When he was finally discharged, Nigel decided to move to Asheville, North Carolina. He described it as “more like a west coast city,” and one of his favourite places. More importantly, he wanted to move somewhere people did not know him before his tour of duty. He figured his sense of alienation would not be as severe, because he would not have to navigate relationships with the people he knew. The before-and-after effect with friends from home had proven intolerable. He wanted to put the experience behind him. He wanted things to get better on their own. He didn’t need anyone to tell him he needed help. Hearing that just screwed him up. He figured if he focussed on other things, he could just block it out.
Nigel visited the Asheville VA hospital within his first year of discharge. He scheduled appointments but didn’t keep them.
“In my mind at that time, I didn’t want to have anything to do with VA. I wanted forget my service life and do something else. I didn’t want to be a ‘fucked-up veteran.’ I wanted to be happy and productive.” He aspired to build a life which focussed on anything but his experiences during his service. He decided to give school another shot. He figured if he threw himself at school, he could achieve something and redefine himself as a student, as opposed to some guy who had been in the Marines. He wanted to surround himself with something else. He’d always been resilient.
Nigel signed up for technical college. It was not easy. He failed his first online course, an introduction to college success class. He forced himself to stay with it, and gradually his performance improved. Things were going to continue to get better he hoped. He was resilient, he knew this about himself already. He’d overcome disappointment and traumatic events as a child. At the age of nine, he’d had an accident where he burned the skin off his feet. He was hospitalised, and had to learn to walk all over again. It was a huge hurdle as a child, but he overcame it. When his family moved to South Carolina from Seattle, he’d also found the transition unsettling.
“I had a really difficult time for a couple of years. But then time went by. It was a process. I overcame the difficult years there.” He figured getting out of the Marines, and back to the life he knew, he’d be able to manage the process in the same way. He figured the adage about “time heals all wounds” would become true. The trouble was, the Iraq experience was affecting him differently. Things were not the same. “That was the hard part,” he said. “This thing wasn’t going away.”
Nigel was constantly being reminded of his deployment in Iraq. He’d get phone calls from people in his unit, with news that yet another soldier had been killed or seriously injured. Eight or nine were killed within the first year after his discharge.
Becoming a student was the best thing he could have done, he felt. If he focused, he could train himself mentally. He could avoid slipping back into the black hole of his Iraq experiences.
But as every person who has struggled for years on end with PTSD has learned, intellectual processes do not offer any real solution. At best, intellectual pursuits provide a mask, or a diversion, and if one gets really good at it, a temporary escape from the endless invasive memories and feelings PTSD deposits in our paths every waking hour.
Nigel was no different. Memories of events constantly hijacked his concentration.
“I was confused about being alive. People I’d been with months earlier were getting killed.” His closest buddies from the unit were the very guys who were killed during the IED blast right after they’d returned Iraq—without him.
“I should have been with those guys who got blown up. Was I supposed to die? Should I be dead?”
Nigel described himself as “just going crazy and walking in traffic.” While he did not exactly throw himself in front of cars, he’d randomly cross jam-packed roads. He wasn’t sure whether he expected traffic magically to stop, or whether he was wishing he’d get hit. Maybe he did want to die.
He began drinking heavily to escape. “All I could think about, for years after getting out of the Corps was death and killing. I hated it, I just wanted to think about other things.” And yet there he was, on an incessant replay of his Iraq experiences “as though the entire deployment was only thing that mattered on the planet.”
Doggedly, Nigel perservered with school. “But I quit caring a whole lot for a while. I began to wonder if it was important. Maybe I should go back to war. It was weird. All I wanted to do was not focus on that. But after two years out, I realized it had affected me so much why not just go back? I had let people down by not going back. I kept having this existential weird idea: I’d been there and actually died in the IED blast and – it sounds weird – I started feeling like I was a ghost in a way.”
It was a crazy time, he said. His relationships with family and friends were deteriorating. He’d become inordinately sensitive to interpersonal dynamics. He’d go into rages over tones in people’s voices. “Not even what they said, just the tones in their voices. I’d get so frustrated.” His family would visit him in Asheville, and something would happen, and he’d erupt. Then he’d be embarrassed. He felt as though he should be by himself, and they’d leave. That was the pattern.
His level of discomfort became acute. He decided to minimize the hurtful experiences with friends and family. He’d hang it up. He decided to be alone. All the time.
Isolation, however, created a downward spiral, driving him further away from himself and the values and people he loved. He lost any sense he could ever achieve anything he cared about. He had no hope he could reconnect. He had urges to kill himself. The thought would enter his head: “You should just die. If you were dead none of this would matter.” The thought played in a continuous loop, month after month.
By then, he’d enrolled at the University of North Carolina, Asheville, where he studied from 2006 to 2011, first doing undergraduate work in molecular biology, and eventually graduating with a degree in chemistry. The class work and lab work allowed him to focus in a disciplined way, and created a distraction from disturbing feelings and impulses. The intellectual process can undercut the dominion of traumatic memories, it’s true. But relief tends to be short lived.
Once he graduated, Nigel was even more alone with his thoughts. He didn’t have books or assignments or professors to distract him anymore. He isolated himself entirely, sometimes not leaving the house for weeks at a time
He arrived at a breaking point.
“I’d sit in my house wishing I was dead. I’d be up all night. Any time I’d hear something outside, I pull the blinds, and go to the front door. I had the sense there was a threat I had to be ready for. In a sense, you have to be ready for things. But for some reason, I was so fixated on the idea that something was coming to get me. I was just on guard, by myself, with my own thoughts.”
He knew then he’d either have to kill himself or he’d have to get help.
A few years before, in 2009, he’d gone on an Outward Bound trip for veterans organized by the University of North Carolina and facilitated by a VA liaison officer, a licensed therapist. There were a handful of veterans on the trip with him. When the ten-day trip was wrapping up, a couple of the Outward Bound instructors approached the liaison officer. They had seen Nigel react in several situations and were concerned about his emotional state. As the group dispersed, the therapist sought out Nigel and gave him her card. She told him to come see her if he ever needed to talk. At that point, he thought, “I’m never going to talk to you. It was kind of neat coming out into the woods for ten days, but I’ll probably never see you again.”
But he kept the card.
Two years later, in 2011, he called her. He didn’t know where else to turn. He didn’t really think he wanted to go to the VA because he still had issues with the Marine Corps. He didn’t trust anything related to the military at that point. He does not trust them to this day, “although now it’s more realistic. I don’t necessarily think they’re trying to assassinate me anymore,” he remarked wryly.
Nigel called her and told her he’d arrived at a breaking point. She asked him to come in. The VA psychiatrists diagnosed him with severe combat-related PTSD. The diagnosis surprised him, in a way. “I had no idea what was wrong at that point. I just knew things were getting really bad. I thought I might be becoming a schizophrenic.”
It was a relief for him to put a name to what had been happening to him. That said, the doctors who diagnosed him informed him there was no cure.
“We’re going to help you manage your symptoms,” was all he heard. He recalled his experience when he was still in the Corps, being prescribed Zoloft. He wasn’t going for it. He told the doctor he just wanted something to fall asleep. The psychiatrist wrote a prescription for Seroquel. Seroquel is an anti-psychotic of questionable use for any other malady, including sleep problems. Despite being untested for any other use, doctors frequently prescribe it for anxiety and insomnia. Its use has been implicated in hundreds of adverse events and deaths, including Type 2 diabetes, and heart disease. Several class action lawsuits have been filed against the drug’s manufacturer, AstraZeneca, and doctors for pushing the drug off-label.
The pharmaceutical drug regimen was not helping. Nigel’s relationship with the VA psychiatrist became hostile. He agreed to try a non-SSRI antidepressant—Bupropion—but it had no effects at all. It certainly did not help him sleep. The psychiatrist maintained the drug worked better when taken with SSRIs. Nigel agreed to try Zoloft. He hated it.
“It was horrible. I had an uncomfortable sensation in my stomach. And it made me yawn all the time.” Then came a feeling of disconnect, of being out-of-body. “I remember looking in mirror and feeling like I was in a dream looking at someone I didn’t know,” recalled Nigel. The sensation unsettled him, and he quit taking the Zoloft. He continued taking the Bupropion, but at a lower dose. The doctor gave him Xanax to take in social situations when he felt anxious.
The Xanax helped some, “but,” said Nigel, “it made me too relaxed.” He found himself doing things he normally didn’t do like punching someone in the face during an altercation. At the time, Nigel was still drinking, although not as heavily as he had been for a few years before. But he noted, “alcohol alone never caused me to hit someone like that,” he said.
Nigel returned to South Carolina to start graduate school at Firman University in Greenville.
At about this time things began to come together for him. A year or so earlier, he’d watched an episode of the National Geographic documentary series, “Drugs, Inc.” The series—nominally an exploration of the uses and abuses of contraband drugs and the criminal enterprises that profit from them—offered little more than “regurgitation of the status quo,” as Nigel characterized it. The series upcycled the worn out, damning indictments about psychedelic and Schedule 1 drugs which have proliferated in media coverage for years. “Except,” noted Nigel, who watched the entire series, “there was this one minute in the middle of the segment about MDMA, a study underway showing MDMA could potentially help veterans with PTSD.”
That was the first time he’d ever heard anything about it.
Nigel did an Internet search and located the Phase 2 clinical trial mentioned in the segment, a study under the direction of Dr Michael Mithoefer, and BSN Annie Mithoefer in Charleston, South Carolina.
He called the phone number. The office assistant told him only 150 people were going to be admitted. She had hundreds of applicants. She said she’d put him on the waiting list and let him know. Then she asked for his address. He was by then back in South Carolina.
“In that case,” said the office assistant, since you’re local, we’d move you to the top of the list,” he said. To this day, Nigel is amazed it worked out. “No shot to being next in line.”
A week later, Annie Mithoefer called.