Carlos Lopez Jr. was still a teenager when he signed up for a two-year stint in the U.S. Army. Not long after, the Iraq War began, and he became one of the first American soldiers to be deployed there, fighting battles in Baghdad, Najaf, and Fallujah.
Five years active duty, three tours, and more than 37 months in “extreme combat environments” later, Carlos Jr. came home. But he “was not the same person,” according to his obituary.
Though he was still kind and loving, his family said, he was also “very aggressive.” Carlos — known fondly as “Los” to his parents, brother, and sisters — turned to an acting career as “an outlet for the combat life he endured” because it “allowed him to express his deepest thoughts.” He would go on to make his mark in Hollywood, appearing on television in the show “Operation Repo” and in military action movies including “Captain America: The Winter Soldier” and the upcoming “Bumblebee.”
Carlos also wrote, directed, and starred in the award-winning short film “PTSD: An American Tragedy,” in which he plays a veteran who returns from Iraq suffering from severe post-traumatic stress disorder.
It was a condition the young actor knew all too well. On June 24, 2018, Carlos himself “passed away of PTSD.”
PTSD: A “new” cause of death
“Passed away of PTSD.”
I was startled to see that phrase in Carlos’s obit. In my 13 years with Legacy, I’d read thousands of obituaries, but never before had I come across one that listed, so matter-of-factly, post-traumatic stress disorder as the cause of death.
What does it mean to die from PTSD?
For someone as young as Carlos, just 35 at the time of his death, it means dying by suicide. As reported in news stories shortly after his death, and later confirmed by his parents, Carlos killed himself after struggling with PTSD for years.
When it comes to causes of death that survivors find difficult to talk about, obituaries have long employed a secret code. If someone died by suicide or from a drug overdose, the obituary might say “died at home” or “died suddenly” or simply “passed away.” However, increasingly over the past few years, families have begun to open up in obituaries, sharing painful details of their loved one’s life and death.
Often, their explicit intent is to raise awareness and prevent others from going down a similar path. In recent years, Legacy has reported on obituaries that highlight:
• Depression
• Domestic violence
• Addiction
• Suicide
Carlos’s obituary was the first I came across that brought this full-transparency approach to PTSD — and, more specifically, to explicitly describe the underlying mental health issue as the “cause” of a suicide death, rather than the suicide itself.
I wondered: Was this an isolated case? Or have other families also begun using obituaries to open up about a beloved veteran’s “invisible wounds”?
The impact of PTSD on American lives
It’s no secret that war is hell. Centuries of evidence documents that military combat has debilitating aftereffects not only on the bodies of veterans, but also on their minds and spirits. What we’re only now beginning to understand in depth is the lifelong toll that the trauma of war can have on military veterans.
Historically, traumatized veterans returning home from war with psychological wounds received little understanding or support. Starting with Vietnam, we began to understand differently post-war symptoms like severe anxiety, nightmares, sleeplessness, and memory lapse. We now know that these are signs of “post-traumatic stress disorder,” and that PTSD is not a sign of weakness but rather a natural response to trauma.
Post-traumatic stress disorder causes a host of mental and emotional symptoms including flashbacks and panic attacks. PTSD is often accompanied by depression, substance abuse, and/or other anxiety disorders, and people with PTSD are at greater risk of suicide or self-harm. Recent studies have shown that PTSD also takes a toll on physical health: PTSD can accelerate the aging process and people with PTSD are at greater risk of developing illnesses such as type 2 diabetes, cardiovascular disease, and dementia.
PTSD can affect anyone who has been exposed to a traumatic, life-threatening event. Because military service members are regularly exposed to violence, both directly (in combat) and indirectly (treating the wounded, for example), they are especially vulnerable.
The prolonged wars in Iraq and Afghanistan have led to millions (nearly 3 million American service members between 2001 and 2015) being deployed. Many, like Carlos Lopez Jr., have deployed multiple times. With roughly 6,800 American troops killed, and more than 50,000 physically wounded in action, the wars have taken a heavy toll.
The wars have also had a profound impact on the mental health of veterans, according to Craig Bryan, an Air Force psychologist who heads the National Center for Veterans Studies. Based at the University of Utah, the NCVS has as its mission to improve the lives of military personnel, veterans, and their families. More specifically, Bryan wants to end veteran suicide by helping veterans overcome PTSD.
A few years ago, says Bryan, following the surge in Iraq, clinics were overwhelmed with veterans suffering from PTSD. Now, as military operations have slowed, new cases are slowing somewhat — but there remain many service members and veterans coping with PTSD.
How many? Up to 20 percent of Iraq and Afghanistan veterans, according to the U.S. Department of Veterans Affairs. That means half a million veterans who have developed PTSD since 2001.
During the same period, the U.S. military suicide rate has increased dramatically. By 2014, suicide had become the leading cause of death throughout the military, surpassing illness, vehicular accidents, and even combat. And while veterans comprise only 8.5 percent of the population, they account for nearly 1 in 5 (18 percent) of all suicides in America.
Like Carlos, many of the service members and veterans dying by suicide in recent years also suffered from PTSD. But at what point did families begin to interpret their loved ones’ deaths as being caused by PTSD?
A decade of PTSD obituaries
In 2008, Jonathan Tauer, an Army veteran who’d served four years including a tour in Somalia during the crisis of 1993, died at his home “of complications from Post Traumatic Stress Disorder,” according to his obituary. It’s the earliest example in Legacy’s database of an obituary that clearly ascribes cause of death to PTSD — but certainly not the last.
In the decade following Jonathan’s death, the number of young veterans “dying of PTSD” increased significantly. Of obituaries published in the past year alone, hundreds mention the deceased’s struggles with PTSD, and more than a dozen specifically cite PTSD as the cause of death.
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