By Tabatha Renz
“I will not break. I cannot break.”
Those are the words I repeated to myself when my husband returned from Iraq and we tried to determine our new “normal.” The words I sometimes still find myself fighting against while I lay in bed at night alone during his current deployment to Afghanistan. The same words uttered by countless other military spouses who are expected to hold everything together despite their lives having been flipped upside down.
The Army told me I must be strong, I am the backbone. The uniformed men, one after another, said that if I break, my husband would break. It is my responsibility to make sure that does not happen. Not on this deployment or the next one or anytime in between.
After more than a decade of war directly affecting roughly two million service members, our military families are just as weary as those who have served boots on the ground in Iraq and Afghanistan. A study published by Military Medicine in 2008 found that military spouses presented with mental health concerns, including suicide, at the same rate as service members.1 Since the release of that study, however, not much progress has been made to combat military spouse mental health issues. We are failing our military spouses, who too often feel burdened and alone. Something must be done.
According to the Department of Defense, certain programs are available to spouses and other military family members. The problem, as reported by Al Jazeera just a few months ago, is that those who try to access these services often cannot find an entry point to them. Rather than being referred to these services, spouses are often pointed back to their primary care physicians. Not able to dedicate more time to their patients’ mental well-being than that of a typical appointment, physicians are unable to address the root cause of their issues. Distressed military spouses instead leave their doctor’s offices with prescriptions for anxiety medication and sleep aids.
That was basically the experience I had.
After my husband returned from deployment, I could not turn off the worry. I had been on edge for a year while my husband was clearing roadside bombs and I was supposed to just turn that off the second his airplane landed. I did my best to figure things out on my own. I tried to lessen my anxiety while simultaneously supporting his transition. It was too much. Yet I did not know where to go for help. I did not know anyone else who was dealing with the same issues. My husband, although well intentioned, could not understand what I was feeling.
A few months later, when I realized that I desperately needed help, nobody would see me. Veterans Affairs (VA) denied each of my pleas, stating that their services were strictly for veterans. I called the local Vet Center, not affiliated with the VA, and was told that I could only set up an appointment if my husband was also willing to start receiving services there. That was not the case. Having exhausted my few options, I was at a loss.
I consider myself lucky, though, because an answer presented itself to me at this critical juncture. I know other military spouses are not as lucky.
I connected with a civilian in my community who was able to arrange counseling for me through a Military and Family Life Counselor (MFLC). The sessions were informal, often occurring in a coffee shop near my office, and the counselor never took even one note. It was exactly what I needed. The MFLC program is designed to offer this type of one-on-one service for relatively short amounts of time. Despite this, the woman that I worked with saw me on a monthly basis for over one year. She probably could have lost her job for doing that, but she saw a need to fill an ever-growing hole. In fact, nationwide, much of the responsibility to assist in military spouse mental health concerns is now falling on the MFLC program. We can only hope that this support system, created to augment existing services, does not crumple underneath the weight.
Several studies reveal that the sacrifices made by military spouses come at a cost to their own mental health. In an American Psychiatric Society survey highlighted by Truth Out, forty percent of military spouses self-reported that the overseas service of their husband or wife negatively affected their mental health. Moreover, twenty-five percent of those surveyed reported frequent problems with sleeplessness, anxiety, and depression.
A study published by the New England Journal of Medicine in 2010 shows similar results4. According to this study, the spouses of service members who were deployed for up to eleven months presented more frequently at military health clinics and received mental health diagnoses at a higher rate, between eighteen to twenty-five percent, than spouses of military service members who were not deployed. The main diagnoses were depression, sleep disorders, anxiety, and acute stress. The problems were worse among spouses with a loved who one had been deployed for twelve months or longer. Spouses in this category received diagnoses at a rate of twenty to forty percent higher than those without a deployed spouse. These findings are also reiterated in “Views from the Homefront,” released by the RAND Corporation in 2011.5
These problems can be even worse among spouses of National Guard and Reserve components. While active duty service members and their families frequently live on a military base, members of the National Guard and Reserve often live in the community, blending in with their civilian neighbors. At times, these families live hundreds of miles from the nearest military base or another military family.
During deployments, isolation makes coping especially difficult for spouses who do not have other support systems in place. Through personal experience, I know that it is possible to only receive one or two formal phone calls from a military representative during the entire year that the service member is deployed. It may not be surprising, then, that a 2008 health care survey indicates that sixty-eight percent of spouses married to a deployed reservist or guardsman self-report they have increased stress. 3
For those who are able to break through the barriers to access and overcome the isolation, other hurdles exist. The stigma surrounding mental health issues that often makes service members feel uneasy about seeking help deters military spouses, as well. According to an American Psychiatric Association survey, sixty-six percent of spouses fear that seeking assistance would harm the military career of their loved one.3 They worry about how the military community will perceive them. After all, the military has told each of us, either directly or indirectly, that it is our job to keep it together.
It might be hard to imagine, but military spouses sometimes feel unworthy of supportive services. Constant denial by the institutions who I felt had put my husband and I in this situation made me think I was not important enough. Richard Sisk, a journalist for Military.com, captured a similar sentiment during an interview with a military spouse.6 This woman felt so completely alone that she expressed a retroactive wish that her husband would have been wounded or killed in combat. This spouse is not evil. She has come to the realization that often the only way to receive support is by making the ultimate sacrifice. The fact that even one military spouse has to endure those feelings is unacceptable and a symbol that this system has failed.
As spouses, we are deeply and undeniably proud of our service members. We are acutely aware that we are not the ones under direct physical threat. We are accustomed to people never asking how we are doing, but only asking about our service member spouse. We sometimes feel like we have no room to complain about our own days, lest someone remind us that at least we are not in a war zone. So, we go from being good at managing our finances and homes, to being good at forcing a smile and suffering in silence.
I have repeatedly heard the argument that we must maintain focus must on the service member. Resources are strained and therefore attention remains on the fighting force. According to the VA, about twenty-two veterans commit suicide every day.7 Do you know how many military spouses are taking their own lives? Neither do I. That’s because, although military spouses are at an increased risk for suicide, no one is tracking these statistics.
Jane Mullen, the wife of former Joint Chiefs of Staff Admiral Mullen, spoke poetically at the 2011 Military Health System Annual Conference about the aspects of war that have changed. Without a doubt, the nature of war has changed, including the types of weapons used, tactics, and life-saving treatments. However, what has not changed and will never change, is the stress and anxiety felt by those left behind. When a service member signs a contract with the military, so too does his or her family. The public, private, and government sectors have made enormous strides in addressing the mental health concerns of military service members, but their spouses have been left out.
If we truly want to support military spouses, we need to focus on their mental health needs. We cringe at the idea of turning our backs on the fine men and women who have fought so bravely for this country; it should be no different for their loved ones at home. The research indicates that a problem exists, so we must respond.
Ideally, the Department of Defense and related entities will address the mental health need of both the military service members and their spouses, realizing that they are a singular unit. Even an increased capacity of the MFLC program would help. At the very least, we can all do our best to break the stigma that prevents some military spouses from seeking help. We need to spread the word that there is no shame in reaching out.
One need not be an expert on the military to lend an ear to a military spouse in need. I can attest to how therapeutic it can be to feel like someone cares because they take a few seconds to ask how you are doing. With added support, all military spouses can be the strong backbone we are asked to be. If we do break, we will have a place to turn to share the burden. No military spouse should have to fight this battle alone. Not on this deployment, the next one, or anytime in between.
Originally from Dillon, Montana, Tabatha Renz is a 2011 graduate of Boise State University. She is currently attending New York University Robert F. Wagner Graduate School of Public Service where she is pursuing an MPA. Her interests center on policies that affect veterans and military families during post-deployment reintegration, especially for National Guard and Reserve components. Tabatha is the wife of an Army Reserve Combat Engineer currently deployed to Afghanistan and is employed by the Iraq and Afghanistan Veterans of America (IAVA).
*The views expressed herein are those of the author and do not necessarily reflect the views of IAVA or any other entity.
1) Eaton, K.M., Hoge, C.W., Messer, S.C. et al. (2008) Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments. Military Medicine. Volume 173, number 11.
2) Alyssa J. Mansfield, Jay S. Kaufman, Stephen W. Marshall, Bradley N. Gaynes, Joseph P. Morrissey, and Charles C. Engel. (2010). “Deployment and the Use of Mental Health Services among U.S. Army Wives”. New England Journal of Medicine
3) Chandra, A., Lara-Cinisomo, S. Jaycox, L.H., et al. (2011). Views from the homefront. Rand Cooperation Center for Military Health Policy Research. <http://www.rand.org/content/dam/rand/pubs/technical_reports/2011/RAND_TR913.pdf>
4) Sisk, R. The toll of war: milwives and suicide. Military.com. http://www.military.com/spouse/military-life/military-resources/the-toll-of-war-milwives-and-suicide.html
5) 7) Kemp, J., Bossarte, R. (2012). Suicide data report. Department of Veterans Affairs. <http://www.va.gov/opa/docs/Suicide-Data-Report-2012-final.pdf>