Mental Health Concerns

Suicide Rate
Recent studies reveal that suicide rates among returning veterans are much higher than among comparable civilians. In fact, one report released in September 2011 indicates that the suicide rate among returning veterans has exceeded the rate of combat fatalities over the past two years. While a number of factors may contribute to the increase in suicides among veterans, certainly mental illnesses including PTSD and depression, are likely to play a role.

Depression
Coming home to such poor job and housing prospects, what starts out as a normative response to a difficult situation can easily morph into a full-blown depressive state. Coupled with other possible issues, such as bereavement, or survivor’s guilt, depression may be part of the response to returning to a civilian lifestyle. Studies have found very high rates of depression among returning veterans (over 20% in some studies compared to a rate of depression of less than 10% among the general population). Indeed many of these studies combined statistics for depression and PTSD.

Anxiety
When deployed, tapping into that "fight or flight" response may be life saving, and the best response to a wide array of situations. Surviving deployment means that vigilance and quick reactions have been honed. However, once back in the United States, most civilian lifestyles do not require that level of response, and in fact the focus on danger and "what might happen" is no longer helpful, but potentially harmful. When the "fight or flight" reaction can’t turn itself off, generalized anxiety or phobias are not uncommon. Statistics regarding anxiety disorders among veterans are hard to separate out as PTSD is classified as an anxiety disorder at this time.

Bereavement
Many soldiers suffer losses while serving. The role grief, loss, and trauma play in mental health and mental illness cannot be overlooked. During deployment, the grieving process and the ability to mourn are constrained at best by the demands of service. Complicated grief and delayed mourning can result and create additional mood and behavioral symptoms for returning veterans.

Substance Abuse

Whether using drugs or alcohol in an effort to self medicate the symptoms of PTSD or other disorders, or unable to kick a habit that got started while deployed, substance abuse rates for returned veterans are much higher than those for civilians.

Pre-existing Mental Health Issues
Often the stresses of service layered with the additional stresses of re-entry to civilian life can exacerbate pre-existing mental illnesses. Sometimes the structure and regimented lifestyle of the military, especially when overseas, can help servicemen and women manage their symptoms. Back at home, the absence of that structure can lead to flare ups of pre-existing conditions like anxiety or depression.

If you or someone you love is returning or has returned from combat, and are exhibiting stress-related symptoms, depression, or have started abusing alcohol or drugs, please discuss this with a counselor and if necessary, check into a rehab center. These are serious issues that will not go away on their own.

We thank you for your service in keeping our country safe.

Your Spiritual Life

The translation of the Bible known as The Message, has a beautiful adaptation of I Corinthians 1:30 that perfectly describes the stage you find yourself in at the moment. It says, "Everything that we have – right thinking and right living, a clean slate and a fresh start – comes from God by way of Jesus Christ." This beautiful sentiment captures your life after addiction. As you have either restored your faith in Him or started a new walk, you have been transformed into a pure, clean creature in Christ. He has recognized your inability to live a faultless life and has forgiven you because you have confessed your mistakes and work to keep from repeating them. As a child of God, all He asks is that you walk with Him daily and work to build your relationship with Him. Build time into your daily life to incorporate prayer and study of the word into your routine. The more time you spend getting to know Him, the less time you will have to be consumed with thoughts of and desires for your old life.

Your Health

Your addiction has taken a toll on your body. Just as much as you need to focus on continuing to build your emotional and spiritual life, you also have to focus on your physical health. Exercise is also necessary to your daily routine and is something you should work to include as often as possible. Research has shown exercise will help increase your metabolic rate, burn fat, and build muscle. It also lowers blood pressure as well as your cholesterol. But more than the physical benefits, exercise is also known to increase endorphins and boost your mood. Because of this, you get both physical and mental benefits through exercise. However, adding in exercise does not mean you have to pay tons of money to go and join a gym or spend a lot of time in fitness classes. Simple things like taking the time to go for a thirty-minute walk or jog around your neighborhood can go a long way to adding exercise to your daily routine.

In addition to exercise, you have to take time to focus on healthy nutrition as well. Good nutrition will take you extremely far in staying true to your sobriety plan. A solid balance of healthy food keeps you more balanced, which will enable you to handle stress and difficult situations in better ways. As you eat better, you may find you feel better physically, which allows you to feel better about yourself in general. With the addition of exercise and good nutrition, you may also sleep longer and better, which will allow you to wake refreshed and remain energized throughout the day.

Your Activities

When you make the decision to start over, it also means getting involved. While you certainly do not want to overextend yourself to the point that you cannot focus on taking care of yourself, you also do not want to lock yourself away in your home. Part of a healthy recovery means getting out of the house and getting involved in the community. For some, this activity may revolve around serving and working with others who are still struggling with their addictions. Focusing on opportunities like this will allow you to work in an environment with others who understand where you are coming from and there is less of an opportunity for you to feel judged. Others may find it beneficial to volunteer in a variety of ways through their local church. Following through on God’s call to serve others and draw them closer to Him provides you with an opportunity to deepen your faith and volunteer in a situation where you feel you are a part of something bigger than yourself.

No matter your long-term goals, the first steps of starting over after addiction involves the primary thought of creating a lifetime of being sober – one day at a time. Intentionally working on your spiritual growth, your health, and your activities allows you to focus your recovery and guide it in a healthy direction that will allow you to remain strong and sober.

Steps One, Two and Three

Whether you know it or not, you have already taken steps one through three. You admitted you were powerless and that your life was completely unmanageable. Every addict and alcoholic takes this first step when he or she hits bottom and realizes that the only way to end the chaos is to stop using or drinking.

Whether you believe in God or you are an atheist, by entering rehab or finding Anonymous or Narcotics Anonymous meetings to attend, you arrived at the understanding that something greater than yourself could get you back on your feet and toward sobriety. If you tried in the past to quit cold turkey and failed, recognizing that you need all the support you can get is taking the second step.

And by looking for a sponsor, and by following the directions of the drug counselors, you are in effect saying that you are willing to turn over your life to something or someone greater than you.

Working the Program

It is usually about this point in recovery that most people start to get a little anxious. With the physical cravings reduced from every single waking moment to something that you can wait to get to a meeting to talk about, you are no doubt feeling as though you are hitting your stride. It’s not uncommon for people at this stage to start thinking, "Yeah, I got this thing under control. I am even ready to make some amends to people I harmed."

This is precisely the reason why the fourth step comes in when it does. Your sponsor will have you sit down and take an inventory of yourself. He or she will have you look at all the things that got you to use or drink in the first place. Admitting you are powerless over drugs or alcohol was one thing, but understanding why you looked to them to numb the pain is another. For some people the reality of their addiction and their personal flaws is excruciating. In many cases it’s the first time they’ve had a chance to really take a long, hard look at themselves. It’s enough to make the most stoic person, even the most hardened criminal sob like a baby. This is good! We all have painful pasts – full of abuse, mental illness, neglect, foster care, etc. Using to forget about the past is understandable. However, there is no way to get clean from your addictions – no matter how horrifying your past is – without facing those demons head on.

Once you have admitted these defects about yourself to your sponsor, and asking God, a therapist, your sponsor or your friends and family who are rallying behind you to maintain your sobriety, to help you remove these flaws, only then are steps eight through twelve even possible to consider.

Although early on in your recovery you were eager to apologize to every single person you harmed while you were in the throes of your addiction, you simply didn’t have the foundation to do this effectively. It is next to impossible to admit wrong doing to others when we are still unaware why we committed the offenses in the first place.

Think of the twelve steps as being similar to being on a plane watching the video that precedes take-off. It advises us that in the event of an emergency, causing the oxygen masks to be released, to place yours over your nose and mouth before you help someone with theirs. This is a simple analogy but there is a clear message here. The first seven steps are in place to protect you and your recovery. With a solid foundation in place, you can face those you harmed and work toward making things right. Once you’ve tackled that arduous task, having had your spiritual awakening as a result of living life sober and on life’s terms, you are ready to help others who are still suffering.

The same can be stated for any addiction by substituting something else for alcohol. Twelve step programs, whether AA or another group, are more successful than many other recovery programs. They understand that the first step towards recovery is the recognition of the addiction and that any denial will derail the process.

Lying vs. Denial

So how do you recognize denial in yourself or someone you love? It is important when confronting this issue to understand the difference between denial and lying or being deceptive. Lying is a conscious act. If you are lying about your addiction, you are doing so intentionally and you are aware of it. Some people lie compulsively and have little control over it, but they still realize that they are being deceptive. If you are lying about your addiction, you are doing so on purpose. Maybe you tell your family that you only had one beer last night, when in reality you finished a six pack. If you suspect someone you love is an addict, observe them carefully to see if they are lying about their actions.

While lying is conscious, denial is not. If you are in denial about your addiction, you truly believe that you do not have a problem. There is a psychological process going on inside of you to block out the threatening reality of your addiction. For this reason, denial is very dangerous. You may not realize that you are an addict. On the other side of the coin, if you are watching a loved one spiral downwards and they can’t admit to having a problem, it can be very frustrating. Understand that their denial is not a conscious decision and that they need help to see the truth.

How to Identify Denial

To complicate the matter further, denial comes in many different flavors. If you can learn to recognize different ways of denying addiction, you may learn to see it in yourself or in someone you love.

• Complete denial. When someone denies having a problem at all, they are totally blind to their addiction.
• Partial denial. It is not uncommon for a user to admit to having less of a problem than they really do. They may state that they could stop if they wanted to or that the drug use is not affecting their lives.
• Failure to see the repercussions. An addict may not deny the addiction, but it is common to deny that it results in problems. They often cannot see that using is destroying their relationships, work, and other aspects of their lives.
• Denial of help. An addict may go so far as to admit to the addiction, but will still struggle on the path to recovery if they cannot admit that they need help.

Whether you are facing addiction in yourself or in a loved one, there are signs to look for, common phrases, and behaviors that indicate denial.

• Rationalizing. Making excuses for using such as, "I only drink because my job is stressful and so is my home life."
• Minimizing. This does not necessarily mean lying. Sometimes an addict will minimize how much they use without realizing they are doing it.
• Blaming. Pinning usage on someone else, "My wife is always on my case. I need to go to the bar just to get away from her."
• Avoiding. Withdrawing from others to avoid having a conversation about addiction.
• Joking. Turning any discussion about a problem into a joke or belittling it to make it seem less serious.
• Arguing. Getting into fights about drug and alcohol use and denying with vehemence.
• Bargaining. Making a deal to use, "If I can have a few drinks tonight, I promise not to drink at all tomorrow.

Forced Treatment

The truth is that an addict will not successfully take the road to recovery without complete acceptance or with any amount of denial. Many times, the loved ones of an addict force treatment in an attempt to deal with the issue. The addict may even seem to accept it, for instance when faced with an intervention, you may see no other option but to take the help. This does not mean, however, that there is no denial present. An addict must come to terms with acceptance on their own terms or run the risk of treatment failing.

Pornography does just that. It removes the element of a marriage, of that committed and trusting relationship. The idea of pornography and its impact on men and women is not new. Although its form may have changed over time, it has been around for decades. What seems to be a little more common now is the admission of an addiction to that pornography by Christian men and women. Just because you are a Christian does not mean you are immune to the pull of pornography, nor does it make you a hypocrite. It simply means you are struggling with a temptation that is affecting you spiritually, physically, and emotionally.

Spiritual Struggles

When we sin, no matter the sin, we feel separated by God. Sin, by its very nature, limits any sort of relationship we can have with the Father. It is when we feel a slight disconnect from God that we allow sin to enter our lives in the first place. When we live our life according to God’s plan, we have a daily relationship with Him, a hunger for His word and understanding, and a feeling of spiritual fullness. An addiction to pornography slowly takes over that role in our life. You begin to spend more and more time with your movies, images, and stories and less time on your relationship with God. This separation causes a deep sense of loss, which may cause you to seek more time with your addiction.

Physical Struggles

Like many other addictions, an addiction to pornography is about personal satisfaction. The wonderful feelings associated with reaching a sexual climax are sought after time and time again. When this physical completion is reached using pornography though, the satisfaction is not nearly as good, which causes you to search more and more for the gratification. Over time, you may feel a decrease in motivation and energy. The secrecy of trying to hide an addiction to pornography also causes exhaustion and depression.

Emotional Struggles

Sex is a vibrant part of any marriage, but it is more than the physical act that calls to us. Relationships are built on commitment and trust and those emotions are what make sex special and whole within a marriage. It is an opportunity to physically show your partner how you love them, how they make your feel. In all meanings of the phrase, it is your opportunity to make love to your partner. When pornography is introduced into the equation, the emotional element quickly flees, leaving only the physical act. It is difficult to feel tied to your spouse when your mind is filled with the images you have recently watched. Although they may not ever say anything, your spouse will feel this emotional disconnect. Because of this, they will slowly pull further away from you, which may cause you to reach further into your addiction. Over time, it can become a vicious spiral that will be more and more difficult to break.

Unfortunately for many, simply making the decision to stop viewing pornography is not enough to end the addiction. As a Christian your first place to begin is on your knees. You know there is power in prayer and that will be your greatest source of strength. But, just as with everything else, God does not simply give you what you ask for. He simply agrees to partner with you and walk with you while you work to be free of the chains of your bondage. Seek support from others who are in your same situation. This can be in the form of a support group, addiction treatment, online supports, or individual counseling. Spend time reading books or other devotionals that deal with this topic to help as you readjust your way of thinking when it comes to pornography. Visit with your pastor or another individual you trust to guide you and not judge you.

However you seek support from your addiction to pornography, you simply have to remember you are not alone and there is hope. When you make the choice to turn away from your sin and remain committed to Christ, you will be forgiven and have the opportunity to start over.

The Bible and Forgiveness

Although the Bible never specifically mentions any phrasing of forgiving yourself, it is clear through other teachings that forgiving yourself is exactly God’s intention. I John 5:19 instructs us that, "if we confess our sins, He is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.” Acts 3:19 indicates once we have repented, our sins have been blotted out. Jesus instructed us in Mark 11:25 that if we have anything against anyone forgive them, so that the Father can forgive us. If God has forgiven our sins, and cleansed us from any unrighteousness, who are we to determine He is wrong and to hold onto them?

Forgiving as an Action

Forgiving is not about forgetting. Forgiveness is choosing not to dwell on the negatives that have happened. When God forgives us, He wipes the sin away, allowing us to focus on Him instead of the sin we committed. Just as we make the choice to remain sober and clean every day, we must also make the choice to focus on the positive elements in our lives. Forgiveness is a choice. We can choose to follow God’s example and turn away from the reminders of the negative, or we can claim to know more than Him and continue to wallow in the anger and guilt of our actions.

Forgiveness as an Emotion

While making the choice to forgive yourself is an action, you have to actively feel that emotion as well. Simply making the decision to forgive yourself is not enough; you have to be willing to feel the forgiveness. Just as you feel yourself become a new creation through Christ’s grace, so must you also feel the forgiveness cleanse your spirit.

Help Yourself, Help Others

As a recovering addict, you know you have caused pain to your friends and to your family. As they see you heal and grow in Christ, you have the ability to restore their faith and trust in you. However, as long as they continue to see you struggle to forgive yourself, they may struggle with the same thing, causing more pain. You know you cannot change what happened. The choices you made while you were addicted have left wounds and scars. But, those can heal and that healing has to begin with you forgiving yourself.

Forgiveness is crucial to healing of any form. As recovering addicts, we know there is much to heal. That healing can only begin as we move from guilt and anger to love and forgiveness. By loving ourselves, we show our families we are capable of loving them as well.

This is a situation that happens all too often. Waking up from the nightmare of your addiction, you anticipated that your family would be there, pompoms in hand, cheering you on every step of the way. At this point, you must be wondering two things: Where are they and how will you ever be successful without them?

Your Sobriety is Your Number One Priority

Before you get too far ahead of yourself worrying about your family and their motives, you have one very important task before that must be accomplished. You must not use drugs, today. Asking questions whose answers will only serve to get you back inside your head is a dangerous endeavor. There is time enough for that when you are more stable in your recovery to ask the tough questions and even confront those issues.

With Time Comes Clarity

After you have a little more time under your belt, you could discuss this with your sponsor. He or she will impart some things to you, which because you were in the throes of addiction, you couldn’t see. Some common reasons for family turning their backs on an addict who is finally in recovery can include:

• Theft
• Repeated, yet unfulfilled promises to stop using
• Abuse – be it physical, emotional, verbal or sexual
• Lying
• Cheating
• Exposing loved ones to danger

Something all of us addicts have in common is that when we are using, drugs become the most important thing above all else. Above honoring marriage vows, protecting family heirlooms, keeping promises, or caring how our abusive actions and words can destroy those we love, the desire to use is stronger than all of those things. Addiction is a family disease that doesn’t just affect the user. Whether or not our recollections are the same as those whom we harmed, wreckage caused by our using leaves prolonged impressions long after we get clean, admit our mistakes and ask for forgiveness.

And This Too Shall Pass

Although we have this belief that the moment we become sober, the world should just open up to us, in reality loved ones, creditors, and others we harmed take a wait and see attitude. Expecting us to slip at the first sign of adversity, for those we harmed the fear of relapse is real. Part of addiction being a family disease is that it is very difficult for people you harmed to not personalize your addiction, and even your recovery. But you must remember that you didn’t get sober because you wanted their approval. You hit bottom and it was time to stop.

But something incredible happens to all of us and it will happen to you as well. Change is inevitable. Nobody can come back from the brink of hell, work as hard as we all do to maintain our sobriety for it to go unnoticed by all who see us. It may not happen in the timeframe you want, but it will happen.

Be Open

The only requirement for those who desire to participate in an AA program is the desire to stop drinking. There is no questionnaire to fill out, no guard at the door, no one individual demanding belief in God as admission. As addicts, we are all struggling with the same disease. There is not a single one of us that is better than any other individual. Some of us may be sober longer than others, some of us may know our sobriety comes with the strength our faith provides us, but we are still alcoholics.

Be Welcoming

If there is anyone who can understand the struggles a new member may be dealing with, it is those who attend the meetings. As members of any 12-step program, we need to ensure everyone who approaches a meeting feels welcome. Every individual needs to be greeted. Offer conversation. Offer a handshake or a hug. Make sure the individual knows they are invited to be a part of the group and that they will find the help they need while attending the meeting.

Be Supportive

There is a simple goal involved in AA: do not drink, just for today. It is the kind of goal that supports the struggling alcoholic. There is no need to focus on the forever, just the here and now. Do not have a drink right now; do not have a drink today. As active members of AA, our responsibility is to support each other through this goal, just as we have received support at times. There is no room for judgment in AA and if you are judging anyone in the meeting, you cannot be supporting them. This does not mean you have to hide any of your beliefs, or that you cannot talk about where your strength comes from. It simply means that if your newest member indicates they cannot get their strength from God because they do not believe in Him, you do not immediately respond with all the evidence of why they are wrong. You simply find common ground where you can and support them through their decision to not have a drink.

The purpose of AA is not to convert individuals to Christianity; it is to provide a way for individuals to get sober and remain sober. As members of AA, we must never forget that. As Christian members, we are called to love and support, never to judge and accuse. Our ability to be welcoming, supportive and nurturing will do more to heal other members and to help them remain clean and sober as we do as well.

Pray

In all things you do, seek solace in your relationship with your Father. When you stay focused on your personal relationship with God, He will strengthen you and fill your mind with peace. This is a trying time. Your soul cries out and your heart bleeds. But, you can be assured in your darkest moments that He is walking with you, supporting you and carrying you. Your daily prayer life will keep you connected to the Father and guide your thoughts and words as you move through this process.

Seek Support

You do not have to face this alone, nor should you have to. Seek support from those you trust the most. Perhaps it is a small group you meet with like a Sunday School class or Bible Study group, Maybe it is a close group of friends or family. Whoever it is you can reach out to, rely on them now. Let them be a sounding board as you decide what you want to say, as well as how and when to approach your loved one. Let them be the ones you cry with and pray with when you feel overwhelmed. This may also be the time to look for support from your physician or other addiction specialist. Rely on those who have been down this road, who have specific training and experience to guide you through the process.

Make a Plan

This is the time to decide how you plan to approach your loved one. You may decide to begin with a simple conversation, or you may choose to stage an intervention. However you approach them, think through how you would like the conversation to go. Plan what you want to say; even going as far as to write things out if that helps you. This plan will sustain you as you move through the conversation; it will serve as a guide when anger and other emotions hit. Your plan should include:

• Statements of how much you love them and what they mean to you.
• Specific incidences of how their addiction has affected you and worried you.
• An offer to approach the next step with them so they know they are not alone.
• A time to listen to their responses and feelings.

Prepare Your Heart

As difficult as it may be, you need to prepare your heart and mind for their possible rejection. Having a conversation like this is not easy for you and your loved one may not want to hear what you have to say. They may react with anger, viciousness, or denial. They may also not be at a point where they desire any sort of a change. You cannot take it personally and you have to remember you cannot make the choice for them.

As you move through the process of approaching your loved one, rely on God, and seek support from your friends and family. If your conversation goes well, you will need them as you help your loved one move forward with their steps into recovery. If your loved one rejects your offer for help, you will need them as you regroup and decide where to go from here. Just remember, you are not alone.

The final step in the twelve step recovery program is to take your message of sobriety and recovery out to other addicts. As a recovering addict, it is your responsibility to help others who are suffering as you did. It is important, however, to only begin volunteering when you are comfortable with your new sobriety. If you are too early in your recovery process, you need to focus on yourself before helping others. There is a reason that this is the final step.

Be an Example and Inspiration

When you are beginning your recovery, the odds of a relapse are high. Every day and every minute is a struggle to stay sober. You often feel hopeless. Although relapse can also happen to "old timers” – meaning those with years of sobriety – the longer you work the steps of the program, the better your odds become of maintaining sobriety. When you have finally reached a better place, you can act as an example of what others can achieve. Remember your early struggles and imagine how it could have helped to have someone to look up to. The power of an inspiring person is immense. You have the chance to offer hope to those who are struggling to believe that they can ever achieve sobriety.

Share your Knowledge

By simply being around to show suffering addicts what successful recovery looks like and that it is possible, you are a powerful source of inspiration. Beyond that simple move, you also have the ability to share your knowledge and experiences with those who need your help. As a volunteer, you can give other addicts tips and tricks that helped you to advance through recovery. You are a vast source of knowledge that can help others make their way through the maze of addiction recovery.

Opportunities

Where you volunteer to help others recover will determine the opportunities that are available. It is a good idea to work where you experienced recovery so that you can share with newcomers the success they, too, can find there. You may be able to volunteer in an administrative capacity, as a tour guide, as a speaker, or as a mentor to other addicts. If you are not yet comfortable working directly with other addicts, you can help in other ways and your presence as someone who successfully became sober will provide inspiration. If you do feel as if you can work with people, your experiences and knowledge will be invaluable as a mentor or a speaker.

Help Yourself

As a recovering addict, volunteering to help others is also a way to help yourself. As successful as you are at this moment, you always have the potential for a relapse. Offering yourself as a mentor, or a sponsor and as an inspiration for what others can achieve can help you to think twice and maybe three times before going back to drugs or alcohol. Knowing that others are counting on you for their own recovery can be a powerful deterrent. Consider volunteering for the help and comfort you can bring to others and for the security you can give to yourself.