Military service members have an increased risk of developing mental health conditions, with studies indicating that 38% of veterans may be diagnosed with a mental health disorder. As veterans, some individuals struggle with previous traumas, lingering depression, or other challenges that come with military life. Veterans’ mental health services are just as vital to their long-term wellbeing as physical health care, though some are hesitant to reach out for help.
Read on to explore four common mental health issues affecting military veterans—such as post-traumatic stress disorder (PTSD), depression, suicide, and substance use disorders (SUDs)—veterans’ mental health treatment options. Then review resources and mental health programs for veterans.
Combat exposure and deployment may trigger some mental disorders, but general military service can also be distressing. The most common mental health concerns within the military veteran population are explored in more detail here.
Post-traumatic stress disorder (PTSD) is a persistent and disruptive state of distress due to exposure to trauma. Individuals with PTSD present symptoms such as intrusive thoughts and memories of the trauma, hypervigilance, nightmares, and flashbacks. Among deployed and nondeployed US military veterans involved in Iraq and Afghanistan, the reported rate of PTSD ranges from 13.5% to 30%. Primary PTSD risk factors include younger age at the time of trauma, previous history of trauma, lower education, more deployments, female gender, and concussion symptoms.
Cognitive processing therapy (CPT) and prolonged exposure (PE) therapy are among the two most studied and recommended cognitive-behavioral treatments for PTSD. CPT focuses on traumatic events and unhelpful negative thoughts that develop in response, and PE addresses traumatic memories and responses by revisiting them in a supportive clinical setting. Eye-movement desensitization and reprocessing (EMDR) therapy helps veterans reprocess trauma by focusing on other stimuli until the memories are no longer distressing.
Medications may provide additional relief or be a primary treatment for those who have an incomplete response to psychological approaches. Sertraline and paroxetine, two selective-serotonin reuptake inhibitor (SSRI) antidepressants, are the only FDA-approved medications for PTSD.
Major depressive disorder is prevalent in the general population, with an average of 21% of individuals having a depressive episode once in their lifetime. The rate for military personnel and veterans is higher yet, with some having twice the lifetime risk. With a high rate of depression diagnosed following deployments to Iraq and Afghanistan, veterans involved in these operations will need care for ongoing depression issues over their lifetime.
Treatment recommendations for military and civilian populations are the same, utilizing evidence-based pharmacological and non-medication interventions to reduce symptoms. However, the stressors related to depression for military personnel reflect the unique challenges of military service life.
For example, many military members have a realistic chance of experiencing trauma or injury during their service, especially during deployment. These life-changing events can trigger depressive episodes that may occur with other disorders, particularly PTSD, which can recur long after service members have already become veterans. The loss of loved ones in the line of duty, a physical ability or their own limbs, can all bring about depressive symptoms, due to unprocessed grief.
Members who leave military service, either involuntarily or of their own accord, may develop depression as they struggle with their identity in civilian life. These military-specific stressors are significant and must be taken into account when considering treatment strategy.
Several non-medication treatments for depression can effectively reduce depression symptoms, such as psychological interventions and magnetic therapy.
United States military suicide rates have exceeded civilian rates since 2008, reaching 1.5 times the civilian rate by 2016. And though the total suicides among veterans have climbed steadily since 1999, the most recent report shows signs of a slight decline since 2018.
Military reports on suicide incidents have revealed other risk factors, including failing relationships, financial difficulties, stigma, and access to a firearm. Additional research and support are needed for subpopulations with elevated suicide risk, such as aging veterans, those with serious medical issues, LGBTQ+ veterans, and native veterans.
The US Department of Defense (DoD) utilizes the guidelines set forth by the Centers for Disease Control (CDC), aimed at lowering barriers to suicide care, promoting social support, and teaching effective life and coping skills. The transition to civilian life is a crucial opportunity for military staff to extend and facilitate veterans’ access to mental health services.
Veterans struggling with distressing military experiences sometimes turn to substance misuse as a coping method. Nearly 11% of veterans presenting at military health clinics for the first time have SUDs.
Multiple effective treatments are available to address SUDs, either within the military health system or private health care clinics. When other psychiatric disorders co-occur with SUDs, as they often do in the military veteran population, treatment addressing SUDs and psychiatric disorders together is recommended.
Several mental health programs for veterans are in place to help individuals cope with psychological distress, adjustment issues, and clinically diagnosed mental disorders. These are some of the primary resources for veterans mental health care in the United States.
The Help for Service Members page condenses several more extensive military mental health resources into a single reference page. Some programs and services include:
Veterans Affairs (VA) Services provides care for service-connected injuries or illnesses, including mental health concerns and readjustment after deployment. There is no cost for mental health care for veterans within the VA health network.
The National Alliance on Mental Illness (NAMI) has released NAMI Homefront, an online collection of resources designed to improve communication, education, and understanding of mental health issues affecting active and veteran military populations. Programs are available for active military personnel, veterans, and their families.
Retirement or completion of service disconnects veterans from the familiar structure and bonds of military life, making it challenging for them to feel connected and supported. As resources for veterans’ mental health expand and develop, more individuals can be connected with the care they require, to cope with their physical and mental health needs.
