PTSD hits soldier's Cape Cod family hard
To fellow players at the Battlefield Game store in Killeen, Texas, 24-year-old Christian Estrada was a good-natured and enthusiastic presence.
The solidly built Iraq War veteran could appear gruff at first, but his face practically cracked open when he grinned.
Estrada responded to teasing about his poor dice-throwing skills with good-natured retorts, and regularly helped out at the new store, which is building a clientele devoted to tabletop miniature war games.
"He was a very good man," Battlefield Games employee Carlos Wong said. "He had such a memorable smile. He was definitely a hard worker. He had a lot of patience."
Estrada spent hours using a fine-tipped paintbrush to bring color to his own tabletop army, the Legion of Everblight.
His family says it was Estrada's real- time war experiences that ultimately undid him.
Honorably discharged from the U.S. Army post in nearby Fort Hood in 2010 for a disability his family says was post-traumatic stress disorder, Estrada shot himself dead in his Killeen apartment June 5.
His sister, Tatiana Garcia, of South Dennis, calls Estrada a casualty of war.
As the family struggles financially to pay for Estrada's funeral, Garcia said she wants people to know about the dangers of post-traumatic stress disorder.
Her brother's death fell at the beginning of National PTSD Awareness Month.
"He has a lot of friends. A lot of people right now are hurting," Garcia said. "They (young enlistees) don't know how bad it is. Nobody's really explaining it to them."
The U.S. Department of Veterans Affairs estimates that 20 percent of Iraq War veterans have PTSD, as do11 percent of veterans of the war in Afghanistan.
The numbers could be higher.
It would be unusual for combat veterans not to experience some PTSD symptoms, like flashbacks, intrusive thoughts, emotional numbness or irritability, said Kevin Lambert of the Massachusetts Department of Veterans' Services, who suffered a spinal injury in Iraq. He also developed PTSD and a mild brain injury as a result of his wartime experience.
"It's been a very stigmatized issue," Lambert said. "We try to make it a normal reaction to being in a war."
Many veteran programs, including a peer intervention program Lambert helped start, Statewide Advocacy for Veterans' Empowerment, are geared toward making sure people get the help they need instead of self-medicating with alcohol or drugs, he said.
"We provide hope. We don't give up on them," said Lambert, who said he's been involved in at least two dozen interventions for veterans who felt at the end of their rope.
"We're going to find a way to help them," he said.
One in three
Experts say PTSD is an anxiety disorder that results from experiencing or witnessing a traumatic, dangerous event.
Even learning about something terrible happening to a close friend or family member could set off PTSD, said Dr. Naomi Simon, an expert in anxiety and PTSD. She is also the chief medical officer of the Red Sox Foundation and Massachusetts General Hospital Home Base Program serving active-duty military personnel, veterans and their families.
It's normal for a person's heart to pound and to have an exaggerated startle response when in danger, Simon said.
The problem comes when the symptoms are re-triggered once veterans return home — keeping them from having a normal family life or even sleeping through the night, she said.
The sooner sufferers come in for treatment the better, Simon said. Treatment can include medication for depression, anxiety or nightmares, and psychotherapy, including cognitive processing therapy, she said.
"You tell the story of the trauma over and over until it becomes less powerful and the fear around it diminishes," Simon said.
She said the clinic at Massachusetts General focuses on short-term targeted treatment for 12 to 16 weeks, although the treatments can be curtailed or extended as needed.
For many recent veterans, the situation is complicated by traumatic brain injuries from explosions and other attacks. Both PTSD and traumatic brain injury, or TBI, can cause anxiety, fatigue and irritability, Simon said.
Massachusetts General officials say 1 in 3 service people returning from Iraq or Afghanistan will experience signs of combat stress, depression, PTSD or TBI.
Soldiers are coming off the battlefield with injuriesthat troops would not have survived in the conflicts of prior generations, Lambert said.
A soldier who would have died on the battlefield in Vietnam as a result of swelling of the brain may now have his life saved by an operation right on the field of combat, Lambert said.
PTSD and TBI are often referred to as "the invisible wounds" of war. Lambert said it's easier to call in sick from work because of complications from a wartime leg injury than to request a day off because PTSD symptoms are flaring.
'He just wasn't the same'
Garcia said the family doesn't know the details about her brother's two deployments to Iraq because he refused to talk about them.
"When he came home he just wasn't the same," said Charlie Clark, of Yarmouth, who became friends with Estrada 10 years ago when they were teenagers working at Dunkin' Donuts in Dennis.
"He really cut everybody out. He didn't talk to everybody like he used to," he said.
"It was like he was in a bubble," Garcia said.
The outgoing and smiling young man who'd come up with a plan to join the Army while just 17 "kept to himself," she said.
Estrada's mother, Magaly Torres of Orleans, said her son was a bright but lukewarm student at Dennis-Yarmouth Regional High School when he scored high on an Army recruitment test and lobbied her into signing the papers that would allow him to join the service.
"I said, 'OK, what about school?'" said Torres, who is from Puerto Rico. "He said, 'I'll take the GED.'"
According to his discharge papers, Estrada joined the Army on June 6, 2006.
He still wasn't old enough to vote when he headed off to Fort Knox in Kentucky and then Fort Hood in Texas.
He was deployed to Iraq in January 2007, the same month he turned 18, and returned for another tour in 2008, family members say.
Estrada's discharge papers show he was the recipient of an Iraq Campaign Medal with two campaign stars, as well as good conduct, commendation and achievement medals.
He was assigned as a scout to the 3rd Cavalry, whose military roots go back to 1845. The cavalry's vehicles include tanks and Apache Attack helicopters.
"He told me he don't want to go back," Torres said, but he didn't say why.
When asked about the war, Estrada would say, "'It was OK,'" Garcia said. She wasn't sure she believed him. "It was like he didn't want to tell us. He was holding something in."
Looking for help
Estrada's sister, Ariana Alvarado, of Dennisport, said she thinks her brother developed psychological issues in training, before he even left the states.
The young man who loved to hold a little nephew in his arms refused to pick up Garcia's twins, born in 2006, saying they were the size of bombs the Army had been trained to blow up in Iraq, Alvarado said.
During one visit home, probably in 2009, Garcia said she found bottles of his medications behind her couch.
"He'd never been on medicine at all," she said.
Her brother told her he'd spent a week in psychiatric treatment after a suicide attempt and was getting help from the Veterans Affairs services in Texas, Garcia said.
Alvarado said one time her brother asked if she heard voices.
Experts say that people with PTSD are more likely than those without to have auditory or visual hallucinations.
Family members say they don't know whether Estrada was still going for counseling when he died. They say he was attending community college in Texas and had plans to one day open a store along the lines of Battlefield Games.
He also wanted to move back to Cape Cod after breaking up with his wife, whom he'd met in the Army.
But he signed a yearlong lease during an unsuccessful reconciliation and remained in his Killeen apartment. He was divorced in May 2012, his family says.
Just before his 24th birthday Jan. 13, Estrada bought a gun. He said it was his early birthday present to himself, Torres said.
Family members are disappointed they didn't get any help arranging for transportation of Estrada's body from officials at Fort Hood.
They said they went to five separate buildings for help getting Estrada back to Cape Cod, where he had lived since he was 3 months old, but were turned down.
They were told he was no longer on active duty and had not signed a life insurance policy offered to him, they said.
The Cape Cod Times was unable to reach officials at Fort Hood despite several phone calls and an email to people identified as media contacts on the Army base's website.
Garcia said she doesn't understand why the Army can't do more. People like her brother "still served the country. They helped. They did their part," she said.
The help that has come so far is local. The Nicholas G. Xiarhos Memorial Fund wired $1,000 to Temple Mortuary in Texas so Estrada's family could claim his body.
Xiarhos was a Marine from Yarmouthport who died in combat in Afghanistan in 2009.
A special fund has been set up at Cape Cod Five Cents Savings Bank to help the family with funeral expenses, which could run as high as $10,000, including transportation, they say.
The wake will be held from 1 to 3 p.m., Tuesday, and the funeral will be Wednesday, Garcia said. His body will be interred at the Massachusetts National Cemetery in Bourne, she said.