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Helping veterans cope with life after a bipolar diagnosis

ARI SHAPIRO, HOST:

Bipolar disorder has less stigma than it used to, as celebrities and politicians have spoken about their struggles with mental illness. That list of public figures now includes a retired two-star general who led troops in combat. And he's on a mission to let veterans know there is life after a bipolar diagnosis. NPR's Quil Lawrence reports.

QUIL LAWRENCE, BYLINE: One of the biggest problems for General Gregg Martin was that bipolar disorder seemed to help him at first.

GREGG MARTIN: I was manic most of the year in Iraq - felt like Superman, bulletproof, pretty much fearless, all over the battlefield.

LAWRENCE: Martin deployed to Iraq in 2003 as a colonel in charge of an engineer brigade that paved the way from Kuwait to Baghdad. He led from the front aggressively and got almost nothing but praise.

MARTIN: That's what the army and other services - they want that. They prize it. They reward it. So it actually - the fact that I had a bipolar brain was a huge benefit for me.

LAWRENCE: He pushed his troops with relentless positivity. He favored intense workouts over sleep. His mania fit right in with the American military mystique.

MARTIN: And I thought that, you know, God was really rewarding me and giving me this strength and motivation and energy because I was on kind of a divine mission as an Army officer. So it never occurred to me that there's something wrong with my brain.

LAWRENCE: When deployment ended and Martin went home, he felt despondent. Martin says he told the nurse at a post-deployment health screening he was depressed.

MARTIN: They said, what do you do to take care of yourself, then, with this condition? I said, well, I do lots of really intense physical activity even though it's hard to do because I'm depressed. I listen to really intense rock 'n' roll music. I do - I repeat, you know, power verses from the Bible. And when that doesn't work, I drink. And, you know, I drink a lot - way more than I ever have in my life. And they said, well, that's - you know, you're fine. There's nothing wrong with you.

LAWRENCE: Nothing wrong. This was 20 years ago, and the military has made a lot of changes around mental health. But troops may still be reluctant to open up, fearing it'll hurt their careers. That's one reason Martin has written a memoir called "Bipolar General: My Forever War With Mental Illness." Experts in the field credit Martin with helping break down the military taboo on getting care.

ALEX LEOW: Some people tend to associate mental illnesses with a sign of weakness, right? So if you are in the military, you are supposed to project this tough image.

LAWRENCE: Dr. Alex Leow met General Martin when he gave the keynote speech at a medical conference. Dr. Leow is a Ph.D., MD, psychiatrist and bioengineer who treats and studies bipolar. And she says people on the bipolar spectrum are often attracted by the way a military career rewards aggressive, daring behavior. But the intensity of war can ignite severe symptoms.

LEOW: It is almost like a double-whammy effect. You know, you are attracting more people on the spectrum into the military but also, because of the stress, because of the combat experiences, also more likely to trigger their bipolar symptoms.

LAWRENCE: Which Martin says happened to him. Iraq triggered intense cycles from mania to depression. And it didn't stop there. Back in the U.S., he kept getting promoted. He took command of the U.S. Army War College in 2010 in the grip of delusions.

MARTIN: My bipolar disorder had increased significantly since Iraq. And now it was pouring gasoline on the flames of a very sick brain. I was the smartest person in the world. I believed that I was an apostle sent by God to transform the entire Department of Defense.

LAWRENCE: In 2012, Martin became president of the National Defense University, NDU. But his extreme behavior was finally raising flags. He'd stride into a random classroom and just start lecturing.

MARTIN: One of the NDU colleges actually took to posting, like, a sentry or a guard outside the door. And if I came into - if I was coming into the building, he was to notify the commandant immediately so he could take charge of me and divert me from going into a lecture hall. I mean, that's how bad it was.

LAWRENCE: In 2014, he was summoned, along with his wife by the chairman of the Joint Chiefs, General Martin Dempsey. Dempsey was a friend. They'd worked together in Iraq and Germany. In fact, Dempsey was the one who had picked Gregg Martin to lead NDU.

MARTIN: And then General Dempsey - he said - he walked across the office, gave me a big hug, said, Gregg, I love you like a brother. You've done an unbelievable job. You have until 1700 hours today to resign, or I will fire you. And I'm ordering you to get a mental health evaluation this week at Walter Reed.

LAWRENCE: His 36-year Army career was ending. But it still took two years of what Martin calls untreated bipolar hell to get well, falling into the gap between military healthcare and the Veterans Health Administration. At the VA in New Hampshire, he finally got prescribed medications to treat his mania and depression. And that's the good news. Bipolar is treatable.

TAMARA CAMPBELL: People go on to live very productive, high-quality lives being treated for bipolar.

LAWRENCE: Dr. Tamara Campbell directs the VA's Office of Mental Health and Suicide Prevention.

CAMPBELL: And we will meet you wherever you are. There is no reason for anyone in the country to suffer alone. And we want to treat you. We're here for you.

LAWRENCE: The VA now treats over 130,000 vets per year for bipolar disorder. And since last year, a vet in crisis can get emergency care at any VA or non-VA facility free of charge. VA has increased its mental health staff by 54% in the past five years. But demand for mental health care is surging nationwide, and that means waiting about a month for a VA appointment or nearly two months for private health care. Still, Dr. Campbell says the sooner vets get treated for bipolar, the better. And she thinks General Martin's willingness to speak publicly will help bring more people in. Martin knows that when his military career ended, he was in the grip of delusions. But one of them, he believes, has turned out to be true.

MARTIN: God put me here to do big things. Nine years later, that's actually true because what I'm doing in terms of mental health advocacy and telling my bipolar story is the most important thing I've ever done in my life.

LAWRENCE: When he's done, Martin says, more civilians and veterans will see bipolar disorder like diabetes or heart disease - as an illness with a treatment and no shame.

Quil Lawrence, NPR News.

(SOUNDBITE OF MNELIA SONG, "CLOSURE") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.
Walter Ray Watson is a senior producer for NPR News.