This is one of two stories in a series on PTSD. The second story focuses on an alternative treatment called Hyperbaric Oxygen Therapy.
Cathi Johnson was in a deep sleep. The kind of unencumbered slumber that's dark and bottomless; the kind that wraps you in a cocoon of ease over which your consciousness hovers, many layers above, grateful for the reprieve.
The kind that had eluded her of late.
Wait…what was that? A twitch? A whisper? A touch?
Then a trumpet call from the amygdala to the hypothalamus activated the adrenal gland, which released neurotransmitting chemicals, and increased her blood pressure. The information-rich blood shaped itself into a pair of hands. Hands that ripped Cathi Johnson from her cocoon.
She was violently reunited with her body. She convulsed upward in a swirl of light and limbs, as gravity and her consciousness caught up. Now awake, she looked around, tentative but shrewd, clocking every detail. She was in her living room.
The TV was on. Every muscle was contracted, deployed for use. She looked down. There was a person. She recognized the face, frozen with shock. The face was her husband's. She was on top of him. Her knee was in his neck.
This was in February 2005, while Johnson was on a 15-day leave from a year-long deployment in Afghanistan with her National Guard unit. Moments earlier, Johnson's husband, Greg, had been sitting on the floor watching TV, while Johnson slept soundly behind him on the couch.
At one point Greg stretched, and when he did, he accidentally touched her.
There are no good dreams. Everything's a nightmare."
Cathi Johnson
As a female machine gunner, Johnson was acutely aware that she was a target. She was trained not to let anyone get close enough to incapacitate her and take her weapon. But she wasn't trained to shut it off.
"If something happens, you automatically react," said Johnson, now 51. "There's no thinking to it."
What she didn't know at the time was that the heightened state of sensory sensitivity she was experiencing was a symptom of Post-traumatic stress disorder, a condition that afflicts one in five veterans of the wars in Iraq and Afghanistan.
That realization came later, after she came home to Ellettsville for good in July 2005. Her family had thrown a homecoming party for her at her brother's house. Even though she knew she was in a safe place among loved ones, her mind was going a thousand miles a second.
His hands are in his pockets. Why are his hands in his pockets?
Somebody just walked in the door.
This person's standing too close.
That person's moving too fast.
What's he doing?
Johnson had four months before she was due to return to her job as a forklift driver and parts modifier for GE. She and Greg moved into a rental house while they looked for a piece of land to build on. She tried to keep herself busy with craft projects. She tie-dyed dozens of shirts, socks and underwear.
But the adjustment to life back home was hard. In the military, everything was regimented, orderly, planned out. Now she found herself stymied by which type of toilet paper to buy at the grocery store.
Inexplicably, she would suddenly fall down without losing consciousness. She'd get lost driving to work. She forgot her husband's middle name, forgot their anniversary.
Sleeping became a near impossibility. When the house creaked, she'd snap awake. If she was asleep before her husband came home from work, she told him to be as loud as possible. And when sleep actually did take her, there was little mercy in it.
"There are no good dreams," Johnson said. "Everything's a nightmare."
A Troubling Legacy
PTSD is fast becoming a signature legacy of the wars in Iraq and Afghanistan. Affecting 300,000 veterans from those wars, it is directly linked to a spike in suicide among veterans over the last several years. Every day, an average of 22 U.S. veterans commit suicide, and veterans now account for 20 percent of all U.S. suicides.
According to a 2010 mental health survey of Army and National Guard Infantrymen that served in Iraq, higher numbers of National Guard members were diagnosed with PTSD than any other branch of the armed service, particularly after being home for more than a year. The study suggested this might be because Guard veterans are more isolated when they get back, because they're no longer on active duty and no longer have the camaraderie of their unit. Most also face the added stress of not knowing whether they'll have a job when they come home.
Johnson was fortunate. GE paid her while she was deployed, and assured her that her job would be waiting when she got back. Her two children were living with her former husband in Louisiana. Greg, worried but proud, eagerly awaited her return. Though Johnson didn't have many of those extra stressors, others she knew did.
"Many people came home and had to fight to get their jobs back," Johnson said.
The Indiana National Guard ranks sixth in the United States for total number of reservists with 14,160 as of January. It deployed 20,436 reservists to the wars in Iraq and Afghanistan, from 9/11 to the present.
"We had several requests from Central Command," said Jim Brown, Director of Veterans Affairs for Governor Mike Pence. "Now it's a very veteran filled guard, just like after World War II."
Brown says that of the 20,436 who served in the wars in Iraq and Afghanistan, 20 percent deployed overseas at least four or five times.
In Afghanistan
Johnson enlisted in the Army National Guard in 1983 when she was 20. She served three years of active duty in South Carolina and Georgia, then transferred home to the unit in Bedford for her remaining three years. After that, it became more of a hobby, and she kept re-enlisting. For one weekend a month, and two weeks of training in the summer, the Bedford unit became a second family.
"I always said, even if they wouldn't have paid me, I'd still be in the Guard," Johnson said. "It was just something I enjoyed."
In early 2004, Johnson decided to retire from the guard. She already had her "20," after which you can retire with a pension. Driving in to the Bedford unit to file her paperwork, she saw something unusual- the unit was in formation. They were going to Afghanistan.
Johnson could have been exempted from the deployment, but as a retention officer who had convinced several in the unit to either join or stay on, she felt duty-bound.
"I had to go," Johnson said. "There was no way I couldn't."
She and Greg married that April, and by May she was at Camp Atterbury preparing for deployment. By July, she was living in a "bee hut" in Camp Phoenix, just outside of Kabul, where she was one of just a few qualified to carry an M249 Squad Automatic Weapon (SAW) machine gun, which weighs 22 pounds loaded. Johnson preferred the SAW to the more common M4.
"The M4's like carrying a purse," Johnson said.
Johnson worked several jobs in Afghanistan. Her unit's mission was to train the Afghan National Army to defend the country. Sometimes she worked in the tool room with the mechanics, sometimes in vehicle dispatch. Often, she kept her SAW trained on ANA recruits, as well as Afghanis brought in to assist with maintenance and construction projects.
It was hard to tell friend from foe and there were rumors of the Taliban infiltrating coalition bases to learn their tactics, so everyone had to be treated as a potential threat.
That guy's hands are in his pockets. Why are his hands in his pockets?
What's he pulling out?
Hand grenade?
RPG?
Detonator?
"Everything was a danger, and there wasn't a switch to turn that off," Johnson said.
Johnson can't pinpoint one specific event that caused her PTSD. It might be the 14 times in 12 months their camp was RPG'd by insurgents. It might be the people she knew who were killed- the man who was a fireman back home, or the IU student who ran over a mine. It might be the dread she felt before she had to inspect damaged vehicles returning from patrol beyond the wire.
"I was always afraid I'd see blood in there," Johnson said.
Back Home
Driving with Greg one afternoon, a car going the wrong way headed straight for them. Johnson, who was in the passenger seat, instantly registered the vehicle as a suicide bomber, and reached to her side for her machine gun. At the last second, Greg swerved into another lane and they barely avoided the car. Johnson looked at her side. Her gun wasn't there.
Once, Johnson woke up in the middle of the night to go to the bathroom. She was surprised to see piles of clothes all over the bedroom floor that hadn't been there when she went to sleep. When she came back from the bathroom, the piles were gone.
On her first day back at GE, Johnson walked in with Greg. The place was bustling with people and machines. She was already shaking. Someone yelled ‘Hey Cathi, how you doing? How many people did you kill in Afghanistan?' She turned to her husband and said, "You gotta get me out of here now."
Eventually, she got back into her work routine and things were fine until one St. Patrick's Day, when a co-worker pinched her for not having any green on. Johnson spun around and got right in his face.
"I'm gonna take your head off!" Then, in the same breath, she said, "I'm not mad at you, you just startled me."
The co-worker happened to be a Vietnam veteran, so he understood. But another time at work, someone startled her, and she punched the person in the neck. Johnson knew something had to change.
I gotta get out of here before I hurt somebody, she thought.
Johnson went on leave, but she didn't fully acknowledge that something was wrong until a woman from the VA called her one day and asked her how she was doing. Johnson almost never cried, but she did then. She broke down on the phone.
She'd had enough. She checked into the VA hospital and stayed under observation for a few days. They told her that she had a traumatic brain injury, and prescribed medication to help her sleep.
But the pills made her sleepwalk. When she baked a cake in the middle of the night and woke up with no recollection of it the next day, she knew she needed to stop taking them.
"I told my husband, ‘Don't eat this cake, I don't know what I put in it,'" she said.
The VA ran a series of PTSD–related tests. Johnson said the whole process felt like trial and error.
"At first it was like, pills, pills, pills, pills," Johnson said, "but after taking twenty or thirty pills a day, for two or three days you're like, ‘I'm not putting another pill in my mouth, it doesn't work.'"
Alternative Therapies
In March, an Indiana law took effect requiring the state to study Traumatic brain injury and PTSD among veterans and recommend new treatments and better coverage.
If we don't get something done, it means more veterans aren't getting treated, and more veterans are committing suicide."
Sen. Jim Banks
Certain experimental therapies, like Hyperbaric Oxygen Therapy, Prolonged Exposure Therapy, and Cognitive Processing Therapy have proven effective in some cases, but because the evidence isn't conclusive, the VA doesn't cover them yet. Sen. Jim Banks, R-Columbia City, who sponsored the legislation and is a member of the National Guard himself, hopes that will change.
"If we don't get something done, it means more veterans aren't getting treated, and more veterans are committing suicide," Banks said.
Johnson hasn't tried any experimental therapies. She says the VA never offered her any. She says her dog, Radar, has helped her more than anything she's tried so far. If she didn't have to get up every morning to take care of Radar in her first few months back home, she isn't sure what she might have done.
"Sometimes I wonder."
Living with PTSD
Today, Johnson lives in Ellettsville with Greg, her 23 year-old daughter, Shaylah, and Radar. They built a house on 30 acres off a private road that has wild turkeys and deer. They have a shop on the property where she and Greg work on their cars, tractor, and four wheelers.
Johnson no longer works, having retired from the guard in 2006 after 22 and a half years, and GE in 2008 after 20. She spends time caring for her father, who has Alzheimer's. She cooks dinner every night for Greg and Shaylah. She dotes on Radar, never leaving him for more than four hours. Every few weeks, she takes him out for grooming and a burger. She goes to church. If a veteran calls her for help filing a claim, she'll help them. If a veteran struggling with PTSD wants to talk, she'll listen.
But she stays home too much.
"It's easier not to go anywhere," Johnson said.
The symptoms are less intense than they were when she first came home, but they're still there.
She has a Harley in the garage that she can't ride because she still falls sometimes. Greg says she runs in her sleep, because she'll occasionally dream that she's chasing somebody or that somebody's chasing her.
While she hasn't hit anyone in the last few years, she says if someone approached her to ask the time in a parking lot, she'd hold out her hand and say "Stop, you're close enough!" before checking her watch.
Johnson knows her triggers, and she does her best to avoid them. Her kids no longer spring out of hiding places to set her off, like they did when they were younger. On a recent evening, when Johnson was doing dishes at the sink, Shaylah waited patiently behind her with her plate so as not to startle her. Johnson turned around and shrieked when she saw her. They both started laughing.
"Some of it's funny," Johnson said.
She takes a slew of medications, which she calls her "be nice to people pills." She sometimes attends Vet-to-Vet meetings, a support group in Bloomington run by her sister, Terri, who's also a veteran. She doesn't see a counselor. Mostly, she copes. Johnson still hasn't tried alternative therapies, mostly because she doesn't think there's a cure for PTSD; even if there were, she says she's not sure they'd do her any good.
"I've been back ten years, someone who just got back might benefit from that," Johnson said. "At least I'm not punching people anymore."
She remembers those early, volatile days. Attacking her husband. Snapping on people. Keeping her back to the wall. When someone walking behind her too close freaked her out. When she had to know who was coming in the door, who was leaving. Who was parked by her car. She knows that she may never be able to shut it off, but she is proud of the progress she's made. She accepts that this is how life is now.
