Updated: May 13
Many military veterans experience a group of mental health conditions that tend to affect military personnel and their families disproportionately. These conditions may include posttraumatic stress (PTSD), depression, anxiety, traumatic brain injury (TBI), and substance abuse, among many other issues. Due to the traumatic environment in which active military combatants serve, veterans are at a significantly higher risk of developing these health concerns. These concerns can often be addressed and resolved with the support of mental health professionals.
PTSD In Veterans
Posttraumatic stress is an anxiety issue that may develop after an individual has been exposed to a traumatic or overwhelming life experience. While the human body tends to return to baseline levels after experiencing a stressful event, people experiencing PTSD continue to release stress-related hormones and chemicals. Four basic types of symptoms characterize posttraumatic stress:
1. Reliving the event:
· Repeatedly experiencing the event in flashbacks
· Having intrusive, repeated, and upsetting memories of the event
· Regularly having nightmares about the event
· Having intense and discomforting reactions to objects or situations that remind you of the event
· Staying away from people, places, or even thoughts that remind you of the event
· Emotional numbness
· Feelings of detachment
· Memory problems
· Loss of interest in everyday activities
· Being emotionally guarded
· Feelings of hopelessness
· Continually scanning the surroundings for any signs of danger
· Problems concentrating
· Increased irritability
· Being easily startled
· Erratic sleep patterns
4. Negative thoughts, moods, or feelings:
· Feeling guilty about the event
· Criticizing or blaming other individuals for the event
· Loss of interest in activities and people
Though traumatic incidents - such as participating in combat, experiencing sexual abuse, or having a car accident—must occur for a person to develop PTSD, not all traumatic experiences result in posttraumatic stress. Only a small percentage of people who go through trauma experience PTSD. The lifetime prevalence of PTSD among American women is 10%, while only 4% of American men will experience PTSD at some point during their life.
American combat veterans have a much higher prevalence of PTSD than American civilians. Between 11-20% of veterans from Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) experience posttraumatic stress in a given year. Approximately 12% of Gulf War (Desert Storm) veterans and 15% of Vietnam veterans are affected by PTSD annually. The lifetime prevalence of PTSD for Vietnam veterans is 30%.
Military personnel is at higher risk for developing posttraumatic stress because service members are intimately involved in wartime incidents that may be frightening, horrifying, and at times, life-threatening. One emotionally overwhelming episode may be enough for PTSD to develop, but combat often facilitates prolonged and repeated exposure to traumatic events.
Depression And Anxiety In Veterans
Mental health conditions that adversely affect moods, such as depression and anxiety, are also prevalent among military veterans - and veterans may experience these issues for many different reasons. Factors such as reduced health (physical and mental), unemployment, and financial difficulties can contribute to negative thoughts and moods.
Upon returning home, some veterans report feeling disconnected from family members and friends. The belief that no one can relate to their experiences or offer meaningful emotional support can prompt service members to bottle up their feelings or even seek social isolation. Such actions, though, may only serve to exacerbate the situation.
Other factors may also play a role in developing negative thought patterns. For example, the grief of losing one's friends during combat, coupled with feelings of survivor's guilt, can lead to the development of depression and anxiety if they are not adequately treated.
Traumatic Brain Injury (TBI) And Veterans
Traumatic brain injury is currently one of the most discussed topics in the medical and mental health communities, as many veterans have returned home with the condition's symptoms. It has even been called a "signature injury" of Operations Iraqi Freedom and Enduring Freedom. Traumatic brain injury may be caused by a blow to the head, the head striking an object, or by an explosion in close proximity.
People who experience a brain injury may become confused, disoriented, experience slow or delayed thinking, and even slip into a coma. Memory loss of events preceding and immediately following the injury is also common. Other symptoms associated with TBI are headaches, dizziness, and difficulty paying attention. In some cases, traumatic brain injury can result in physical deficits, behavioral changes, emotional deficiencies, and loss of cognitive ability.
In the most recent conflicts in Afghanistan and Iraq, 78% of all combat injuries are caused by explosive munitions. Mild TBI or concussion is one of the most prevalent combat injuries, affecting roughly 15% of all active military combatants in Iraq and Afghanistan. Due to the devastating effect of roadside bombs in these countries, the ability to effectively treat traumatic brain injury is of great importance in veteran care.
Other Mental Health Issues Experienced By Veterans
While post traumatic stress, depression, anxiety, and traumatic brain injury are at the forefront of most people's minds regarding veteran care, there are other mental health conditions that warrant attention. These include:
· Drug and alcohol abuse
· Suicidal ideation
· Anger issues
· Sleep apnea
An individual who serves in the military will not necessarily develop a mental health condition. Further, a mental health concern experienced by a veteran may have no relation to the veteran's military service. Mental health professionals who work with veterans will typically assess each person individually and consider all symptoms and life experiences before making a diagnosis or starting treatment.
Therapy For Military And Veterans Issues
The U.S. Department of Veterans Affairs (VA) provides a wide range of mental health services and treatments to aid military veterans. Treatments may be given in various settings: short-term inpatient care, outpatient care in a psychosocial rehabilitation and recovery center (PRRC), or residential care.
For veterans experiencing posttraumatic stress, antidepressant, anti-anxiety, and mood-stabilizing drugs may be prescribed by a doctor or psychiatrist. These medications can address depression and anxiety issues, reduce irritability, improve sleep patterns, and ease nightmares or intrusive thoughts.
While the use of mood-influencing medications is particularly common in treating depression and anxiety, talk therapies can also be very beneficial. For example, cognitive behavioral therapy, acceptance and commitment therapy (ACT), and interpersonal therapy (IPT) can help veterans reduce emotional pain and re-establish positive social relationships. Certain types of treatments--such as cognitive processing therapy (CPT) or prolonged exposure therapy (PE)--may also be used to promote positive thought patterns and behaviors in veterans experiencing mental health issues. Medical guidelines strongly recommend both CBT and PE for the treatment of posttraumatic stress. Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs), established by the VA, provide a 24/7 health care setting for veterans with PTSD.
Veterans with traumatic brain injury may experience a variety of mental health issues. Different therapeutic strategies may be applied, depending on which areas of a person's functioning are affected. Conventional treatments for TBIs include rehabilitation therapies (for example, speech-language therapy), medication, assistive devices, and learning strategies to address cognitive, emotional, and behavioral deficits.
Support And Therapy For Military Families
Military life and deployment can take a toll on each member of the family system. Children and teenagers may become irritable or rebellious, and the parent at home may have to cope with the increased burden of caring for the family alone daily. Deployment can lead family members to feel anxious, alone, or unsupported. Military families also have to face the possibility that the deployed family member may return seriously injured or may not return at all. A family who is out of touch with extended family members of the military community may be more likely to experience increased stress during this period.
While happiness and relief may often be experienced when a deployed family member returns home, initial joy might give way to feelings of frustration as issues associated with reintegration increase. The returning parent may experience personality changes or developed mental or physical health concerns, children may have been born or developed to different stages in life, and marital bonds may have been weakened. The need to readjust to new roles within the family system may increase tension between family members.
Many resources are available for military families leading up to and during deployment. Family therapy programs help parents explain the deployment process to young children, while support programs are in place to help returning veterans and their family members go through the reintegration process with as few issues as possible. At present, the VA has identified six key ways to assist military families:
· Increase behavioral health care services
· Promote awareness that psychological health is as important as physical health
· Promote housing security for veterans and military families
· Increase opportunities for federal careers
· Increase opportunities for private-sector careers
· Provide more opportunities for educational advancement
Unused Resources Available To Veterans
Though the United States Department of Veteran Affairs (VA) has expanded its mental health services and integrated supplementary programs for the benefit of veterans who are experiencing mental health issues, a significant proportion of these services remain unused. Of all army veterans who have a mental health concern, approximately 60% do not seek assistance from a mental health professional. Studies indicate that roughly 70% of veterans with posttraumatic stress or depression do not seek help.
Surveys conducted among veterans experiencing mental health challenges have highlighted several reasons for the under-utilization of available resources. Common responses include:
· Fear of being stigmatized within the military community
· Fear of confronting trauma
· Constrained access to care (due to location or wait time)
· Lack of expertise among available mental health care providers
· The belief that friends and family can provide all needed care
· Lack of knowledge of available mental health resources
· Lack of knowledge of how to access possible mental health care
Don't allow these reasons to prevent you or a veteran you know from seeking help.
So, hopefully, this information has helped improve your knowledge of the mental health issues that veterans face daily. A little knowledge can help a veteran in need. Please keep an eye out for your fellow veterans out there. It can be trauma from the combat zone that causes these issues, and a friend can help them get through them.
Good Therapy (2019). Military and Veterans Issues. Retrieved from https://www.goodtherapy.org/learn-about-therapy/issues/veterans-mental-health-issues
Image provided by Shane, L. (2018). Studies show shortfalls in veterans' mental health care needs. Retrieved from https://www.militarytimes.com/veterans/2018/02/01/studies-show-shortfalls-in-veterans-mental-health-care-needs/