Treatment Resistant Depression

While we return to our daily lives after the holidays and get into the Christmas spirit, some families will not be celebrating this year. One family is James Weigl’s, a soldier who returned home after deployment, suffered from depression, and ultimately took his own life. Forty-three percent of soldiers who commit suicide do so after returning home from deployment, demonstrating that follow-up care with soldiers after deployment is just as important as mental health treatment while in active duty.

The story is an all-too familiar one. The article in the Milwaukee Wisconsin Journal Sentinel details the life of James Weigl, his active duty tour, return home, and his decline into depression. It’s a lengthy article, but it gives you an idea of how diverse the problems are that soldiers grapple with. It also details some of the hopefully-past problems the Army has in properly screening for mental health concerns earlier, rather than later:

Recruiters did not note Weigl had been diagnosed at the age of 4 as having attention deficit hyperactivity disorder that was so pronounced he had attended special classes in school. Nor did they ask Weigl about a family history of mental illness. His mother and other close family members suffer from treatment-resistant depression. Studies show family history of depression is a strong indicator of vulnerability for the disease.

While none of this should’ve made Weigl ineligible for active duty service, it should have served as notice to the Army that this is an individual who may need treatment in the future and someone who should be tracked more closely if future problems arise in his behavior.

Here are some of the passages that stood out to me:

Kathy and Mike Weigl begged their son to get help. But he refused, saying he was afraid that any record of psychiatric trouble would jeopardize his military standing.

After his tour of duty ended, he was sent back to the States and got into a weather-related auto accident:

The force of the crash knocked him unconscious. He was treated and released at a local hospital.

A few days later, he started to complain of double vision, according to medical records. He had constant neck pain. He lost his sense of taste.

Back home, his parents were frantic with worry. But his commanding officers accused him of faking to get out of duty. The Weigls think Army officers should have seen their son was sinking into a deep depression.

As you can see, commanding officers just three years ago still had an attitude that if a soldier is complaining, they must be lying to get out of work. Nice.

Alone in his barracks a few weeks later, he took out some ceiling tiles and fashioned a noose from an electrical cord. He was getting ready to put it around his neck when another soldier burst into the room. He had been sent by the captain to find out why Weigl was not at roll call.

When Weigl showed up late, not mentioning that he had come within minutes of killing himself, he was chewed out for his tardiness. […] At first, Weigl refused all offers of help.

“He didn’t want to lose his top-secret clearance,” Kathy Weigl said.

And that’s the root of the problem for many soldiers — the minute you complain of a mental health concern, you’re at risk for losing your security clearance. Security clearance is a big deal, because it means you can operate in more senior and prestigious positions that the typical soldier.

It’s hard to read a story like this and not see all the opportunities for more aggressive interventions. It’s also easy to second guess decisions in hindsight, which, at the time, might have seemed reasonable to his commanding officers. But more information about Weigl’s susceptibility to depression and more sensitivity to his health and mental health concerns earlier on may have been enough to get him earlier interventions and treatment. Earlier interventions, we know from research, can be more effective than later ones. In this case, it may have been enough to save a life.

Read the full article: A soldier’s story