Suicide Antidepressants 13/02/2005 Iraq/Florida Soldier, Just Returned from Iraq, Kills Self Summary:

Paragraphs 69 & 70 read: "Sgt. Greene did reach out for help after he returned from Iraq. He began seeing a psychiatrist - though he hid it from his wife."

"Lisset discovered prescription bottles of antidepressants and sleeping pills in their home. He told her he had started getting therapy and had been diagnosed with post-traumatic stress disorder."


http://www.sptimes.com/2005/02/13/Hernando/_Over_my_dead_body_.shtml


SPRING HILL - The words haunt Lisset Greene as she struggles to understand what happened to the man she loved. Home from fighting in Iraq, he had grown depressed and distant as he witnessed thousands of his fellow soldiers head off to war.

Curtis Greene was angry about the war and frustrated with Lisset for not understanding what it had been like there. They argued, so fiercely that twice the police had to break it up.

Gone was the man smiling with her and the kids in family photos. "He was not the person I knew when he came back from Iraq."

One night he disappeared from their home outside Fort Riley, Kan. Lisset and the kids went to stay at her father's house in Hernando County. When he called her to apologize for running out, he promised he would come home to Fort Riley. But he wasn't about to return to Iraq.

"Over my dead body are they going to make me go back."

"I knew he was having dreams, nightmares," Lisset said. "He would wake up at night really sweaty."

On Dec. 6, he showed up for work, his uniform pressed, his boots polished. He sang cadence.

That night, he was found hanging in his barracks. Sgt. Curtis Greene, 331st Signal Company, was 25.

During the war in Iraq, the military has made unprecedented attempts to understand the psychological toll of combat.

For the first time, the Army sent a team of mental health experts to assess the military's behavioral health system in an active combat campaign. The team was sent after a dramatic spike in soldier suicides - with five soldiers taking their own lives in Iraq in a single month.

Military leaders say they are expanding psychological services for soldiers, including mental health screenings, post-traumatic stress disorder support and new suicide prevention initiatives.

"The Army is more concerned than ever at looking at and taking care of the needs of the total soldier," Army spokeswoman Martha Rudd said.

It's not enough, some veterans advocacy groups say. And with the protracted ground war, they say, we haven't seen anything yet. Studies indicate soldiers are suffering from post-traumatic stress disorder on a scale not seen since Vietnam.

Steve Robinson, executive director of the National Gulf War Resource Center, said countless soldiers return from Iraq struggling with emotional scars. He questions whether the military is truly prepared to treat them.

"If we send soldiers off to war and they come back broken, we owe them the best the nation can muster to send them back into health, emotionally, spiritually, physically," Robinson said. "They're doing something, but I don't think it's enough."

Lisset wonders: Is that my husband's story?

"All I know is that I don't have a husband anymore, and my children don't have a father."

Greene grew up in a military home. His stepfather, Donald Greene, served in the Navy from 1968 to 1976; he remembers little Curtis helping him spit shine his shoes.

"We never had a problem out of him," Mr. Greene said. "I never knew him to have an enemy."

He asked about joining the military right out of high school in Siler City, N.C.

"I told him that if you want to sow a few oats and you want to see the world, my suggestion is to go into the service," Mr. Greene said.

But Mr. Greene, who served in Vietnam, also warned that he still struggled with memories of the horrors of war.

Sgt. Greene enlisted in the Army in the fall of 1997 and met Lisset Rivera the following year. Both were stationed in Germany, she working supply, he in communications.

Friends teased her about dating a younger man - she was five years older. But she said the other soldiers all liked him.

"Everybody said he was the coolest white boy," Lisset, a Puerto Rican who grew up in New Jersey, said with a shy smile.

They were married in a small civil ceremony in Germany early in 2000. Back in the states, Sgt. Greene took to Anthony, Lisset's son from a previous relationship. It was long absences from Anthony, who lived with Lisset's parents when she was stationed abroad, that convinced her to leave the military.

Sgt. Greene stayed in. He told Lisset the Army provided him with structure and stability. "He loved the military," she said. "He would praise it."

The family moved to Fort Hood, Texas, where as a member of the 16th Signal Battalion, Sgt. Greene earned a reputation as a strict taskmaster.

Staff Sgt. Daniel Boggs remembers Sgt. Greene clashing with a new soldier over his attitude. "Curtis didn't like it," Boggs said. "It wasn't a big deal, but he made it a big deal."

Boggs and Sgt. Greene didn't get along at first, but by April 2003, when they were deployed to Iraq, they were close friends.

The Army team of mental health experts was sent to Iraq in July 2003, after five soldiers committed suicide that month.

The resulting study, published in the New England Journal of Medicine, found that as many as 17 percent of soldiers serving in Iraq showed signs of major depression, generalized anxiety or post-traumatic stress disorder.

Most soldiers suffering from psychological problems told researchers they had not sought counseling because of the stigma or fear that it would ruin their careers.

The study found that 72 percent of soldiers reported their unit's morale was low; it found that mental health workers there felt untrained to treat combat stress.

Because of these barriers to getting care, many experts believe the number of soldiers in Iraq suffering from combat-related psychological problems is far greater than one out of six.

"One of the major impacts of war are mental health problems," said Dr. Charles W. Hoge, the chief of the division of psychiatry and neuroscience at the Walter Reed Army Institute of Research.

Hoge, a principal author of the study, said he hadn't met Sgt. Greene and could not comment specifically on his case.

But he said the general "hallmarks" of post-traumatic stress include re-experiencing a traumatic event in some way, such as nightmares; avoiding anything that might remind you of the traumatic event; and hyperarousal, a physiological response to stress that can lead to irritability and restlessness.

Among soldiers who develop PTSD, the study said, "There was a strong reported relation between combat experiences, such as being shot at, handling dead bodies, knowing someone who was killed, or killing enemy combatants."

The details of what Sgt. Greene experienced during his eight months in Iraq are unclear.

Boggs said he was stationed in Fallujah and Ramadi, while Sgt. Greene built communications networks near the Jordanian border. They talked often, but Boggs said his friend never went into detail about what he witnessed, just that he hated it there.

Sgt. Greene told his stepfather that he had to kill a few people, and that the guilt was weighing on him. "Curtis seems to think that he was a murderer," his stepfather said. "Curtis was raised to respect life; in the military you're taught to take it. I think he struggled with that."

The Army does not provide detailed information about where specific soldiers were stationed or incidents they witnessed, said Rudd, the Army spokeswoman.

Lisset said her husband shared his worst experience: A soldier next to him was shot in the face and died instantly. He told her he screamed until he got to his destination, then watched as the man was placed in a body bag.

He felt guilty because they had switched seats in the car shortly before the shooting.

"He said they treated the body like a bag of trash," she said. "He said that he was supposed to be in the passenger seat, and the bullet was for him."

In World War I, it was known as shell shock, in World War II, combat fatigue. The psychological effects of war on soldiers have always been a struggle.

But the rigorous evaluation of war-related mental health problems is relatively new, according to Matthew Friedman, executive director of the Department of Veterans Affairs National Center for PTSD.

In the mid-1980s, the National Vietnam Veterans Readjustment Study found that about 30 percent of male Vietnam veterans suffered from lifetime problems with PTSD. Friedman and other experts believe a flood of soldiers with psychiatric problems will return from Iraq.

Rick Weidman, a spokesman for Vietnam Veterans of America, says of the more than 1-million soldiers who have served in Iraq, the number with psychological problems is probably at least 1 in 3.

"Iraq is Vietnam without water," he said. "We will see a great deal more of this."

Sgt. Greene's family said he never talked to them about depression while he was deployed. But one thing is certain: He wanted out of Iraq.

He got out of his Texas-based battalion after about eight months by re-enlisting in the Army, Lisset said. He was able to return to the United States by signing up for another three years with the 331st Signal Company, 1st Brigade, 1st Infantry Division, stationed at Fort Riley, she said.

He seemed "normal" when he returned from Iraq in December 2003, she said. He finally met his newborn daughter, Laila, and couldn't stop gushing about her.

But after they moved to Fort Riley . . .

"He changed; he changed," Donald Greene said. "He was just in the ozone, so to speak. He was detached, in turmoil inwardly."

Lisset said he had nightmares and couldn't sleep. He cried easily, but avoided talking about Iraq.

"He just said it was ugly, and that you don't know what it's like until you're there," she said. "He always said he wouldn't wish it on his worst enemy."

When the evening news reported deaths in Iraq, he would weep and ask her to turn off the TV.

"He really cried, like it was someone he knew," she said. "He'd say that we shouldn't be there. He always wanted to know why we were there."

He was terrified that his company would be deployed to Iraq. That company remains at Fort Riley.

The Department of Defense recently announced that it is expanding its assessment of soldiers coming home. It will require all soldiers to fill out a health questionnaire within three to six months of their return.

Rudd said the Army also offers a deployment psycho-support program and an extensive suicide-prevention program.

"I think there are still gaps," Steve Robinson said. His group wants mandatory face-to-face sessions with a qualified mental health care provider.

Military mental health programs are stretched too thin, he said, and should be proactive, not simply react after suicides and other incidents.

In the meantime, many VA hospitals are working to expand psychological services, despite talk of subsidy cuts and possible enrollment fees for some veterans.

Dr. Glenn Smith, a psychologist with the post-traumatic stress disorder clinic at the James A. Haley VA Medical Center in Tampa, is organizing workshops about PTSD for veterans and their spouses.

He is working to erase the stigma around mental health issues that can develop in a combat zone. "PTSD is a normal reaction to abnormal stress," he said.

The VA recently was authorized to add 50 outreach personnel to the 940 it has nationwide to assist with its readjustment counseling service.

Sgt. Greene did reach out for help after he returned from Iraq. He began seeing a psychiatrist - though he hid it from his wife.

Lisset discovered prescription bottles of antidepressants and sleeping pills in their home. He told her he had started getting therapy and had been diagnosed with post-traumatic stress disorder.

She said he wanted out of the Army, but finances were tight. They would argue, and Lisset said she saw a look in his eye that scared her. "He didn't punch or hit me, but he threatened to kill me," and she didn't know what he might do.

He took off in the middle of the night, leaving Lisset and the kids in Kansas. He drove to Virginia and told his family there that he had "gotten out of the military."

By the time he called Lisset, she had taken the kids to stay with her father in Spring Hill. She begged him to return to the base, worried he would be arrested for going AWOL.

He did go back, and told her his punishment would be working extra duty.

He called the next day, Dec. 6, and asked about their future together. Lisset said she loved him but thought he needed counseling. He agreed, but said he believed she would be better off without him.

He hung up. She tried repeatedly to call him back, but there was no answer.

Four hours later, fellow soldiers found him dead, hanging in his barracks.

With so many mental health programs available, Sgt. Greene's stepfather wonders why nobody in the Army noticed the warning signs.

"It seems to me like somebody somewhere would have spotted this," Mr. Greene said. "He was seeing a psychiatrist."

He fears the questions around his son's death will never be answered. "I'm just a grieving daddy who raised a boy and lost him."

Lisset doesn't know what to believe. Did her husband have psychological problems before he was deployed? Did Iraq trigger something in him? Could the Army have done more to help him?

"I know it could have been prevented," she said.

She feels the Army has not provided her with any answers. She has not seen his suicide letter, which she was told is being held as evidence in an ongoing investigation.

"You can't expect a soldier to go and be expected to take people's lives - women, children, anyone - then expect them to come back and be fine," she said.

Lisset and the kids are staying with her father in Spring Hill. She is trying to explain to Anthony what happened to his stepdad. Most days, Anthony insists that she help him put on the gold star pin "for Daddy" that the Army gave him.

Sgt. Curtis Greene is buried at Florida National Cemetery near Bushnell.

"He was a good, honest person," Lisset said, looking out over the rows of tombstones. "He was willing to die for his country. But when he came home, I thought he'd be safe."

Researchers Carolyn Edds and Caryn Baird contributed to this report. Mary Spicuzza can be reached at mspicuzza@sptimes.com or 352 848-1432.
[Last modified February 13, 2005, 06:28:02]