Veterans and Depression

Addressing the Problem

Table of Contents

There is an unfortunate link between veterans and depression. Over 1 in 10 male veterans are depressed. And, female veterans face an even higher rate of depression at 15%.

Considering the anxiety and depression rates among veterans, our hope today is to illustrate how you or a veteran you know can get help and start on the road to recovery and defeat depression.

Veterans and Depression

It can be difficult to determine the exact rate of depression among veterans, and much of the statistics we have are self-reported. However, we must look at the numbers presented and digest them as they are.

A 2008 study reported that as many as 20% of US veterans from the wars in Iraq and Afghanistan showed signs of PTSD or major depression. This number is even higher than those quoted above and is indeed troubling.

While we need more study into the specifics of what causes the waxing and waning of depression rates among veterans, it’s clear that many of our beloved soldiers need help. What is exceptionally worrisome is the military population is not one that tends to seek help.

There are a number of common reasons people choose not to seek help for mental illness.

We’re here to address the stigma against taking care of your mental health. It is of the utmost importance to you and the people you love.

Please take some time to consider the points below.

Embarrassment and Stigma

Soldiers tend to be tough of mind and body. It is the nature of their work and their training. And, there is often a tough-guy culture in the military of continuing on without complaint and hiding one’s discomfort or pain.

This combines poorly with the fact some people view mental illness as a sign of weakness or a moral failing of the person affected. This mindset can make getting help much more challenging.

Mental illnesses like depression are a disease that needs to be properly addressed and treated if a person wants to recover. Being “tough” isn’t going to fix any real mental health issues and any medical expert will say as much.

Furthermore, anyone can get depressed, especially veterans when we look at the numbers.

The unique struggles a veteran faces can lead to experiencing extreme violence and loss — facing traumatic experiences many of us don’t. These struggles can also be one of boredom, isolation, and discomfort.

Your depression isn’t lessened by someone who may have had it worse, and perhaps ended up okay.

We don’t always control what triggers bad reactions in our brains. What we do control is whether we seek help or not. And addressing the problem is ultimately a tough decision.

Lack of Access

Some people worry they can’t afford access to treatment for their depression. While this may sometimes be the case, it’s not true for the majority of people who have depression.

For all its past (and current) failings, the US Department of Veterans Affairs tries to make sure veterans have access to mental health treatment as needed. That said, we won’t deny the VA sometimes has long wait times at its facilities.

Most health insurance plans also cover at least some level of mental health treatment. Getting an official diagnosis for your depression may also make it easier to find further treatment.

If you can’t or don’t want to drive to see a mental health professional, there are also a number of ways to speak with a therapist or doctor over the phone or from a computer. This is called “telehealth” and is a booming industry these days.

Even if you can’t get as much care as you’d like, it’s important to at least try and consistently see mental health professionals for your issues. Giving up completely on your mental health isn’t going to improve your situation.

Lack of Results

Some people seek help for a mental health problem and find they aren’t getting the results they’re looking for. This can be very discouraging and cause them to give up on trying to improve their situation completely.

The first thing you should do if you’re feeling discouraged by your results is take a step back. Look logically about how much you’ve invested, in terms of time and effort, into seeking help.

If it’s only been a few weeks or you haven’t been taking your treatment seriously, then you may not see beneficial results. However, treating depression is hard, and even those who try may not see the results they need at first. But, you still must not give up.

While you should not give up on seeking help, it may be time for a different approach. Even switching the therapist and/or psychiatrist you see may be enough to make more headway.

However, some people suffer from what is called treatment-resistant depression. These people find that traditional treatments don’t work as well, or at all—as they normally would.

One potential solution for these veterans is Transcranial Magnetic Stimulation (TMS). This is a non-invasive, FDA-cleared therapy option that uses magnets to stimulate and “rewire” your brain to improve your mood.

A Person is a Person

Soldiers face many unique experiences the average person doesn’t have to. Many soldiers see friends hurt or die. Others may experience an injury themselves or any number of other traumas.

However, despite any veteran’s unique experiences and the training process meant to toughen them up, they’re still a person. If you’re seeking help or considering it, remember that.

Veterans and non-veterans experience very similar rates of depression. The exception is for Vietnam veterans, who were notoriously treated poorly after coming home from what was at times a notably brutal war.

To some people, this may seem strange. Civilian life can be stressful, but one might assume it tends to be less stressful than a soldier’s.

However, at the end of the day, the human mind is the human mind. It is excellent at coping with stress, but also seems to have issues with that stress at similar rates between civilians and veterans.

This isn’t bad news, either. Veterans and depression statistics show that these are human beings, not some unique outlier. This means they are also treatable at similar rates to the average civilian.

Some Important Caveats

With all the above in mind, that doesn’t mean soldiers and veterans can always be approached in the same way as civilians when it comes to mental health treatment.

For one, many veterans would find a traditional approach somewhat frustrating. Techniques meant to help a person with the troubles of civilian life often need to be adjusted to fit a soldier’s perspective.

Certain traumas, like those related to violence, are also much more common for veterans. This means a mental health professional will often be tackling issues far less common among civilians.

PTSD and Depression

One area veterans do differ from civilians is in their rate of Post-Traumatic Stress Disorder (PTSD).
According to one study, the rate of PTSD among civilians and veterans was as follows:

Veteran PTSD numbers are worth discussing not only because PTSD is itself an important issue, but also because it is often co-diagnosed with depression. So why are the rates so different?

While troubling, the high rate of PTSD among veterans can pretty readily be attributed to the far greater rate of traumas experienced by that group.

We mentioned how these traumas do not seem to affect depression rates but, by their nature, they do affect PTSD. The high PTSD rates have less to do with soldiers themselves and more about the situations they are put in.

The First Steps to Getting Help

If you find that you are anxious and it is difficult to feel happy, something is wrong. Having gone to war and suffered, as a result, does not mean you need to suffer forever.

Accepting You Need Help

If you do think you are having trouble with your mental health, the first thing you need to do is accept the truth of your situation. You’re not weak, but you may need help to get better.

Seeking Out Professionals

From there, the next step should be trying to get in contact with a mental health professional. Search for well-reviewed professionals in your area. Some may even specialize in helping veterans like you or your loved one.

These professionals can build you a treatment plan and also help answer any questions you may have. They can be a great resource for dispelling any fears or misconceptions you may have about depression and for getting you on the path to recovery.

Building Your Network

Alongside professional help, you’ll want to work on building a network of people to support you if you can. The goal is to get people you can trust to let your guard down around.

Family can be a great place for this network building, but there are other places to look, too. You may even find veteran support groups in your area, where many people with similar experiences to you gather for healthy discussion.

Removing Toxic Forces

It’s also important to identify people in your life who put a damper on your mental health. In an ideal world, you’ll want to cut them out of your life or perhaps just spend less time with them.

Watch for anyone who implies your problems aren’t real or are otherwise feeding into the negative stereotypes we discussed earlier. Those people are the ones who are wrong, not you for wanting help.

Keeping At It

Once you have professionals you’re seeing and a network of people you can rely on, it is all about consistent effort. Recovering from mental illness is not easy and it can take multiple approaches, sometimes at once, to get results.

Your goal should be to never give up. If one approach doesn’t seem to work, find another that might. You can tell the professionals you’re working with about your concerns, and they’ll often help you find those alternatives themselves.

Treating Veterans with Mental Health Issues

When treating veterans for mental health concerns like depression, it’s important to address all co-occurring issues and related conditions.

Most effective standard treatment plans for veterans include either medication, talk therapy, or a combination of both.

Psychotherapy and behavioral approaches

Psychotherapeutic approaches for PTSD are trauma-focused, meaning they focus on processing past traumatic events and their effect. Some trauma-focused therapies involve visualization, talking, or simply thinking about a traumatic memory. Others may focus on changing beliefs related to these events.

Working past these traumatic issues takes time. Sessions usually last 8 to 16 weeks before making any meaningful difference.

Some effective trauma-focused therapies include:

  • Cognitive-Behavioral Therapies (CBT) — the gold standard of therapy, adapted to address trauma and change unhelpful behaviors and thought patterns.
  • Prolonged Exposure Therapy — a type of CBT that gradually introduces trauma-related memories and triggers so that a person may face and overcome their fears in a controlled environment.
  • Exposure and Relapse Prevention (ERP) — a type of CBT similar to prolonged exposure therapy that also focuses on controlling compulsive behaviors that come with certain triggers and intrusive thoughts.
  • Cognitive Processing Therapy — a type of CBT that teaches you how to evaluate and process emotions and thoughts since the traumatic event.
  • Brief Eclectic Psychotherapy (BEP) — which has elements of CBT, helps patients practice relaxation methods while recalling and reframing thoughts related to the traumatic event. The patient may write a farewell letter to leave the trauma in the past.
  • Narrative Exposure Therapy (NET) — in which the patient walks through events in chronological order (from birth to today) so that a person may be able to view themselves from a different scope.

Mindfulness

Mindfulness is a strategy that people have been using for centuries. It can have profound benefits for people struggling with mental health issues like depression or anxiety. When used to PTSD, it may help veterans focus on things that matter in life like relationships or pleasurable activities.

Mindfulness helps people get in touch with the present moment and reduce stress. Mindfulness can be adapted to everyday situations and help people get a better hold on their PTSD symptoms as they practice with time.

Dr. Sunder of Inland Empire TMS has worked at the Veterans Hospital in San Diego and successfully ran a PTSD and Mood Clinic for Veterans for over a year. He has been a Principal Investigator for FDA Studies researching new treatments for PTSD. He has a Facebook Page “BeatPTSD” that has helped a number of veterans overcome their PTSD symptoms.  He also designed the 12-week mindfulness meditation program “The Resiliency Challenge” for Veterans with PTSD.

You can read Dr. Sunder’s article on Why Minduflness Creates Resilience in Patients with PTSD and Addictions at the Journal of Addiction Research and Therapy. Here he explores traditional practices that have been around for thousands of years and how we can now measure their effectiveness with advances in brain imaging — and why it is reasonable to integrate these practices with current treatment procedures.

When Nothing Seems to Work

Did you know as many as two-thirds of depression sufferers don’t react to the first antidepressant they’re prescribed? As many as a third don’t react to several antidepressants and some don’t ever find one that seems to help.

Though this can be disheartening, there are further options that can be effective when standard treatments are not.

Talk to your treating doctor about what (if any) medications are helping and how much they are helping you. It is important to give these medications and therapies a strong effort and stick with them while the full process unravels.

When standard treatments don’t work, secondary alternative treatments can be effective options to turn to.

An alternative treatment that Inland Empire TMS stands behind and offers to clients is Transcranial Magnetic Stimulation (TMS).

Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) is among the latest advancements in technology to treat conditions like treatment-resistant depression.

TMS is FDA-approved for treatment-resistant depression, using magnetic frequencies to stimulate specific regions of the brain associated with mood. It’s been proven that repetitive TMS treatments can rewire the brain’s electrical currents to increase levels of neurotransmitters like serotonin and dopamine in the brain.

Over weeks of TMS treatment sessions, this gradual rewiring can have lasting beneficial effects for the person. 

While it is only currently approved for treatment-resistant depression, TMS is being increasingly used off-label to treat other psychiatric conditions — including PTSD, anxiety, OCD, and much more. Because of the ability to target varying regions of the brain with TMS, it can be used to bring balance regions in the brain associated with these conditions as well.

We Can Help Veterans and Civilians Alike

While the care of veterans with depression often needs to be tailored to their experiences, recovery is still possible. There are secondary options outside of medications and talk therapy; don’t give up after trying just one of these options.

Transcranial Magnetic Therapy (TMS) is one popular option that we offer at Inland Empire TMS for a simple reason — we find that it works. And Dr. Sunder has extensive experience in treating veterans with both PTSD and depression, distinguishing his TMS for Veterans program above the competing treatment centers.

If you’re curious about how our facility’s TMS and associated psychiatry services may be able to help you, we’d love for you to contact us for more information.

Sources

  1. Liu, Y., Collins, C., Wang, K., Xie, X., & Bie, R. (2019). The prevalence and trend of depression among veterans in the United States. Journal of Affective Disorders, 245, 724-727. doi:10.1016/j.jad.2018.11.031
  2. RAND Corporation. (2008, April 17). One In Five Iraq and Afghanistan Veterans Suffer from PTSD or Major Depression. Retrieved from https://www.rand.org/news/press/2008/04/17.html
  3. U.S. Department of Veterans Affairs. (n.d.). VA mental health services. Retrieved September 7, 2021, from https://www.va.gov/health-care/health-needs-conditions/mental-health/
  4. U.S. Department of Veterans Affairs. (2014, October 8). Study: Depression, anxiety rates roughly equal among older Vets, non-Vets. Retrieved from https://www.research.va.gov/currents/fall2014/fall2014-8.cfm
  5. U.S. Department of Veterans Affairs. (2018, August 08). PTSD Treatment Basics. Retrieved from https://www.ptsd.va.gov/understand_tx/tx_basics.asp
  6. Lehavot, K., Katon, J. G., Chen, J. A., Fortney, J. C., & Simpson, T. L. (2018). Post-traumatic Stress Disorder by Gender and Veteran Status. American journal of preventive medicine, 54(1), e1–e9. https://doi.org/10.1016/j.amepre.2017.09.008