans, and their families. More specifically, Bryan wants to end veteran suicide by helping veterans overcome PTSD.
A few years ago, says Bryan, following the surge in Iraq, clinics were overwhelmed with veterans suffering from PTSD. Now, as military operations have slowed, new cases are slowing somewhat — but there remain many service members and veterans coping with PTSD.
How many? Up to 20 percent of Iraq and Afghanistan veterans, according to the U.S. Department of Veterans Affairs. That means half a million veterans who have developed PTSD since 2001.
During the same period, the U.S. military suicide rate has increased dramatically. By 2014, suicide had become the leading cause of death throughout the military, surpassing illness, vehicular accidents, and even combat. And while veterans comprise only 8.5 percent of the population, they account for nearly 1 in 5 (18 percent) of all suicides in America.
Like Carlos, many of the service members and veterans dying by suicide in recent years also suffered from PTSD. But at what point did families begin to interpret their loved ones’ deaths as being caused by PTSD?
In 2008, Jonathan Tauer, an Army veteran who’d served four years including a tour in Somalia during the crisis of 1993, died at his home “of complications from Post Traumatic Stress Disorder,” according to his obituary. It’s the earliest example in Legacy’s database of an obituary that clearly ascribes cause of death to PTSD — but certainly not the last.
In the decade following Jonathan’s death, the number of young veterans “dying of PTSD” increased significantly. Of obituaries published in the past year alone, hundreds mention the deceased’s struggles with PTSD, and more than a dozen specifically cite PTSD as the cause of death.
Matt Brennan (1989 – 2011) died at 22 “following a courageous battle against Post Traumatic Stress Disorder (PTSD).”
Wayne Cherry (1980 – 2012) died at 31 “after a fierce battle with Post Traumatic Stress Disorder.”
Parker Chadick (1985 – 2012) “went to be with his Lord and Savior” at 27 “after a four year struggle with Post Traumatic Stress Disorder.”
William Mix (1981 – 2012) “took his own life” at 31, “after struggling with depression and post traumatic stress disorder for several years as a result of his military service.”
Dane Michael Freedman (1988 – 2013) “took his own life” at 25 to end the “battle with PTSD” he fought “every day.”
Bruce Campbell (1975 – 2014) “ended his life” at 38 after suffering from PTSD since his return from Iraq.
Bradley Coy (1992 – 2014) died at 22 “after a battle with Post Traumatic Stress Disorder (PTSD).”
Robert Parkhill (1976 – 2015) died at 38 “of complications related to PTSD.”
Brian Gammon (1978 – 2015) died at 36 “as a result of his ongoing battle with Post Traumatic Stress Disorder-PTSD.”
Zac Quick (1976 – 2015) “lost his life” at 39 “to the unseen wounds of the real world wars he fought.”
Joshua Miller (1981 – 2016) took his own life at 35 after “his memories of war became too much to bear.”
Neil McElroy (1984 – 2017) died at 33 when “the demons he fought” — alcoholism, depression, and PTSD — “finally overcame him and he took his own life.”
John McAvoy McGregor (1984 – 2017) was 32 when he “lost his battle with PTSD. “Regardless of all the good he did, regardless of the passion that drove him to help others, John couldn't quite get a handle on helping himself.”
The trend isn’t limited to obituaries for Iraq and Afghanistan veterans. A number of obits for Vietnam veterans declare that their lives ended as a result of PTSD. Some killed themselves, some succumbed to physical illnesses brought on by PTSD — all struggled throughout their adult lives with a condition that was only beginning to be understood.
Surprisingly, there are no obituaries for female veterans that cited PTSD as the cause of death. Yet we know that PTSD affects women as well as men. In fact, women are more than twice as likely to be diagnosed with PTSD. And now for the first time in U.S. history, women are being allowed to serve alongside men in combat. So why aren’t we seeing the same language in the obituaries? The type of trauma might play a role: While both men and women in the military experience PTSD, says Bryan, it’s typically for different reasons. For male veterans, PTSD is usually the result of combat trauma. Female veterans, though, are more likely to develop PTSD as the result of sexual assault — a topic that many people remain unable to talk about, and many others are unwilling to listen about.
But it seems entirely possible that will change, too. The fact that so many families are talking now about veterans’ PTSD struggles suggests people have begun thinking bigger about what an obituary can accomplish.
To the extent that obituaries are about conveying information, families are simply reporting the facts, says Bryan. The decreasing stigmatization of mental health over the past decade, he says, means that families can feel more comfortable sharing details about a loved one’s mental health issues and/or suicide, in the same way that they would cancer or heart disease.
And as with families who’ve lost loved ones to cancer, there often is an additional motivation: to raise awareness and help others.
Many families are intentionally using the obituary as a way to get the word out about veterans and mental health. Some even include a direct plea to veterans and families coping with PTSD:
“Please learn all you can about Post Traumatic Stress Disorder (PTSD) so you will have an understanding of the toll it takes on our Veterans, their families, and their friends… Make sure your loved ones seek the help they need.”
—Obituary for Zachary Gladstone (1992 – 2017)
“We ask any battle buddies who might be contemplating the same, to reach out and get help… The aftermath of your death will cause indescribable agony to those who love you. We need you here. Please. If not for you, then for them. Get help.”
—Obituary for Adam Roy (1987 – 2018)
“We are all very sad that his life had to end this way and we hope this raises awareness for other veterans who are suffering from these same issues.”
“For those of you who are reading this and are suffering with any form of PTSD please STOP. TAKE A DEEP BREATH AND REACH OUT! There are so many hands ready to clasp yours to help you. They are just waiting for you to take the first step to recovery.”
—Obituary for Jason L. Andrews (d. 2016)
This kind of message, Bryan says, can have “a much more powerful effect when you’re hearing the story from someone who has personal experience,” rather than from a public service announcement.
For someone who is struggling, reading what others have gone through could help them feel less isolated: “Others have experienced this, and so I can relate to them [and] perhaps I’ll listen to them.” An obituary that talks plainly about mental health could also be helpful for others families coping with suicide loss — when they read about another family’s experiences, they know they are not alone.
For the family publishing the obituary, writing about their loved one’s suicide and struggle with PTSD can be a helpful way to cope with their own grief and anger. It is not uncommon to feel angry after a loved one has killed themselves. Some bereaved families may also be angry, Bryan notes, because they feel that the system failed them and their loved one.
Increased discussion of PTSD, suicide, and mental health over the years has certainly raised awareness. But some families aren’t just mentioning a loved one’s PTSD — they are telling that person’s whole life story through the lens of the condition.
Like many in the mental health field, Bryan worries about where to draw the line. On the one hand, we want to destigmatize and help people understand suicide and mental health. On the other hand, we must be careful not to normalize suicide as a reasonable option to consider — especially when it comes to a temporary condition like PTSD.
“People say, ‘Well, you can never overcome the trauma,” Bryan says. “That’s hogwash. Yes, you can. People do it all the time.”
PTSD is very treatable, he says — that’s why his research center is focused on making sure that veterans with PTSD receive the most effective and efficient therapies.
Trauma-focused psychotherapy is the recommended form of treatment, with the therapist using different techniques to help the person with PTSD process the traumatic experience or change unhelpful beliefs about the trauma. According to the VA, this therapeutic treatment typically lasts 8-16 sessions, or about three months, with more than half of veterans overcoming PTSD in this timeframe.
And studies have shown that “when people overcome PTSD, they’re sort of done with it,” Bryan says. No more nightmares, no more panic attacks. They are able to move on and live happy, healthy lives — free of PTSD.
But most veterans are not receiving the best kind of treatment. The primary reason, Bryan says: Most psychologists and social workers are not trained to do PTSD therapies before coming to the VA.
That puts the VA in the position of having to provide that training themselves. It is “difficult and time consuming to train therapists to do those therapies correctly and effectively,” Bryan says.
On the other hand, physicians require little to no additional training to prescribe the medications that are endorsed for PTSD treatment. Thus, while the VA recommends psychotherapy as the most effective way to treat PTSD, not all veterans who need this type of care will receive it. And, as the VA itself makes clear, anxiety and depression medications are more readily available, though significantly less effective.
Still, Bryan emphasizes, “The VA is light-years ahead of everyone else.” And VA healthcare seems to be having a positive impact on veteran suicide rates. Suicides have risen more rapidly — 4 times faster — among veterans not receiving VA care.
Carlos Lopez Jr. had sought care through the VA, says his father Carlos Lopez Sr, trying for more than a year to get an appointment with a VA counselor for his PTSD. "All he got," says his mother Juanita Lopez, “was a pill.”
Carlos Jr. was prescribed an anti-seizure drug called gabapentin, sometimes used to treat chronic pain. After he began the medication, his parents noticed an immediate and significant shift in his mood and demeanor. His nightmares worsened, and he became paranoid. He began asking his family if he was a bad person, if he had hurt someone, if the government was coming to their house. A few days before he died, he told his parents that he thought he was having problems because of the medication. They urged him to stop taking it.
On Sunday, June 24, 2018, Carlos Lopez Jr. shot himself on the balcony of his downtown L.A. apartment.
His parents are adamant that, while suicide was the manner of his death, it was not the cause. PTSD was.
“The problem that we have in the country,” says Carlos Sr., is that we “try to end the story with the word ‘suicide’ … The question should be, ‘Why did he commit suicide?’
“There's a problem there that’s not being addressed.”
Juanita and Carlos Sr. want their son’s life and work to be his legacy, not the manner of his death. “Passionate,” “exuberant,” “successful,” “a storyteller,” “a leader” … these are some of the words Carlos Lopez Jr.’s parents have used to describe him. (“He’s hot!” is what the funeral home director said when they showed her pictures of Los.)
That’s why they are doing all they can to get the word out about veterans and PTSD, including discussing Carlos’s struggles in the obituary, screening his film “PTSD: An American Tragedy” at his memorial service, and submitting his movie to film festivals. They want to make sure Carlos Jr.’s own message gets through loud and clear: PTSD is real, and veterans need help.
A similar message rings out in obituary after obituary for veterans with PTSD. Their families are using the obituary as a platform to highlight the problem of PTSD in the hopes that others can be spared the heartache and sorrow they have endured. And because there is so much more to each veteran’s life story. Each obituary, like the life story it represents, is beautiful and unique:
“Though he had an aversion to sharks, Matt loved taking trips to the beach.”
“Wayne loved spending time with family, his friends, the outdoors, snow, baseball, golfing and his country.”
“William was an avid reader and loved the outdoors… He dreamed of obtaining a career in herbal medicine… was also artistically creative and made beautiful jewelry and other Native artifacts.”
“Dane Michael will always be remembered for his infectious smile and his ability to light up any room, his brave sense of adventure and his caring spirit.”
“Bruce will be remembered as a fun loving, energetic, hardworking, loyal man who would have given anything for his family, friends, and country.”
“His second-grade teacher wrote on his report card that Brad had a 'heart as big as Texas,' which sums him up nicely.”
“Celebrate [Rob’s] love for food and give a hamburger toast for his love of Big Macs!”
Zac “met his wife, Brandi Lynn Quick, while serving together… The best and truest of friends, they were married at a Hooter’s restaurant by a close friend on August 1, 2014, then immediately got tattoos together to celebrate.”
Josh “was the guiding light and protector of his siblings, even if he liked to pull the occasional “older brother” tricks on them.”
Neil “occupied his time doing community service and volunteering to work with children's athletics and, while undergoing treatment himself, assisting the rehabilitation of other veterans with disabilities similar to his own.”
“John was a tall man of stature and with a Warrior's fearlessness. He was referred to as a ‘Ninja’ by his nephews.”
“Among the things we will miss most about Adam are his handsome face, the coy smile he would share in a flash, his incredible sense of humor that was the source of so, so much laughter, and the fierce protection he gave to his children, family, friends, brothers and sisters-in-arms, and his beloved country, the United States of America.”
“Zachary touched the lives of so many, and I think we all can say that the world lost a sweet soul last week. He never met a stranger, but always met a friend.”
What comes through in all of these obituaries for veterans who died because of PTSD is not just their pain — it’s their bravery, compassion, intelligence, sense of humor. These young men were strong, capable, courageous, ambitious, loving, and loved.
Carlos Lopez Jr. certainly was. And that's how his family will always honor and cherish him.
Jessica Campbell is a senior editorial producer at Legacy. Her recent feature stories include "The Most Fascinating Women Who Died in 2016," "R.I.P. Journalists We Lost in 2017," and "The First Brave Woman to Allege 'Sexual Harassment.'"