The June 20 deaths of Nicholas Mavrakis III, his wife, Lesley, and their children, 13-year-old Ace and 5-year-old Pippa, unleashed an outpouring of grief in the family’s Jackson Township neighborhood and beyond.
The deaths, which police are investigating as a triple murder and suicide, also are raising questions about the potential role that post-traumatic stress disorder might have played.
Just 30 seconds into the 911 call placed by one of Lesley Mavrakis’ relatives that alerted emergency services to the deaths, the relative told dispatchers, “I know her husband has like PTSD from the military, and he’s been having some problems.”
Tony Mavrakis, Nicholas’s brother, later posted on Facebook that PTSD likely pushed Nicholas to kill his wife and children.
But what is PTSD? And is there a link between PTSD and violence? Can PTSD lead someone who has it to kill someone else?
PTSD 101
Craig Bryan, a professor of psychiatry at the Ohio State University who studies PTSD in veterans, thinks of PTSD as a psychological injury, not dissimilar to other injuries veterans might sustain in combat.
The disorder begins when someone undergoes a traumatic event, like the unexpected explosion of a landmine or IED.
Research has shown that such incidents can cause chemical and physical changes in two principal areas of the brain, Bryan said.
Specifically, traumatic events affect the amygdalae, two almond-shaped clusters in the center of the brain that govern fight or flight responses, emotional control and memory processing; and areas of the frontal cortex that deal with emotional control, motivation and reward systems.
Other areas of the brain that deal with memory also are affected.
Those seemingly minor brain changes can have serious effects on someone’s life. It is harder for people with PTSD to control impulses and emotions. Other symptoms include repeated nightmares and trouble sleeping.
According to the U.S. Department of Defense, Mavrakis served 20 years in the U.S. Army from April 1993 until July 2013. He retired as a staff sergeant.
He was deployed to Afghanistan from January 2002 to July 2002, a few months after the Sept. 11 attacks. He later served in Iraq – twice from February 2003 to February 2004 and September 2007 to November 2008.
Bryan, himself an Air Force veteran who served in the Iraq War, said people with PTSD are more likely to perceive that they are in danger or that someone is “out to get them.”
Trevor Meyer, 44, understands that mindset. His father, a Vietnam War Marine veteran, struggled with severe PTSD. As co-founder and CEO of Warrior Beat in Canton, Meyer works with veterans with severe PTSD nearly every day.
“You never go into that period where you feel relaxed or at ease or just enjoying the present moment, being able to go out to go grocery shopping or to a restaurant or to a movie without scanning for threats, without looking for potential combatants,” he said.
Sometimes the pressure that constant vigilance creates comes to the surface after a subtle trigger reminds someone with PTSD of the traumatic event they experienced. Other times, tension builds slowly, Meyer said.
Even when people with severe PTSD go to sleep, the anxiety and fear that dominates the day can return in nightmares.
Those with severe PTSD rarely sleep well and frequently are physically exhausted.
But it also isn’t limited to the military, as many people are likely to experience some significant trauma in their lives. The VA estimates that 7 or 8 out of every 100 people will have PTSD at some point.
Is there a link between PTSD and violence?
There is a consensus among researchers that a link between PTSD and violence exists, but how strong that association is remains less clear, Bryan said.
One thing is certain, the professor said: The vast majority of veterans are not violent.
Estimates for the share of Iraq and Afghanistan veterans who suffer from PTSD of any severity range between 11% and 20%, according to the Department of Veterans Affairs.
Even among the veterans who do suffer from PTSD, the likelihood they will be violent toward another person is low, Bryan said.
However, there is evidence to suggest that people who suffer from PTSD, whether a military veteran or anyone who has experienced a traumatic event, are more likely than those without the disorder to commit violence.
In a 2010 study based on questionnaire responses from more than 1,000 Marine veterans in San Diego, researchers found that veterans who reported symptoms of PTSD were six times more likely than those who did not report symptoms to exhibit anti-social behavior such as aggression or violence, even when controlling for other factors like age.
Because those who suffer from severe PTSD perceive the innocuous as threatening, have difficulty controlling impulses and are constantly fatigued, minor annoyances or disagreements can quickly escalate to violence, Bryan said.
Part of that response is training and experience in combat, Meyer said.
“It teaches us to stand and fight when sane people would turn and flee,” he said.
But Meyer and Bryan caution that PTSD is very unlikely to be a cause of a violent incident, just an escalatory factor.
There is some conflicting evidence on a direct link between PTSD and violence.
A 2014 study of about 1,100 veterans nationwide conducted by the VA and Duke University researchers found that veterans with PTSD and alcohol abuse problems were much more likely than those without both conditions to report committing acts of violence.
However, veterans with PTSD who did not abuse alcohol had rates of violence that were about the same as veterans without PTSD or an alcohol problem.
Though, many veterans with PTSD turn to alcohol, research shows.
PTSD also makes veterans more violent toward themselves. The changes in the brain caused by trauma lead to depression.
In 2018 in Ohio, the suicide rate among veterans was double the state average.
Is there a treatment?
Fortunately, there are a variety of methods to treat PTSD.
Bryan pointed to exposure therapy, which involves gradually exposing patients to situations that remind them of the traumatic event, and cognitive processing therapy, which involves teaching patients ways to think differently about the traumatic event.
Medications often are used in tandem with therapy.
Another method that sometimes accompanies traditional talk therapy and medication is art or music therapy.
That is what Meyer does every day at Warrior Beat. The organization specializes in drum therapy in which Meyer and other instructors organize drum circles, teach veterans and their families to play percussion and live stream performances all over the country.
Drumming helps people with PTSD get in tune with their body’s natural rhythms, like a heartbeat and breathing, allows for creative expression and it lets people relax and enjoy themselves.
“They’re able to express really deep painful emotion through the drum, get it out there in a safe environment where they know they are being heard,” Meyer said.
Another positive, he added, is that resources for veterans are abundant in Stark County whether it be from the local VA and the Vet Center in downtown Canton, veterans groups like Veterans in Recovery and options like equestrian therapy at Pegasus Farm or drum therapy at his own organization.
“If there is one thing I could share … with other veterans is that there is hope,” Meyer said. “Not only is there hope, but that hope will develop into success.”
Signs of PTSD
Trevor Meyer, co-founder and CEO of Warrior Beat in Canton, says the following are indicators that someone with PTSD is entering a crisis:
Withdraw from normal activities or pastimes Incidents of explosive anger or other extreme reactions Increase in alcohol or drug use
He also offers the following advice on what to do:
If you see the early signs of crisis, ask the person with PTSD if they are okay with questions like “I noticed you’re not yourself late, what can we do to help you?” but remember that “no one likes to be hounded,” Meyer said. If a situation seems to be escalating, call members of the person’s support system: friends, fellow veterans’ group members or therapists. Call the Veterans Crisis Line at 800-273-8255 (press 1) if the situation becomes very serious. If you fear imminent harm to yourself or others, call emergency services.
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