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Why many combat veterans are still suffering, years after the fight ended

Editor's Note: If you are having thoughts of suicide, go to SpeakingOfSuicide.com/resources or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).

On average, 20 U.S. military veterans daily die by suicide, and suicides among active duty personnel are increasing. A number of treatments for veterans with depression and post-traumatic stress disorder exist, but they have drawbacks. Special correspondent Mike Cerre looks at treatment options and follows up on U.S. Marines with whom he was embedded during the war in Iraq.

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  • Amna Nawaz:

    Long after they come home, many troops continue to face battles with post-traumatic stress disorder. Some of them find that traditional therapy programs are not enough, and instead seek different programs and medicine than before.

    Special correspondent Mike Cerre reports on the new ways former soldiers are now fighting to overcome their trauma.

  • Mike Cerre:

    After three tours of duty in Iraq and one in Afghanistan, veterans of Fox Company, 2nd Battalion, 5th Marines, known as FOX 2/5, thought their wars were over.

    But their fight has followed them home. More members of their unit have since died from suicide than from combat, as they continue to battle PTSD, post-traumatic stress disorders, from their service.

    Former Corporal William Yellowhair was the unit's third and most recent suicide.

  • Cpl. William Yellowhair:

    I like to know what we're going into, what we're getting into, what kind of operations we're going to be doing.

  • Mike Cerre:

    Despite more than a decade of in- and out-patient treatment at the VA hospital in Prescott, Arizona, William Yellowhair's body was found in his garage next to his service duffel bag and pictures of his Iraq service.

    As an embedded reporter with FOX 2/5 on two of their tours of duty in Iraq, and following up with them over the years, many of them have shared their difficulties with varying degrees of PTSD and the different treatments they have tried, with mixed results.

  • Kaine Marzola:

    I felt extremely isolated because I couldn't relate to anybody.

  • Mike Cerre:

    Kaine Marzola, highlighted here fighting from a rooftop in Ramadi, Iraq, was first diagnosed with PTSD while still in the Marines. After his discharge, he was treated at his local VA hospital near Las Vegas.

  • Kaine Marzola:

    When they started to giving me all the medications, I lost all of that. I lost what made me special, what made me different, what made me stand out amongst my peers. I just was a zombie. I didn't care. Didn't have a fight, no more fight left in me.

  • Mike Cerre:

    Frustrated by the traditional PTSD drug and therapy protocols, he created one of his own based on an intense physical training to regain what he calls his fighting spirit.

  • Cpl. Michael Elliot:

    Seeing things out here, being part of a war, part of history, it has impacted us all in different aspects, I think. Definitely, it's changed my life forever. I won't go back to the States the same.

  • Mike Cerre:

    After coming home, former corporal Michael Elliot was initially reluctant to get treated for his PTSD.

  • Cpl. Michael Elliot:

    I hit rock bottom. I got a DUI for drinking. Quit my job that I had here, a little short-term job. I was just like, this is not me. Something is wrong. I need help.

  • Mike Cerre:

    He confessed to driving to the VA Hospital in Helena, Montana, for nearly a year, and sitting in the parking lot, before mustering the courage to share his problems with professionals.

  • Cpl. Michael Elliot:

    It's a safe place. It's a place where people are actually here to help you. And a lot of time, out in the community, your family and things like that, you feel like you don't want to complain with your story or your issues to people.

  • Mike Cerre:

    According to the VA, nearly 10 percent to 20 percent of recent combat veterans, and 15 percent of Vietnam era veterans, are experiencing some degree of PTSD. Together, they account for nearly 20 percent of the VA's patients.

    Most experts agree that psychotherapy programs are the most effective long-term treatment. The problem, it's not easy or readily accessible to veterans when they need it in their daily lives.

  • Dr. Thomas Neylan:

    Well, some of it has to do with the nature of PTSD, and that is that people with PTSD try to avoid memories and things that remind them of their experiences.

  • Mike Cerre:

    Dr. Thomas Neylan, head of San Francisco VA Hospital's PTSD clinic, understands FOX 2/5 and other veterans' complaints with existing PTSD treatments. Namely, cognitive therapy can take months of emotional sessions discussing their trauma, which can be too difficult and time-consuming to complete.

    The prescribed antidepressant medications mostly treat PTSD symptoms, rather than the underlying problems.

  • Dr. Thomas Neylan:

    These medications have side effects. Sexual side effects is really common, sedation, insomnia, and there's a host of them. And yes, the medicines are better than they used to be, but no one's happy with the current status.

  • Mike Cerre:

    What are some of things you're looking at to maybe make the cognitive therapy easier or more accessible?

  • Dr. Thomas Neylan:

    There's been a lot of effort to sort of optimize cognitive therapies, to speed them up, to telescope them into a shorter period of time.

  • Mike Cerre:

    The VA is also using teleconferencing to make the therapy more accessible and convenient, and developing mobile apps to help vets deal with their PTSD crises wherever they might emerge.

  • Woman:

    Welcome the body. Shift back to that feeling of calm tranquility.

  • Dr. Karen Seal:

    We can recommend some complementary integrative therapies that are known to reduce stress and have some preliminary evidence for PTSD, such as yoga or mindfulness meditation or acupuncture.

  • Mike Cerre:

    Dr. Karen Seal, the director of the San Francisco VA's integrated care clinic, believes many of these complimentary treatments the VA is now offering can reduce the dependence on prescribed drugs.

    Many veterans are relying on recreational drugs for their symptoms, which the VA can't prescribe, like marijuana, and MDMA, commonly known as ecstasy, which is further along in the clinical trials and more promising for treating the underlying causes of PTSD, according to the Multidisciplinary Association of Psychedelic Studies, conducting the research.

  • Man:

    This is the time for the supplemental dose, if you want to take it.

  • Man:

    Sure, why not?

  • Rebecca Matthews:

    Cannabis only works in symptom reduction, is the hypothesis. And with MDMA, we believe, is that it can actually cure PTSD, with the way it works in the brain and the way that the neuroplasticity and the relearning and reconsolidation of the memories.

  • Mike Cerre:

    MDMA taken alone is not believed to be a silver bullet cure. Therapy is still required and experts warn against taking MDMA and other psychedelics for PTSD without professional assistance.

  • Sal “Doc” Chavez:

    About a week ago, I had a sniper came real close. You never know out here. An IED, we used to — I guess the first couple months, we saw them every day.

  • Mike Cerre:

    Sal Chavez, a former Navy corpsman with FOX 2/5, has tried several therapy programs, both at the VA and in private practice. He believes his 15-year struggle with PTSD is responsible for his excessive drinking, fighting, divorce, and frequent thoughts of suicide.

  • Dr. Skip Rizzo:

    We're seeing people that end up killing themselves because they never got the treatment, or the treatment was ineffective in addressing their needs.

  • Mike Cerre:

    Dr. Skip Rizzo, a research psychologist at USC's Institute for Creative Technologies, has been developing virtual reality programs for engaging this generation of PTSD veterans in exposure therapy.

  • Dr. Skip Rizzo:

    The goal isn't that just by going back to the scene of the crime, you're magically going to get fixed. The goal is, is to activate those emotions and reprocess them, and to do it repeatedly and in that safe context.

  • Mike Cerre:

    With the help of Dr. Todd Adamson, a former VA therapist, Sal Chavez agreed to reexperience a particularly traumatic event we both were involved in during a roadside ambush on FOX 2/5's final approach to Baghdad, when they suffered their first fatalities, on April 4, 2003.

  • Sal “Doc” Chavez:

    Everything was on fire. It was loud. Rounds were going off, Matech being shot off. You could feel the percussions of all the explosions.

  • Man:

    How do you feel in your body right now that you're watching this?

  • Sal “Doc” Chavez:

    A little tense. I know that this is a virtual world, but I'm like — my habits are doing what I'm supposed to be doing.

  • Man:

    Yes.

  • Mike Cerre:

    V.R. can never be an exact representation, but it's stimulating enough for the vet and the therapist to work together more efficiently and to make the traumatic experiences easier to deal with.

  • Sal “Doc” Chavez:

    So I had to find it within me to start making the hard choices of facing myself, finding help, doing whatever I had to do to get healthy again.

  • Mike Cerre:

    Kaine Marzola is working with other vets on overcoming their PTSD problems. And Michael Elliot is getting his master's degree in social work to do the same, as the Marines of FOX 2/5 continue their battles with PTSD.

    For the "PBS NewsHour," I'm Mike Cerre reporting from San Francisco.

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