Mental Illness
Mental Illness in Veterans
One of the most tragic legacies for veterans of the United States armed forces is a problem that has been widely known but little talked of for many years–the problem of mental illness and mental health issues arising from service activities. After two decades of ceaseless warfare in one part of the world or another, researchers are learning much more about the levels and frequency of mental illness occurring in veterans, particularly those exposed to combat.
The Data on Veteran Mental Illness
According to a recent study, as many as 16 percent of all US service members deployed to Afghanistan or Iraq have developed serious depression or PTSD issues. Other mental health issues, such as traumatic brain injuries, interpersonal violence, substance abuse disorder, and even suicide are also highly prevalent in this same population of service members. Most frighteningly, the study found that there may not be a predictable timeline for the appearance of these mental health issues. Some service members returned from combat with obvious problems; in others, the appearance of mental health disorders was much more subtle and occurred over a longer term.
With as many as one in six combat veterans affected by mental health issues in recent years, the number of potential survivors is staggering. With over 2.8 million active duty American military personnel deployed to Iraq, Afghanistan and other combat-intensive areas since 2001, there could be nearly half a million service men and women currently suffering from mental health issues related to those conflicts alone, many of whom are undiagnosed and untreated.
Types of Mental Illness Experienced by Veterans
Like everyone else, veterans are susceptible to all types of mental illness. However, a couple of specific disorders seem to plague combat veterans at higher rates than the general public.
Post-Traumatic Stress Disorder (PTSD)
Since 1980, when PTSD was officially codified in the Diagnostic and Statistical Manual of Mental Disorders, it has been studied and better understood by the psychological community. However, narratives and other evidence show that the condition existed long before this, with terms such as “soldier’s heart,” “shell shock,” and “combat fatigue” being used in earlier times to describe conditions that sound very similar to modern PTSD. In 2013, there was an attempt to update the classification of this disorder, but ongoing debate still exists, primarily because it cannot be limited only to combat veterans but can be experienced by a wide range of people, including children, who have suffered trauma.
In about 20 percent of PTSD cases, symptoms worsen or become persistent and can cause significant life impairment. PTSD is characterized by uncontrollable thoughts, including flashbacks and nightmares, that make both waking and sleeping hours difficult. Avoidance behaviors and hypervigilance are common manifestations. Veterans experiencing PTSD may be unable to hold gainful employment, maintain personal relationships or succumb to addictions in an effort to deal with the trauma.
Depression
Depression is often seen as a “milder” problem than PTSD or physical injuries, but its effects can be just as devastating. Depression is actually responsible for nearly ten percent of all military health network appointments, which indicates its high prevalence in the military community.
Depression can revolve around a number of factors such as separation from loved ones, stresses related to service, and threats of harm. After deployments, military medical facilities have documented five percent increases in healthcare visits for depression symptoms.
Depression often presents in physical ways, such as weight gain or loss, problems with motor skill coordination, fatigue and insomnia. It may also present emotional or mental difficulties, such as loss of interest in formerly enjoyable activities, mood swings, and even thoughts of suicide. Depression diagnoses are sometimes difficult to make, and it is estimated that about half of all cases are misdiagnosed or undiagnosed altogether.
Suicide
Of course, the most serious mental health problem facing veterans is suicide. As a stark reminder of this issue, a recent study shows that suicide rates among veterans are at their highest level in recorded history, with more than 6,000 veterans annually succumbing to this tragedy, an average of 16 per day. Additionally, these new numbers represent a 30 percent increase in the number of suicides by veterans since 1999. Veterans account for nearly 18 percent of all suicide cases in many states and have a suicide rate 1.5 times higher than non-veterans. Veterans are at the highest risk of suicide during their first year after leaving the military to transition to civilian life.
Substance Abuse
Substance abuse is a substantial problem for many veterans and military personnel, and springs from both mental and physical causes. Substance abuse disorders (SUD’s) may involve alcohol, prescription medications, over-the-counter legal medications, or illegal drugs and may be associated with adverse physical and psychiatric symptoms. One study linked 30 percent of veteran suicides or suicide attempts, and 20 percent of all veteran deaths resulting from high-risk behavior to alcohol or drug use or misuse. By comparison, 31 percent of all driving-related fatalities involve the use of alcohol or drugs.
The DSM classifies SUD as a behavior that involves compulsion, or the lack of control over use of drugs or alcohol. This abuse of substances can also lead to physical changes that further deepen the cycle, causing physical dependency on the drug of choice.
As veterans struggle with mental illness and mental health issues, it is important that they receive the support and care they need. Sometimes, the only way to ensure that this happens is to hold those people and agencies accountable whose job it is to provide these services, but who may not be doing so in a fair or constructive way.
