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Description

What’s the point of going to treatment if you’ve essentially been dealt a death sentence? That’s the way some veterans feel about a potential PTSD diagnosis. Another thing holding people back? The fear that their trauma isn’t bad enough. So how do you admit you need help? And where do you turn when you’re ready? This week we’re joined by Jason Kander who served as an intelligence officer in Afghanistan, Tara Consolino, Director of Suicide Prevention and Substance Use Disorders at the Detroit V.A., and Rajeev Ramchand, a psychiatric epidemiologist with the RAND Corporation, to talk about what happens when your symptoms don’t look like the ones in the movies.

 

Season 2 of Last Day is created in partnership with The Jed Foundation. The Jed Foundation (JED) empowers teens and young adults with the skills and support to grow into healthy, thriving adults. You can find tips, tools and resources for taking care of your emotional health available at: www.jedcares.org/lastday

 

Resources from the episode:

• Keep up with the Veterans Community Project’s initiatives for homeless veterans.
• Listen to Jason’s weekly podcast, Majority 54, to better learn how to have a civil and productive conversation about the most divisive issues.
• To learn more about recommendations for reporting on suicide, visit https://reportingonsuicide.org/.

 

If you or a veteran you know are struggling, dial 1-800-273-8255 and press 1 to reach the Veterans Crisis Line. You can also text 838255 or chat online at www.veteranscrisisline.net.

 

You can also contact one of the resources below for a free, confidential conversation with a trained counselor anytime.

 

National Suicide Prevention Lifeline: 1-800-273-8255

Crisis Text line: Text “Connect” to 741-741

The Trevor Project: 1-866-488-7386

 

To follow along with a transcript and/or take notes for friends and family, go to https://lemonadamedia.com/show/last-day shortly after the air date.

 

Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.

Transcription

SPEAKERS

Dr. Rajeev Ramchand, Jason Kander, Stephanie Wittels Wachs, Tara Consolino, Speaker 5

Stephanie Wittels Wachs  00:02

Have you experienced treating of that who is resistant?

Tara Consolino 

You’re adorable.

Stephanie Wittels Wachs 

That woman laughing in my face is Tara Consolino. She’s the Director of Suicide Prevention and Substance Use Disorders over at the Detroit VA.

Tara Consolino 

Here’s the “problem” with post-traumatic stress disorder. Oftentimes when someone is suffering from this, if they admit that they’re suffering from PTSD, there’s that myth that if I have PTSD, I’m effing crazy, right? And if I’m effing crazy, and I have PTSD, then that’s a death sentence. And that right there can be the reason why somebody doesn’t come in for care, because they are either in denial, or they think what’s the point?

Stephanie Wittels Wachs 

Got to admit, in the earliest conversations, we had the season about what stories we want to cover, it was always a given that we’d need an episode about veterans, PTSD and suicide. Because it is a very familiar story, both in the media and in the data, which we learned in episode one isn’t always the case, veterans are 1.5 times more likely to die by suicide than Americans who’ve never served in the military. for female veterans, the risk factor is 2.2 times more likely, there were over 6100 veteran suicides in 2017, the most recent data to date. So yes, the numbers are there. And these numbers point to an undeniable problem. But it’s not super helpful to only focus on these big scary numbers because it almost starts to feel like suicide is an inevitable conclusion to post traumatic stress, which makes it really hard to walk through the doors and get help in the first place.

Tara Consolino

Why am I gonna waste my time or my money coming in to talk to these Yahoos that know nothing about me know nothing about what I’ve done. And I absolutely hear that I hear that, people’s sense of trust is completely obliterated, oftentimes, when they’ve endured a trauma. Absolutely. So now, not only am I saying, trust me to come in and chat with me, and you don’t know me. But I’m saying trust me that I can help you figure out how to get you better.

Stephanie Wittels Wachs  02:28

Easier said than done, especially when you’re feeling hopeless and helpless, and like no other person on this earth could possibly understand you. That’s why you need to find Tara, or some Yahoo like Tara, who has an unshakable faith that she can and will help.

Tara Consolino 

If I really didn’t believe that my sailors and my soldiers and my marines could get better if I didn’t think they could get better. Honestly, I’d go back to private practice and make the easy money. But the fact of the matter is therapy works. medications work and you put the two together, and you’ve got people like myself and the rest of my team, be it at the Detroit VA or the VA healthcare system as a whole who are here legitimately to serve those who serve.

Stephanie Wittels Wachs 

This is like standing ovation, slow clap kind of inspiration. She is so good. But I also know some of you probably heard the words VA, service, soldier and are settling end to enjoy a story that has nothing to do with you. Like grabbing a bowl of popcorn and watching Bradley Cooper return home for more and lose his ever-loving shit on screen from a safe distance. But it is important to note, PTSD is not just about veterans. When it comes to post traumatic stress, it is not as simple as us versus them. Everyday people can be traumatized and traumatized people are everyday people.

Tara Consolino  04:03

When you have a diagnosis of post-traumatic stress disorder, you are a normal person who was put through an abnormal situation who is now having normal symptoms.

Stephanie Wittels Wachs

So what happens after you accept that it’s normal to need help? How do you learn to trust someone when you’ve built up all these walls to protect yourself? How do you even start when, like Tara said, you feel like you’re effing crazy.

Stephanie Wittels Wachs 

I’m Stephanie Wittels Wachs, and this is LAST DAY.

Dr. Rajeev Ramchand 

I often just want to remind people that for the past, you know, 15 years the suicide rate has increased by 30% in the total population.

Stephanie Wittels Wachs

This is Dr. Rajeev Ramchand. He’s a psychiatric epidemiologist who works with the RAND Corporation.

Dr. Rajeev Ramchand 

It is increased in every single state, it is increased among men and women is increased among old and young, it’s hard to find a group that is not experienced this increase. Now, the increase, for example, in the DOD over that same period has like tripled, right? So it’s way more than the civilian trend. But there is this underlying disturbing phenomenon of an increase in suicide in the general population. So I say that not to kind of ignore the framing of the populations at risk, like the veteran suicide population, but to realize that they are not the only groups right now who are dealing with this, and they, at some level are probably just reflecting what’s happening in the general population in general society.

Stephanie Wittels Wachs 

Suicide Prevention Research is shamefully underfunded. So it’s really hard to identify actual risks and practical solutions for a group as large as the entire population of the United States. So narrowing our focus helps clarify the data. And vets are a group that actually have a ton of empirical data. Not just anecdotal. My neighbors, cousins, best friend’s, sister said this before he died, but more reliable case studies, especially when it comes to the link between trauma and suicide. Which brings us to today’s story, the main character, Jason Kander, who enlisted in the Army National Guard, shortly after 9/11.

Jason Kander  06:34

I was 21 years old and just thought, well, this is what I should be doing. And there were people who, because it was obviously a different era, and there was no draft, there were people who were saying to me, but you don’t have to.

Stephanie Wittels Wachs

We stopped drafting Americans into service in 1973. And since then, serving our country is a choice, and one that not everyone understands.

Jason Kander 

I mean, I was about to start Georgetown Law School, I come from a family that had means and people were a lot of people were confused as to why I was doing it. And frankly, that kind of pissed me off whenever people were confused, because I was like,  what right would I have to feel as though I don’t have an obligation here, because if I don’t, somebody else is gonna go. And I felt really strongly about this really corny idea that people found corny, but I’m in it, which was that if I go over there and do my job, well, then some more Americans come home safely.

Stephanie Wittels Wachs

Jason ignored the naysayers and followed that impulse all the way to Afghanistan, where he served as an intelligence officer.

Jason Kander 

What my deployment to Afghanistan to me was a full utilization of everything I had, I mean, you’re just fully utilized the whole time. You know, I mean, sometimes you’re sleeping, and sometimes you’re bored. But when you’re outside the wire, you’re fully utilized. Your body and your brain are at its complete and total capacity. 100%. And that is exhilarating. And it also takes a toll.

Stephanie Wittels Wachs  08:01

Have you ever experienced anything like that? That sort of full max capacity?

Jason Kander  08:06

No, in fact, my very first convoy like I think I’d been there a day, maybe two was the first time I ever experienced the feeling of like, the physical Ill feeling of wow, I might die.

Stephanie Wittels Wachs 

So here’s Jason in a role where he’s routinely going outside the wire, aka leaving the base, doing it without armor. And the first time was really fucking scary.

Jason Kander 

Now, after a while, like that was just what I did. I mean, it was you just start doing it. And you don’t feel that sick to your stomach, like after the second or third time and you just don’t feel it. It’s just your job. And it’s what everyone around you is doing. But so your brain doesn’t register that it’s still kind of going to a place where even if you take the traumatic part of a combat deployment out, just the very nature of putting yourself in a place mentally and emotionally where you’re prepared to take another human life changes your brain.

Stephanie Wittels Wachs 

Jason wasn’t thinking about his brain, though. He was just focused on the mission. By this point, he’d gone from being afraid to die to building that possibility into his basic routine when commanding a convoy. But while he was prepared for that outcome, he was still doing everything in his power to increase his chances for making it back home. As an intelligence officer, it was Jason’s job to win the trust of key Afghan officials. He had to play a cool, joke around, not let on that he was on high alert. Eventually, he got so good at it, that it felt normal, which was kind of the point.

Jason Kander 

From the moment you get off the bus, the message that is ground into you overtly, and implicitly, is what you’re doing is no big deal. And other people are doing much harder, much more dangerous stuff. And that’s there as a consistent theme the entire time you’re in the service. And that sounds pretty bad when I say it. But it’s a really necessary, it’s a really necessary thing. Because for me to keep going into those rooms, where I knew that there was a reasonable chance I would never get out. I had to feel like there were plenty of other people doing harder stuff. The problem is they don’t turn it off when you get home. And nobody says, “Hey, that was pretty crazy.”

Stephanie Wittels Wachs  10:36

So no one’s there to validate your experience. No one’s like, “Hey, friend, just so you know, that was crazy” you probably need to spend some significant time working through that experience. Nope. Instead, you are thrown into a new intense experience, trying to go back to the “normalcy” of home.

Tara Consolino 

If you ask people, what do they miss, oftentimes, they’ll miss that structure that routine, that day to day knowing I know what I have to do, when I have to do it, and how it needs to be done. There’s really not a lot of ambiguity, so to speak, when people transition out of the service, it is so black and white.

Stephanie Wittels Wachs 

On one side, there is absolute clarity, who you are. And what you do is literally spelled out on your uniform, your location, your rank, your role. It’s not like that in the civilian world. In fact, it’s sort of a free for all with a tremendous amount of vague uncertainty.

Tara Consolino 

It is really going from one world to the other. And just like whether it’s retirement, or divorce, or any other stressful time of life, you might be super excited to get out of the service suite, I’m able to live my own life, I can grow my hair out, I can grow a beard, I can get tattooed, I can do all of these things that I couldn’t do when I was “the property of Uncle Sam.” But once people are out, it’s so difficult. And that’s where I have to admit the VA does indeed step up. They have entire teams called Transitions Care Management, which is there to work closely with the God and the departing service members to be able to figure out who are you? Who do you want to be? What is your sense of identity? And what services can the VA give you to help get you back in your square?

Stephanie Wittels Wachs  12:30

My new best friend Tara is right. The VA offers some pretty incredible programs for vets who are returning home. But here is the catch. They’re optional. The Department of Defense and the VA have transition programs, but they’re not a requirement. So it’s very easy to just check the boxes and think I’ll deal with this later. I just want to get home. But when you get there, it’s unrecognizable. I mean, imagine you come home one day and you walk into your house and everything is different. The walls are a different color. The furniture is all different. The Family Photos are unrecognizable. On the outside, it looks like home. But on the inside it is bizarro world. And to make matters worse, no one else sees what you see. This is what returning home can feel like, it’s jarring and stressful. And yet another thing you are not prepared for.

Jason Kander 

When I came back, everything looked totally different. But it was more like I had seen how the world really was. And all these people around me had no idea. And it still feels that way sometimes, right? And there’s a lot of ways that that manifests itself. One of them is what I now know to call hyper vigilance, which is this feeling that the world is a very dangerous place. But there was also all sorts of other things.

Stephanie Wittels Wachs 

One of those things was a sort of low simmering anger. He wasn’t getting into fistfights or flipping over tables or anything like that. But he could feel himself getting angry when people said stupid things, which is what people do all the time all day long. But remember, Jason was literally trained to disguise what he was feeling, inside he was about to boil over. But on the outside, cool as a cucumber.

Jason Kander  14:21

When I say angry, I mean like there was this anger underneath that would be a real problem and would and would cause me to have all sorts of other symptoms. And that anger is really all it is whether it’s the anger, the self-loathing, the emotional numbness, the you know, the hyper vigilance, all the different stuff that comes with post-traumatic stress. What I learned in therapy was, it was all just a desire for control. If you can feel that if you can feel angry instead of you know, sad or empty then you can control your emotions. And it gives you a sense of control. And really, that’s a post-traumatic stress is about. I mean, when you think about it, I came from a world where if I didn’t control the situation around me, I would be kidnapped and killed. And so I came home with a really turbocharged drive to control the situation, and anger, shame, all sorts of things just became ways for me to do that.

Stephanie Wittels Wachs

Yes, our old friend, the illusion of control, or current friend, who never takes the hint, and goes home, that little voice inside of you, that tells you to grab a shovel, and just keep digging until all the bad feelings are safely buried. But eventually, the emotional wiring starts to short circuit.

Jason Kander  

Well, and then what happens is, is you, you have all these negative emotions, and you get tired of feeling those. And so you learn how to numb them, you just learn how to just completely numb all these negative emotions, these things you’re telling yourself about yourself that you know, all this stuff, the anger and the paranoia and all that stuff. And then what you don’t realize when you’re doing that is you don’t have like a smart bomb ability to go in and just numb and just take out the negative emotions. So that’s how you become emotionally numb, is that it just you just become numb to all emotion. And after a while, joy just feels like it’s something just on the other side of a wall, you know, you’re aware you should be feeling it, you can feel some, you know, residue of it, but you can’t fully access it.

Stephanie Wittels Wachs  16:42

Jason was experiencing textbook symptoms of PTSD. But part of why he didn’t seek help is because he didn’t think he had PTSD, which actually seems to be another defining characteristic of PTSD. Tara saw this a lot when she first started at the VA.

Tara Consolino

So I spent the first several years working with combat trauma, specifically Post Traumatic Stress Disorder, and I was a psychotherapist on the PTSD clinical team. What I actually found was, I would have people coming into my office, and they’d come in for an evaluation for me to provide an assessment, to then diagnose them, figure out what kind of treatment plan what kind of services we were going to offer. And they’d come in and they’d be like, well, I don’t have PTSD. I don’t have nightmares. I don’t have PTSD. I don’t have flashbacks, I’m, you know, not like those Vietnam veterans. And the reality is, is that, you know, this is a diagnosis that absolutely has components, but there’s no one size fits all. Sometimes it’s as simple as someone being more agitated than usual.

17:53

Someone who is you might think that they’re an adrenaline junkie, wow, this guy, you know, he started, you know, shooting guns, and he started riding his motorcycle really radically. He started bungee jumping and in saying, oh, he’s just an adrenaline junkie. And you know, that might be the case. But it could also be that he or she is having extreme feelings of numbness when he or she is holding their newborn child. And they’re saying, Oh, my God, I know I should feel something, and I don’t feel anything. I’m feeling nothing. And that right there is a very strong symptom, that then when you really kind of psycho analyze it, and you see, why are they doing all of these behaviors? Why are they making all these decisions? It may simply be to feel something.

Stephanie Wittels Wachs  18:48

Jason didn’t jump out of planes or chase tornadoes. But he did try to feel something by running for office. More on that, after the break.

Stephanie Wittels Wachs

We’re back. Jason Kander came home from Afghanistan in 2007. And by 2008, he’d been elected to the Missouri State Legislature. By 2012. He was the Missouri Secretary of State making him the first millennial ever elected to statewide office. From the outside. He was a young progressive star on the rise. Inside, the house was on fire. And the only other person who could smell the smoke was his wife, Diana.

Jason Kander

My wife and I been together since we were 17. So she knew who I was before what I was like before, and then saw me get gradually worse for 10 years after. So the first major impact was there’s a thing called secondary post-traumatic stress.

Stephanie Wittels Wachs 

Secondary post-traumatic stress, also known as secondary traumatization. doesn’t mean it’s contagious, or anything like that. But it does mean that the symptoms of one person’s trauma can also be traumatic for the people closest to them.

Jason Kander  20:10

For instance, hyper vigilance, like when I’m constantly feeling like somebody’s trying to break in the house when I’m constantly patrolling the house at night, sometimes armed, or, you know, when I’m on the road for a campaign or for work, and I’m calling home and I’m like, have you triple checked the alarms? Have you locked all the doors? That had a real effect on my wife, not to mention the fact that, you know, in the middle of the night, like, every single night, I’m having these violent nightmares, she’s got to try to wake me up from them. And then I described them to her in the middle of night, so that was pretty tough, I think on her, but it also just, I became more and more emotionally distant.

Stephanie Wittels Wachs

Here again, what felt like a personal problem was actually a well-documented concern for veterans returning home. More specifically, vets returning home with untreated PTSD. Turns out not talking to your partner is kind of a symptom, as is trouble sleeping, and depression and increase substance use, all of which can contribute to relationship problems, divorce rates for veterans with PTSD, or two times greater than veterans without PTSD. And here’s the thing, we could go on a whole tangent about how this may relate to the people who are being recruited in the first place, their preexisting risk factors, how the military incentivizes people to get married young, but instead of going on that tangent, let’s just say Jason was lucky, and he knows it.

Jason Kander

I’m seriously blessed, and that I’ve had this incredible partner through this whole thing. And somebody who, because we had been together for so long, I think, was operating on faith that I was still in there. And I’m really glad that she stuck with it until we found that I was. People can listen, and they can be supportive.  Nobody can get there for you, you know, I started to have, well, my symptoms just over time got worse. And I’d say I started to have suicidal thoughts or suicidal ideation. Probably three or four years before I finally did something, but they weren’t. They weren’t constant that you know, at first. And they weren’t. They weren’t persistent. I mean, they would, I’d have a bad couple of weeks. And then I wouldn’t feel that way for a while. And then. But it was enough to where, you know, I mentioned earlier that I used to patrol the house at night armed. It was enough to where that only lasted a year or so maybe a few months before I had said enough things that sounded like suicidal thoughts that my wife convinced me to start keeping that gun at my father in law’s house, right, and I started patrolling with a table leg at night.

Stephanie Wittels Wachs 

When you are patrolling the house with a table leg after your guns been confiscated by your partner, because you might be a suicide risk, it is safe to say that things have crossed a significant line.

Jason Kander 

You know, my wife would tell you and she said this publicly a couple of times that she started entering, making sure to always when I was home, and she was coming home with our son True, she would start she would make sure to enter the house first. Because she was worried that I was in there and had killed myself. For me, you know, I never, I never had a plan, which they tell me is significant. It was always it was suicidal ideation. But it became a lot more common. My therapist put it to me once it’s like, he was like, you just felt like it’d be better if he were dead. And I was like, yeah, that’s where I got to I was like, it would just be better. And I believed, I got to the point where I believed it would be better for everybody. I felt like a burden on my wife and my son and on so many other people. And I kept that completely to myself, Diana, my wife was the only one who knew that I had felt this way.

Stephanie Wittels Wachs  24:05

Tara told us that this is one of the most common things that people share on the veteran crisis line, almost verbatim, feeling like they’re a burden and life would be easier for their family without them. This sort of thinking should immediately raise alarm bells. But Jason was not there yet. He had other fish to fry, much bigger ones.

Jason Kander

You know, meanwhile, I was getting ready to run for president as his comment in a story like this. But I knew that I was getting worse and worse. And I had self-medicated with adulation and accomplishment and attention and professional achievement. And I say I don’t want to take too much credit away from myself. I was also self-medicating with the sense that I was making a difference, right? Like, it wasn’t just like narcissism. I mean, it was as is common with people who have experienced trauma, I had an enormous desire for redemption. And I felt like the only way that I could maybe ever feel like I had done enough was if I just saved the world.

Stephanie Wittels Wachs

This is where I would typically jump in and relate as a person who tries to outrun my own demons through hyper productivity. Except it’s embarrassing to even try to compare myself to this guy. I’m basically on the JV field of shame fueled Workaholics. Jason is captain of the varsity team. I literally had my producer fact check his birthday twice, because I refused to accept that he and I are the same age, which we are. But anyway, I digress. He is impressive. But also, I don’t want to overstate his impressiveness because it was a very deceiving facade, covering up some very dark shit.

Jason Kander

It was getting harder and harder for me to get the level of endorphins to feel something. And I gave the keynote speech at the largest annual fundraiser of the New Hampshire Democratic Party. This is after having campaign in 47 states inside of a year Bender, New Hampshire and Iowa a dozen times each the year before me, it was Joe Biden, the year before that it was Hillary Clinton, the year after me it was Elizabeth Warren here I was I was the keynote. We understand that patriotism is not about making everybody stand and salute the flag. Patriotism is about making this a country where everybody wants to. Honestly I crushed it, though. Great all that night. felt pretty good the next morning, and then I got on the plane. And it was just like, no, it was just it. And I realized then I was like, wow, if this doesn’t do it, something’s really wrong.

Stephanie Wittels Wachs  26:48

So Jason decides that a presidential run is a bit excessive, and he takes it down a couple notches.

Jason Kander

So that’s when I decided, Okay, I’m gonna go home, I’m gonna run for mayor and try and seek redemption by serving my neighbors. And at the same time, I’ll go to the VA, I still wasn’t ready to admit to myself, there was post-traumatic stress. But I was like, I could go to the VA, something’s wrong with me. And I went home started running for mayor that was going great. We were gonna win. Pretty handily. But I didn’t go to the VA.

Stephanie Wittels Wachs

Stigma is basically a form of emotional terrorism. And it isn’t just holding us hostage from the outside. Oh, no, it is often coming from inside the house.

Tara Consolino 

You know, we’ve kind of all been hearing the word stigma for years, except what we’re finding is that it’s what does stigma mean? It’s not just sigma, it’s self-stigma. It is anticipatory stigma. If I have this diagnosis, I will then anticipate, oh my gosh, what does this mean for my career? What does this mean for my wife for my husband or my spouse? If I indeed have this diagnosis?

Stephanie Wittels Wachs  28:00

It goes right back to what Tara setup top; people are afraid that a PTSD diagnosis means they’re effing crazy. And the fear of getting that diagnosis can hinder them from getting help in the first place, or being honest, when they do finally reach out, as was the case with Jason.

Jason Kander

I had not answered all the questions, honestly, because I was worried about that, you know, like, I still thought I was going to run to be commander in chief at some point. And I just thought people would never be cool with it, if you had suicidal thoughts and couldn’t sleep and that kind of thing. And so, you know, the stigma is what kept me from being honest in my first time. And so as a result, like I wasn’t enrolled, and they just got worse and worse. And then finally, I took the step of calling the Veterans Crisis Line, suicide hotline. And what really struck me was, I thought I was calling and was going to be told, like, Hey, this is not related to your service, don’t call this number, you’re fine. You’re not suicidal that. But in talking to the woman on the other end of the phone, I could tell just by her tone of voice that my phone call was no different than anybody else’s. And that’s when I got pretty serious about it and realize, like, Oh, I better do something or I’m not going to be around anymore.

Stephanie Wittels Wachs 

The fact that someone was finally validating his experience was comforting, but it also made it real.

Jason Kander 

My best friends didn’t know, the people closest to me in my office, and in my campaigns didn’t know. And so when the woman on the other end of the line asked, I don’t remember the exact line of questioning, but when she asked me, you know, if I had suicidal thoughts, and I said, Yes, it was like a big deal for me, because this was a second person that I was saying this to and then I got pretty emotional as a result. So that was important for me. But it was also for me, just like that her reaction was not like, what? I mean, this her reaction was like, Okay, well let’s talk about your service. Let’s talk about how you’re feeling, you know, it was just very comforting and that it was so routine for her. And also, it was comforting, but also really upsetting because I had been telling myself the story that like, I wasn’t the person who needed this, but it was clear that I was.

Stephanie Wittels Wachs  30:21

Realizing this, he pushes pause on politics and drops out of the race. His public statement explained that he was dealing with PTSD, and he needed to focus on his treatment at the VA. This is also the moment where Jason starts to let go of some of that necessary brainwashing that accompany to active duty.

Jason Kander

Because they tell you, in no uncertain terms, that what you did is not that big of a deal. And what you’re doing is no big of a deal. And because they don’t flip that off. As a veteran, you feel like saying it could be post-traumatic stress. That feels like stolen valor. My first visit to the VA, I sat down with a clinical social worker to go through, you know, basically to get your diagnosis essentially. And she asked me, Why did you go so long thinking that what you experienced was in combat, and I said, Look, I have all these friends who are in firefights, and all these things. I said, You know, I went to these meetings, and she’s like, Yeah, but you went to meetings by yourself, basically, in the most dangerous place on the planet, for really long periods of time you were outside the wire, you know, nobody knew where you were. And you were at risk of being kidnapped. Because you didn’t have any idea whether these people you were meeting with, who they were loyal to, and I was like, yeah, and she’s like, what are your friends say about this? Your friends who went through firefights and stuff was like, well, they always say that they could never could have done my job. But I just, they’re just being nice. And she’s like, no like, that what they went through is combat and what you went through is combat. And it took that for me to understand that no, like what I did was combat, it was just different than what I’d seen in the movies.

Stephanie Wittels Wachs  32:00

It is amazing how powerful the movies are. I’m an outsider. So of course, my understanding of the military is largely shaped by whatever I see on screen. But it’s interesting that someone like Jason, who’s been there firsthand, is also comparing himself to some Hollywood hero. And listen, I love the movies. But so much of our faulty wiring comes from Fictional portrayals of complicated things that are really fucking hard to unpack in 90 minutes. And while I don’t have combat experience, I can tell you as a storyteller, you usually go for the big dramatic ones. So PTSD stories are usually about the people who experience the most combat the most trauma, which kind of erases the very real stress that many veterans are dealing with day to day.

Tara Consolino 

Oftentimes, I’ll have a soldier or marine who’s in my office, and there’ll be like, but I didn’t go through what he went through, or I didn’t have it as bad. Okay. I didn’t have an orange today. That doesn’t even have any correlation here? Stop, just stop.

Jason Kander 

The thing is, is whether you did what I did, whether you maybe even never went outside the wire, but, you know, you heard the bombs, or whatever it is, it doesn’t matter. Like your brain doesn’t know what my brain experienced. And my brain doesn’t know what anyone else has experienced. And so what I’m always trying to get across to people now, and what I learned in therapy is comparing your trauma to someone else’s is a giant waste of your time. I mean, I wasted 10 years when I could have, I could have been recovering. And I could have been better. But instead, I was so busy, you know, classifying my trauma and putting it in a little box. And that’s the problem with never turning off that training that says it’s no big deal.

Stephanie Wittels Wachs 

So what does recovering from trauma look like in practice? What happens after you take those first steps? More on that after the break.

Stephanie Wittels Wachs  34:06

We’re back.

Stephanie Wittels Wachs

So Jason called the hotline, partially because he was in crisis, but also he just didn’t know where to start.

Jason Kander 

In my case, they said, okay, you need to go to your VA, they’re in Kansas City, we’re gonna let them know that you’re coming and need to go ahead and get enrolled in the system. So I went, I think the next day, I don’t remember exactly. And then and I want to, I’m going to explain this, but I always worry about discouraging people from trying. But it was a process. And for me, what happened was I went and I filled out all this. I answered all these questions. And, and then I was told, okay, we’re gonna go ahead and submit for you to be enrolled in the system. It’s gonna take a few months. And I was really discouraged by that. Now, that doesn’t happen in every case.

Stephanie Wittels Wachs 

But it does happen too often. And usually to people who are less equipped to push past those initial roadblocks.

Jason Kander 

Think about it this way, like, here I am. I mean, I got a phone full of influential contacts. I’m the former Secretary of State of Missouri, I got a Georgetown Law degree. And I’m looking at this going, I don’t know how I’m going to navigate this, particularly because I wasn’t in the best place. And six weeks before that, I toured a place in Kansas City here called Veterans Community Project, which was started by a friend of mine, a fellow combat veteran. And it was just one of the most inspiring things I’d ever seen. I mean, the vibe was like if, if Forward Operating Base in Afghanistan, and a startup in Silicon Valley had a baby. I mean, it was just genius, what they were doing for vets, and I intuited as a guy who was going to be the mayor. And six weeks later, you know, after going to the VA, I call my buddy, and I’m like, I’m not sure what to do. And he’s like, come on. And so six weeks after that tour, I walked through the front doors of the Outreach Center, like thousands of other vets in Kansas City. So they expedited my paperwork, handle that for me, and a week later, I was in starting weekly therapy.

Stephanie Wittels Wachs  36:14

This is important to note, we constantly highlight that being a person is hard, and therapy is the answer. But getting from Okay, fine, let’s do this thing to sitting in that cozy office, or these days popping on a Zoom call can be a process in and of itself.

Tara Consolino 

Here’s my thing with therapy, the first thing that I have to say is, if you don’t have chemistry with whomever you see, find a new therapist. Because oftentimes people will go for one session, and be like, Oh, my God, what a waste of time, this guy or gal totally didn’t get me. The approach didn’t work. And here’s the thing that might be the case, think about how many people you have had interactions with in your life, and how few you may have become friends with, you have to have that chemistry component. Even though therapy is not friendship, but there has to be that chemistry there where you’re speaking the same language,

Stephanie Wittels Wachs 

I am here to confirm that trying to find the right therapist can be super challenging. And throughout the process, it is easy to be like, I’ll just lean on the people I already connect with. But here is an important distinction. a therapist can be friendly, but they are not your friend. And your friends can be helpful, but they’re not your therapist. And that is what we call boundaries.

Tara Consolino

When you think about it, who in your life is 100% honest with you, who truly bears witness to whatever journey you’re walking along. Oftentimes, we don’t have that. And a therapist truly will do that. a therapist will say, okay, talk to me about this. And they will listen unconditionally, and really hear you out and help you draft a map to say, Okay, what kind of journey Are you looking to take, I’m not going to tell you how to get there. But I can walk next to you. And I can help draw the path with you. And that’s just something that we can’t do for ourselves.

Stephanie Wittels Wachs  38:26

Jason wanted to walk next to someone who really got him who understood his specific brand of trauma inside and out. To him that made the VA the obvious choice. But much like when he first deployed, not everyone in his life understood the decision.

Jason Kander 

And they were all saying, you have means you have connections, why would you go to the VA? Well, I’m really glad I did. Because I just wanted to talk to somebody who I knew I was never going to say anything that hadn’t heard before. And I wanted and that’s what a lot of people don’t realize about the VA system, by the way is that whether you’re going in for your shoulder or your brain or whatever, there’s just things about being a soldier or marine or whatever, that are different. And they see our bodies and they see our brains and they know what they’re looking at. You want to see someone who specializes in what’s wrong with you. And you know, there was just never a moment where I said anything to my therapist where he went. Oh, really. He was just like it was always like, Yeah, that makes sense.

Stephanie Wittels Wachs 

This need to find someone who gets you isn’t just for veterans. No one wants to waste their time and money explaining surface details to a therapist. You want to talk to someone who understands enough to cut through the bullshit and get to the deeper issues. This is especially true when you’re talking about something as complicated as trauma. We’ve been trying to get clarification on when trauma becomes a risk factor for suicide. It is very important to note that not everyone who is traumatized will become suicidal. But those who do go on to develop PTSD are at a significantly higher risk.

Tara Consolino  40:09

Is the correlation strong there? Yeah. Because the fact of the matter is, suicide is also a symptom. When someone dies by suicide, they’re not dying by suicide, they’re suffering to the extent that suicide is the only answer for them. And that’s not the answer. The fact is when someone is suffering to the point of feeling that they are a burden on someone, that they are hopeless or helpless, that they’re isolated, that they are alone, that they’re never going to be able to be who they used to be, but they’re unable to see who it’s possible for them to become. The fact of the matter is that when you’re suffering from Post-Traumatic Stress Disorder, and you’re feeling like nobody understands if you’re suffering from depression, where the pain or the ache, or you just need the world to stop turning for a second, and people don’t sleep well, when you’re suffering from these anxiety diagnoses, or trauma, or depression, you put lack of sleep on top of that, that’s going to be a perfect storm for suicide to enter the picture.

Stephanie Wittels Wachs 

Understanding that suicide is a symptom of PTSD, but not an inevitable outcome was a big revelation. Another was this idea that we hear so much about post-traumatic stress, but not enough about what’s on the other side of it.

Jason Kander 

It’s also why I talk a lot about post traumatic growth, because that’s the chapter of my life that I feel that I’m in. And I need people to know that post traumatic growth is a real thing. You know, one of the, I think my most important role, really, in public life, is to portray and project what I am now, which is somebody who has been through this treatment, and has come out on the other side, so much better for it and fully capable of doing whatever I want to do. And the reason I think that’s important is because when you think about post-traumatic stress, and this portrayal in whether you’re talking fiction, you know, whether it’s the news, or whether it’s movies, what we see and what’s portrayed is always people who are struggling with it, but never people who have already been successfully through treatment, so much so that after I really got a lot better and was, you know, now I go to see my VA therapist as needed and is being you know, every few months, and it’s just yeah, tune up, usually, right?

42:38

But, when I really started to get better, and I was getting to the end of my like weekly regimen of it, I felt really awful about the fact that I’ve gotten so much better. And I said to my therapist, I said, Hey, you know, most people don’t get better. Did I even have it? And he and he was like, Ah, this is what it does, it makes you believe that it never existed. And he said, and that’s what the portrayal of it in public life does. So he pulled out these studies that showed me that the vast majority of combat veterans who had gotten post-traumatic stress treatment through the VA had entered a recovery phase and had and got to a point where the symptoms didn’t disrupt their life anymore. And he said that the main difference between those who achieved that and those who didn’t, was their level of commitment to the program was basically doing your homework doing what you’re supposed to do. And I had no idea like I literally did not know that most people got better from it.

Stephanie Wittels Wachs 

Jason thought his house had metaphorically burnt to the ground. But it turned out, it just needed some repairs. And this wasn’t a situation that was unique to him. People he was close to, were also suffering in silence.

Jason Kander 

When I was over there. There were two other guys at my camp, like where I was working out who did work like mine. I didn’t stay in touch with the two other guys for many, many years. And I just assumed that, you know, what we did wasn’t that big of a deal? Well, one of those guys a year after he came home, he died in a one vehicle accident. Which, you know, I suspect was not an accident. Another one, the other one had a one vehicle accident at one point that I don’t know whether it was an accident. It was pretty serious. And, you know, I finally got in touch with him. After I’d gotten better and everything I finally got in touch with him, maybe a little less than a year ago. And he was just getting ready to retire from active duty. And he said yeah, he’d been experiencing a lot of the same stuff over the last several years. And I convinced him that as soon as he got done with his active duty that he was going to go and he was going to get treatment and then he attempted suicide within a few weeks but much to his chagrin at the time, he survived.

And then he spent several weeks in an inpatient program for post-traumatic stress. And he said that at some point, while he was in there, they played for him a video of this guy talking about post traumatic growth. And it was me. And he came out, and he called me and now like, he’s doing really well. And he’s as much of an evangelist about post traumatic growth as I am, which is a great thing. But what if he and I and the other gentlemen, what if we had just stayed in touch? As soon as we got home? What if we had been talking to each other and saying, Hey, I’m having really bad nightmares about being kidnapped, hey, I can’t sit with my back to the door in a restaurant. Like, you know, if that had happened, probably the three of us would have been like, Hey, we’re all having exactly the same problems. Maybe it is related to our service. And I think also, we would have understood that what we did over there was pretty serious. So I guess the lesson of that, by the way, is, if you’ve gone through something traumatic, whether it’s a car accident, or a deployment, and there’s people who you were with and who went through some of that with you, stay in touch with those people and have really candid conversations, because it’ll help.

Stephanie Wittels Wachs  46:14

Dropping out of the Kansas City mayoral race wasn’t the end, it was the beginning. It’s when he stopped using work as a coping mechanism, and started actually working on himself. He’s not the President, he’s not the mayor. He’s the main character in a much happier story than the one he thought he’d be telling.

Jason Kander 

My daughter was born six weeks ago. And, you know, we had thought we were never gonna have more kids. I mean, because of our careers. And because we didn’t really talk about this, but it probably because of this, my state of mind and that kind of thing. So the day after my daughter was born, I sent an email to my therapist at the VA, and I just thanked him, you know, he’s been a really important person in my life.

Stephanie Wittels Wachs

Seems like, can you even imagine if I mean, how do you think your world would be different now? If you have not done all that?

Jason Kander 

I think it would either be the same as it was, which was unacceptable, or I would not be alive. It’s funny. I mean, the idea of even comparing my life is like, No, I mean, it’s so starkly different, you know, I am. back then. I mean, I was, I was traveling like crazy. I mean, from the outside, everything looked great. But I was deeply unhappy. And I was in a spiral. I was super busy all the time. And I thought that that made me happy. But what I didn’t understand was all that did was keep me from being in my own head. And you know, cut to now where I have a job I love I, you know, I talked earlier about how I just wanted to help Americans get home safely. That’s literally what we do.

Stephanie Wittels Wachs  48:06

Today, Jason is the president of the Veterans Community Project. It’s the same organization he told us about that initially connected into therapy when he needed it most.

Jason Kander

Among other services we provide, we create villages of tiny houses for homeless veterans, and we eradicate veterans homelessness and the towns we go to. And it’s deeply satisfying. But I also coach my son’s Little League team. And I, you know, and I have a podcast that I enjoy, but like, it’s not because I want to run for anything. And I say, whatever the hell I want, you know, and my life is exactly where I want it right now. And back then, my life was irrelevant to me. It was, I was a vessel through which, you know, progress could potentially be made. And that was all that I thought I was good for.

Stephanie Wittels Wachs

So let me ask you this, because one of the things that we really want to normalize on the show, is, your life is exactly what you want right now. Right? Like, you’re living the dream, you’re doing everything like you’re living the life you want to have. You still have bad days, right? I’m wondering, in this kind of, like, wonderful life that you’ve created for yourself. What is a bad day, like now? What tools do you have in place because I don’t want people to ever think like, I went to get help. I call the crisis line and then boom, magic, like, everything’s fucking great. It’s, you know, there’s, I’m wondering if you can kind of address that and how you tackle those days now.

Jason Kander 

So let me start with this, though, that the biggest misconception that I think people have about getting help is that it’s like taking a pill or like getting an IV drip, right? It’s not antibiotics, right? I think I thought that it was this passive process where you go in and you talk and then eventually you’re better. No, it’s hard work. I have days just like anybody else that’s suck. And I can remember at one point being in going to see my therapist, like, at this point, I was in a groove where I was really starting to feel better. And then I just had like five just really shitty days in a row. And it scared me because I was I was like; I was having nightmares again. And I was having some of the symptoms, a lot of them. And I become really attached to feeling better. And I was scared that it was, I couldn’t beat it, right?. And I remember I said to my wife, like, I don’t know if I’ll ever be happy. And I went into see my therapist, the next day for my weekly appointment. I told him and he goes, it’s been how long and I said, five days, and he goes, sounds like you’re just having a shitty week.

50:53

And I was like, I was like, What do you mean? He goes, well, I mean, depression is two weeks. And you know, he said, it’s not that he said, if it goes on for another, you know, like, eight days, we’ll talk about it. He was like, but I don’t think that’s what it is. You’re just having a shitty week. And I literally had no idea that that was a thing I could have, like, up until that point, I had worked so hard to just not feel bad. And so I would do everything I needed I could possibly do to avoid feeling down and or feeling upset or feeling, just feeling anything. And so when I learned that I could just feel like shit. And that was all right. That was a big deal for me. And, you know, and I remember he told me that appoint me. So just feel the feelings. He said, If you feel good, don’t tell yourself you can’t feel good, because other people didn’t make it home safely and you did don’t. Don’t say well, you know, I feel good now. But I won’t feel good. He was like, just feel good. If you feel good, just enjoy it. And don’t pile guilt on top of it. He’s like, and if you feel shitty, just feel shitty. You won’t stay feeling shitty, but just feel it. So his big lesson to me that appointment was feel the feelings. And I think one of the biggest things I learned was the ability to be comfortable with being uncomfortable.

52:10

And so yeah, I mean, I have shitty days. There’s no doubt about it. But the difference is now when I have a shitty day, I’m not like, the fuck is wrong with me? Like why? Like, what’s wrong with you, Jason, what, you know, you made it home. Other people didn’t, I don’t do that anymore. I say, Man, I’ll try and have a better day tomorrow. And that’s really, I think one of the most important things I’ve learned.

Stephanie Wittels Wachs

When Jason said he had to learn how to be comfortable with being uncomfortable. I immediately thought about Jeremy Richmond, who we talked about in Episode Three. If you look at these two stories side by side, there’s actually a lot of similarities to men working through trauma while trying to save the world. Jeremy’s story was about how he couldn’t outrun the darkness. And it was hard to frame that episode without suggesting that his suicide was inevitable. The best we could come up with was, well, if you can’t outrun it, welcome it in, walk alongside it. And I love that concept. But if I’m being totally honest, part of me still had no idea what that could really look like. But I think it’s this.

Going from thinking that things would just be better if you are dead, to actually feeling like tomorrow has the potential to be better is a monumental shift. It doesn’t happen overnight. And it’s not some magical transformation that you cross your fingers and hope for. You have to work for it in lots of boring and uncomfortable incremental ways. like making that first phone call or filling out forms honestly, or just reaching out to people who know what you’re going through and being completely transparent about where you are. When you’re struggling with thoughts of suicide. These seemingly simple things can feel incredibly difficult. But one by one, slowly but surely, they add up to building a life worth living. Even when some weeks are shitty.

Stephanie Wittels Wachs  54:44

Next week, we see what happens when you find yourself in the midst of a potentially life-threatening emergency. That the emergency room is just not equipped to handle.

Speaker 5

Psychosis was a totally different animal. It was like we had two options. We had waited like on a two-month waitlist to see a psychiatrist or we went to an emergency room. That was it. We had no other route into getting, like very serious professional help for him.

CREDITS

LAST DAY is a production of Lemonada Media. Our supervising producer is Jackie Danziger associate producer is Giulia Hjort with additional production assistance by Claire Jones. Technical Director is Kegan Zema, music is by Hannis Brown. Executive producers are Jessica Cordova Kramer and me, Stephanie Wittels Wachs. We are thrilled to partner with the JED Foundation this season and grateful for all their wisdom and support. You can find them online at @JEDFoundation. And you can find more mental health resources at jedcares.org/lastday. If you want to hear more LAST DAY we have a whole first season. Go listen to it wherever you get your podcasts and while you are there. I beg of you to take a moment to rate review and subscribe if you haven’t done so already. You can find us online at @LemonadaMedia and you can find me at @wittelstephanie. I’m Stephanie Wittels Wachs. See you next week.