SAN ANTONIO – March 21, 2003, is a day Eric Alva will never forget.
Just three hours into the ground war in Iraq, Alva became the first U.S. service member injured in Operation Iraqi Freedom.
Alva's convoy had stopped outside the city of Basra and he was eating an MRE when he got up to get back into his vehicle.
"I was turning around to walk back toward the seat and that's when the explosion went off. It was either an IED or they say it was like a land mine or something," Alva recalled. "It was a huge explosion, which of course I was still awake and very much alert to, that something very damaging had just happened."
Alva was rushed to a hospital in Kuwait, where he underwent surgery.
"After awaking, that's when I realized my left leg was broken. My right arm was broken with nerve damage," Alva said. "You can see the finger was blown off and then, of course, my right leg had to be amputated above the knee."
Nearly 15 years later, he's still living with the physical and emotional scars. The retired Marine said even to this day, he has nightmares about the explosion and is easily frightened by loud noises. Something as simple as a co-worker heating up their lunch can trigger him.
"Someone was warming up a Lean Cuisine or something and they forgot to pop holes for it to ventilate. The thing popped so loud in the microwave," Alva said, recalling a recent event. "It was a big pop explosion and, you know, people laughed and I started crying because I dropped to the floor. I dropped to one knee and everyone was like 'What's wrong with Eric?' It's just something that stays with us forever."
Alva said when he came home after his injury, he was always angry. The slightest thing could set him off.
"You just feel this impatience. You feel this anger and what it is, is you're upset your life has changed and you're not talking about it. I couldn't control my anger. I couldn't control my sadness. I couldn't control my emotions," Alva said. "It took me about two years until I realized I needed to talk to someone. Someone said, 'You have PTSD. And I was like, 'What is that?'"
Alva had never heard of Post-Traumatic Stress Disorder, and 15 years ago, the Department of Veterans Affairs wasn't exactly set up to deal with the onslaught of soldiers who would come home from Afghanistan and Iraq with PTSD.
"There wasn't that many therapists at the time who were even skilled in trying to help people," Alva said. "We knew that the veterans were coming home and I know from talking to veterans from Vietnam there was nothing of this sort set up because people just figured there was nothing wrong with you. It was war. Get over it. Deal with it."
Despite having reservations about it and feeling "weak" for seeking help, Alva began seeing a psychiatrist who prescribed medications.
"And then you say, 'What kinds of medications?' And they say, 'Antidepressants.' And then there becomes the whole stigma, like, now I'm really crazy," Alva said.
He stuck with the treatment plan, taking his medications and going to therapy sessions. Over time, he got better and said he has personally seen the treatments improve.
"We're more advanced and sophisticated today that we know how to treat it. We know how to recognize it," Alva said. "We know how to control it. We know how to deal with it, and the services today are far more advanced than what we have ever seen."
In fact, San Antonio now has its own VA-run PTSD clinic.
"With post-traumatic stress disorder, generally what's going on is that a person's brain has learned that terrible things can happen, and the brain is trying to keep them safe from similar things happening again in the future," said Dr. Timothy Rentz, program director for the VA's PTSD clinic. "We've learned that PTSD is treatable and that most people can recover from PTSD. I think it used to be believed it would be a chronic and untreatable condition."
One way Rentz and the post-traumatic stress disorders clinical team treat veterans is by exposing them to situations they would normally avoid.
"That deprives them of the opportunity to retrain their brain in the context of being a civilian or in the context that's different from where the trauma occurred. Those same things like loud noises or being around a crowd of people that really aren't a red flag, and if you avoid them, your brain never learns that they actually are safe," Rentz said. "So exposure is decreasing avoidance so that you can give your brain a chance to learn that you're getting false alarms. We actually have to get that false alarm activated in order to reprogram the way a person’s brain reacts to it."
With so many veterans in need of care, Rentz said, it can take longer than they would like for someone to get treatment, but with expanded mental health services now available at VA satellite offices, the situation is improving. The VA is also using technology to reach clients in need of help.
"We have a program of doing video teleconferencing, either into local clinics or into a person’s home if they live far away from the VA or it’s very difficult for them to get here, and the same treatments we would provide here in the office can be delivered via teleconferencing," Rentz said. "So we have a lot more availability in terms of providers and we have more modalities of providing therapy. We also have a lot more referrals."
As more and more service members get treatment for PTSD, Rentz said, he believes the stigma attached to it seems to be slowly breaking down.
"It’s not a disease; it is actually adaptive. In fact, it makes you fight harder and run faster and it makes you better able to deal with threats. It's just out of context. It's not a sign of weakness. It's a sign that your brain is learning exactly what it's supposed to learn. It's doing what it's designed to do, and our brains are slow to learn that it’s safe again," Rentz said. "PTSD is not something to be embarrassed about or ashamed of. It's, in fact, a normal reaction to exposure to traumatic events and there are fantastic treatments out there, very effective treatments, and most people with PTSD can recover. You don't recover from it like it never happened. You're not going to forget what happened. You're never going to feel good about something terrible that happened. But you can recover so that your emotional, physiological and behavioral reactions go from being big to being small and tolerable."
Eric Alva is a good example of how a veteran can recover from PTSD and learn to live with the trauma he survived, but he admits it's not an easy road. There's no quick fix and you need to be patient.
"You have to stick to keep pushing forward and getting your benefits, to getting your rating, and then making sure people are listening because they will listen. They will help you. But we are in a system right now that is overwhelmed with people needing services," Alva said. "The help is there. The help is abundant. You have to seek out that help. My advice is to go and take that step. The VA takes care of its veterans and so does the military."
If you or someone you know is in need of immediate help, the VA has a 24-hour Veterans Crisis Line staffed by qualified responders, many of whom are veterans. The number to call is 1-800-273-8255. You can also initiate a confidential chat by visiting VeteransCrisisLine.net or by texting 838255.