Read Part I and Part II of the story: "One soldier's harrowing journey from the Iraqi battlefield to suicide"

The problems deepen: Multiple concussions linked to depression

Sgt. Spencer Kohlheim had been wounded on two separate attacks in Iraq.  They were concussions; invisible wounds that caused migraines and led to an increasing sense of hopelessness according to his family and close friends.

"The IED is our number one injury right now," said the manager of a transition program for returning soldiers at the Northern Indiana Veterans Affairs hospital in January of ‘09. "IEDs can cause traumatic brain injury without [the solider] being hit by any fragments.  Depression is a standard reaction to traumatic brain injury.”

The New England Medical Journal has linked depression to multiple concussions, or mild traumatic brain injury, within the three to four months after soldiers return home.

Sgt. Patrick Clouse, 27, was there when Kohlheim got out of the base hospital after the second IED attack. “He had constant headaches,” Clouse said. “He was taking meds all the time; those heavier Ibuprofen they give you after the IEDs.  There would be very few days that he didn’t have a headache.”

“He was depressed during his two week leave this summer,” his ex-wife Beth said. “He called me on July 4th when he was already back in Iraq.  That was his excuse for not seeing the kids.  He said he’d been [feeling] that way since he’d been hit by the first IED."

During his leave, Krissy, his fiancée, said, “He didn’t want to leave his mom’s house in Florida.  I tried to tell him he didn’t have that much time left.  [But] even up to two weeks before he came home from Iraq, he was very depressed.  He said he was tired of it.”

“I talked to him on his R-n-R after he was wounded,” Bill Dunnafin said. “That was the first time he ever told me, I don’t want to go back.”

“Spencer never got to the first step”

“Now, on my second year of therapy, I’m just starting to get a sense of what’s working for me,” said Spencer’s old Guard buddy Edgar Pimental, 43, who’s battled post-deployment depression following two tours to Iraq. “Every time I think about it [suicide], I think of one reason why I shouldn’t do it.  Spencer never got to the first step.”

This April the Army Times reported on veteran suicide attempts for fiscal 2009.  The numbers are truly staggering.  The VA data reveals 950 veterans attempt suicide every month, and an average of 18 successfully kill themselves.

The data reveals recent war deployments as one of the primary factors in suicide attempts- 1,868 veterans who served in Iraq or Afghanistan attempted suicide, and 98 veterans killed themselves in fiscal 2009.  VA intervention or lack thereof, would prove poignant in Spencer’s case.

An overseas deployment can wreak havoc on marriages, the distance erasing years of trust and partnership.  Stateside spouses are more likely to have affairs, but in Afghanistan Spencer supposedly had an affair with a female soldier.  When he got home he thought he wanted a divorce from Beth.  Eventually they did divorce.  In Iraq he leaned on Krissy for emotional support, but when he came home to LaGrange, she was immediately spooked by his emotional swings.

Krissy decided to break up with Spencer, she said, until he could sort out his depression.  He claimed all he needed was her, but she believed he needed professional help.  She said Spencer carried big Ziploc bags full of pills he received in Iraq.  Some were muscle relaxers, others heavy Ibuprofen.  She also claims some of the pills were anti-depressants, but that he would never take them.

“It got to the point I didn’t know what to do for him,” Krissy said. “[Finally] he went to the Veteran’s Affairs hospital at Fort Wayne.  Neither of us understood why they wouldn’t see him.  The receptionist said she denied him because he was still on active duty.  She said he had to wait a week or two weeks, I believe, but first he had to be cleared through his unit.”

Being rejected at the VA hurt and confused Spencer.  According to both Krissy and Beth, he felt betrayed, and that his country had turned its back on him.  But his thinking was clouded, and he may have been looking for places to cast blame.  When he wasn’t running to the Legion or other bars in downtown LaGrange, he was calling Krissy or Beth, and also possibly his former girlfriend from Afghanistan.  Krissy started to lose trust in him.

“The VA should have given him a spot,” said a family friend, a soldier deployed to Iraq in 2009. “There’s always somebody.  If they can’t do it, they give you the number of someone who can [help] on the spot.  It’s either they didn’t do their job, or he pushed away, one of the two.  If he got turned away someone didn’t go through the right protocol.”

A brigade commander of multiple deployments to Iraq offered a different view.  “He should have known better,” the colonel said when I asked him his opinion on Kohlheim’s case. “How could a senior non-commissioned officer who’d served that many years not know that he would be on active duty orders for 180 days and that he would fall under [the active duty medical care system]?  I cannot believe he would have gone to the VA unless he knew he wasn’t going to get help.  And if he knew it, maybe that’s why he went.”

The brigade commander admitted that the current screening process for combat trauma can be problematic because it’s based on “self-assessment”. “Whenever you have a system open to self-assessment, it will only be accurate if the soldier accurately reports what he’s been exposed to,” he said.

Edgar Pimental agrees with the commander up to a point. “Spencer may have known it, if he was in his right mind,” Pimental said, admitting that he and many Indiana Guardsmen think of the VA first whenever they have a problem. “I think he was really trying to get help, but in the wrong places.  The bar, the VA, a girlfriend who was leaving him…If Kohlheim was at his [Army] job, he would have been in his right mind tactically, but you’re talking about a soldier who’d been through two IEDs and you’re asking him to think like a civilian?” Pimental asked.

Pimental claims his VA psychiatrist confirmed that Spencer was scheduled for an appointment a couple of weeks later. “She said the ball was dropped on that one.”

(A representative of the Northern Indiana VA refused to confirm whether Spencer Kohlheim was denied assistance or whether he was ever a patient, citing HIPPA laws regarding the privacy and security of health care information.)

“Although Spencer flew off the handle sometimes, he was still the greatest guy in the world to me.  When he drank he was always happy,” Pimental added. “Whatever happened in Iraq, he experienced it really bad.”

Spencer would later hang himself in his Indiana garage.

James Foley has been embedded with US troops in Iraq and Afghanistan and writes periodic dispatches for Raw Story. The lead editor on this story was Sahil Kapur, in Washington.