or the most part, Adam Nilson wants to avoid the stigma that comes with being a United States military veteran living with post-traumatic stress disorder and deployment-related injuries. “You feel like no one understands you; you don’t feel close to anybody, and then there are all these misconceptions about what you are and what you aren’t,” says Adam. “So, I really don’t talk about military service to people.”

In 2010, three years after joining the Ohio National Guard, Adam was officially deployed with an Operational Mentor and Liaison Team, also known as an OMLT. It was a North Atlantic Treaty Organization-run mission that worked with the Partnership for Peace, and teamed up with European militia. While in Afghanistan, their mission was to mentor Afghan soldiers by observing operations during combat missions and then improving their skills.

Although Adam has been home from Afghanistan for over seven years, he mentally returns overseas daily and doesn’t think he’ll ever feel like a civilian again. “Once you go through that, there’s no going back,” he says. “Once you’ve been in combat, for good or bad it changes you.” Adam makes comments about the complicated experience of being a soldier in Afghanistan. He says one paradox was the beautiful mountainous landscape in the desert of a war-torn country. Another is the feeling of combat. “Combat is one of those things that you love and hate at the same time,” he explains. “In one aspect, it’s kind of a rush, but it’s absolutely terrifying in another aspect… then you get these weird feelings of, I shouldn’t enjoy this. This is war and people are getting killed. But I do, strangely, enjoy this. And you’ll never feel that alive again, ever, no matter what you do. I’ll never let go of that excitement. I’ll probably never let go of the guilt of being excited by it.”

A folded American flag hangs on the wall in the living room of Adam's.

Shortly before Christmas in 2010, Adam and his unit returned to the United States. He says that’s when his PTSD really started to manifest. He was jumpy; his sleep was filled with nightmares and he had a heightened startle response. Adam assumed that this was normal and that eventually he would readjust to civilian life. However, he is still living with PTSD and is experiencing more severe issues. “I think I must have had some of the symptoms the whole time I was there and didn’t notice it,” says Adam. “But we were just always on edge. Even back where we were kind of safe, we weren’t really safe, so you’re just always alert.”

Adam sits on the couch with his mom's dog, Sunny. Adam finds comfort in her presence and when he was first back from deployment found it difficult to connect with people, but easier to connect with dogs.

Adam drives his car near his hometown in Ohio. During his time in Afghanistan, the Taliban would hide IEDs on the road to blow up the passing soldiers often using
potholes and then covering them with asphalt or under boulders.

Adam walks through the Ohio Western Reserve National Cemetery in Seville, Ohio looking for his friend Coolhand's grave marker.

Adam says the two “wizened warriors” shared a quiet, knowing look and said, “Wolfman, we love you brother, but you’re fucked up. Don’t wait 40 years like we did. Go see somebody.” Wolfman is Adam’s military nickname, which he attributes to his ability to grow a beard overnight and his overall hairiness. With his friends’ encouragement, Adam began seeking help from the U.S. Department of Veterans Affairs. According to the VA, between 11 and 20 out of every 100 veterans that served in Operation Enduring Freedom, like Adam, are living with PTSD.

Adam shares a moment with his mom's 4-year-old Labrador, Sunny.

As early as the American Civil War, soldiers returning from combat displayed PTSD symptoms. The Victorian era thinking often attributed the bizarre behavior to the physical rigors of combat, rather than the mental strain. The Athens Lunatic Asylum was originally built in part to accommodate the high number of soldiers returning from war with “acute mania.” However, for soldiers like Adam, there may not be a place like the old Asylum for them to seek proper treatment.

Although the VA recognizes that PTSD is a mental health problem that many veterans face after combat, Adam has had an incredibly tumultuous relationship with their health care system. “It was an eye-opener that once you’re hurt in the service, they really don’t care about you anymore,” Adam says about his experience with them. From the moment he first sought help, he came across issues and obstacles that he never expected from an organization designed to assist veterans.

Adam lays on an acupuncture table. Adam doesn't take medication for his physical injuries or his PTSD. Instead, he finds acupuncture to be helpful in his pain management.

Adam Nilson lays on the acupuncture table after his therapist inserted the needles.

Adam feels that mental illness has a negative connotation and that PTSD is misunderstood. He explains that it can come in many forms, such as nightmares, but that doesn’t mean it would make someone lose control. With the negative connotation, Adam explains that he’s had trouble getting some jobs and knows friends that have gone through similar situations because of the negative stigmas. Although society views PTSD as a mental illness, Adam finds this label inaccurate. “For me, it’s a normal reaction to an extraordinary circumstance,” Adam says. “I don’t feel sick, I don’t feel ill. I just went through some bad times, and I’m having trouble readjusting.”

“Over there, life and death is very black and white. Either you’re going to live or you’re going to die. And what we learned was that when your ticket gets punched, that’s it."

“Combat is one of those things that you love and hate at the same time,” says Adam. “In one aspect, it’s kind of a rush, but it’s absolutely terrifying in another aspect...then you get these weird feelings of, I shouldn’t enjoy this, this is war and people are getting killed, but I do, strangely, enjoy this. The biggest satisfaction comes at the end when you’re alive and your buddies are alive...And you’ll never feel that alive again, ever, no matter what you do. I’ll never let go of that excitement. I’ll probably never let go of the guilt of being excited by it.”

he act of deinstitutionalization “simply just switched the post office address from the mental hospital to the local jail prisons and jails,” according to Tom Walker, an Ohio affiliate member of the National Alliance of Mental Illness. Over the past three decades, the number of individuals with severe mental illness in prisons and jails now exceeds the number in state psychiatric hospitals exponentially. In the 1970s, state hospitals began to close, shuffling patients into the community with little to no resources. The idea was that the mentally ill would do better with community-based mental health care rather than institutionalized care. But adequate funding and organization did not follow this change, and the lack of resources and commitment to a community-based system of care continues to be detrimental to a large portion of communities today.

The Ridges began the process of deinstitutionalization in 1993, closing their doors permanently and creating a population surge in Ohio correctional facilities. According to a national survey completed by The Treatment of Persons with Mental Illness in Prisons and Jails, the majority of state prisons and jails in Ohio each house more mentally ill inmates than does the largest remaining state hospital.

WHAT THE EXPERTS ARE SAYING

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