Brought to you by the Depression Is Real Coalition, The Down &
Up Show is dedicated to the reality of depression. Each week our
hosts will talk with some of the world's top experts on depression,
as well as people who have been impacted by this illness. The reality
of depression is that it is a debilitating and potentially deadly
medical condition that affects more than 15 million Americans every
year. The other reality of depression is that there is hope.
Down & Up Show #52: Veterans with Depression
DR. REEF KARIM:
Welcome to the Down and Up Show on Depressionisreal.org. I'm your
host, Dr. Reef Karim, psychiatrist, addiction specialist and relationship
therapist. Today we have 1st Sgt. Patrick McCathern with us for
our Memorial Day edition of the show.
He served in the United States Air Force for 26 years and is now
a retired civilian working for the U.S. Army. Today we'll discuss
his experiences with depression while in the military and how he
found treatment. Pat, it's great to have you on the show today.
PATRICK MCCATHERN
It's great to be here. Thank you for having me.
DR. REEF KARIM
Good. So tell me a little bit about your experience with depression,
especially coming from the military background.
PATRICK MCCATHERN
Well, my Dad was retired military and I decided, well-I figured
I'd go in. And the military grooms Type A personalities. We gotta
be hard-charging, moving up the ranks, no weaknesses, can't show
any weakness, at least that was my perception while I was in the
military.
And even though I'd have periods of depression, I would just fight
through it and put it in the background the best I could. But in
1993 I just fell into a really deep depression and then I thought
about my Mom who had been hospitalized for attempted suicide, an
uncle who had been-who had committed suicide and I was starting
to think that this was a self-fulfilling prophecy because it just,
it was like a deep hole that I fell in and then I got to the point
where I could not find my way out. I'm about 180 pounds and I-my
weight had dropped down to 150. I just wasn't eating. I'd sleep
too much, I wouldn't sleep, I wouldn't even go to work. And nobody
even noticed, nobody seemed to say anything because...They didn't
ever say, "Hey, you ought to go to the hospital". It was, "Oh, you'll
just work it out". Because I was-I was ruminating so much about
all of these bad things and-it did become somewhat of a self-fulfilling
prophecy.
When I'd be around co-workers and friends, they'd keep their distance
cause they could tell I was just off my game and they figured, well,
you know, he'll just have to work it out, which was telling me that's-nobody
does care. So that evolved to July of 2-of 1994 where I had had
a rope, made a noose, hung it over my door, was leaning forward,
was probably 20 seconds from passing out and my dog walked by and
just looked at me.
And my only thought was who's going to take care of my dogs. And
I called the one friend that I thought I had and then I went to
the hospital and then everything began. Prior to that I had-I'd
gotten so bad I went into the hospital and I just didn't care. I
didn't care about my security clearance, about my job. It just didn't
matter.
DR. REEF KARIM
And you served a long time in the Air Force. You didn't discuss
your depression with anyone.
PATRICK MCCATHERN
No, I did not. I was afraid that I would lose that security clearance.
What I found is after going to the hospital, seeking treatment,
while I was in the hospital, the people who worked there thought
I should have gotten an award for most visitors. Nobody talked to
me prior to going in the hospital and then they're coming out of
the woodwork.
And I think part of it is they just didn't know how to approach
someone who is depressed. Because I found in my career if you say,
"I'm depressed", some people, ignorant, uneducated, will look at
that as, "Wow, that guy is crazy". And they just do not understand
what depression is.
DR. REEF KARIM
Did you feel like the co-workers wouldn't understand where you were
coming from or did you think that perhaps they didn't read that
you had depression and they read something else?
PATRICK MCCATHERN
I think it was a little bit of both. They didn't know how to approach
because, one: they thought maybe I had lost my mind and was crazy
and would turn on them or, two: they just did not have a clue. They...
In the military once a year you go through a suicide prevention
seminar which turned into Power Point slides which turned into a
video which turned into, okay, I got that out of the way I'm good
for a year. There wasn't as much emphasis on it. Much more so now,
though.
DR. REEF KARIM
Serving in the military can be demanding.
PATRICK MCCATHERN
Yes, it can.
DR. REEF KARIM
How-how-how did you make it through those really tough days, you
know, they days when you felt like you couldn't get out of bed and
yet you're in the military?
PATRICK MCCATHERN
When I got to that point where I couldn't get out of bed, I didn't
go to work. I just didn't go. And the guys I worked with know-they
knew I was having a rough time, just covered for me. Probably the
single best thing that happened while I was in the hospital is my
commander came to see me.
And when he-when I got out of the hospital, a very smart guy, he
challenged me and he slowly brought me back by increasing the challenges.
And they were very empathetic. Now there were some people that came
and they just didn't know what to do. It just made them very uncomfortable.
But my commander got me back on the road to recovery along with
seeing the psychiatrist, going to a men's group. It's almost as
if when you're on the road to recovery and then you've reached that
recovery point, you don't even remember the road as to how you got
there.
But it-taking that first step... Now I mentioned the security clearance
and I read all these pieces on-in the Army where individuals will
not seek any help because they're worried about their job and their
security clearance. And I'm telling you it's a myth. When I was
in the hospital and I had a top secret special compartmented information
clearance, which is very high, it was suspended for two weeks and
then reinstated.
Then I got another job where I needed that plus even higher access,
and I had to fill out another form for that. And I put in there
I was in the hospital, why I was in the hospital, how long I was
in the hospital, and shortly thereafter I was granted access. What
would have prevented me is if I would have lied about it or if I
would not have revealed.
Or if I had not sought help, they would have denied the clearance.
So the myth of losing the clearance only occurs if you believe that
myth. If you come forward, there are people, there are agencies,
organizations that are willing to help, and it will only further
your career.
DR. REEF KARIM
Yeah, it's funny, a recent study by the American Psychiatric Association
showed that over 50% of military members surveyed thought that seeking
help for mental health concerns would have at least some negative
impact on their career. So those fears that you stated are-are-are
definitively shared by that many other military members.
PATRICK MCCATHERN
They're unfounded. I believed those myths until I actually experienced
it. I contacted Dr. Ensel, the Director of NIMH, because I had been
in the Real Men, Real Depression campaign. And he indicated to me
that one of the problems is a lot of military men, instead of seeking
help in the military community, are going to civilian practices
who may not be adept at dealing with the stressors of the military.
And, see, that concerns me because especially in the Army and our
vets and what I've read with suicide attempts and suicides is alarmingly
high. To piggyback off that story when I talk about the myth and
the stigma, right after this, and I think it was 1997, and this
came from a First Sergeant Conference because the First Sergeant
in Air Force is people, that's their job.
And Dr. Meredith got a call that the Air Force News wanted to do
a piece on suicide. And he called me and he was a little unsure
of whether I'd want to do that, and I did. And this goes to how
people are viewed with depression. The cameraman and interviewer
were expecting to see this short, little, lightweight guy cowering
in a corner.
And here he finds this 220 pound, 6'1" big guy who is not cowering
in the corner. And after that interview was done I said, "Well,
what do you think? Do you think you would-what would you do if you
had problems"? He said, "I believe I would seek help". So that started
a piece with the Air Force News.
And then they did a print article. And all of a sudden after all
of this comes out people are wanting me to autograph magazines,
they think it took a lot of courage, they seek help now, they see
that it's okay. But it just takes more education for the public
to reverse the stigma and myth.
DR. REEF KARIM
And what made you want to speak out about your depression and share
your experience?
PATRICK MCCATHERN
Well, for most of my career I wore cryptographic equipment and secured
communications, and there was an opportunity to become a First Sergeant.
And their motto is "My job is people. Everyone is my business".
And I have to meet a board for that. The board is like an hour and
a half long and they're asking you a lot of questions, how you would
handle situations.
Let's say somebody got AIDS, blah, blah, blah, blah, blah. So something
comes up about suicide, you know, the incidents of suicide's arising
in the Air Force and I told them, "Well, I have some knowledge about
that since I attempted to commit suicide". And their eyes got as
big as silver dollars.
I told them the story and the command's Chief Master Sergeant looked
at me and said, "That took a lot of courage". Anyway, I was accepted
as a First Sergeant and from there it's gestated into where it has
gone. Through not seeking it out it just occurred.
When they did the Air Force News piece, and it's the longest piece
they've ever done, it was about five minutes long. And we showed
the film at a Commander's Call and there were about 600 people there.
And I showed it first to the Commander and he said, "Go for it".
And at first I'm thinking, "Oh, God, what have I done"?
You know, I was a little shaky and I went behind the curtain. And
then after it's done, all this applause, I mean, people are standing
and cheering. And people after that are stopping me in the hall.
They're telling me about family members and-and-and other friends,
etc.
And I figured, my God, if I can have this kind of impact and reach
out and if it saves one person, then it's worth doing, because it
did occur, I'm not going to hide it and it doesn't hurt me. I mean,
there's nothing anybody could do to try to hurt me that I haven't
tried to do to myself. That's the way I look at it.
DR. REEF KARIM
Now from a sharing perspective, there's-so many of us are scared
to reveal our vulnerabilities. But it's our vulnerabilities that
really connect with other people. So many other people share them.
PATRICK MCCATHERN
Yes. I-I-I wholeheartedly agree. As a First Sergeant in my entire
time, there were-people would come in and talk to me. All but one
I got them to go willingly to seek help. I didn't have to drag them
kicking and screaming. One young airman I had to do that because
it was a very overt threat, I wasn't sure.
And so many people identify, as you stated, but they don't want
to speak out. In my work center here people come to me. There are
people who remember me from past duty assignments. Their wife will
call me to help their husband. And what I found is all it takes
is for somebody to listen.
DR. REEF KARIM
With the increasing number of studies and information on our military
service members with depression, more people are beginning to talk
about this issue. When you were in the service, were there others
that you could talk to about this or did you feel like you were
the only one with depression?
PATRICK MCCATHERN
I felt I was the only one. I thought everybody else was fine, nobody
else had the issue. It was just me. I was like the lone wolf of
depression.
DR. REEF KARIM
You know, there's also a stigma specifically among men and depression.
Do you see any additional stigma amongst men more than women in
the military?
PATRICK MCCATHERN
I believe so. Women seem to be more open with their emotions. We
seem to be stuck in the Neanderthal hunter/gatherer mode, that it
would be a sign of weakness to have-to show that emotion that maybe
you are a bit rundown, maybe you're a little lost in your way right
now.
DR. REEF KARIM
What sources exist for military members seeking information about
mental illness right now? What... How has the resources for service
members improved from now since you were in the Air Force?
PATRICK MCCATHERN
Well, it used to be if you went into the hospital and it would say
"Mental Health" right on the door and you'd have to go in that room
and people would see you going in that room and they go, "Ohhh,
what's he going into the room for"? So now they made it a separate
building.
Also, in the Army they have a program set up for the soldiers returning
from Iraq, might be suffering from PTSD, it's an entire separate
facility. And they will take care of you, cradle to grave dedicated
to you. I know there's a lot of bad press on PTSD in the Army and
the way they're handling it and the way the VA under-reported it.
I think the VA is a bit overwhelmed and-but the Army is making great
strides.
They're trying to get away from the term of calling it "mental health"
or "mental disorders", to try to encourage people to come in and
seek help. And more and more people are seeking help, and more and
more men are finding out that it's okay to say, "You know, I'm not
feeling quite right and I'm kind of disoriented (ph.) in my life
right now".
DR. REEF KARIM
What have you learned from becoming an advocate for mental health?
PATRICK MCCATHERN
I learned that there's a lot more to do. I learned that there needs
to be more emphasis on the message. It's kind of hard to do in this
day and age of sound bytes. But I've also learned that more one-on-one
time.
In 2005 I was invited to the Space Wing at Patrick Air Force Base
in Florida. And I spoke to these auditoriums full of people and
I mentioned to them the way that you help somebody with depression
is first you have to know them. Your co-worker, how are they doing?
Do you really know them? Do you talk to them or do you ignore them?
The main thing I've learned is you don't treat it lightly. You can't-you
don't have an x-ray machine to look into their brain and go, "Hmmm,
okay, they're depressed". You have to talk them. But never overreact.
DR. REEF KARIM
Well, to follow up on that, in your opinion what types of programs
or program reforms do you feel are necessary to help members of
the military feel comfortable seeking help for mental health conditions
like depression?
PATRICK MCCATHERN
That's hard to say. I mean, it keeps evolving. I speak to my experience
in 1994. When I went to the emergency room and I told them I was
depressed and suicidal, the first thing they did was have me disrobe.
I'm thinking, "It's my brain, not my body". And it was just a checklist.
The big thing is the technicians they have in those wards need to
have a better understanding of what they're dealing with instead
of the "I went to school and I know a little bit", because I was
treated like a four year old when I wasn't psychotic, I was depressed.
Once I let them know that and I would be treated as a senior off-NCO
with all due respect, then the took a different take on it
And I'm seeing some changes in the way they're addressing it such
as moving mental health out of the hospital, calling it a different
name, setting up clinics specifically for people who are coming
back from Iraq or dealing with these issues that they find horrible
and horrendous. That's a step in the right direction, I believe.
I think what would really help is more senior leaders speak out,
not just give it lip service but really speak out. When you have
a general who might say, "I went through depression and I sought
help", that makes a big difference. When you hear people like Mike
Wallace who's respected talk about his depression, that helps. But
we need to have more of the higher echelon people speaking out.
And I think it will trickle down.
DR. REEF KARIM
What advice would you have liked someone to tell you or what advice
would you like to give someone about depression who may or may not
be seeking help?
PATRICK MCCATHERN
That's a tough call because everybody's different, but I would say
"Seek help, and you have everything to gain and nothing to lose".
The old adage of "permanent solution to a temporary problem"...
DR. REEF KARIM
Right.
PATRICK MCCATHERN
...is completely true, but when you're that far in depression, you
just don't see it that way.
So the main thing for somebody who's depressed is to seek out somebody
who is trusted and confide in them.
DR. REEF KARIM
Yeah, one of the-one of the cardinal signs of depression is the
isolationism.
PATRICK MCCATHERN
Yes.
DR. REEF KARIM
It's the fact that you don't wanna reach us. You're right. I mean,
it's-it's-it's kind of-it's almost irony in that if a treatment
provider's like, "Well, if you're-you know, if you're really depressed,
just come on in to my office and I'll be around", the reality is
you're gonna be at home ruminating, not leaving your place, because
you're isolating cause you feel so lousy.
PATRICK MCCATHERN
The help must start early and it has to start with that co-worker
or that friend that noticed that change. And that's when they need
to get involved, before that depressed person gets into that isolationist
period. It's a-it's a tricky road, it's hard to read but you have
to be committed to do it.
We're a fast-paced society. A lot of times we just don't have time
for it or we think we don't have time. But if somebody committed
suicide, somebody always says, "Why didn't they talk to me"? Well,
sometimes you have to talk to them before it happens and get out
of the blame game. It's tough to do. It takes 100% effort on everybody's
part.
DR. REEF KARIM
Great. Do you have any last thoughts at all?
PATRICK MCCATHERN
Well, I think I covered all those thoughts. The main thing is to-is
that the fact the stigma-I'm trying to alleviate that as much as
I can, but to eliminate the myth. It just makes you stronger.
Actually, after I spoke out, it only increased. It did not decrease.
I didn't lose respect; I gained respect. So you... Actually, you
have everything to gain and nothing to lose. You have everything
to lose if you don't seek help.
DR. REEF KARIM
Yeah, I mean, it's fantastic that you're speaking out on this. I
think high ranking officers, people in the higher positions, you
know, they can do a lot of good. And it shows that the illnesses
like depression, I mean, they affect all socio and economic classes,
they affect all people of different levels. It's just good to hear
from people that also are doing well after having a really hard
time in their life.
PATRICK MCCATHERN
I've never felt better in my life.
DR. REEF KARIM
It's good to hear. Well, thank you so much for spending time with
us, Sergeant McCathern.
PATRICK MCCATHERN
Thank you very much.
DR. REEF KARIM
For Depression is Real Coalition, I'm Dr. Reef Karim. Join us next
time for another segment of the Down and Up Show on Depressionisreal.org.
