What is Veteran and Military Mental Health Issues?

As the U.S. experiences continued periods of war, there have been growing concerns about the mental health of veterans and those currently serving in the military. The main mental health issues are posttraumatic stress disorder (PTSD) and depression, affecting roughly 14% to 16% of U.S. military personnel who have served in Afghanistan and Iraq. However, it’s equally important to recognize other problems such as suicide, traumatic brain injury, substance use disorders, and violence, all of which can significantly impact service members and their families. These mental health problems aren’t only caused by deployments or combat incidents, they can also arise from general military service. The impact of these mental health issues can be varied in timing and intensity, particularly during strenuous periods like active service and the process of transitioning back to civilian life.

Based on recent reports, there are 18 million veterans and 2.1 million active-duty and reserve service members in the U.S. The post-9/11 deployments have resulted in an increase in the number of veterans, with over 6% of the U.S. population either having served or currently serving in the military. These statistics don’t even include the family members affected by military service. By understanding the link between military service and physical and mental health, healthcare providers can enhance the patient care and potentially save lives.

PTSD was officially recognized as a disorder in 1980, following the aftermath of the Vietnam War. However, references to PTSD-like symptoms can be traced back to different periods in history, with terms such as “shell shock” and “combat fatigue”. PTSD is complex and involves interplay of biological, psychological, and social factors making its study and diagnosis quite challenging. PTSD is not limited to war veterans; it can affect anyone who has experienced or been exposed to violent events like assaults, disasters, terror attacks, etc. Symptoms include flashbacks, nightmares, heightened emotions, anxiety, and can significantly disrupt a person’s life.

Depression is another prevalent mental health issue in both active-duty military members and veterans. Conditions in the military, such as being separated from one’s family and the stress of combat, can all contribute to an increased risk of developing depression. As this condition is quite common, it’s crucial for health professionals to identify and provide appropriate care for these individuals.

Major depression can cause feelings of intense sadness, loss of interest in activities, sleep problems, weight fluctuations, fatigue, concentration difficulties, feelings of worthlessness, and suicidal thoughts. These symptoms greatly affect the individual’s ability to function at their full potential and it’s important for healthcare providers to accurately diagnose and treat it.

Veteran suicide rates are at their highest ever, with over 6000 veterans dying by suicide each year. This rate is 1.5 times higher than that of non-veterans. Given this alarming rate, there is a high priority to improve suicide prevention measures.

Substance use disorders (SUDs), including alcohol use, continue to be a problem among veterans and military members. These disorders involve an inability to control the use of a substance and can lead to significant medical, psychiatric, interpersonal, and occupational problems. SUDs can develop into addiction, where the individual compulsively seeks the drug despite wanting to quit and experiencing adverse effects.

What Causes Veteran and Military Mental Health Issues?

Posttraumatic Stress Disorder

We don’t completely understand why some people develop Posttraumatic Stress Disorder (PTSD), but it’s clear it’s not just a mental issue – it’s also biological. Our current understanding involves factors such as your brain’s fear response, genetics, abnormalities in brain circuits, and even the impact of childhood trauma on your body’s stress responses.

Recent research has found differences in brain structure size and neurotransmitter levels (chemicals that transmit signals in the brain) in people with PTSD compared to those without. Our genes and external factors might strongly influence PTSD and there are also individual factors we should look out for like past traumas, belief systems, available support, and others that can interact in complex ways.

There are several risk factors that increase the chance of developing PTSD. These include experiencing trauma during childhood, with frequency and intensity of a traumatic event playing a crucial role. Other factors, such as lower rank, being unmarried, having a low education, experiencing poor morale or unit social support, and being unaware of common psychological reactions upon returning home increase the risk of PTSD.

Depression

Depression, also known as Major Depressive Disorder (MDD), is a condition we have studied for many years, but we still don’t fully understand its cause. It’s clear that MDD is related to the brain and there’s much debate regarding which brain markers and processes are the most critical in development.

There’s a known link between MDD and heightened reactions to stress hormones called cortisol, which might explain why stress is a significant risk factor for depression. Certain brain pathways involved in emotional regulation may also malfunction in depressed individuals. Moreover, the neurotransmitter called serotonin, known for its role in regulating emotions, is another key player in MDD.

Common risk factors include unemployment, financial stress, being female, and having a personal or family history of mental health issues. Additional risk factors for military personnel include legal complications, rank and promotion issues, deployments, combat exposure, physical fitness concerns, frequent relocations, and leadership discord.

Suicide

When studying suicide, researchers aim to identify the factors and signs that make individuals more or prone, with the goal of providing early help. While serving in the military, members may face various stressors – from physical health problems to conflicts with leadership and service separation. Being a young male, especially between the ages of 17 and 19, significantly increases suicide risk, but female veterans are also at a high risk.

Other protective factors against suicide include having a sense of duty, belonging, strong bonds with others, and access to healthcare. Additionally, having increased educational levels, being married, financially stable, and practicing a religion may also help to reduce suicidality.

Substance Use Disorders

Substance use disorders result from repeated drug use in people who are genetically vulnerable or have socio-psychological predispositions. Drug addiction is now recognized as a chronic relapsing condition that leads to a cycle of desirable effects strengthened by dopamine signaling, a neurotransmitter linked to reward in the brain.

Several genetic factors contribute to substance use disorders, mainly affecting pathways associated with transmitting signals in the brain. Continuous research into how the environment influences our biology of substance use through mechanisms called ‘epigenetic’ changes continues to provide us with further insights.

Risk Factors and Frequency for Veteran and Military Mental Health Issues

Post-traumatic Stress Disorder (PTSD) affects between 2% and 17% of US veterans, a figure higher than in other Western countries. The variation can be due to different war settings, changes in how PTSD is diagnosed over time as well as different study methods used in research. The delay between exposure to trauma and diagnosis can also have an impact.

Moving on to depression, it is the most common mood disorder, with up to 21% people experiencing it at some point in their lives. Women are more likely to suffer from depression with a lifetime prevalence of up to 25%, compared to 12% in men. It’s particularly of concern to the VA and DoD due to its high incidence rates, especially among military personnel who have higher risks of suffering from depression than the general population. Soldiers who have been deployed to different conflict zones are particularly at risk. For instance, 15% of those returning from deployment showed symptoms of major depression.

Before 2000, suicide rates were lower among military personnel than civilians. However, this trend has reversed in the past 20 years, with military suicide rates now exceeding civilian rates. Every day, about 21 veterans commit suicide. This rate is worryingly 50% higher than the general adult population. Female veterans, in particular, show a 50% higher incidence of suicide than their civilian counterparts.

Substance Use Disorders (SUD) are also a significant problem. Diagnosis can be hard due to changing criteria and the fact not all veterans use VA services. Like in the general population, SUDs are more common in males. Single and younger veterans also have a higher risk. The risk can increase because of having traumatic military experiences or difficulties re-adjusting to civilian life. Some individuals with troubled backgrounds or childhood trauma also enlist in the military to escape their home situations which can also increase the risk of SUDs.

The most common SUDs among veterans are alcohol use disorders. More veterans drink alcohol than non-veterans and are more likely to engage in heavy drinking. Especially, those who’ve experienced a lot of combat. High rates of smoking are also found among veterans as compared to civilians, and the rate of opioid prescriptions has also increased. PTSD and other mental disorder diagnoses can increase the risk of receiving an opioid prescription. Illicit drug use is comparable to that in civilians, with marijuana being the most used illegal drug among veterans. Notably, the instances of cannabis use disorders increased by 50% among VA patients from 2002 to 2009.

Signs and Symptoms of Veteran and Military Mental Health Issues

When dealing with mental health concerns in military service members or veterans, it is vital to find out about their military service history. Often, these individuals might avoid talking about their history, which could make it challenging for healthcare providers trying to get a complete medical history. As such, making it a routine practice to ask about military service during initial encounters is crucial. Here are some helpful questions to include:

“Have you or someone close to you ever served in the military?”
“During which period did you serve?”
“In which branch of the military did you serve?”
“What were your responsibilities during your time in the military?”
“Did you serve in a hostile or combat area?”
“Have you encountered enemy fire, witnessed combat, or experienced casualties?”
“Did you sustain any wounds or injuries or require hospitalization during service?”
“Were you exposed to noise, chemicals, gases, demolition of munitions, pesticides, or any other potentially hazardous substances during your service?”
“Have you ever used the VA for healthcare services?”

Some individuals might struggle with identifying or discussing the emotional or cognitive aspects of Posttraumatic Stress Disorder (PTSD). Instead, they might describe physical symptoms like difficulty sleeping. Healthcare providers should, therefore, check for signs of this disorder by getting a comprehensive patient history.

For depression, getting a thorough medical history is crucial. Healthcare providers need to understand the severity of the patient’s condition, previous episodes of similar symptoms, factors that ease or exacerbate the situation, the effect on daily life, and the individual’s psychiatric history. This history should also include job or relationship stressors, as well as potential support structures.

In terms of suicide risk, it is important to get a complete medical history. This includes identifying factors that can make the situation worse or better. Healthcare providers should specifically inquire about prior suicide attempts, and signs of self-harm.

For Substance Use Disorders (SUDs), healthcare providers need to look out for a pattern of drug use that leads to distress or impairment. While presentations may vary depending on the substance(s) used, a comprehensive patient history and examination — including medical and mental health comorbidities, family history, and social background — is crucial. Consideration should also be given to:

The pattern of substance use, treatment history, intoxication or withdrawal potential, and continued use potential
Emotional, behavioral, and cognitive conditions
Living environment
Employment and finances
Criminal justice involvement
Readiness to change

Finally, alcohol consumption can affect several organ systems and can lead to changes in behavior, mental health, and social interactions. Similarly, other substances can cause impaired function in nearly every organ system, leading to diseases from direct toxicity, the method of administration, and high-risk behaviors such as needle sharing, unprotected sex, or poor hygiene.

Testing for Veteran and Military Mental Health Issues

When it comes to posttraumatic stress disorder (PTSD), screening and diagnosis are crucial for effective treatment. Screening helps detect individuals who might be developing PTSD, even if they don’t meet the full criteria yet. In simple terms, it helps catch the signs early so that prevention efforts can be put into place.

One of the common screening methods used by healthcare providers is the PC-PTSD-5, a 5-question survey with simple yes/no answers. This is favored by medical professionals for its accuracy, simplicity, and tolerance by those taking the test. Another screening tool is the PTSD Checklist for DSM-5 or PCL-5. This is a longer questionnaire, but it’s helpful for diagnosing the condition and tracking changes in symptoms before and after therapy.

For a diagnosis of PTSD, healthcare providers generally follow the criteria set by the DSM-5, a handbook used by professionals to understand and diagnose mental health conditions. Broadly speaking, the criteria include exposure to serious trauma, distressing memories that interrupt your day-to-day life, avoidance of reminders of the trauma, persistent negative mood, and increased arousal or reactivity.

When it comes to diagnosing PTSD, a thorough process is used which combines self-reporting measures, like the PCL-5, and structured clinical interviews. Although research is ongoing for biological measures like heart rate and neuroimaging (creating images of the brain), these are not widely accessible yet.

Major depressive disorder, often referred to as depression, is common yet often undiagnosed. Screening is recommended for anyone aged 12 or older. For veterans and those on active duty, screening tools are recommended without any exception, as they’ve been shown to increase detection rates significantly. Confirming a depression diagnosis usually involves a comprehensive assessment of symptoms including a persistent low mood, loss of interest in activities, changes in weight, changes in sleep patterns, agitation, fatigue, feelings of worthlessness, decreased focus, and thoughts of death or suicide.

Substance use disorder (SUD), where one’s use of substances like alcohol or drugs interferes with health or daily life, can also be screened and diagnosed. Screening could involve questions about the amount consumed, ability to control one’s use, the time spent on obtaining the substance, and the impact on social and professional life. Diagnosis would follow the criteria mentioned in the DSM-5, which involves confirming 2 to 3 symptoms for a mild SUD, 4 to 5 for a moderate SUD, and 6 or more for severe SUD.

Suicide risk is a significant factor that needs to be considered, particularly with these disorders. Although predicting suicide risk with complete accuracy is challenging, it’s important to have conversations about suicidal thoughts to help understand a patient’s mental state better and provide necessary support. The tools, such as Item 9 on the PHQ-9 questionnaire, whilst having limitations, are still used to understand the patient’s state of mind.

In all cases, it is important to remember that there are resources and support available, and seeking help from professionals is a crucial step towards recovery.

Treatment Options for Veteran and Military Mental Health Issues

If you’re diagnosed with Posttraumatic Stress Disorder (PTSD), treatment should ideally start soon after diagnosis if symptoms persist for at least a month. However, symptoms often present months or even years after the traumatic event. Treatment normally involves talk therapy, and medications may be considered as an alternative or in addition to therapy, based on what you prefer and your ability to access therapy.

Talk therapies for PTSD include exposure therapy, cognitive processing therapy (CPT), trauma-focused cognitive-behavioral therapy (TF-CBT), and eye-movement desensitization and reprocessing (EMDR). Your doctor might suggest different types of therapies based on your symptoms. Therapies focused on uncovering and managing fear could work better if you’re experiencing a lot of fear and avoiding certain things. Cognitive therapies, which help to change unhelpful thought patterns, might be more beneficial if you’re struggling with feelings of guilt or mistrust after the traumatic event.

As for medication, several types can help to reduce PTSD symptoms, especially symptoms related to stress or mood issues. Medications might not be as effective for managing symptoms related to avoidance or emotional numbness. Some medicines, such as selective serotonin reuptake inhibitors (SSRIs), have been extensively studied for PTSD treatment and have been found to improve symptoms.

Combining therapy and medication might also be beneficial, depending on the individual circumstances. Some studies have found that combining these treatments or using them individually can be equally effective. Often, sticking with treatment is easier when patients can choose the kind of treatment they prefer.

Treatment for depression involves a combination of medications and talk therapy. Different types of talk therapy include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and others. Despite the variety, no single type of therapy has been proven to be superior to others, but CBT and interpersonal psychotherapy are often the first choices due to their well-documented effectiveness. As for medication, several types could be beneficial depending on individual factors, such as other health conditions, side effects, and past experiences with medications.

Regarding suicide, it’s crucial to assess any indication of suicide ideation and past attempts promptly and create a crisis response plan. Healthcare providers and patients should communicate regularly about recent stressors and identify signs of a potential crisis. It’s also essential to have a contingency plan if the patient’s distress escalates, including emergency resources and follow-up consultations.

For substance use disorders, talk therapy commonly serves as the cornerstone of treatment. Cognitive-behavioral therapy is a frequently used approach, where patients learn to recognize and change thoughts and behaviors related to substance use. Medications can also help by reducing cravings or withdrawal symptoms, offering assistance in quitting substance use. Self-help groups, such as Alcoholics Anonymous or Narcotics Anonymous, could also be beneficial for ongoing support.

When trying to diagnose Posttraumatic Stress Disorder (PTSD), doctors take into account several possible conditions that might cause similar symptoms, especially if the patient has other mental health disorders. Here are some of these conditions:

Acute stress disorder: This refers to people who show at least 9 out of 14 symptoms in 5 categories (intrusion, negative mood, dissociation, avoidance, and arousal) within 1 month following a traumatic event. If the symptoms persist beyond 30 days, the diagnosis is updated to PTSD.
Adjustment disorders
Depressive disorders
Anxiety disorders: including specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder.
Substance use
Obsessive-compulsive disorder
Bereavement
Schizophrenia and other psychotic disorders
Personality disorders, especially borderline personality disorder
Dissociative disorders
Conversion disorder
Traumatic Brain Injury (TBI)

When it comes to Major Depressive Disorder (MDD), three conditions that have to be considered are grief, adjustment disorder, and Persistent Depressive Disorder (PDD).

Grief generally happens when a person loses a loved one. Common symptoms may look like depression, such as lack of interest in things, low mood, and memories of the person who passed away.
Adjustment disorder typically involves a strong emotional or behavioral response to a stressful event, without meeting the criteria for another mental health disorder.
PDD shares a lot of symptoms with MDD. The key difference lies in the timeline of each disorder. In MDD, symptoms must be present for at least 2 weeks, while in PDD, symptoms must continue for 2 years without a break of 2 months or more.

Finally, in the case of Substance Use Disorders (SUDs), the diagnosis will depend on the specific substance involved. In addition, for most other DSM-5 diagnoses, it’s crucial to rule out substance-induced disorders as they can look very similar or trigger the onset of such disorders. Substance-related conditions can include psychotic, bipolar, depressive, anxiety, obsessive-compulsive, related sleep disorders, sexual dysfunction, delirium, and neurocognitive disorders.

What to expect with Veteran and Military Mental Health Issues

Posttraumatic Stress Disorder (PTSD)

The progress of PTSD can be different for each person and can sometimes become a long-term problem. Roughly half of adults will get better within three months, while another third may take up to a year. However, a small number of patients may still have symptoms even ten years later. If a person does get better without treatment, it’s likely to happen within the first year. That said, they may still face problems like difficulties in work or education, troubles in personal relationships, and a lack of social support. Current treatments have been effective in reducing symptoms and achieving recovery. It’s typically recommended to treat all conditions at the same time in individuals with additional mental health disorders for the best results.

Depression

Major Depressive Disorder (MDD) is a condition that can differ greatly between people. Less than half of the cases get better within three months of starting, compared to roughly 80% that improve within a year. Severe MDD can have a higher risk of coming back and can sometimes become a chronic condition that needs ongoing attention. Studies show that patients who keep taking medication for at least 6 to 12 months after their first depressive episode are less likely to see the return of symptoms than those who stop the medication earlier. The ultimate goal is recovery, but ongoing care and collaboration in treatment programs reduce the chance of MDD occurring later in life.

Suicide

Suicide is a serious concern, particularly for patients who have previously attempted suicide. The risk of suicide is highest in the first year after an attempt, but the risk can remain high up to a decade later. Several studies suggest that the chance for another suicide attempt ranges from 5% to 10% over a timeframe of 5 to 35 years. Healthcare providers should look for signs of depression and Substance Use Disorders (SUDs), as they are associated with a higher risk of suicide attempts.

Substance Use Disorders

A major study of VA patient-centered medical homes found that depression, severe mental illness (except PTSD), and SUDs were related to a higher risk of hospitalization and death within 1 year. The authors think the exception for PTSD is due to these patients frequently seeking healthcare. This supports the idea that mental illnesses, including SUDs, can lead to poorer health outcomes, but these can be somewhat lessened by access to healthcare.

Another study focused on veterans with intensive PTSD treatments who were categorized into 7 groups based on their substance use: no substance use, or using alcohol, opiates, sedatives, cocaine, or marijuana alone, and using multiple substances. The researchers compared changes in factors like PTSD symptoms, violence, suicide risk, medical problems, and employment before and after PTSD treatment, and evaluated the effect of abstaining from substance use on each group. Although the rates of abstaining from substance use varied among the groups, it was consistently related to improved outcomes in all the groups, except for employment.

Possible Complications When Diagnosed with Veteran and Military Mental Health Issues

Posttraumatic stress disorder (PTSD) is often seen alongside other physical and mental health disorders, creating a complex network of interconnecting diagnoses. For instance, studies of veterans have shown that those with PTSD often have more medical issues than their counterparts without PTSD. Common health problems include lower back pain, headaches, joint problems in the legs, and some loss of hearing.

PTSD is also seen frequently in patients experiencing chronic pain, which is then linked to an increased chance of alcohol use disorder (AUD). Among veterans who have been diagnosed with obstructive sleep apnea and are obese, there’s a notable link between these issues and anxiety or mood disorders, especially PTSD.

A longstanding relationship has been identified between PTSD and AUD. Men are more likely to have AUD, and women have a higher rate of PTSD.

Depression and PTSD are often linked. Individuals suffering from both experience greater medical burdens and longer treatment needs.
Traumatic brain injury (TBI) and PTSD are often seen together, contributing to symptoms such as cognitive limitations and behavior alteration.

Similarly, we see major depressive disorder (MDD) manifesting in symptoms like weight gain and fatigue, which can lead to more serious health problems like heart disease, high blood pressure, and diabetes. Among veterans, this is sadly seen in the high rate of suicides, as well as in frequent issues with pain and substance use disorders (SUDs).

Attempted or completed suicides are impactful and traumatic events. Whether substances are used or not, they create a ripple effect, influencing the lives of those around the affected individual.

SUDs can be made worse by psychiatric issues such as distress that often surfaces before cravings. Among veterans with SUDs, the vast majority also have another mental health disorder. These veterans suffer from a lower quality of life and higher aggression rates.

Medical conditions that can result from the use of drugs include:

Heart diseases such as hypertension, heart muscle disease (cardiomyopathy), infection of the heart’s inner lining (endocarditis) and heart failure
Digestive diseases such as pancreatitis, cirrhosis, chronic liver disease, and hepatitis B or C
Kidney failure
Brain issues such as dementia, attention impairment and stroke
Lung diseases such as chronic obstructive lung disease, bronchospasm, pneumonia, inflammation of the lungs, and tuberculosis
Sexually transmitted infections and bacterial infections
Reduced immunity
Complications during pregnancy and childbirth

Preventing Veteran and Military Mental Health Issues

Posttraumatic Stress Disorder, or PTSD, is a condition that can be quite challenging and scary for those dealing with it, particularly because it is often tied to past traumatic experiences. It can impact both your physical and mental health in ways you may not always notice right away. For these reasons, it can be tough for someone to acknowledge they’re suffering from this to the point where they’re ready to seek help. The good news is that social support can significantly help in reducing the effects of PTSD. It’s important to recognize the signs and get a commitment to begin proper treatment. This will bring relief not just for the patient, but also for their loved ones.

Military members have a higher risk of developing Major Depressive Disorder (or MDD) due to the stressful and risky nature of their work. Despite efforts from the Department of Defense to offer better access to mental health care, there remains a stigma that might discourage people from seeking treatment. They might worry about appearing weak or causing damage to their professional progression. Support resources are widely accessible, and educating patients about these can help them guide their own care. Making use of available social networks to encourage compliance with a treatment program is also helpful. With the right screening, diagnosis, and access to mental health programs, it’s possible to reduce the prevalence of MDD among active and veteran military members.

Given that veterans are more prone to suicide, it’s a policy within the Veterans Affairs Department to have a safety plan in place for those at risk. This plan would typically include 6 steps to help manage and ward off suicidal tendencies. These involve identifying warning signs of an impending crisis, using various coping strategies, reaching out to people one trusts, seeking professional help, and limiting access to means that could lead to self-harm. However, it’s important to understand that a safety plan, while certainly helpful, doesn’t guarantee complete protection. Therefore, comprehensive assessments and therapeutic interactions are vital, especially for those who may act on impulse.

When it comes to Substance Use Disorders, or SUDs, treatment usually involves short-term therapy to help change harmful behaviors and thoughts linked to substance abuse. Some substances, like tobacco, alcohol, and opioids, can be managed with medical treatments. For substances like cocaine and marijuana, where there are no approved medications, counseling forms the backbone of treatment. The military and the Veterans Affairs Department provide free counseling, including programs that help quit smoking, which have been proven to improve long-term outcomes. This way, a treatment plan can be tailored to a patient’s specific needs, helping rebuild relationships and provide valuable life skills for veterans.

Frequently asked questions

The prognosis for veteran and military mental health issues varies depending on the specific condition and individual. However, it is generally possible for individuals to experience improvement and recovery with appropriate treatment and support. Some key points regarding prognosis for specific conditions include: - Posttraumatic Stress Disorder (PTSD): Roughly half of adults with PTSD will get better within three months, while another third may take up to a year. However, a small number of patients may still have symptoms even ten years later. Current treatments have been effective in reducing symptoms and achieving recovery. - Depression: Less than half of cases of Major Depressive Disorder (MDD) get better within three months, compared to roughly 80% that improve within a year. Severe MDD can have a higher risk of coming back and can sometimes become a chronic condition that needs ongoing attention. Ongoing care and collaboration in treatment programs reduce the chance of MDD occurring later in life. - Suicide: The risk of suicide is highest in the first year after an attempt, but the risk can remain high up to a decade later. Healthcare providers should look for signs of depression and Substance Use Disorders (SUDs), as they are associated with a higher risk of suicide attempts. - Substance Use Disorders: Access to healthcare can somewhat lessen the poorer health outcomes associated with mental illnesses, including SUDs. Abstaining from substance use is consistently related to improved outcomes in terms of PTSD symptoms, violence, suicide risk, medical problems, and employment.

To get a complete understanding of Veteran and Military Mental Health Issues, it is important to consider factors such as military service history, experiences during service (including exposure to combat or traumatic events), physical health problems, conflicts with leadership, service separation, job or relationship stressors, support structures, and prior suicide attempts or signs of self-harm. Additionally, a comprehensive patient history and examination, including medical and mental health comorbidities, family history, social background, and patterns of substance use, are crucial in assessing and addressing these issues.

Signs and symptoms of Veteran and Military Mental Health Issues include: - Difficulty discussing or identifying emotional or cognitive aspects of PTSD, with a tendency to describe physical symptoms like difficulty sleeping. - Depression, which may manifest in various ways and require a thorough medical history to understand the severity, previous episodes, triggers, impact on daily life, and psychiatric history. - Suicide risk, which necessitates a complete medical history and specific inquiry about prior suicide attempts and signs of self-harm. - Substance Use Disorders (SUDs), characterized by a pattern of drug use leading to distress or impairment. A comprehensive patient history and examination are crucial, including consideration of emotional, behavioral, and cognitive conditions, living environment, employment and finances, criminal justice involvement, and readiness to change. - Alcohol consumption, which can affect multiple organ systems and lead to changes in behavior, mental health, and social interactions. - Other substances that can cause impaired function in nearly every organ system, resulting in diseases from direct toxicity, method of administration, and high-risk behaviors such as needle sharing, unprotected sex, or poor hygiene.

There are screening tools that are recommended for veterans and those on active duty to increase detection rates of depression. It is important for healthcare providers to have conversations about suicidal thoughts to understand a patient's mental state better and provide necessary support. Additionally, there are resources and support available for these issues, and seeking help from professionals is crucial.

The doctor needs to rule out the following conditions when diagnosing Veteran and Military Mental Health Issues: 1. Acute stress disorder 2. Adjustment disorders 3. Depressive disorders 4. Anxiety disorders (including specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder) 5. Substance use 6. Obsessive-compulsive disorder 7. Bereavement 8. Schizophrenia and other psychotic disorders 9. Personality disorders, especially borderline personality disorder 10. Dissociative disorders 11. Conversion disorder 12. Traumatic Brain Injury (TBI) 13. Grief 14. Persistent Depressive Disorder (PDD) 15. Substance-induced disorders

- Lower back pain, headaches, joint problems in the legs, and some loss of hearing are common health problems seen in veterans with PTSD. - Chronic pain is often linked to an increased chance of alcohol use disorder (AUD) in veterans with obstructive sleep apnea and obesity. - PTSD and AUD are frequently seen together, with men more likely to have AUD and women having a higher rate of PTSD. - Depression and PTSD are often linked, leading to greater medical burdens and longer treatment needs. - Traumatic brain injury (TBI) and PTSD often co-occur, contributing to symptoms such as cognitive limitations and behavior alteration. - Major depressive disorder (MDD) can lead to weight gain and fatigue, which can result in more serious health problems like heart disease, high blood pressure, and diabetes. - Substance use disorders (SUDs) can be worsened by psychiatric issues, and the majority of veterans with SUDs also have another mental health disorder. - Medical conditions that can result from drug use include heart diseases, digestive diseases, kidney failure, brain issues, lung diseases, sexually transmitted infections, reduced immunity, and complications during pregnancy and childbirth.

You should see a healthcare provider or doctor specializing in mental health for Veteran and Military Mental Health Issues.

Veteran and military mental health issues are common, with conditions such as Posttraumatic Stress Disorder (PTSD), depression, suicide, and Substance Use Disorders (SUD) affecting a significant portion of the veteran and military population.

Veteran and Military Mental Health Issues are typically treated through a combination of talk therapy and medication. Talk therapies such as exposure therapy, cognitive processing therapy (CPT), trauma-focused cognitive-behavioral therapy (TF-CBT), and eye-movement desensitization and reprocessing (EMDR) are commonly used to address symptoms of Posttraumatic Stress Disorder (PTSD). These therapies can help manage fear, change unhelpful thought patterns, and address feelings of guilt or mistrust. Medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be prescribed to reduce PTSD symptoms related to stress or mood issues. Combining therapy and medication can be beneficial, and the choice of treatment depends on individual circumstances and preferences.

The main mental health issues for veterans and military personnel are posttraumatic stress disorder (PTSD) and depression. Other problems include suicide, traumatic brain injury, substance use disorders, and violence. These mental health issues can arise from deployments, combat incidents, or general military service.