One Military Mom's Struggle with PTSD

More than 230,000 women have served in Iraq and Afghanistan. And though they were barred from direct combat, they did not escape trauma. A retired lieutenant colonel who says she “loved the first Gulf war” now struggles against a personal enemy so fierce, it makes her afraid to hug her own grandchildren.

By Louise Farr
Robin Milonas, Robin Milonas's War, PTSD, post-traumatic stress disorder,
Meditation, prayer and talk therapy are some of the methods Milonas uses to cope with post-traumatic stress disorder.
Photograph: Jodi Bieber

THE POLICE OFFICER saw Robin Milonas, but she didn’t see him. And even if she had, it probably would have made no difference. On that spring evening in 2006, Milonas was driving home in twilight when she spotted a shadow on the road. Though she was in Washington State, thousands of miles from Afghanistan, she instinctively registered the shadow as a land mine, of the sort insurgents plant.

Panicking, Milonas swerved. The officer came after her, lights flashing, and pulled her over to ask if she had been drinking. She hadn’t. She had just left a hair appointment.

After looking at her driver’s license photo, in which she wore the uniform of the U.S. Army Reserves 364th Civil Affairs Brigade, the cop backed off. “I’m just going to give you a warning this time,” he said. “Go straight home and don’t make any stops.

“And take it easy,” he added, waving her along.

Nice of him to say, but this was the third time Milonas had been stopped for erratic driving since returning from her tour in Afghanistan. Taking it easy was no longer an option.

Until recently, Milonas had been living on a constant upward trajectory: ROTC and long-distance running in college, followed by five years in the army, then two decades in the reserves while she juggled marriage (to an army sergeant), motherhood (caring for his three kids from a previous marriage), graduate school (she earned a master’s in education) and careers as a middle school teacher and an adjunct college professor. By the time she landed in Afghanistan in January 2004, she was a much-decorated lieutenant colonel attached to the Special Forces; for a time, she served as her group’s liaison to President Hamid Karzai in Kabul, where he showed her the now bombed-out schools he had attended as a child and told her of his hopes for educating Afghan women.

In the U.S. military, women are still technically barred from serving in most direct-combat roles. But in a report to Congress in March encouraging the removal of the bans, the Military Leadership Diversity Commission noted that these rules are based on standards “associated with conventional warfare and well-defined, linear battlefields. However, the current conflicts in Iraq and Afghanistan have been anything but conventional.”

Like so many other female soldiers, Milonas witnessed horrific violence, and her own life was often placed in jeopardy. After her posting in Kabul, she was sent to the Bagram airfield, up north, where her job was to convoy gifts of food, household goods and school supplies into the countryside for impoverished villagers, in hopes that they, in turn, would help her gather intelligence about Taliban insurgents. It was dangerous work, but Milonas didn’t acknowledge her fear—to herself or anyone else. “I was good at covering up,” she says. “I had to be. I was an officer with troops to lead.”

Then, after almost a year, Milonas came home.

WE ARE SITTING in the ersatz-Colonial lobby of a Best Western hotel in Puyallup, Washington, a wooded town in the shadow of snowcapped, volcanic Mount Rainier; the famous site is an apt metaphor for this calm--looking woman whose emotions can erupt at any moment. Signs for evacuation routes dot the landscape, but so far there has been no clear exit for Milonas, whose buried trauma began breaking the surface when she returned from her deployment in November 2004.

It should have been a joyful homecoming; instead, gunfire from training exercises at Fort Lewis army base, near where she then lived, sent Milonas diving to the floor, thinking she was hearing the Scud missiles that had rained down on Bagram. Emotionally withdrawn and unable to sleep, Milonas obsessively checked doors and windows to make sure they were locked. She was unable to hug her grandchildren, because they reminded her of the vulnerable Afghan kids she felt guilty for leaving behind.

This was not where Robin Milonas, now 53, expected to be at this stage of her career: struggling to regain her old life, her old self, but mired, like countless other soldiers, in post-traumatic stress disorder (PTSD), a condition twice as likely to affect women as men. “I kept asking, ‘Where’s the pink pill?’ There’s got to be something to make this go away, ” she says.

Fake flames flicker in the hotel’s electric fireplace, and Milonas—an attractive, heavyset woman dressed carefully in a soft corduroy skirt suit, tan cowboy boots and an armful of golden bangles—sits in a satin wing chair and talks about life before wartime.

The third of four children, Milonas grew up near her grandparents’ farm in Yorktown, Virginia. Her father worked in a shipyard, her mother at a naval weapons station. Her late stepfather served in the air force, and one of her sisters, an RN, is an air force captain. Milonas attended college nearby, at historically black Hampton University. “My military career was going to be glamorous,” she recalls with a wry smile. “My big escape, taking me far away from home.” Her first post was Fort Dix, New Jersey.

She seems surprisingly relaxed. But then a loud whirring noise reverberates through the lobby. “I can’t tell where it’s coming from,” Milonas says, her eyes alarmed behind her glasses. It’s only a housekeeper vacuuming a hallway, but hypersensitivity to noise is another symptom of PTSD.

The plan was to make the military her career. Then, at Fort Dix, she met infantryman Kevin Milonas and fell for his green eyes, his smile and the kindness she sensed in him. He’d been married before and had custody of his three kids. “Robin was outgoing and adventurous,” Kevin would later tell me. “She liked to travel and go to events. She had a deep interest in me and what I was going through as a single father, and I found that very fascinating and comforting.”

They married; Kevin was transferred to Fort Lewis, and she got herself reassigned to go with him. The children were still young, and two parents in the military was, she says, “too much.” Kevin was further along—a master sergeant—so rather than re-enlist when her time was up, Robin became a special-ed teacher and joined the reserves. She spent one weekend each month with a transportation unit, preparing for war but never expecting to actually fight one. Then the 1990–91 Gulf War broke out, and Milonas was deployed to the Middle East while her husband remained home with the children for nearly a year. “It crushed his poor little ego,” she says with a laugh.

Milonas had just made major; the second-highest-ranking officer in her unit, she was excited to be taking a group of young soldiers to rebuild the airport in Kuwait. “I enjoyed the adventure, not knowing what was going to happen next,” she says. “There’s that feeling you get, that adrenaline rush.” Her commander was a woman, as was the company training officer. “We felt we were invincible,” Milonas says. “I was successful in my job. I loved the first war.”

As Milonas advanced and was promoted to lieutenant colonel, her duties fell under the Special Forces command, where she was now focused on intelligence and outreach—“winning the hearts and minds of the public,” as she puts it—work that would require her to have close contact with civilians during her next deployment. “I thought it was going to be like the first Gulf War,” she says.

“I didn’t know I was going to be exposed to so much trauma and mutilation.”

AFTER ARRIVING in Afghanistan in January 2004, Milonas was first stationed in Kabul, where she met Karzai and was a liaison to the Minister of Women’s Affairs during the run-up to an International Women’s Day program in March. “It wasn’t until I went to Bagram air base [a few months later] and was at the grassroots level that things began to affect me,” Milonas says.

Pained by the poverty she saw outside the base, she hired locals for jobs on the post and brought children in to earn money helping at a weekend bazaar and to learn Tae Kwon Do at a mini club that troops had organized. She set Kevin—by then retired from the military and working for Boeing—to buying tiny sneakers to send over.

In Bagram, Milonas witnessed horrors of a kind she hadn’t been exposed to on her earlier overseas tour: A little boy, his leg mangled from stepping on a land mine. A nightmarish misadventure when an interpreter mistakenly led her convoy into a field of unexploded mines. But worst of all was the drowning infant she couldn’t save. Milonas and her convoy of SUVs were returning to base after delivering food to a village when she spotted children playing in a stream. An old man plucked an apparently lifeless baby from the water and, holding him by his feet, began to shake him. “I wanted to do CPR but knew I couldn’t,” Milonas says.

In repressive Afghanistan, the female soldiers were under orders never to touch a male—not even an infant. She remembers begging the Marine assigned to guard her troops to let her help the child. Impossible, he told her: “You’d be putting the team at risk, ma’am.” Male soldiers were equally helpless; the convoy had strict orders about where they could go, where they could stop. And so they drove on.

There were traumas on base, too—one soldier committed suicide, and at least one other attempted it. “You try not to think about it because you have too much time left on your tour. The only thing you want to think about is doing your job, counting down the days,” she says. At the same time, however, she became attached to the local kids. They needed her; she wondered if she should volunteer for another tour. “My spouse sort of gave me an ultimatum,” Milonas recalls. “He said, ‘No, you’re coming home, and you’re coming home now.’ ” But the woman who returned to him was not the wife who had left.

POST-TRAUMATIC STRESS disorder did not enter the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders until 1980, but soldiers have reported feeling its symptoms for as long as battles have been recorded. The syndrome rose in the public consciousness as the wars of the 20th century gave rise to such terms as shell shock and combat fatigue, but the illness is not limited to warriors (see PTSD: Not Just for Soldiers).

The APA defines it as a disorder that can develop after an extremely stressful ordeal in which one experiences or witnesses actual or threatened death or physical injury, or learns of the unexpected or violent death or injury of a loved one or close friend. Symptoms include hypervigilance (of the sort Milonas experienced seeing the shadow on the highway and hearing the hotel vacuum), insomnia, anger, nightmares and flashbacks.

Jonathan Shay, a Boston Veterans Affairs psychiatrist and recipient of a MacArthur Foundation “genius” award for his work on the psychological effects of warfare, has described sufferers as feeling “dead,” as though they were looking at life through “a dirty window.” This is the detachment Robin Milonas felt when she left Afghanistan and returned to her family.

Her symptoms became apparent almost immediately. At bedtime, she needed to leave a light on and music -playing—but still couldn’t sleep. She heard the voices of Afghan kids crying in her head. “Be kind to your mom,” Kevin warned his children and their families when they visited. “She’s going through something. She’s different.”

Indeed, the once-affectionate grandmother who ordinarily hugged her grandchildren and played with them fled upstairs to hide in her bedroom. Milonas’s daughter (who asked that her name not be published) had been in the army reserves herself for six years but hadn’t gone to war. She couldn’t understand how her mother could have come back so “jumpy and suspicious . . . extra needy.”

This was not the independent woman who’d raised her, the role model she’d emulated. She followed her mother from room to room, attempting to soothe her, repeating, “It’s OK, Mom.”

But it wasn’t OK. Milonas didn’t want anyone to touch her, not even her husband. “You don’t expect anything like this; it was a shock,” says Kevin. A soft-spoken man with long hair and a beard his wife describes affectionately as “scruffy,” he tried to tease her out of her funk. It didn’t work. Sexual intimacy was out of the question and still is.

“My anxiety goes up, and I can’t breathe,” Milonas explains. “My spouse is resigned to it. It’s not that I don’t love him. I just can’t be that close to him anymore.” She also felt an undercurrent of anger at Kevin because he’d insisted that she return home.

“I think about it and wish I’d stayed longer to do what I thought needed to be done,” she says. “It’s not a very pleasant feeling.”

Back teaching school in January 2005, Milonas found herself afraid to move around the classroom or to get close to her rambunctious middle school students. Sometimes she had to grip the edge of her desk just to stay in control of her emotions. School bells panicked her, too, and when the workday ended, she paced at home for hours to calm herself.

Also shocked by these changes was Milonas’s onetime army colleague, now a retired lieutenant colonel, Elizabeth Burris, who lived nearby. Before Milonas’s Afghanistan deployment, the two had become quilting buddies. “As a soldier, she was on top of everything—quick-witted, sharp, multifaceted, with excellent speaking skills,” Burris says. Now her old friend was so rattled, she couldn’t distinguish left from right. And she had forgotten how to quilt. “It was heartbreaking,” says Burris, who suffers from PTSD herself and was being treated at a Department of Veterans Affairs center in nearby Tacoma. Recognizing the symptoms, she suggested that her friend seek help.

At the Tacoma VA, Milonas met with a therapist who tentatively confirmed Burris’s hunch and referred Milonas to the VA’s Women’s Trauma Recovery Program in Menlo Park, California, for a more thorough, inpatient evaluation. But Milonas didn’t want to believe she was suffering from PTSD. “No, I can’t have that,” she remembers saying. “That’s for people who are weak.”

MORE THAN 230,000 women have served in Iraq and Afghanistan; according to the VA’s National Center for PTSD, nearly 20 percent of them have been determined
to have post-traumatic stress disorder. But some say the real victim count could be much higher, given veterans’ sensitivity to the stigma surrounding psychological problems.

Denial is common among sufferers, even those who know they have the disease: A study published in the Journal of Traumatic Stress showed that a majority of Iraq and Afghanistan veterans with new PTSD diagnoses failed to attend the recommended number of treatment sessions. Experts suspect that many are acting out of fear of harming their careers—a concern that may be especially pressing for women. “Saying you need help is a deal breaker,” Milonas says. “You’re already trying to prove yourself by working harder than anybody else.”

Still, when school let out in June 2005, Milonas checked into the Menlo Park facility, a Spanish-style building set in tranquil grounds dotted with redwoods, flowers and fruit trees. She underwent a battery of tests to assess her mental and physical health.

The result: the PTSD diagnosis her Tacoma therapist had expected. For two and a half months, Milonas was treated with a combination of medication, group and individual therapy, cognitive behavioral therapy designed to alter negative thought patterns, meditation and relaxation exercises. “It was comforting, because I met other women like me,” she says, adding that most of her fellow soldiers’ symptoms stemmed from trauma due to sexual assault and harassment.

Kevin visited when he could. “It’s no different than if she developed a physical ailment,” he says. “She’s my wife, and I have to be there for her.” He corrects himself. “I don’t have to be there. I want to be there.”

Milonas would have liked to stay in treatment longer, but the fall term was beginning and she’d already used up her sick leave. Back in the classroom, she found that the Eastern technique of mindfulness—emptying her head to focus on the present rather than on the past or future—helped her cope with the panic she often felt. With medication, she had stopped hearing the voices of Afghan kids clamoring in her head. And as a result of repeatedly talking in therapy about her war experiences, she was no longer as deeply frightened by street sirens, school bells and fire alarms. “I’m finally learning that no one’s injured that I know,” she says.

A Northwest rainstorm patters on the roof of the Tacoma Vet Center, a brightly lit, low-slung building behind a gas station in a corner mini mall. This is where Milonas continues her treatment with weekly individual therapy and occasional group sessions. We are sitting with her counselor, Debra M. Bretey, in the women’s-group meeting room, a serene space decorated with a framed quilt and spindly-legged chairs upholstered in teal. An air force veteran with salt-and-pepper bangs and a gentle voice, Bretey later tells me that when she starts dreaming her patients’ nightmares, she has to visit her own therapist.

Sometimes Milonas attends the group for male veterans, in their room down the hall, where the chairs are rugged black leather. Women are too nosy, she says, adding that she prefers to be left alone. I wonder aloud if this is code—her way of saying I ask too many questions. “I’m fine,” she replies, with a glance at Bretey. “I have my grip.” Her hands are clasped tight, fingers laced, in a prayerlike position that turns out to be yet another calming strategy. Milonas has learned a number of these tactics.

At home, after school lets out, she listens to a CD of a Native American flute player. To banish bleak thoughts, she burns sage as a cleansing ritual, and she uses controversial thought-field therapy—tapping her fingers on acupuncture pulse points—to help decrease anxiety. Deep breathing and visualization exercises take her to her “safe place,” a cornfield on her grandparents’ Virginia farm where she played as a child.

The techniques often soothe her, but not always. Two years after leaving Menlo Park, Milonas checked herself into a local hospital because she was having thoughts of suicide. She still has them sometimes. “Prayer helps,” says Milonas, who is a non-denominational Christian. “I credit my faith for my being here.

“It’s hard some days just to get up and keep going, knowing the things you’ve given up,” Milonas explains. She lists those things: She would have made full colonel if she hadn’t had to retire in 2005 because of her illness; if she could face night driving, she would still be teaching college-level health and PE courses (“The dark is not my friend,” she tells me); she would have a closer relationship with her grandchildren if they didn’t remind her of the children in Afghanistan. “I love them. But if I can avoid dealing with them, I avoid them,” she says.

The changes are physical as well as emotional; a cocktail of antidepressants has boosted Milonas’s weight by 70 pounds—not easy for a woman whose Special Forces training included a 10K road march with 80 pounds on her back. The drugs might also be partly responsible for the flatness of her affect. She lists her meds: Prozac, Abilify, buspirone and trazodone, plus pain pills for fibromyalgia, an exhausting muscle condition associated with PTSD that is common in women veterans. “I’m a walking drugstore,” she says.

After her 2005 PTSD diagnosis and her retirement from the reserves, Milonas applied to the VA for increased monthly disability payments, which she hoped would enable her to afford more time off for residential treatment. (She was already collecting a small sum for physical problems stemming from her deployment in the first Gulf War: lower-back pain and ringing in her ears.) The Veterans Benefits Administration turned down her PTSD application, saying she hadn’t adequately proved that her condition was related to her military service.

“It’s like being smacked in the face,” Milonas says. “I was very naive. I thought, If I do my job and I do it well, Uncle Sam will take care of me.”

Milonas remembers a VA adviser telling her that claiming sexual trauma would make it easier to get benefits. She replied that she had not suffered sexual trauma. “It’s like, ‘Well, OK, good luck,’ ” she says. She appealed, but the decision was upheld. Kevin bitterly recalls the runaround his wife was given. “They’d say, ‘Oops, you need this.’ ‘Oops, you need that.’ ‘Sorry, you have to reapply.’ I honestly believe they hope you’ll go away.” But she didn’t, and in December 2009 Milonas got approval for her PTSD compensation. She was awarded a lump sum to cover the four years it took to get her claim accepted (four years is the average time it takes to reach a favorable decision, according to the National Organization of Veterans’ Advocates), plus an ongoing monthly pension.

Final approval was based on a sergeant’s confirming the drowning-baby incident. His account had been filed with Milonas’s first claim, in October 2005, but had somehow been overlooked. “Ms. Milonas’ case was complicated by the fact that she was not in direct combat,” the VA explained in a letter when I inquired about why her case had taken so long.

“I don’t know how much more direct it has to be, aside from being fired upon,” Milonas says dryly. But she’s gratified. “They’ve taken care of me. I don’t feel like I’m fighting with my own government anymore.”

Last summer the VA approved changes to its claims procedures: Veterans who have served in a war zone no longer have to prove that their PTSD is combat related. The diagnosis has to come from a VA health care professional, who must also confirm that the PTSD is service related.

However, concerns persist that to avoid paying benefits, the military sometimes diagnoses adjustment disorders or pre-existing personality disorders instead of PTSD—even though the service members were considered psychologically healthy by the military upon entering the service. The Department of Defense denies the charges, but in a September 2010 hearing on the subject, Bob Filner, chairman of the House Committee on Veterans’ Affairs and a Democratic congressman from California, told his listeners, “I remain extremely concerned that our dedicated service members struggle to get the proper mental health care and support while fighting America’s wars.” VA diagnoses of mental health problems have increased 40 percent in the past six years; as the drawdown of troops escalates and more soldiers come home, many question the VA’s ability to cope with the likely rise in PTSD claims. [NOTE: In May 2011, a federal appeals court ordered a major overhaul of the VA's mental health care system, noting that an average of 18 veterans a day commit suicide.]

ROBIN MILONAS MISSES the military. The walls in her home office are covered with framed citations and awards. Among them are more than 15 ribbons and medals, including a Bronze Star. “Part of it never leaves you,” she says.

A different kind of grouping is displayed in the formal living room, which is dedicated to Milonas’s doll collection. The figures—some black, some white, some even life-size—sit in miniature chairs and lounge on a sofa, their faces beautiful but vacant. “I enjoy taking care of them,” Milonas says.

Last year she attended a VA-sponsored weekend retreat for women veterans at a ranch near Spokane, where they were offered horseback-riding lessons, art classes and trust-building exercises. “I went in with no expectations, thinking I would get nothing out of it,” Milonas says. But something shifted as the women sat around the bonfire talking about the experiences that still haunt them at night. “I came out of this retreat telling myself I was going to have more good days,” she says. Milonas now feels ready to join a women veterans’ therapy group and is working on her driving in the hope of attending evening sessions this fall.

Teaching is still a trial, however—so much so that Milonas is talking to her doctors about whether she should apply for 100 percent disability benefits, which would enable her to focus full time on her recovery. Absent that magical “pink pill,” she is still facing a long slog. For example, she is driving more, “but I’m numbing more” to get through each effort, she admits. “I’m afraid that if I let my emotions show, I won’t be able to control them.”

So she gathers what strength she can muster and pushes on. “I’m trying,” she says about her grandchildren. “Usually, I shut myself off and say, ‘Hi, bye, see you guys later.’ But now I try to be a little closer, and I try to hug ’em.” It’s still not easy, and it still doesn’t feel quite right. But she does it all the same. “I just look at it as one of the things I have to do in order to get better—until it takes hold and becomes a part of me again.”

She turns from her dolls and picks up a quilt she’s been working on. It’s not as intricate as the ones she and Elizabeth Burris used to make, but its colors are vibrant: sunrise shades of gold, yellow and blue. In the middle of each square is a silhouette of a dark-skinned woman, arms outstretched. Perhaps Lt. Col. (ret.) Robin Milonas will be able to link together enough pieces to create a new whole.

LOUISE FARR is the author of The Sunset Murders. She is based in the Los Angeles area.

Click here to read PTSD: Not Just for Soldiers.

Originally published in the June 2011 issue of MORE.

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First Published Thu, 2011-05-12 11:11

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