The guest columnists write that we have to do more to prepare soldiers and marines for the mental trauma of combat. ©LUIS SINCO

I have often said that some of the deepest scars don’t bleed. They are carried silently — in the minds, hearts and souls of those who have given everything in service. These invisible wounds — of trauma, moral injury, depression and spiritual collapse — are every bit as real as the physical ones, and often far more enduring.

I spent my life in uniform. I commanded soldiers across continents, led in combat and reached the high echelons of military leadership. On the outside, I embodied success and strength. But on the inside, I was unraveling.

What I didn’t know was that I had Bipolar I Disorder — a genetic, biological illness that had been quietly smoldering for decades. During the Iraq War, the stress, sleep deprivation and relentless tempo of combat “triggered my genetic predisposition,” as I’ve explained before. My highs became euphoric, grandiose and unhinged. My lows were black, crushing and suicidal. I was doing great in the Army — until I wasn’t.

Eventually, I lost my position, my reputation and nearly my life. But I was blessed to find my way to the White River Junction VA Medical Center in Vermont, where an extraordinary multidisciplinary team surrounded me with compassion, skill and hope.

They didn’t just treat me — they saw me. The psychiatrists, therapists, nurses, social workers and chaplains formed a circle of care that helped rebuild me from the inside out.

“I decided that I would OWN my condition and not be embarrassed, ashamed or stigmatized,” I’ve written. And that’s exactly what I did. Through medication, therapy, faith and purpose, I began my climb back toward life.

Healing powers

When I first heard Gregg’s story, I was struck by how closely his journey mirrored what I see in clinical practice every day: People who have given everything of themselves — mind, body and spirit — and are left shattered by invisible wounds that medicine alone cannot heal.

As a psychologist and integrative-medicine provider, I’ve learned that true recovery must engage the whole human system. Healing accelerates when we address the mind and the nervous system, the emotions and the spirit, together. Compassion is not a “soft” intervention; it is a physiological one. It regulates the heart, steadies the breath, and reawakens the sense of safety necessary for neural repair.

But the deeper question is this: How do we prepare soldiers beforehand? How can we strengthen them emotionally, physically and spiritually before they face the horrors of war? Because the truth is, no one walks through combat unchanged.

Yet we can fortify the mind, body and spirit in advance — helping soldiers process and integrate trauma rather than be consumed by it. When the nervous system has been trained to regulate stress, the mind to recognize and reframe fear, and the spirit to stay anchored in meaning, trauma can be metabolized instead of stored. This preparation doesn’t prevent pain, but it transforms how the body and brain experience it — allowing soldiers to absorb, adapt and heal rather than drown in it.

Building the armor

Gregg and I both believe that prevention begins with resilience training that is physical, emotional and spiritual. As Gregg has written, “Building resilience and mental, emotional, spiritual and physical toughness are key to protecting the soldier — a form of armor.”

We spend months hardening soldiers’ bodies for combat, but not nearly enough time strengthening their inner architecture. Mindfulness, guided imagery, breath regulation, gratitude practice, faith development and psychoeducation on trauma responses can form a kind of psychophysiological armor — flexible, protective and lifesaving.

“It’s physiologically real,” Gregg reminds us, “just like diabetes, cancer or heart disease. It’s not due to a lack of character or moral failing.”

That truth alone can lift the burden of shame that keeps so many veterans suffering in silence.

Restoring the spirit

When the battlefield is behind us, the real journey begins. It’s not about returning to who we were before; it’s about becoming someone wiser, more compassionate and more deeply human.

Gregg’s story is living proof that rebirth is possible. Through treatment, faith and the fierce grace of community, he has found peace and purpose again. His new mission is to bring hope to others who stand where he once stood, in the ruins of a life that once made sense.

“Maintain an attitude of gratitude at all times,” Gregg likes to say. Gratitude, he explains, is what turned his ashes into soil for something new to grow.

As I often tell my clients, healing begins when a veteran feels seen — body, mind and soul. That is when the nervous system exhales. That is when the armor becomes wisdom and the wound becomes light.

Shared call to action

Together, we believe that invisible wounds demand visible compassion. Medicine and spirituality must not work in parallel; they must work in partnership.

For clinicians, that means expanding treatment to include meaning-making, moral repair and psycho-spiritual resilience. For spiritual professionals, it means understanding the neurobiology of trauma and the physiology of faith.

The next generation of veteran care must integrate both. Healing the invisible requires us to see the whole person.

And when we do — when science and spirit join hands — lives are not only saved; they are transformed.

Major General Gregg F. Martin, U.S. Army (Ret.) is a decorated combat veteran, engineer and former president of the National Defense University. He is the author of Bipolar General: My Forever War with Mental Illness (2023).

Dr. Mary Macedonio is a clinical psychologist, integrative medicine provider, coach and minister. Her work bridges neuroscience, psychology and spirituality to help individuals transform pain into purpose and trauma into growth.