SALT LAKE CITY — The popularity of the film, "American Sniper" has prompted a national discussion about the hidden wounds of war like mental illness and suicide.
In Utah, therapies designed to heal those wounds are being researched and practiced. They are wounds inflicted during the life-and-death battle that begins for many veterans when they try to move from military service back to civilian life.
"It was very depressing. I didn't feel like I fit in. I knew I didn't fit in anymore," said Michelle Fisher, an Air Force veteran who left the battlefields of the Middle East only to fight a new enemy back home: depression.
Marine veteran Kris Good agrees: "Nobody was watching your back, you weren't watching anybody else's back like we were over there."
There were similar emotions for Army veteran Tabatha Worth after she returned from a tour of duty in Afghanistan.
"I felt isolated. I felt alone," she said.
Depression led to thoughts of helplessness and suicide.
"It was like I had all that pride, all that honor and integrity, and then I didn't have that anymore, and I was lost; I was adrift; I was hopeless; I just wanted to end it," Worth said.
Dr. Craig Bryan is a retired Air Force psychologist who directs the National Center for Veterans Studies at the University of Utah.
I thought the things I did were wrong. Normal people aren't supposed to do that, and I didn't want people thinking that I was that kind of person.
–Spencer Boilingbroke, Marine veteran
"A shrinking number of Americans have a direct connection with someone who served in the military," he said.
In fact, Bryan believes that disconnect with those they served gives veterans "the feeling that they don't really fit in and people don't really understand what they've been through."
Spencer Boilingbroke is a veteran of the Marines. He initially felt happy to be back with family and friends upon his return from Iraq in 2008. Then he started to be ashamed of his service and his actions during the war.
"I thought the things I did were wrong," he said. "Normal people aren't supposed to do that, and I didn't want people thinking that I was that kind of person."
Army veteran Gordon Ewell speaks to veterans about his experiences with traumatic injuries and with the urge to take his life. He believes most people don't understand the kind of wounds they can't see.
"It's a wound they (soldiers) received in combat, no different than being shot or blown up," Ewell said.
Bryan has treated these invisible wounds of war in Iraq, in Utah where he counseled veterans at high risk of committing suicide.
"This is how individuals with psychological injuries die," Bryan said. "This is sort of like the heart attack of mental illness."
Bryan and other mental health professionals want to stop the epidemic of military suicide. They have just published a five-year study using Brief Cognitive Behavioral Therapy to treat soldiers with suicidal tendencies. The results: soldiers undergoing the 12-session psychotherapy were 60 percent less likely to attempt suicide.
The therapy focuses on three areas including simple strategies to manage emotions and solve problems effectively. It also, according to Bryan, emphasizes self-esteem by asking the patient to "think about how you think about yourself, how you think about life and the world."
Veterans said managing their emotions after they return to civilian life can be challenging.
"Everything is kind of flipped upside down on me," Ty Davis, a recent veteran of the Army, said. "I don't know how to adjust right now like get along with people."
"(I had) no control of my emotions," Army veteran Ben Lopshire said. "I'd wake up and I'd be mad and ornery all day."
Fisher describes the emotions this way: "Once you get triggered, you are slammed with an emotional cocktail, and it's all flight, fight or freeze."
Bryan hopes veterans won't fight or flee from treatment like the promising therapy he helped to develop and test.
"It's just very simple strategies that most of us use on a daily basis," he said. "We exercise, we talk with other people, you know, we do breathing exercises."
In other words, they choose to live, and Ewell said that is the right choice emphasizing that, "This life is too precious to waste."
Retired U.S. Army Sergeant Josh Hansen prescribes to Bryan's therapy for learning to live a life worth living. He founded Continue Mission with the goal of improving veterans' quality of life by getting them out in nature, enjoying recreation and being around other veterans.
"The biggest part is the camaraderie," Hansen said. "Veterans we talk to they miss the camaraderie of people that understand them."
The entire country is trying to understand the challenges veterans face. At the top, President Barack Obama has signed a law designed to help prevent suicide among veterans. And on the front lines, mental health professionals like Bryan are hoping to change attitudes and convince soldiers it's time to start living again.
As far as Lopshire is concerned, that could be the toughest part of this mission.
"I think really the challenge is getting the vet to the services and making that connection and having it work and sustaining it."
Worth feels veterans counseling and supporting veterans is a part of the answer.
"Most of the help that I've gotten in my darkest times has been the hand of another vet reaching out," she said. "We are a family, not by birth but by choice, and we will do whatever it takes to help our fallen comrades."
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