Talking about Veteran’s Mental Health
The questions and answers below are some adapted from a recent Twitter chat APA hosted on veteran’s mental health. APA member Elspeth Cameron Ritchie, M.D., chair of psychiatry at MedStar Washington Hospital Center and former army psychiatrist provided comments for APA. Dr. Ritchie retired from the Army in 2010, after holding numerous leadership positions within Army Medicine.
How prevalent are mental health disorders in the veteran population?
It depends on the time and place where they served. Certainly, rates are higher among Vietnam veterans and veterans from the recent wars in Iraq and Afghanistan. Post-traumatic stress disorder (PTSD), rates among those soldiers deployed to a combat zone are about 25%. However, in one study that looked at veterans seeking care at the VA, they have a lower rate of depression and anxiety than their civilian counterparts.
What are the most common mental health disorders that veterans face?
PTSD, depression and anxiety are among the most common. Traumatic brain injury is also very common, which may occur along with PTSD, depression or anxiety.
What are common signs of these disorders? What should veterans and their families look for?
Family members should be aware of the veteran withdrawing from friends and family or having difficulty doing their jobs or other activities of daily living, such as driving. For PTSD specifically, flashbacks and nightmares are some of the more common symptoms.
What are some unique considerations mental health professionals should have when treating a veteran?
Recent veterans are usually proud of their service. In general, they are proud of their time in uniform but may have very mixed feelings about the war or the government who sent them to war.
Stigma is prevalent and causes many to not seek mental health support, and this is no different in the military community. What are some strategies to decrease the stigma around mental health among the veteran population?
There are lots of initiatives. Some of the most promising are to allow easy access to mental health through primary care, vet centers, and the community-based outpatient centers. Vet Centers are community-based counseling centers that provide a wide range of social and psychological services, to veterans, active-duty service members, and their families. Peer support counselors can also be a lifesaving portal.
What are common signs of military-related PTSD?
A startle reflex to loud noises, checking for bombs on the side of the road, and grief over the deaths of fellow service members are just a few examples of common signs of military-related PTSD.
What are some treatment options for military-related PTSD?
Treatment can be grouped into three buckets, Dr. Ritchie suggests: medication, talking therapy, and everything else. The latter bucket includes meditation, exercise, animal assisted therapy, and other ways to calm down on overactive nervous system.
How can a family member support a veteran experiencing a mental health disorder like PTSD?
Be informed. There are lots of resources online, such as the VA Mental Health page and the VA Caregivers Support Program. Consider joining a support group, either virtually or in person. NAMI (National Alliance on Mental Illness) provides education and has support groups and online discussion groups for family members of people with mental illness.
What is “moral injury”?
Moral injury is not an official diagnosis but a condition where the veteran feels shame and guilt, over what he should or should not done in the theater of war. These may include guilt over civilian deaths, sorrow over the death of fellow service members, or anger at the government for sending them to war. The guilt can be corrosive and lead to suicidal feelings.
U.S. Department of Veterans Affairs