In December 2011, a therapist asked our daughters, who were suffering from debilitating separation anxiety, to draw a picture of how they thought their dad was injured. We had always spared them specifics in hopes of protecting them. Now we learned they had filled in their own dramatic and disturbing details. I nearly broke down as my sweet little girls colored scenes of violence, blood and gore. It was no wonder they brimmed with stress. But our oldest son felt the impact the most. When he reached his teenage years, I leaned on him to watch his three younger siblings, so I could leave the house for errands. I quickly realized the responsibility was too much for him to handle. Our son grew hypersensitive to Chuck’s moods, desperately trying to keep the younger kids quiet so they didn’t trigger their father. If Chuck became agitated, our son would do his best to distract his siblings or move them to another part of the house. Even if my husband had a good day, our son couldn’t shake the anxiety that the mood in the house might swing at any moment. The kids couldn’t simply leave the house; Chuck occasionally struggles with the simplest daily tasks, such as remembering to eat and preparing his food. My son was terrified his dad would get lost or hurt himself while he was on caregiver duty.

I watched as secondary post-traumatic stress overtook our son. He began to display many of the same symptoms as Chuck, becoming irritable, sullen and quick to anger. He was chronically late to school because panic attacks would keep him locked in the bathroom. Like his father, he complained of headaches and fatigue and wanted to stay in bed all day. When I told him he had to go to school, he resented it. He didn’t understand why he was being forced to power through things.

At 12 years old, our son reached a dangerous phase. I’d find him sitting quietly with the chilling thousand-yard stare that I recognized from my husband. He began to see how close he could get to committing suicide without actually doing it. He stood near balconies and ledges, looking over the edge in a trance. I remember grabbing him by the shoulders once, pleading with him to let go of the responsibility he felt to help me care for his dad. I begged him to have fun and enjoy all the good times and mischief that come with being a teenager. But he couldn’t shake the chronic nervousness and dread. The afternoon that I listened outside my son’s bedroom door, I waited to hear any signs of the anger he’d just shown, but there was only silence. I forced my way in and found him semiconscious on the floor — a dog leash that he had wrapped around his neck was still hanging from the top bunk. The feeling of suffocating and knowing that he was about to die saved his life. He had the strength to break free from the noose, but collapsed afterward.

Some people are surprised that Chuck’s injuries would cause such problems for our family, particularly because his wounds aren’t as apparent as severe burns or lost limbs. At parties, friends will casually say, “He seems fine to me,” not knowing that the exhaustion of socializing will keep him in bed for the next two days. Loved ones get angry when we arrive late for dinner, calling us inconsiderate rather than understanding how hard it is to get a family of six out the door when your husband constantly battles dizzy spells and struggles to keep track of time. Teachers are quick to label our kids’ outbursts at school as poor behavior, not knowing how nervous they were that their dad had to go to the neurologist again to figure out why he was losing consciousness during conversations. In many ways, Chuck’s injuries are even harder on our children than on him. Our kids don’t understand why their mom and dad don’t have a typical husband-wife relationship. They become frustrated when family outings are canceled at the last minute, or when their dad misses another event. And because they can’t see their father’s injuries, the details of what happened to him are supplied by their imaginations.