BOISE — In July 2009, George Nickel found himself on the other side of a gun pointed at Boise police officers.
Minutes before, he noticed his dog missing from his Vista apartment. The Army veteran suited up in tactical gear, loaded a pistol, strapped an AR-15 rifle onto his back and began shooting locks and kicking open doors — demanding his dog be returned.
It wasn't long before Boise police officers arrived at the scene and fired over a dozen rounds back in his direction. The alcohol-induced actions led to eight months in Ada County jail and medical treatment for a diagnosis of post-traumatic stress disorder and a traumatic brain injury.
The events stemmed from a day in February 2007, when Nickel was on patrol for roadside bombs in Iraq, and his vehicle was hit with an explosive. After months in medical care, he tried to re-enter service but was unable.
“That’s when it all started,” he said. “I spent 2008 in a downward spiral, leading up to the standoff.”
The standoff would eventually lead to a partnership between Boise law enforcement and veterans to reduce risk of similar instances in the future.
Now, a decade later, Nickel works as the director of student and veteran affairs for the Wyakin Foundation — a Boise-based nonprofit that focuses on helping veterans pursue education and transition back into civilian life — after having gone through the program himself.
Looking back, he can point to the signs of post-traumatic stress he couldn’t identify at the time.
“One of the symptoms is irritability,” said Nickel, “but many people don’t understand it’s a lot of anger.”
For Nickel, he couldn’t enjoy daily life and lacked motivation, he said. He couldn’t get himself out of his house.
Those living with PTSD can be prone to avoidance as a coping method, said Dr. Caroll Berndt, associate chief of staff for Behavioral Health at the Boise VA Medical Center. Often, other disorders such as depression, anxiety, insomnia and substance abuse go hand in hand with PTSD.
“A lot of times, veterans who have PTSD want to feel better, but they don’t want to talk about the trauma,” she said.
After Nickel was released from jail, he went through the Boise VA Medical Center’s six-week intensive inpatient program, with a focus on cognitive processing therapy — recounting what he remembered and identifying what he misremembered.
In fiscal year 2018, the Boise VA admitted 38 veterans into this six-week inpatient program.
“Memories are stored and triggered in all of our senses,” said Berndt. “Smell, taste and sound are extremely evocative for veterans with PTSD.”
Seeing trash on the side of the road gave Nickel anxiety attacks. He felt claustrophobic in his own car. His fixated on memories from Iraq, unable to focus on anything else. His symptoms of PTSD, unknown to him at the time, caused him to self-medicate with drinking, he said.
But none of the symptoms Nickel experienced in 2008 pushed him toward seeking medical assistance himself.
“Isolation will kill you,” he said.
Josh Callihan, veteran and public affairs officer at the Boise VA Medical Center, speculates the reason behind self-isolation for veterans suffering with mental health issues is the ingrained mindset of self-preservation and the idea that asking for help is a last resort.
“You could give cheeseburgers and $100 bills to these guys and they won’t show up for (help),” said Callihan.
Stigmas surrounding mental health issues after discharge seem to be lessening, said Callihan. The Boise VA Medical Center sees increasing need for services and is planning on expanding its behavioral health department that Berndt oversees.
But stigmas against veterans' suffering from post-traumatic stress in the civilian world remain an issue. Fear of outbursts, such as Nickel’s in 2009, often scare employers from hiring veterans, said Marv Hagedorn, chief administrator of the Idaho Division of Veteran Affairs.
“But this is not the case with all veterans,” said Hagedorn.
Recently, the medical center made the decision to start accepting individuals who were dishonorably discharged from the military, in hopes of combating rising suicide rates. Callihan and Berndt urge veterans to check their eligibility for service, because it may have changed.
Sometimes, Berndt said, outbursts that lead to dishonorable discharge can be caused by mental health issues.
For those experiencing similar symptoms that Nickel faced in 2008, he would tell them to put their ego aside.
“Accept the help that is offered,” Nickel said. “Even before the standoff, all the treatment was available to me. I wasn’t able to accept it at the time. I still had the mentality in my head that I would suck it up and help myself, and that’s not the case.”
Every second Thursday of each month, individuals embedded in the veteran community — from judges to law enforcement agents to medical providers to counselors — join the Boise Police Department at police headquarters to discuss issues and coordinate resources for service members.
The partnership, Joining Forces of the Treasure Valley, an initiative that grew from Nickel’s standoff with police in 2009, works together to improve the lives of Idaho veterans and their families.
“PTSD is never cured,” Berndt said. "It is managed.”
The Treasure Valley is home to an array of therapeutic activities outside of the traditional medical field aimed at combating post-traumatic stress disorder and other combat-related injuries. But often, organization leaders said, veterans may be unaware of resources available to them.
The Idaho Veterans Wellness Center — an arts therapy program organization — was founded in 2013 by retired psychiatrist Dr. Alex Bormann who worked at the Mountain Home Air Force Base from 2003 to 2006.
During an 18-month period of work, two of his patients killed themselves.
“The one issue is that some forms of PTSD present differently in different people,” Bormann said. “Standard therapies that are provided are often not effective in all patients.”
His organization provides sculpting, painting and other forms of artistic expression to get veterans together in a comfortable, hands-on environment.
“People often say about PTSD that trauma is locked in the body and it has to be physically expelled,” he said. “Talking doesn’t always do the trick.”
Ellen Burnell — who worked for 20 years at the Boise VA Medical Center teaching music therapy — runs Waves of Wellness in Eagle, connecting veterans who suffer from PTSD with music.
“Some songs are so conditioned in veterans,” said Burnell. “If they were in a tank and they played certain music, if you hear that song, you’re going to go right back to the battle field. If you hear that song and you’re out in the street, it’s going to be a trigger.”
Music, she said, helps people express themselves in ways they might not be able to voice.
Other alternative therapies in the Treasure Valley including scuba diving, equine therapy and kayaking and rafting programs.