No Really, How Are You Doing? Asking Important Questions About Military Suicide

I thought I was fine. I didn’t see it coming. The day felt off from the moment I woke up. It wasn’t the first time I awoke from disturbing dreams, and these were darker than any I remembered. That afternoon was interrupted by a pounding headache and blurry vision. I couldn’t read my notes or speak clearly. My words came out jumbled, out of order, and the words I said weren’t what I was trying to read. It felt like my brain had exploded. I was crying uncontrollably. I had to pick up my son before daycare closed, so I couldn’t immediately go to medical. My officer in charge called me, encouraged me to take a day off and go to medical the next morning. When I returned home with my son, he cheerfully greeted a neighbor who happened to be outside. He asked how I was doing, and the tears came. I managed to choke out, “I’m … not okay. I don’t know what’s wrong.” His family watched my son. His wife drove me to the ER. I didn’t realize how much pain I felt until it stopped once the IV was placed in my arm. Oh my god—this is what no pain feels like?! Shit. When was the last time I felt this? I couldn’t remember.

When the doctor said, “CT scan negative” and discharge paperwork said, “Migraine,” I felt ashamed and a little silly. I was released that night with medication and instructions to follow up at medical the next day. The next morning the doctor told me, “Start tracking your headaches. … Stress can do this.” I took the medicine, but it didn’t help. I had constant tension headaches to the point that my pounding head woke me up in the middle of the night. I just wanted the pain to stop.

I kept expecting something to be medically wrong with me, but my labs were clear. The behavioral health doctor gave me a few tools to deal with stress: targeted journaling, progressive muscle relaxation, and gently noted again, “Stress can do this.” He also remarked, “Maybe this isn’t caused by one thing.” I was puzzled. O.K. So what things? Why now? This was garrison! It was supposed to be smooth. I excelled through the stress of nine years of active duty service up to this point, and before that four years at the Naval Academy. Six months living abroad in a foreign country, eight months deployed to a remote village outpost in Afghanistan.

Hanf’s graduation at the US Naval Academy, Annapolis, Maryland, May 2010. Courtesy Janell Hanf

I had endured countless challenges seamlessly before. SERE school, losing friends in training and aviation mishaps, losing two high school friends to medical conditions before I had even left for my first deployment. They were friends who had been on the path to applying to service academies with me. Both were devastated when they didn’t pass the stringent medical examination. I kept running down a list of stressful situations that hadn’t broken me. Treating Afghan casualties from nearby IED blasts. Enduring months apart from the man I loved as our deployments and training schedules required. Coming back from maternity leave to serve as a company commander as my husband deployed to Africa. … I was effective. I was performing. I was fine. At least, up until that week, I had never not been fine.

The dark stress dreams? Those times when the thought crossed my mind of crashing my car on a drive home? Ignored. Pushed through—I’m good. I don’t need help. Drinking? Every day? I’m in control. I don’t have a problem. But I was snapping at my son. Where did my patience go? I was so emotionally stretched that even when my husband was home between training exercises, I wasn’t much of a support to him.

I took dozens of small stress-relieving steps, everything I could think of within my control. Two months later I had an emotional breakdown at work. A workshop on relationships and communication made me realize I hadn’t even considered the impact my husband’s workup, his own stress, and the constant interruptions from our work were having on our home life. Walking out of that workshop to cry on a rock for 30 minutes was a tipping point. I needed more help and I couldn’t get healthy all on my own. I self-referred to the cognitive behavioral therapy skills group on base. Day one, looked around and thought, Oh great. I’m the only officer in the group. “Hi, uh—my name is Janell. I’m here for stress and headaches that aren’t going away. I’m trying to get healthy. My husband deploys soon. I need more tools. I need to be strong for my son. …”

Through sessions of guided discussions, instructional tools, and insightful worksheets at CBT, I confronted one of the deep culprits of my pain. The voice in my head. I confronted negative narratives and lies I was telling myself and living. I’m not good enough. I don’t belong here. I suck at my job. I can’t be a good mom and a good Marine. I don’t deserve success. I must define success on the other’s terms. Prioritizing my needs is selfish. My mental health is fine. My relationships are fine. I’m good.

Hanf meeting then Commandant of the Marine Corps, General James F. Amos, when he visited, along with his wife, during the holiday season. Helmand, Afghanistan, December 2012. Courtesy of Janell Hanf (the image, taken by the Commandant’s official photographer/PAO staff, was originally available on DVIDS)

Doctors never diagnosed me with a mental health condition, just migraines and “stress.” I did my fair share of beating myself up for mistakes I had made in the past and minimizing the situations that had been significant to me. I felt trapped. Overwhelmed. Anxious. I knew better than to answer “yes” to screening questions on annual health assessments. Just circle “no” and ignore the painful memories. When I got blood on my hands, those were just Afghan IED casualties, not people I knew.

Almost every Marine leader I know has had close calls with suicide. We have each been one or two degrees of separation from close relatives or family members of Marines who died by suicide, or directly been affected by the suicide attempts, ideations, or deaths of Marines in our units. We constantly hear the statistics of active duty and veteran suicide. When darkness overshadowed my thoughts and dreams, the idea of escaping the current painful situation seemed enticing, almost tempting. But I knew I had to live for those I loved. When the pain was unbearable and my husband was away for training, instead of walking into an empty house alone, I fell apart in front of people who, thank God, got me to the first stage of help.

I couldn’t drown it with alcohol, sweat it out in a workout, or talk it out with a counselor. I didn’t know what was wrong when I accepted the offer of a drive to the ER. But that was the first step for me on the journey to a healthier mind.

When the CBT skills group ended, I knew I had a call to action. I was to write about my pain when fear whispered to keep my mouth shut and go back to work like nothing happened. To those who ask, “How do we get a handle on mental health and suicide?” I don’t have the answer, but one essential step is to talk and be open and authentic about personal struggle.

I’m not OK. I need help. I’m in pain. I’m struggling. I want to be better, but I don’t know where to start. It was difficult to acknowledge those feelings and take the first step towards getting the help I needed.

Hanf enjoying a family hike in the mountains, December 2018. Courtesy of Janell Hanf

I was afraid something bad could happen, yet I chose to take the leap to get help despite not knowing if my career would be impacted. Maybe I got lucky that the only thing I was officially diagnosed with was migraines and not a specific mental health condition such as substance abuse, PTSD, depression, or anxiety. Most of the people who went to the CBT skills group were there as part of a recovery program for one of those conditions, by order of their doctors. I was there because I self-referred. Is that why things turned out O.K. for me? I really don’t know. My command was surprisingly supportive, and I didn’t lose my security clearance.

It’s possible this could all impact my career further down the line. But I would rather accept the risks of getting a bad fitness report, or losing a job prospect or security clearance, even friends, than accept constant burning pain, tension headaches, panic attacks, and emotional breakdowns as a regular part of my life. Some people might “successfully” self-medicate with alcohol and prescription drugs, or suffer in silence out of fear, but I was willing to try any and every behavioral remedy possible. I made the leap for my life, not for my career.

Hanf after a concert with a community church choir she joined. December 2019. Courtesy of Janell Hanf

It still is terrifying to be open, honest, and vulnerable. But CBT gave me tools to identify tension and burning headaches. Tools that help defuse the stress before it bottles up and escalates to an uncontrollable level. It doesn’t end with being fine. I’m never fine. I can and will strive to get stronger, better, and more resilient every day.

As Marines, we claim that we live by our core values of honor, courage, and commitment. I was lying to myself about how I was doing. Deep down, I was scared to speak up and ask for help. I was not as committed to my mental health as I was to my physical health.

My new mission is to inspire others to live meaningful, wholehearted lives, commit to their personal physical and mental health, and flourish through the challenges of whatever lies ahead. Getting help saved my life.