The Mental Health Needs of Returning Veterans: A Growing Crisis

In recent years, public awareness regarding Post Traumatic Stress Disorder (PTSD) and the possibility of difficulties when veterans return to civilian life has increased. So much so that PTSD has become a well known acronym. But beyond PTSD, the full spectrum of mental health and substance abuse issues faced by vets returning from Iraq, Afghanistan, and other conflicts around the world are numerous and sufficiently severe as to merit being labeled a crisis. Adding to the problem, the unemployment rate for returning veterans is well over 20%, and homelessness rates are unconscionably high. Some writers and reporters have compared the current state of affairs for returning servicemen and women to the AIDS crisis of the early 1980s: unless you were directly affected, you just didn’t know how bad things were.

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.