Private Battles

This five-part series documents military families struggling as their loved ones leave to fight in Iraq and Afghanistan. Originally published in the Dallas Morning News June through December, 2010.

The story of war is not just about combat on the battlefield. It's also about the families who remain behind to fight their own private battles.

It's the story of Aimee Ybarra, a mother of two grade-school children, whose husband came home after his fifth combat tour and told her he wanted to leave their 15-year marriage because he had gotten used to being gone. It's the story of Lisa Bernreuther, who's steeling herself for her husband's sixth deployment; he's only been home from his last tour since April. She keeps his Army boots by the door, she says, "because sometimes I forget I even have a husband."

And it's the story of Gwendolyn Roberts, a bright, outgoing sixth-grader and "Daddy's girl." When her father left for war for the third time in five years, the spark went out of her and she tumbled into severe depression.

After nearly nine years of war, military families like these at Fort Hood in Central Texas find themselves in a relentless cycle of crisis and stress.

Over the next several months, The Dallas Morning News will examine how:

  • Repeated combat tours to Iraq and Afghanistan have split up marriages and forced kids to grow up without one or both parents for chunks of their childhood.
  • Troops return home from combat tours with severe injuries and psychological disorders, thrusting spouses and other family members into new roles as long-term caregivers.
  • Suicides in the military have risen to record levels, and the divorce rate has climbed steadily since the U.S. went to war in 2001.

These burdens of war have fallen heavily on the troops - who represent less than 1 percent of the U.S. population - and their families.

"Injuries that result in long-term changes in behavior or abilities can seriously challenge marriages, thrusting the spouse into a caregiving role, increasing the risk of depression and other psychological problems and increasing the likelihood of divorce," said a March report published by the Institute of Medicine.

Yet "there are not enough mental health providers to meet the demand, case managers and providers are overwhelmed, wait times are too long for appointments and between appointments for those in need of mental health and other services," the report stated. The institute's two-year study was mandated by Congress to help veterans readjust to civilian life.

The extended military operations and multiple combat tours are not just a short-term problem for military families. They will have a lasting impact on the well-being of the next generation - the nearly 2 million children who are growing up in military households.

"This isn't going away," said Ybarra, 33, the mother of a 10-year-old girl and a 6­year-old boy, who lives near Fort Hood. She has been separated from her husband, a first sergeant, for a year and is in the process of divorce. He is leaving soon on his sixth deployment.

"I can guarantee you that in the next 10 years," she said, "we'll still be seeing the effects on my children."

Uncharted territory

The Iraq and Afghanistan wars have developed into the longest sustained combat operations since the Vietnam War. The all-volunteer military, which replaced the draft in the mid-1970s, finds itself in uncharted territory: a seemingly endless era of military operations and deployments.

"We've never been here before in history," said Maxine Trent, a licensed professional counselor who has seen hundreds of military family members from Fort Hood. "We've never asked our military families to do what we're asking them to do."

Family Readiness Groups are the traditional approach to supporting military spouses during deployments.

Made up of soldiers, family members and volunteers with each unit, the groups offer a network of communication and support. While many of these groups have been effective, others have split into cliques or deteriorated into gossip-mongering, according to military spouses interviewed by The News.

That lack of social bonds can further isolate military families already suffering from stress or depression.

One of the first studies to look at the psychological impact of deployments found that spouses of troops sent to Iraq or Afghanistan were "more likely" to have depression, anxiety, sleep disorder and other mental illnesses compared with spouses of those not deployed.

Researchers from the University of North Carolina at Chapel Hill looked at recent medical records of more than 250,000 female spouses of soldiers who had five or more years of military service. (Men married to female soldiers made up only 5 percent of the sample, a size too small from which to draw conclusions.)

The report, published in January, also found that the longer the deployment, the more likely the spouse was to be diagnosed with a mental disorder, said Alyssa Mansfield, the study's lead author and a research epidemiologist.

Since October 2001,more than 2 million troops have been deployed to fight the two wars. No military installation has been busier than Fort Hood, the country's largest active-duty base, with more than 50,000 active-duty soldiers. More than 85 percent of its units have deployed to Iraq or Afghanistan for at least one yearlong tour. Most units have served at least two tours. Several are on their third or fourth combat tours.

Fort Hood is also home to more than 100,000 Army family members. About 85 percent live off post.

Trent, the lead counselor at Military Homefront Services, a private, nonprofit clinic, said her center has been "really, really swamped," since it opened two years ago to meet the psychological needs of military families at Fort Hood.

From its start in January 2008 through this May, the clinic, part of Scott & White Healthcare system in Central Texas, has served nearly 5,000 patients - more than five times the number anticipated.

"A lot of times, moms will initially come in with concerns about their kids" before acknowledging their own difficulties, Trent said. "What they're telling us is, 'We're exhausted. Our kids are exhausted.' "

Breaking point

Even in normal times, military life demands much from families. Service members move from one installation to another every two to three years and often spend months away from home in training.

These are not normal times for military families.

"Because of the need, we have recycled the same folks back to the front lines," Trent said. "This was never intended to be - back-to-back deployments - never intended to be part of the military lifestyle."

At times, combat tours have been extended from a year to 15 months. "That's another birthday. That's another Christmas," Trent said. "In terms of milestones, particularly in a child's life, you've just missed another."

The majority of military personnel are married - more than 50 percent in the enlisted ranks and more than 70 percent of officers. Of those married, more than two-thirds have children.

Few studies have looked at children of parents who have deployed to Iraq or Afghanistan. The Rand Corp., a Washington, D.C., research center, published a report in March that found that children from military families with a deployed parent reported higher rates of anxiety, depression and behavioral difficulties than children in the general population.

The study, commissioned by the National Military Family Association, also showed that the longer the parent was deployed, the greater the number of difficulties the children reported.

Martha Roberts' experience reflects the report's findings. The 40-year-old Army wife from Killeen has made it through each of her husband's three deployments with help from her church, Unity Baptist. But when her daughter Gwendolyn became depressed, Roberts sought the help of counselors at Military Homefront Services.

Gwendolyn, 12, went to therapy for a year and feels better- especially now that her father has returned home. Sgt. Glenn Roberts, with 22 years of military service, has decided to retire this summer.

"I made a promise to her when she was 7 years old that I would be out of the military by the time she turned 11," Roberts said. "I'll be a little late, but close."

The divorce rate in the armed forces has risen steadily in the past decade. It stands at 3.6 per 1,000 couples, compared with a rate of 2.6 per 1,000 in 2001 when the war in Afghanistan started. (The U.S. Census has estimated the civilian divorce rate also at 3.6 per 1,000 couples in 2007, the latest figures available.)

However, those statistics offer only a snapshot of military marriages and do not count veterans who get divorced after leaving the military.

Other surveys indicate more military marriages are in trouble - especially for deployed soldiers. The Army's latest annual survey of troops in Iraq found that the percentage of married soldiers who said they expected to get a separation or divorce grew from 12 percent in 2003 to 22 percent in 2009.

Pam Posten, an Army wife at Fort Hood, said deployments are particularly hard on young spouses: "I think the majority struggle with being away from their families and home for the first time. And if you add to that a first-time mom whose husband's deployed - that's a lot to take on."

Aimee Ybarra was a young military wife with a preschool daughter when she and her husband moved to Fort Hood in August 2003. Just afterward, she learned she was pregnant with her second child. Three months later, her husband left for Iraq on his third combat tour. And two weeks after that, a burglar broke into Ybarra's off-post house.

With no friends yet in their new community, and their closest relatives in California, Ybarra and her daughter, who was 4 at the time, had only each other for support. For weeks after the break-in, they would huddle together in bed at night, sometimes crying themselves to sleep.

"It was a scary time," Ybarra said.

Spouses who get divorced can face economic devastation, including the loss of health benefits.

Carissa Picard moved five times during her eight-year marriage to an Army helicopter pilot. In March, after the couple agreed to divorce, Picard and her two sons, ages 6 and 9, had to leave her house at Fort Hood. She moved into a temporary residence in San Antonio while looking for work.

More should be done to help divorced military spouses get back into the job market, said Picard, who also believes divorced military spouses should be eligible for unemployment compensation.

"It's such a drastic change in your life status," she said. "It's just like transitioning out of the military for a soldier."

Coming home

Like clockwork, counselors typically hear from military spouses about two to three months after a deployed unit returns. The initial euphoria has worn off and reality has set in.

"What I usually get from the spouse is that, 'My husband's been back from Iraq or Afghanistan. ... He's a different person. I don't understand it,' " said Ashley Koonce, a therapist in Killeen.

Sometimes the soldier seems more angry and temperamental than before, or he or she has withdrawn from family life.

"You will get a lot of spouses saying, 'I've had to be so strong for so long, and I expected relief when he got back,' " Koonce said. "But now there's more stress."

These changes are often resolved after a short adjustment period. But other times, they point to a deeper medical or psychological issue.

Defense Department figures show that 163 active-duty Army personnel committed suicide in 2009, up from 140 in 2008 and more than double the 77 suicides reported in 2003. The Army suicide rate is higher than that of civilians. There is no single explanation, Pentagon officials say, but the wear and tear of repeated deployments appears to be a major factor.

Roadside bombs - the most common cause of U.S. casualties - have produced many cases of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Rand Corp. estimates that more than 300,000 troops who have returned from Iraq and Afghanistan report symptoms of PTSD or major depression.

The report, issued in 2008, noted that only slightly more than half of service members with PTSD or TBI had sought treatment within the past year.

More than 36,000 service members have been wounded in the wars in Iraq and Afghanistan. In many cases, their injuries would have resulted in death in previous wars - advances in protective armor and medical technology have helped more survive. And that means more spouses, parents and other family members are taking on new roles as full-time caregivers.

Kelly Russell, 28, an Army spouse who lives near Fort Hood, needed help adjusting to her husband's behavior after he returned from his second combat tour in 2007. He was eventually diagnosed with PTSD and TBI.

"His patience level was almost to zero," said Russell, the mother of two young boys. "I needed an outlet as far as dealing with his mood changes. It wasn't just the normal mood swings. With PTSD and TBI, it's drastic from one minute to the next."

One day, her husband, who declined to be interviewed, brought home a leaflet promoting the Military Homefront program. "I called immediately," she said.

"I was getting overwhelmed most of the time," she said, recalling that she told her therapist: "I feel like a single mother. Even though he's home with me, I feel like I'm raising these kids by myself, and it's frustrating."

With her husband's five deployments in eight years, Lisa Bernreuther might be one of the most seasoned leaders of a Family Readiness Group - one with an answer to just about every problem. She became friends with Amparo Bracero-Sierra, whose husband was deployed to Iraq for the first time in their marriage. When Bracero-Sierra was hospitalized with a brief illness, Bernreuther came to her aid. And Bernreuther stood next to the nervous Bracero-Sierra for the homecoming ceremony in April when both of their husbands returned from Iraq.

But Bernreuther, 48, said that every family deals with deployments differently, depending on variables such as the ages of their children and whether the spouse works.

Her advice boils down this: Try not to follow the news about the war too closely, and keep your personal business off Facebook and other social media websites, where husbands and boyfriends can read it. "It could be misconstrued," she said.

Her final suggestion sounds like the 11th Commandment: Trust your spouse.

"If we didn't have trust, there's no way I'd be able to survive," Bernreuther said. "I don't know how some women, if they don't trust their husbands, how they get through a deployment. I really don't - because it's very hard."

She still has trouble adjusting each time her husband returns home. With her only child grown and living on her own, she works full time and gets into her own routine.

"It's like I'm a single person," she said, "because I'm here by myself for so long."

ABOUT THE SERIES

In the midst of the longest U.S. combat operations since the Vietnam War, military families are struggling through a relentless cycle of crisis and stress. Many suffer their own wounds of war: Depression. Anxiety. Divorce. Suicide. Staff writer David Tarrant and photojournalist Sonya N. Hebert have spent four months meeting dozens of military families and chronicling their journey through these perilous times. This is the first of a series of reports that will appear over the next several months.

SUPPORT AND RESOURCES FOR MILITARY FAMILIES

The National Association of Military Families, www.nmfa.org, has resources and support for military spouses and children. It also runs Operation Purple camps for military kids.

Blue Star Families, bluestarfam.org, is a network of military families with 70 chapters around the U.S.

Strong Bonds, www.strongbonds.org , offers relationship enrichment classes for military couples.

The National Guard Family Program, www.jointservicessupport.org, provides outreach and information to Guard families.

Force Health Protection & Readiness, fhpr.osd.mil/deploymentTips.jsp, is a family support program for reservists.

VA North Texas Health Care System, www.northtexas.va.gov, offers more information on local Veterans Administration programs.

TRIAD fund, www.triadfund.org , has state and local resources for veterans and military families.

Scott & White's Military Homefront Services, [email protected], 254-680-1139, offers counseling and other services.

Fort Hood's new Resiliency Campus focuses on helping troops before they go to war

Standing 6-4, with a head shaved smooth as a mortar shell, Monty Mitchell looks the part of a battle-hardened soldier with three combat tours and a Bronze Star to his credit.

The 44-year-old staff sergeant loves working on his vehicle - a Chevy Tahoe equipped with a four-wheel-drive lift. He relaxes by watching NASCAR on the Speed Channel.

He's not the kind of guy you'd expect to see taking a cooking class with his wife.

But that's where he was in late March, gamely by Deana's side, as the couple spent the day at a family resiliency program at Fort Hood. Mitchell, who supervises a dozen soldiers in a field artillery unit, believes in leading by example.

"If I'm asking my soldiers to do it, then I should be able to do it," said Mitchell, who has 16 years of military service.

The military has ramped up the number of programs for military families in recent years, with a major focus on resiliency training. It's part of an effort to help soldiers learn how to better handle combat stress and the strain of military life in general.

Fort Hood, the largest base in the nation and a three-hour drive south of Dallas, offers a broad assortment of services. At the center is the new Resiliency Campus, a complex of buildings with a wellness center and classrooms that became fully operational in September.

The campus is the first of its kind and showcases physical, psychological, financial and spiritual programs, said Col. Bill Rabena, the facility's commandant.

A gym includes weights and exercise equipment, as well as tai chi, yoga and massage therapy. Instructors teach personal finance, weight-control and marital classes, plus state-of-the-art breathing, focusing and calming techniques. Chaplains can be reached there 24 hours a day, seven days a week. Counselors with the Military and Family Life Consultant program are also based at the campus and provide short-term, problem-solving counseling and services.

"We deal more with the preventive side, trying to build that resiliency and inner strength before the [deployment]" to the war zone, rather than wait to fix soldiers and families after they have suffered a mental health crisis, Rabena said.

Last fall, the Army rolled out the servicewide resiliency training program, which will include all soldiers from young recruits on up the ranks.

Beginning Oct. 1, all active-duty and reserve soldiers will take a confidential, online evaluation of their resiliency. A similar assessment for military family members is in the works. The evaluation will offer advice to soldiers and family members based on their resiliency scores.

After attending the resiliency day program in March, the Mitchells, who have two teenage children, started working out every week at the wellness center. Deana, 42, also leads their unit's Family Readiness Group. "I know what [being in the Army] means to him," Deana said. "That's why I stand behind him."

But Deana and the kids are already bracing themselves for Mitchell's next deployment. "We try not to get too attached to him when he's here," Deana said, "so it's easier to deal with it when he's gone."