Long buried combat stress returns after 9/11

Don returned from Vietnam with horrific memories, and his service was looked down on by some. He busied himself at home, avoiding anything that might evoke feelings he wanted to bury. After 9/11 it all came flooding back but he didn't see it in himself. His wife, family doctor, and VA helped him face his issues and lift the burden of combat stress.

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What is depression?

Jump to a section below

• What are the signs of depression?
• What is the treatment for depression?
• What can I do if I think I might be depressed?
• Take the next step – Make the connection.
• Explore these resources for more information about depression in Veterans.

You’ve lost interest in things you used to enjoy. You avoid being around people. You feel intensely sad, down on yourself, or hopeless. You’re irritable…with everyone. Could it be depression?
Everyone experiences sadness, irritability, or low energy from time to time. But depression is different from these occasional feelings. If you have depression, it can be hard to do everyday activities and you may have problems with your relationships. You might focus on what’s not going well in your life and have trouble seeing the positive. Perhaps you don’t feel pleasure in the activities, people, and things you used to enjoy.
Some Veterans experience depression because of the loss of someone close to them, like a loved one or a buddy from their unit. Others might feel depressed after losing or changing jobs. When this sadness lasts for more than a few weeks or is seriously impacting your life, it may be a sign of depression.
Depression is a common problem that affects people in different ways. It not only affects your mood, but also affects your body, actions, and thoughts. Depression can interfere with daily life and normal functioning.
Depression is not caused by personal weakness and is not a character flaw. It can affect anyone—young and old, men and women, all ethnic groups, and all walks of life. However, there are effective treatments are resources for dealing with depression.

“I stopped exercising altogether, stopped being social and going out with my friends, even missed an entire week of school because I didn’t feel like getting out of bed. I knew something was up, but at the time I just thought I was in a funk.”

Stressful situations or traumatic events that sometimes occur in military life might be associated with depression in Veterans and Service members. Life events that may cause stress include:

• Death of a friend or family member
• Traumatic events such as combat, injury, natural disasters, or physical or sexual abuse
• Health problems or disabilities
• Retirement
• Transitioning to civilian life after military service
• Preparing for deployment
• Reintegration
• Relationship problems or divorce
• Birth of a child
• Changing jobs, difficult work situations, or losing a job
• Financial problems

No matter what stressors you may experience or where the depression may have come from, it’s important to seek treatment.

What are the signs of depression?Back to Top

The signs and symptoms of depression may be hard to notice at first. One way to tell if what you’re experiencing might need attention is to consider if your thoughts, moods, or behaviors have changed noticeably. Is your mood different than “usual” for you? Have others noticed a difference?
For some people, these symptoms may not be something new. It might seem as if you have always felt down and blue.
Two common symptoms of depression are:

• Feeling sad or hopeless
• Losing interest in or not getting pleasure from most of your daily activities

“Over there, I never had the time, energy, or free will to even begin to deal with some of the emotions I was bottling up. A few months after I got back was a different story, though. I was finally having to deal with all the issues I’d stored away”

If you experience either of these symptoms nearly every day for at least two weeks, you may be depressed.
Not everyone with depression has the same symptoms or feels the same way. One person might have difficulty sitting still, while another may find it hard to get out of bed each day. Other symptoms that may be signs of depression or may go along with being depressed include:

• Gaining or losing weight
• Eating more or less than usual almost every day
• Sleeping too much or not enough almost every day
• Feeling restless and unable to sit still
• Feeling that moving takes great effort
• Feeling tired or as if you have no energy almost every day
• Feeling unworthy or guilty nearly every day
• Having low self-esteem or feeling down on yourself
• Finding it hard to focus, remember things, or make decisions nearly every day
• Feeling anxious, worried, or nervous
• Drinking more alcohol or caffeine
• Taking more of a prescription or over-the-counter medication than as directed
• Smoking or using tobacco more often

Having thoughts of suicide, thinking others would be better off without you, or that there is no other way out of your problems are very serious symptoms of depression and need immediate attention. It’s important you talk to someone right away if you have thoughts of death or suicide. If you are thinking about death or suicide, call the Veterans Crisis Line at 1-800-273-8255 and Press 1. You can also use the Veterans Crisis Line online chat. Both services provide free, confidential support, 24 hours a day, seven days a week.

What is the treatment for depression?Back to Top

If you are depressed, there are things you can do to recover. There are a number of effective treatments for depression that can lead to positive and meaningful changes in symptoms and quality of life. Hundreds of thousands of Veterans have gotten help—and treatment works.

“I wasn’t a big fan of pills, or therapists for that matter. But I got to the point where anything was worth a shot. Now that I got the treatment I needed and see how much better every day looks, I wish I would have gone in sooner.”

Treatments for depression can involve counseling, therapy, medication, or a combination of these. Therapy and counseling can help you learn new ways of thinking, practice positive behaviors, and take active steps to cope with your symptoms. Antidepressant medications work in different ways to affect the chemicals in your brain that may be associated with being depressed.
You may need to work with your doctor or counselor and try different types of treatment before finding the one that fits best with your preferences, symptoms, and challenges.
In addition to getting treatment, you can adjust your lifestyle to help relieve depression symptoms. Try to work these into your daily routine:

• Walk, jog, or work out—Physical activity can improve your mood and help you sleep better
• Eat healthy meals regularly—Good nutrition helps your body and your mind
• Try to get a good night’s sleep—Getting quality sleep can help you feel better
• Practice relaxation or grounding techniques—A shower, deep breathing, or time in a quiet place to collect your thoughts can help relieve stress and get you through difficult moments

What can I do if I think I might be depressed?Back to Top

Your close friends and family may be the first to notice you’re having a tough time. Turn to them when you are ready to talk. It can be helpful to share what you’re experiencing, and they may be able to provide support and help you find treatment that is right for you.
You can also take a confidential and anonymous self-assessment to help you find out if your feelings and behaviors may be related to depression. This short list of questions won’t be able to tell you for sure whether or not you have depression, but it may indicate whether it’s a good idea to see a professional for further assessment.

Take the next step – Make the connection.Back to Top

“Anyone who knows me will tell you that I’ll be the last one to admit I have a problem or need help with something. But it turns out I didn’t have to admit weakness to get help. I just needed to realize that there’s support out there that I can use.”

Every day, Veterans connect with helpful resources and effective treatments for depression and find solutions that improve their lives. It can be difficult to handle depression on your own, so talking to your family and friends can be a first step. You can also consider connecting with:

• Your family doctor: Ask if your doctor has experience treating Veterans or can refer you to someone who does
• A mental health professional, such as a therapist
• Your local VA Medical Center or Vet Center: VA specializes in the care and treatment of Veterans
• A spiritual or religious advisor

Explore these resources for more information about depression in Veterans.Back to Top

“The counselor I talked to was a Veteran himself and broke it down to me like this: In the service, you wouldn’t hesitate to fix a flat tire on your vehicle, or put a field dressing on a wound. So now that you’re out, why should taking care of your mind, body, and emotions be any different?”

Vet Centers
If you are a combat Veteran or experienced any sexual trauma during your military service, bring your DD214 to your local Vet Center and speak with a counselor or therapist—many of whom are Veterans themselves—for free, without an appointment, and regardless of your enrollment status with VA.
http://www2.va.gov/directory/guide/vetcenter_flsh.asp
Learn more about depression and how it can be related to other issues such as chronic pain, trouble sleeping, relationship problems, retirement and aging and posttraumatic stress.
afterdeployment.org
Take an online workshop with interactive exercises to evaluate the symptoms you are experiencing and hear from other Veterans and Service members dealing with depression.
http://www.afterdeployment.org/web/guest/topics-depression#
VA Medical Center Facility Locator
This website will allow you to search for VA programs located near you. If you are eligible to receive care through the Veterans Health Administration, you can enroll in one of VA’s depression treatment programs.
http://www2.va.gov/directory/guide/home.asp?isflash=1
SAMHSA Mental Health Services Locator
The Substance Abuse and Mental Health Services Administration provides information on services and resources near you.
http://store.samhsa.gov/mhlocator