Not Just BBQs and Parades: Memorial Day Can Be Painful

This post was written by Carla Schnitzlein, D.O., a member of the Committee on Military and Veterans at the Group for the Advancement of Psychiatry, and Jonah Cremin-Endes, Fourth Year Student, Netter School of Medicine and Navy Health Professions Scholarship Program Scholar.

"Days like these are hard for me. I just keep thinking about my friends who didn't make it." This sentiment was made by a Battle Buddy at a Memorial Day gathering.

Once a year, America pauses to celebrate Memorial Day and those who gave their lives in service. However, what might this day evoke for those service members, veterans, and family members left behind?

For many, Memorial Day is only about barbeques and parades, a time of festive celebration. In the Hamptons, for example, Memorial Day weekend signals the start of the busy summer social season. Its origins, however, are much more profound, as are many of the day's meanings.

History

Memorial Day was first celebrated nationally on May 30, 1868, after Major General John Logan issued General Order No. 11, establishing a day to honor soldiers who died during the Civil War. The "Memorial Day Order" called for the decoration of graves with flowers—in fact, the holiday was called Decoration Day until 1971.

The order stated that no specific form of ceremony was mandated. Instead, it focused on cherishing the memory of those lost.

Anniversary Reactions

Yet, while many Americans mark this day of remembrance as the kickoff to their summer, it is important to remember that such commemorations may trigger difficult memories and feelings for service members and veterans who lost battle buddies and shipmates while in combat or, later, to suicide. Family members and loved ones may also be affected. Days of remembrance like this can trigger anniversary reactions, some of which can be quite intense.

For example, some people may experience symptoms of post-traumatic stress disorder (PTSD), such as irritability, sleep disturbance, intrusive memories, and over-reactivity to war-related events and reminders. Because those diagnosed with PTSD are especially sensitive to anniversaries—and may not, of their own accord, always make connections between the calendar and their level of distress—it is important for clinicians, family members, and friends to anticipate such moments and be prepared to respond with understanding and support.

Consider the case of a Sergeant First Class (SFC) who lost most of his comrades in an ambush in Iraq. In the course of his treatment, he revealed that in the week leading up to the anniversary of that event, he would experience worsening nightmares, anger outbursts, and even thoughts of suicide.

"Doc," he told his psychiatrist, "I don't know why I'm still here. Almost everyone I knew then is gone now—either in the blast, or they killed themselves."

However, knowing that he struggled with these responses on an annual basis created opportunities for both safety planning and continued processing of his grief. Knowing about anniversary reactions also allowed his treatment team and his family to better understand what previously had been a puzzling pattern of symptoms and to become more effective in responding to them.

Guilt

A particularly important response to consider is the lingering sense of guilt among many survivors of combat. Guilt may represent the belief that some action taken (or not taken) led to a tragic outcome. This is illustrated by the case of a veteran reflecting on their loss of battle buddies to an improvised explosive device (IED):

"I was supposed to be on that deployment, but at the last moment, I got hurt and couldn't go. I trained with those guys. We knew how to watch out for each other. I just keep thinking that if only I had been there, I would have spotted the IED." Many struggle with this kind of survivor's guilt, asking themselves the anguished question, "Why am I still here when they are not?"

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There is much work to be done to support our service members, veterans, and those who care about them and for them. As 16 to 17 veterans continue to die by suicide every day, it is essential to recognize the complex meaning of Memorial Day while we honor and remember those who have survived, as well as those who made the ultimate sacrifice for our nation.

If you or someone you know is struggling or in crisis this Memorial Day, help is available. Call or text 988 or chat at 988lifeline.org. To find a therapist near you, visit the Psychology Today Therapy Directory.