For many war veterans fighting to restore their mental health, the season of tears begins in November and doesn't end until the last New Year's party favour has gone out with the trash.
The annual eight weeks of torment begin with the ceremonial cannon shots of Remembrance Day, which brings with them flashbacks to violent encounters and dead friends. That often is just the start of a long grind of holiday stress that is especially difficult for those suffering from depression, anxiety or other mental-health disorders – a season with high expectations of joy and togetherness that are often filled instead with sorrow, isolation and crisis, including a spike in suicides.
"The nightmares the last couple weeks have been brutal. This time of year doesn't help, Remembrance Day doesn't help. Remembrance Day is a tough day, and it goes on for weeks," said Kevin Berry, a veteran of the Afghanistan war who was diagnosed with post-traumatic stress disorder last year.
Mr. Berry is part of a growing brigade of Canadian veterans diagnosed with PTSD, some of whom may spend years avoiding a head-on confrontation with mental illness. According to a study by the Canadian Forces completed in the fall, at least 5,773 soldiers who served between 2001 and 2008 were diagnosed with mental illness, about half of them PTSD. About 4,000 of the overall cases, like that of Mr. Berry, could be attributed to service in Afghanistan.
In fact, the study found 13 per cent of the soldiers who served in Afghanistan have been diagnosed with mental illness. While military officials say the rate of new cases of mental illness should level off with the end of Canada's combat mission, the total numbers will continue to grow for years.
And the numbers remain an underestimate of actual cases because soldiers are still reluctant to come forward and risk ending their careers, according to Walter Callaghan, a retired officer with the Canadian Forces medical service who is now a graduate student at the University of Toronto.
"I think the next thing we need to come to terms with is the whole notion many of these conditions can be cured," said Mr. Callaghan, who studies the social effects of operational stress injuries on soldiers. "There might be a plateau in new acute cases of PTSD, the ones that show up within six months of the trauma, but new cases will be coming in for years and maybe decades. Ten years, minimum."
Nearly six years passed between the end of Mr. Berry's mission patrolling Kabul with the Canadian infantry and his PTSD diagnosis, in the spring of 2010.
He served early in the Afghanistan war, in 2003-04. Three comrades died on his tour in Kabul. He went on more than 100 patrols, spending hours each day in fear that a bomber was just around the corner of every mud wall.
One early traumatic experience came the day he beat and nearly killed a young Afghan boy he took for a suicide bomber. (The excited boy was merely trying to turn in a mortar round to Canadian soldiers.) "The only reason I didn't shoot him is I didn't think I could hit him without hitting the bomb," Mr. Berry recalled.
He hurt his knees falling off a vehicle, and became partially deaf from constant exposure to noise. Mr. Berry, then 20, started drinking heavily shortly after his return. As early as 2005, he awoke from a dream where he was in hand-to-hand combat with two Taliban only to discover he was in his own bed, choking his girlfriend. Fit, 6-foot-4 and 220 pounds at the time, he still shudders at the memory.
He worked as a doorman in Vancouver nightclubs, where he was attacked with beer bottles and had guns and knives pulled on him. Odd behaviour would come and go, Mr. Berry said, until it all started to get worse again by 2009. He would drive around the streets of Vancouver, eying an abandoned suitcase or errant soccer ball as if they might be roadside bombs. A stack of bricks looked like a minefield marker.
And the drinking: He would down more than two dozen beers a day just to get to sleep. "My life was unravelling," he said. Finally, in May, 2010, he had a breakdown in the office of the bar he managed. Three times prior he had attempted to reach out for help to Veterans Affairs Canada. But this time, as he bawled into the phone, he was taken seriously, he said.
Nothing about his treatment has been easy, including the labyrinth of bureaucracy he's had to negotiate through Veterans Affairs to go on short-term disability and collect the lump sum of $27,000 he is entitled to so far because of PTSD.
His case also highlights some of the inequities introduced by recent new veterans legislation. He receives $619 a month, for life, for the knee injuries and deafness he had treated before the new legislation came into force in 2006. He gets a one-time payment for PTSD because it was diagnosed afterward. If he lives to be 78, he'll receive at least 10 times more for his rickety knees and half-deaf ears than he will for mental illness. Had the knee and ear injuries been diagnosed a couple years later, he would have received a fraction of the $370,000 (before inflation adjustments) he will get over a typical lifetime.
"Almost any soldiers who has been through it will recognize this story," said Mr. Callaghan, who himself was awarded $70,000 for the type 2 bipolar disorder he developed while serving 10 years in the military. "For mental illness, the criteria are arbitrary, the funds insufficient. There's no rhyme or reason. And the difference between the old and new payment system is completely unfair."
Mr. Berry is now sober, in psychiatric care. He has dropped most of the 100 pounds he put on since coming home, and he's in a solid relationship with a woman. But he worries about the holiday season.
Mr. Callaghan, who suffers from his own bipolar disorder, acts as an advocate and buddy and peer to other ill vets. The phone rings much more frequently at this time of year.
It can be tough to get in to see professionals from either the civilian- or military-care systems around Christmas, Mr. Callaghan said. Reservists, like he was, can have a hard time connecting with comrades. Reserve-forces parade halls are often padlocked for a couple of weeks at this time of year.
And those aren't the only challenges, Mr. Berry says. The mental-health minefields are everywhere. Just the other day, he took a pre-Christmas trip to the mall to have his photograph taken. His heart raced with an anxiety attack. "Malls are tough," he said. "Especially at this time of year."