Many active military personnel and veterans experience some mental health conditions that tend to disproportionately affect military personnel. These conditions may include posttraumatic stress disorder (PTSD), depression, anxiety, traumatic brain injury (TBI), and substance abuse, among other issues. Due to the traumatic environment in which active military combatants serve, combat veterans in particular are at a significantly higher risk for developing these health concerns. These concerns can often be addressed and resolved with the support of a mental health professional.
PTSD in Veterans
Posttraumatic stress can develop after an individual is exposed to a traumatic or overwhelming life experience. While many military members return to baseline levels after experiencing undue stressful events, many experience trauma-related symptoms. Posttraumatic stress is characterized by four basic types of symptoms:
- Reliving the event
- Negative thoughts, moods, or feelings
Combat veterans have a much higher prevalence of PTSD than civilians. In the United States 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 on an annual basis. The lifetime prevalence of PTSD for Vietnam veterans is 30%.
Military personnel are 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 incident may be enough for PTSD to develop, but combat often facilitates prolonged and repeated exposure to traumatic events, making such individuals at higher risk for PTSD.
Sexual Abuse in the Military
The United States Department of Veteran Affairs (VA) defines military sexual trauma (MST), as sexual harassment that is threatening, or sexual assault that occurred while the victim was in the military, regardless of victims’ gender or relationship to perpetrators. This is now regarded as a significant and pervasive concern in the military.
Research reveals that approximately 1% of US veteran males (32,000 men) and 22% of veteran females (23,000 women) are exposed to sexual assault or repeated sexual harassment during their military service. Between 10% and 33% of servicewomen may experience attempted rape during this time period. The prevalence rates of MST may range from 3% to as high as 71% based on the method of data collection and the definition of MST used.
A variety of emotional, behavioral, physical, and mental health issues that have been linked to MST. Primary among these issues are depression, posttraumatic stress, anxiety, substance use, and an increased risk of suicide. A high percentage of female veterans who experience MST eventually develop posttraumatic stress, with a rate of approximately three times higher than their male counterpart in similar circumstances. Of servicewomen who develop PTSD due to military sexual trauma, an estimated 75% develop co-occurring depression, and over 30% may develop anxiety.
Servicemen who experience posttraumatic stress due to exposure to military sexual trauma are more likely to abuse alcohol, drugs, and other substances than servicewomen who have experienced similar trauma. A study involving more than 2300 male and female military personnel who served in OEF/OIF revealed sexual harassment as the identified stressor independently linked to suicidal ideation especially among female veterans.
Depression and Anxiety in Veterans
Mental health conditions that adversely affect mood, such as depression and anxiety, are also prevalent among military veterans—and veterans may experience these issues for many different reasons. Factors such as poor 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 is able to 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.
There are other factors which may also play a role in developing negative thought patterns. For example, the grief of losing one’s friends and acquaintances during combat, coupled with feelings of survivor’s guilt can lead to the development of depression and anxiety if they are not effectively 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 symptoms of the condition. 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 traumatic brain injury may become confused, disoriented, experience slow or delayed thinking, and may 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 posttraumatic stress, depression, anxiety, and traumatic brain injury are at the forefront of most people’s minds when it comes to veteran care, there are other mental health conditions that warrant attention. Active military personnel and veterans can experience almost an syndromes found in general population. Psychological struggles that these individuals experience include:
- Drug and alcohol abuse
- Suicidal ideation
- Anger issues
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 take all symptoms and life experiences into consideration before making a diagnosis or starting treatment.
Intervention for Active Military Personnel and Veterans
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 a variety of 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 psychiatric and other health care providers. These medications can address depression and anxiety issues, reduce irritability, improve sleep patterns, and help to ease nightmares or intrusive thoughts.
While the use of medications is common in treating depression, and anxiety, and other psychiatric disorders, talk therapies can also be very beneficial. For example, cognitive behavioral therapy,therapy can help affected veterans reduce emotional pain and reestablish positive social relationships. Certain Professionals also use other forms of ttherapeutic interventionherapies may also be used to promote positive thought patterns and behaviors in veterans experiencing mental health issues.
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. Common 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 Intervention for Military Families
Military life and deployment can take a toll on each member in 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 on a daily basis. 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 or 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, the initial joy might give way to feelings of frustration as issues associated with reintegration arise. The returning parent may have experienced personality changes or developed mental or physical health concerns. Children may have been born or reached a different stage of development, and marital bonds may have weakened. The need to readjust to new roles within the family system may lead to increased tension between family members.
Although 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 combat veterans who have a mental health concern, approximately 60% do not seek assistance from a mental health professional. Furthermore, 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 a number of 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
- Belief that friends and family are able to provide all needed care
- Lack of knowledge of available mental health resources
- Lack of knowledge in how to access available mental health care
MentalVerdure.com provides psychological therapeutic intervention to military families leading up to, during, and after deployment. Our family therapy programs help parents explain the deployment process to young children, and we provide support to help returning veterans and their family members go through the reintegration process with as few pro as possible. At present, the VA has identified six key ways to assist military families, and MentalVerdure.com’s social services professional will work with the VA to support our veterans with the following:
- 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