From quiet to bursting with expression

Johnson returned from Vietnam War to a country very different from when he left. He read about the race riots and campus protests, learned he shouldn’t come home wearing his uniform if he didn’t want people to spit on him or scream at him.

“It was an era of unwelcome landings,” Johnson said.

Johnson thought it best to not talk about the war. The nightmares raged on for a year. As they dissipated, other out-of-character behaviors started emerging: hypersensitivities, hypervigilance, not responding to emotional events. His family sometimes saw a different Darryl, one who sealed himself off, got quiet for long stretches of time and would abandon social obligations – often, funerals – at the last minute.

Still, the turning point for Johnson happened decades after his discharge when he worked as a social studies teacher at a private school in Green Bay. About a quarter of his middle school students were Hmong American, and Johnson often faced a language barrier with his student’s parents during parent-teacher conferences.

But they found a common language on his classroom map. Those parents had been children of Hmong soldiers fighting in Vietnam’s secret war in support of U.S. forces in Laos, across the border from where Johnson was stationed. The parents would point to the villages they grew up in, and they could trace their fingers along the Mekong River, the body of water they had to cross to make their way to the refugee camps in Thailand.

The connection allowed Johnson to remember the past anew, but not without guilt.

“I was able to go home after my two years of service and selectively remember those things that were good. Whereas, they lost everything and had to start again with nothing,” Johnson said. “It was disturbing.”

That’s when Johnson understood he still carried wounds from the war. With the gentle prodding of his wife, he decided, four decades later, it was time to get treatment for what he was beginning to suspect was PTSD. He looked into his VA benefits and, much to his chagrin, learned he didn’t qualify. At the time, the VA didn’t cover benefits unless a soldier was physically wounded.

Years later, the VA rules changed on this, and he pursued therapy in 2005 with his VA benefits. He learned from other Vietnam veterans of a therapist trained to work with his population, so he took a chance.

“It’s been a great experience, being able to talk to someone about these things. If I wanted to give him some (expletive) reasoning for why I got mad or upset, he’d challenge me,” Johnson said.

His therapist recommended art therapy to him, an idea that made him nearly laugh out loud. But, it turned out, Johnson had a lot to express, mostly about life’s contradictions. Love and hate, war and peace, apathy and action. These polarizing ideas became the stuff of inspiration. Plus, swirling colors along a canvas was surprisingly meditative.

Years later, he displayed his work in the Wisconsin Veterans Museum in Madison.

“One of the biggest things for people struggling with mental health is trying something new,” Johnson said. “It’s so simple: Try something new. It’s three words, but it’s huge in our lives.”

Industry shortage

If Johnson’s experience is any indication, humans can hold on to their mental health conditions for the better part of their lives without seeking help. According to Substance Abuse and Mental Health Services Administration, older adults are at least 40% less likely to seek out or receive mental health services than younger individuals.

Endicott, from UW-Madison, isn’t surprised by this. Young people are far more attuned to the signs and symptoms of depression. Older adults tend to avoid mental health terms.

“They don’t use that term, either because of stigma or they don’t recognize it. They don’t say things like ‘I’m in a low mood’ or ‘I’m depressed.’ It might come out more as irritability, lack of energy, not getting engaged in things,” Endicott said.

But it’s also the case that very few geriatric psychiatrists exist to help older adults understand this language, Endicott and Robbins both said. There’s not a lot of incentive to enter the field, Robbins said. You have to be comfortable with medicine, psychiatry and neurology, Robbins said, especially with regard to the prescription side of psychiatry. In addition, geriatrics is not a very lucrative job because “it’s pretty much a Medicare-focused practice,” Robbins said.

As it stands, there’s already a shortage of physicians in psychiatry. Around 3% of all physicians in psychiatry specialize in geriatrics, Endicott said. Put another way, for all the geriatric psychiatrists in Wisconsin, each of them would have to have 20,000 patients, Endicott said.

The good news, Robbins said, is that a majority of older adults are quite content with where they are in life. They don’t have the same worries for the future that people in their 20s, 30s and 40s have.

Today, Johnson makes things at his home. He keeps himself busy through pursuit of creative practice. He likes to make birdhouses, which he gives away to his friends and neighbors.

Johnson doesn’t have all the answers, but he’s learned the importance of connection, a struggle that so many older adults face.

“I always tell people: You are who you hang with. In today’s world, we can be a whole lot more healthier if we have friendships that are diverse, who can help us try something new,” Johnson said. “I’d say get yourself in alongside other people who maybe you don’t know, people who’ve experienced trauma. To me, it’s been the best thing.”

Where and how to get help

Endicott said family can be an extremely important resource for older adults. Her advice, and this isn’t exclusive to older adults, is to always check in and be direct if you notice a family member withdrawing. It’s especially vital for older adults, who may not volunteer when they’re having a mental health struggle, Endicott said.

“It’s about people being proactive, being direct, showing up more, not being afraid to say, ‘I’m worried about you,’ and being a good listener,” Endicott said. “You don’t have to be a mental health professional to really help people just by listening well.”

In addition to family support, experts recommend other resources for older adults who are struggling with their mental health:

● Find the local Aging and Disability Resource Center. The ADRC has information about a variety of services and programs, including wellness programs and long-term counseling.

● The National Alliance on Mental Illness offers peer-support groups to anybody struggling with mental illness or a loved one’s mental illness. Find a local chapter.

● The Institute of Aging has a Friendship Line, available to anybody who feels alone, isolated or depressed. It also has a service for elder suicide prevention and grief support. The toll-free number is 888-670-1360.