Veteran Experiences with Mental Health Conditions and Treatment
Veterans with GWI often described co-occurring mental health challenges. Some conditions, such as posttraumatic stress disorder (PTSD) were diagnosed and treated separately, while others such as depression were more closely intertwined with GWI symptoms and functional limitations. Across many mental health diagnoses, Veterans shared feeling stigmatized and at times isolated. Below, we highlight some of the mental health conditions that were described by participants as well as descriptions of some of the treatments they sought to manage these mental health conditions.
Posttraumatic Stress Disorder
PTSD was a common co-occurring mental health diagnosis among those who we interviewed. Veterans described exposure to traumatic events during deployment and current struggles with nightmares, hypervigilance, and mood. We heard about the day-to-day challenges Veterans living with PTSD faced. Shannon described a stigma associated with being a Veteran with PTSD, and Paul noticed PTSD affecting his everyday life.
Shannon discusses the struggle of having PTSD in a small town.
Shannon discusses the struggle of having PTSD in a small town.
You deal with people on a daily basis with PTSD and if you can’t recognize that, or if you’re just categorizing you know just PTSD as dangerous then you need to be educated. Because it’s for anybody who has suffered any sort of trauma. So, it just goes back to, the PTSD and the education that just because you’re a Veteran does not mean that you’re a danger, so. You know, so that’s an experience that I have firsthand knowledge of in this town, so I fly under the radar, don’t go into town. I you know, thank goodness I can just go straight up and straight, hit the freeway, you know. So I don’t have to go through town because I am a target. I have had many, many instances with judges, well one judge in particular, I shouldn’t say judges. But one judge in particular who has it out for me, you know, and so. So yeah I’ve become a target on many levels, you know? Not just in, not just with the businesses here but also with some of people, you know? Or the county offices. So yeah, it’s just and since it’s such a small town it affects the way I live, so, yeah. So I’m kind of glad that I live like way up here where I have no neighbors and I’m far enough away from everybody, you know. But that is part of the problem, and the condition you know of PTSD is, you do isolate yourself, but then it doesn’t help when your community isolates you also, so, yeah. That’s a tough thing, but to go back to the VA, medical services that has helped immensely, you know. Being able to go to all the different programs and you know all the resources that they have, have helped a lot, you know it’s just unfortunate that I have to go there for all of that, which but it’s okay because I get out of town, because I don’t go that way, you know. So that’s okay. But I’m glad that they do have resources and like right now I’m taking, now I did recently take the mindfulness class, so that’s a tough one but I’m trying to be way more mindful of that, of different situations. But other than that I mean there’s so many resources at the VA that sometimes I end up going five days a week.
Roy reflects on the effects of the Gulf War on his mental health.
Roy reflects on the effects of the Gulf War on his mental health.
On the PTSD side, the symptom of your pain is just the mental anguish of the things that we’ve done. Nobody ever asked about that. How do you feel about bombing little kids, women, people that had nothing to do with the war effort, people who honestly didn’t run very fast? They got caught up in that war, and it was hell. It was hell on a lot of people. I regret the fact that we brought a lot of people that had nothing to do with that war, a lot of pain and a lot of bad days. In some instances, during Desert Shield/Desert Storm, when you kind of look at it, I mean this is just my opinion, some of them people that we bombed, they didn’t have a grave to go to, to mourn their dead. Some of them people were just blood spots in the sand and stuff. And for that I’m ashamed. But war is just war. What can you say about it? Things happen. And some bad, sometimes you have a miracle in the midst of all the madness, but for the most part, it’s just madness. And a lot of people, if you ain’t experienced it, it’s kind of a hard thing to explain. A lot of people that have been down range, it’s not necessarily the—Oh, everybody died event, and I’m the only one that survived. I look at it this way: It’s the war experience. It was just the fact that we had to go and do something against our moral beliefs of hurting people. When I was younger, I was a martial artist. The thing is there, in that arena, it’s about preserving life and understanding how to preserve life. When I came into the military, I bought into the program, hook, line, and sinker. I had good mentors train me well. They did. The stuff to do my job, in the face of danger. They taught me well. But there’s some hard prices that you pay for war. And a lot of it falls on the back of the innocent. Not necessarily the evil people that perpetrate it, but the innocent people that are just there, that get caught up in it. It’s kind of a shameful act, in my opinion.
“Roger” struggles with frustration and guilt as part of his PTSD.
“Roger” struggles with frustration and guilt as part of his PTSD.
Now the fatigue and the PTSD from that just, your head could explode from that frustration and the guilt, I’m dealing with that. But I retired out of [Fort name redacted] and I immediately went to work as a civilian, just finding things to do and I’ve got lucky and scored a few corporate jobs, and did rather well. Got divorced, especially when you have a nightmare and you find yourself on the floor and the wife says, well I didn’t know what to do, I was afraid I was going to have get the shotgun and shoot you because I was afraid for the kids. I’m like, thanks, appreciate your support. So that didn’t last much longer. And, gotten few years later got remarried and still tried to tough it out, trying to make a living, you know you just tough it out and you go to the VA doctors when you can. You know and they want to focus on your alcohol, well yeah I’m trying to put myself to sleep and stay asleep. And they say, well how much do you drink? I don't know I drink until I sleep, you know? And of course, we know how alcohol works, after a few years it just takes more and more and more to put you, to knock you out.
Paul understands his PTSD triggers, and avoids them at all costs, resulting in him changing jobs.
Paul understands his PTSD triggers, and avoids them at all costs, resulting in him changing jobs.
The first thing the PTSD, so I do have symptoms. I'm not a violent, aggressive person, so nothing like that. I'm very calm and mild and common sense and grounded, so that’s not an issue. It just, some of the stuff, I don’t like traffic, like it freaks me out. Heavy traffic or if somebody cuts me off or rides my bumper that really freaks me out because of that one, that traffic accident where all the prisoners fell off and got smashed. So that just really bothers me. I don’t like big groups. I cannot stand to be around crowds. This may sound bad, but I really don’t like people. I kind of have my little group of people that I'm around my group of people. And I'm not social; don’t want to be social, totally disinterested. You know what I mean? So I do have those issues. So I just basically, I go to work, I go home, I don’t do a whole lot. I guess I kind of isolate myself and I do it intentionally. The aches, the pains, that stuff I just deal with it. I just, you know, just keep going. Go to work, go home.
Paul: Now at work, I can tell you the work thing, I was in a position before where I had to go to meetings all the time. And I didn’t like being around people so I intentionally would do everything I could not to go to meetings, to find reasons not to be there. Got to the point where I actually refused to go to meetings because I didn’t want to be around the people, so it affected me that way.
Interviewer: Yeah. It sounds like you’re still able to work and still in a different type of capacity.
Paul: Yeah, I've, I'm in a different job where I don’t have to go to these meetings and all that. I can't stand some of the people. Part of my previous life, I was a cop. And right now, technically I'm a cop still, but I don’t do cop duties anymore. Previously I used to do a lot of investigations, and I've, because of doing a lot of investigations I'm very privy to a lot of what some of the upper echelon has done so I don’t particularly like or trust them. So when I would have to go to a meeting and be surrounded by them and it really put me off…
Mike stresses the importance of staying active to stave off negative effects of PTSD.
Mike stresses the importance of staying active to stave off negative effects of PTSD.
I want to die on my feet. I don't want to die sitting on some couch. And that was that way when I was 20, and it's going to be that way if I’m lucky enough to make it to 70. I mean, I’m going to try and stay active. And there's a lot of things, and that's one of the things with PTSD. I don't find a whole lot of joy in anything anymore, but everything has been stripped from me, so it's kind of hard to do that. I can't really do physical manual labor. That doesn’t happen, because either I'll throw my back out, or my joints will hurt even worse, or, it just doesn’t work. If I do manual labor for any great amount of time, three or four hours, it will knock me down for two or three days. But if I go walk, and I go pick weeds, or I ride a riding lawnmower, I’m all good. It's when I exert myself is when it gets worse, and it definitely gets worse. It's not in my head. It's in my body.
Anxiety and Panic
Anxiety and panic were also described by several of those whom we interviewed, with symptoms affecting day-to-day life as well as relationships.
Shannon needs to stay acutely aware of what’s happening to her body to ease her health anxiety.
Shannon needs to stay acutely aware of what’s happening to her body to ease her health anxiety.
Shannon: But yeah I’m very, very aware of my body, so. Sometimes it even causes me anxiety, so sometimes it’s not so good. But, yeah, I mean it just, yeah 'cuz when I, if something like triggers in my body then it will increase my anxiety, so yeah. That’s kind of a tough one sometimes to decipher.
Interviewer: ‘Cuz then you’re like, oh no I’m getting worse. And then you focus on it__
Shannon: Right, well and then, and that’s why I think the medicine is important. Because the medicine, or the symptoms of, some of the symptoms 'cuz I have different varying degrees of anxiety, can trigger, or. An anxiety attack can mimic a heart attack, you know the symptoms. And so that’s, it’s counter, it’s not productive when you’re having a panic attack because when you have a panic attack then you’re thinking you’re having a heart attack. And then you go to the emergency room. And I mean and if it’s just a panic attack, that’s not an emergency but I mean it is having an effect on your body. But if you have the medication to where you can take the medication, then you’re like, oh okay now all those symptoms have gone away I’m not having a heart attack and I don’t need to rush to the emergency room every single time. I think that, overall for mental health also would be very beneficial, to be able to take the medication. See I do take the medication as needed. And so, I had to get an outsource doctor to give me the medication but I only take a half a milligram as needed__
Interviewer: If you’re having a panic attack, or?
Shannon: __and I control that, yeah. And I control that. I mean I might go two weeks, I might even go two months and not have a panic attack. But then when I do, I have it, and then, you know. And that helps me because it’s like, okay well now the symptoms are gone, I mean sometimes it doesn’t help, I mean sometimes I have panic attacks that are just out the roof, and sometimes I have mild panic attacks. But it’s nice to have the medicine because I know that with the cortisone or the cortisol, and all that going through your system, that can’t be good for your body, when you’re having a panic attack. So, yeah that’s, but I’ve had to go to an outside source for that.
Robert’s wife knows when he’s having an anxiety-filled day.
Robert’s wife knows when he’s having an anxiety-filled day.
I take medication to help me sleep and to help me be not so anxious with my anxiety and stuff. Yeah. It’s difficult sometimes when I get anxiety I can’t sit still and I rock up in my chair and I go back and forth and my wife says, you got it today, huh? And I says, yeah, I got it. She can read me pretty good.
Rick says using marijuana after prescription medications didn’t help his mental health conditions.
Rick says using marijuana after prescription medications didn’t help his mental health conditions.
And I started to have panic attacks. I thought I was dying. The emergency room civilian care get three times, thinking that I was having a heart attack. My heart issues racing, racing heart, dizziness, nausea. Diagnosed as a what do they say a panic attack, anxiety. They gave me more pills. So at one-point VA had me on five Clonidine a day trying to get me, break the cycle of these panic attacks. Five Clonidine a day, three Xanax a day, two to three Xanax a day. Five Clonidine. And SSRI called Trintellix because the others hadn’t worked. Ambien to sleep, highest milligram 10. Civilian care I was getting 12, that was another issue that I had prior to military care was sleep as well. Having to be prescribed Ambien as well. And treating all of those things with marijuana. Psychological issues, anger, depression, possibly depression I don't know. And sleep, and mood. And still continue to use that to this day.
Depressed Mood
Many of the Veterans we interviewed discussed experiencing depressed mood or depression. Mood changes were described in the context of GWI symptoms such as pain, fatigue, and headaches. For example, for Shawn it was the loss of function and social isolation that made the depression “set in.” Broader life experiences or changes such as transitioning back from deployment were also sources of mood changes and depression.
Roy explains his struggles with depression.
Roy explains his struggles with depression.
I’m starting to hurt more, back’s hurting, you know, I don’t really want to do the things that she needs done and all that good stuff. It was just—it became a drag, and everything. I started getting depressed, anxiety, felt like I was useless, a piece of crap. Still feel that way, to this day, because I don’t really produce anything besides my retirement and my disability. And all that. And so that was a good portion of it. I promised my wife, you know—Sus, I won’t come home—you won’t come home to a mess. I’m not going to off myself, I’m not going to be that greedy. Because I honestly had to think about suicide and stuff. My kids. What would happen to my kids if I left them all behind, and everything like that. I really, truly did. I had to think about being selfish like that, because it would have been easy to—because what’s left for me?
Shawn reflects on letting depression and guilt send him into a dark spiral.
Shawn reflects on letting depression and guilt send him into a dark spiral.
So yeah, even if I've had sick leave, like when I worked for the VA. If I missed a day of work, I came back, and there's was a lot more work. But also somebody had to do my job while I was gone. And so I’m feeling guilty. Do I go and apply for a job, and I know the Disability Act will cover me to an extent as long as I can safely do the job, but at the same time, the burden I’m going to put on somebody. What can I do that I’m going to be close enough to a restroom if I have that? What do I do if it's a small crew, and I wake up, and I have these headaches? I can’t get out of bed. So you really, the depression weighs more and more. And then people see you and like, what's wrong? You're in a bad mood. No, I just don’t feel good, and it becomes your life. And then you get that negative feedback from the girlfriend or from other people and like and unfortunately, I’m somebody that really worries too much about what other people think, so that makes it even worse.
The VA programs and medications for depression only go so far, according to Robert.
The VA programs and medications for depression only go so far, according to Robert.
And I just—my mind is just so scrambled right now. There’s so much I want to say and it’s just for having migraines and headaches for this long it has done something to me. I’ve been like re-wired because I can’t—a lot of times even when I talk to my wife, I can’t get what I’m trying to say to her across the way I want to. And sometimes she gets frustrated like that and that’s not a good way to be. And that’s why I’m trying to do everything that they ask me to do here at the VA; go to different classes and do these different opportunities, you know, physical therapy and all these different classes. How to Heal Yourself and things like this because if I don’t do it, I won’t know what will help. And that’s what’s most important. And a lot of times I don’t even feel like getting out of my house. But when I do get out of my house it’s usually to come up to the VA for appointments, or maybe I have to go shopping for some food and that’s it. I don’t get out very often. And that’s what the migraines have done to me. I’ve been put in depression. I’m on depression meds. I’m on sleep meds. There’s just so much and my body can only take so much.
Suicidal Ideation or Attempt
A number of Veterans described difficulties with their physical state and mental health, which at times got so bad that they felt hopeless and contemplated suicide. During these challenging times, all ultimately found a reason for living, such as meaning in relationships, helping others, spirituality, or something else.
“Santos” recalls that his “whole life fell apart” and considered ending his life, but connected with two other Veterans going through “similar problems.”
“Santos” recalls that his “whole life fell apart” and considered ending his life, but connected with two other Veterans going through “similar problems.”
So it was from the time I got back till [month redacted] of '92 my marriage fell apart, I was starting to experience all of these physical symptoms, the joint aches, the rashes, the fatigue, and then what I now know as PTSD. All of those symptoms. The depression with PTSD. The only time, I mean I seriously contemplated suicide at that point. I was the unit [job redacted]. I had the access codes to more weapons and ammunition than you would want to know about, and I seriously contemplated killing myself because my career was shit, my marriage was crap, my body was falling apart. The military was everything that I wanted, everything that I had lived for. And to see it just go down the tubes like that, and what was the hardest is I just didn’t understand what was going on. I didn’t understand what the heck was wrong with me. So I was able to, the only people that I could really talk to was the people that I went over there with because a lot of those guys were having similar problems. At one point, I was sharing a barracks room with two other guys whose wives threw them out because they couldn’t get along with their wives. So it was kind of, and at the time, we thought it was kind of funny that the three of us are in a barracks room together, but over time, it wasn’t funny anymore. This is serious shit watching your whole life fall apart. Again, I didn’t understand what was going on physically and mentally.
“Doug” recognized he was in a dark place and admitted himself to a hospital to get help.
“Doug” recognized he was in a dark place and admitted himself to a hospital to get help.
I admitted myself to the mental ward at one time when I was going through a particular situation, and there was no way I was going to be able to bear whatever I was doing. It was ideations of suicidal, suicidal communication, but it wasn’t something I was going to do… But it came to the point where I needed to educate myself on how to bear things and how to deal with things, and I didn’t think it was really beneficial for me to be there to get taken care of. I was there for about three weeks. And I just needed a break because there was so much I was going through at the time. And I ended up receiving that care, but at the same time, I knew the unit, they were backlashing like I was pulling a fast move or something. Usually a lot of times when soldiers go to receive mental care, the command usually tries to language that, saying they're trying to get out of something. They're trying to avoid something.
“Roger” was able to pull himself back from the brink with a call to the Veterans emergency line.
“Roger” was able to pull himself back from the brink with a call to the Veterans emergency line.
Before I came out there I did have a kind of a breakdown you could say, where all of my personal problems and everything was just coming down on top of me. And I was, I never thought I’d do it, but I, was started thinking about suicide, you know? But I pulled back from all that, because and I told him, what I was doing was , well shooting yourself with a pistol is messy, you know? I don’t want someone cussing my name because they got to clean up my brains. Hanging myself is, nothing’s going to support the rope. I’m going through all these options and one of them I settled on was, some really good, saved up all kinds of medicines over the years and just thought I would do it all with a whole bunch of alcohol, you know? And, divorce was happening, bad relationship was happening and the world was closing in on me. So that’s when I called the emergency line. And, I pulled myself back actually.
After Chuck lost everything, he sought comfort in his religion which he credits for saving his life.
After Chuck lost everything, he sought comfort in his religion which he credits for saving his life.
I lost everything. I lost the farm I had, I lost the job I had for 26 years, I lost it all. And that’s when I was living in this trailer, which the Lord put me here. And on my fridge I put Matthew 22:37, to love thy Lord thy God with all their heart, mind, and soul. And every morning I would get up and read that. Every morning I would get up and read that. Until I finally got to a point where I couldn't function anymore, and when I kept hearing these Vets that were committing suicide, 22 a day, I got down on my knees one night, I said, Lord, I can’t do this no more, I said, I’m ready to commit suicide, it's just that bad. And I told my Lord and Savior, I said, Lord, I need you to show me your true will. I need you to pick me up. And I’m telling you what, the next day, He picked me up, and He showed me He cared.
Mental Health Treatment Experiences
Veterans share various experiences with mental health treatments such as psychotherapy and medications. Each shared personal preferences for different forms of treatment with varying degrees of success. Many learned to cope with their ongoing challenges with various lifestyle changes as well. To hear more stories and strategies related to coping, click here.
“Santos” was faced with a decision: mental health treatment or his job.
“Santos” was faced with a decision: mental health treatment or his job.
My bosses are really pissed off now because I've been going to the VA. Ever since I started going to the VA, that was kind of like a curse because you can’t go there at 6:30 at night because I have to go during duty hours, and the VA wanted to see me, okay, you’ve got an appointment. I said, I can’t make that. I can’t make that. So my boss, meanwhile, my boss is getting pissed off. So, anyways, so I told them, I said look, I want to see somebody for my PTSD, but it has to be off hours. So they said, okay, well, we're going to send you, since we cannot accommodate you because you're working, we're going to send you to an outside psychologist… . So I started seeing her and going in on a regular basis, on a weekly basis. And at that point, I thought that maybe seeing her was starting to help, but then the VA sent me a nastygram saying we're not going to pay for her because we’ve got facilities right here that you can go to Monday through Friday, so they refused to pay her. So it was basically the VA cut me off with her, so now I've got a choice. Either go get PTSD treatment during duty hours and risk my job, which I wound up losing anyways, or don’t get any treatment. So my options were really bad.
Debra tried several types of therapy before finding something that worked.
Debra tried several types of therapy before finding something that worked.
I made it through two sessions, and then I started having panic attacks. I started not going, I would cancel every session I made. And she, made sessions, you know, three months in advance. And I’d look at my calendar and go, ah. And I just, I couldn’t do it, prolonged exposure. I don’t think that works real well for sexual trauma. I had buried that stuff, really deep. And, it was okay there. I didn’t mind it being there. You know but when I brought it to the forefront, I started having nightmares, I was you know screaming in my sleep, and I was panic, I’ve never had a panic attack in my life, I thought I was dying. I didn’t realize panic attacks were like that. I couldn’t breathe, my heart was pounding out of my chest. I was, it was ridiculous. Thank God my wife, you know had seen panic attacks before, and she calmed me down, and she said, you need to stop going to this. I had an appointment, in an hour, and the thought of going there, and talking about it, one more time, five more times, six more times. I just couldn’t do it anymore, couldn’t do it. So prolonged exposure is not a great, it did not work well for me.
And I don’t know that, I know that they’ve had some good results with that on combat trauma. I don’t think they’ve had a whole lot of good results on sexual trauma, though. I mean, I did some research afterwards and it’s not really a great therapy for that. For me. Well, therapy’s not a good thing for me anyway. Although tapping worked really well. I came out of that using tapping. Have you ever heard of tapping? No? It’s where you start out, let’s see, here, and you say your mantra or whatever it is you want.
The VA’s actually started looking into using tapping. But I went to a woman down on, off of [ROAD NAME]. And she did it for free, but just for Veterans, she wanted to see if she could help them with their PTSD, and that sort of thing. And she did, I saw her for eight sessions, hour sessions. And we did tapping on that, we did a little age regression stuff, you know just kind of some fun stuff. And, it helped more than prolonged therapy did, or prolonged exposure.
Peter has tried many therapy programs, and found his service dog helped his depression and PTSD the most.
Peter has tried many therapy programs, and found his service dog helped his depression and PTSD the most.
Mentally, I've tried every CBT and acceptance and commitment therapy that you can name off. I went through a really good class here. The therapist is no longer here. I can’t remember his name. It was like a 16-week program for dealing with chronic pain, and it absolutely was probably the single best therapy that I've encountered for dealing with chronic pain. And it basically was an acceptance kind of thing, but it wasn't here's some papers, and I’m going to lecture you for 20 minutes, and you go home and feel no pain. We actually worked at it for three months. It was, and there were other Veterans there that were in chronic pain. We opened up to each other, and it was like, okay, I’m not crazy. It was just fantastic. The biggest thing that has helped me with that. (Referring to service animal) So he not only helped me with depression and PTSD, he helps me with pain. He helps me with nightmares. I take prazosin, so I don’t actually always know when I’m having a nightmare until I wake up and he's laying on me, so I've obviously been thrashing around.
Jeremy shares difficulties finding the right counselor.
Jeremy shares difficulties finding the right counselor.
I tried the PTSD counseling, three different providers in a year and a half. It’s hard enough to open up one time and you get a relationship with somebody where you start to feel comfortable with a little bit more sharing and they’re gone. And then, hey, we got a new provider and they want you to start all over again. We keep doing this and we keep doing this. And finally, I just said, you know what, I ain’t comin’ back. And they just are flabbergasted. I don’t understand why. I said, well you know what, some things you just don’t wanna relive. And because you guys can’t seem to keep medical professionals I don’t wanna have to start over every time. And I finally just said enough is enough. But I feel that I’ve found medication that has made an improvement for me and I got away from it for a little while and I’m back on it now, probably as of five months ago, and things are coming back to normal for me, what I would consider normal. But it’s almost like the VA leaves it up to you to decide what you wanna do. And sometimes we just don’t know what to do other than, you know, we know that things ain’t right. And I think that I’ve had 30+ medication changes. I’ve got more pills in my house than a pharmacy. And it’s a pill dump, right? So, I’ve gone through a lot of research and figured out, you know what, I’m takin’ these two pills. I’ve had where the VA screwed up, they gave me two pills in combination and they're not supposed to mix and somehow it got through the pharmacy. I took both of those and blacked out for four days. Had some embarrassing moments during those four days, ended up in the ER, where an ER doctor says, oh my God, you can’t take both of these at the same time it’ll kill ya.