Seeking Professional Help for Emotional & Mental Health

Almost all of the Veterans we spoke to described the mental and emotional challenges of living with TBI and reintegrating into society after deployment. Many sought professional counseling and therapy, in both inpatient and outpatient settings. Although some felt it was most beneficial to work with mental health professionals who were themselves Veterans – or to join groups with other Veterans - others have found that even those without combat experience can be helpful. One Veteran found that having a service dog was the best way to cope with his anxieties.

Individual and group therapy

Most of the people we interviewed described ongoing struggles with symptoms of depression, anxiety, and anger, as well as the challenge of coping with changes in their thinking and processing. Several of the Veterans we talked to described sinking into depression after their injury and mourning the loss of their previous abilities or identities. When asked how she copes with the anger she still harbors about having to leave the Army after her head injuries, Jessica replied “Therapy. That’s just the honest answer.”

 

Jessica sought therapy and counseling to cope with her anger.

Jessica sought therapy and counseling to cope with her anger.

SHOW TEXT VERSION
PRINT TRANSCRIPT

Therapy. That’s just the honest answer. I’ve been angry for three years now. It took me two years to enlist to begin with because I had some medical problems. I had a really bad knee and other things so the Army barely wanted me to begin with. I fought really hard to get in and then immediately was injured and kicked back out. That was a really frustrating thing and then to have a set-back that pushed me even farther back to where I feel like now my education and everything else suffers. I’m very, very angry. So yeah, it’s taken a whole lot of therapy, counseling time, to be able to cope with what I’m considering grieving a career and my health at this point.

Marcus recalled that his injury exacerbated his struggles with depression and alcohol. After starting treatment with a psychiatrist and talking “about exactly what happened to me and how it affected me,” he realized that he “couldn’t continue to hold all that stuff in…because talking about it was letting it go and that was my therapy.”

 

Marcus said depression is the biggest thing he has to learn how to treat.

Marcus said depression is the biggest thing he has to learn how to treat.

SHOW TEXT VERSION
PRINT TRANSCRIPT

But from that moment on when I was indulging in those behaviors my depression was just becoming more profound, so I’ve always been dealing with depression, and not, I was not always getting the proper care for depression because I just didn’t seek out any help, I just kind of accepted that I was depressed. So now - specifically in the last three years really - I’m specifically treating my depression. But for all those years before, I just, my depression was just there, it got worse and it got worse. There were points in my life, there were some good points, still some good things happened, but depression is the biggest thing that I continue to, that’s like the biggest thing that I have to learn how to treat because how I feel reflects on what I would do or what I might not do. So, if I can figure out how to at least continue that treatment on my feelings and the depression, then I think I could experience some levels of success in spite of my physical limitations. But I think just getting my mental state, treating that, constantly treating that could be helpful, has been helpful.

I just went to a psychiatrist and I just talked about exactly what happened to me and how it affected me and I think that was the biggest thing was just realizing that I couldn’t continue to hold all that stuff in. Even though I might have thought I was dealing with it, or coping with it in my own way. I had to get to the point where I could let it go or talk about it, because talking about it was letting it go and that was my therapy. Anyway, so certainly in the past year but really more in the past six months is when I’ve really reached this point, in the last six months, where I’m making progress. I wasn’t always making progress and I was just stagnant. So really in the last six months I’m treating the depression, I’m talking about it, I see a therapist every week, I take medication. Along with my other medication that’s supposed to - I only take one kind of medication that’s related to my post-concussive syndrome. That a medication called Topiramate just for headaches. That’s the only medication I’m taking in that sense. So, it was really, I could live the rest of my - if I’m 53 years old now and I don’t figure out how to deal with this better, I don’t think I’ll ever accept it, but if I don’t learn how to deal with it better I’ll keep having those ups and those downs and then one of those downs may just stay down, and then I would have to relive all that all over again, and I think that’s a big fear for me to have to relive that again, those really dark days.

Others described the benefits of therapy as a way to develop specific skills and strategies for coping with changes to their thinking and emotional state post-injury.

 

The cognitive skills Carlos learned while in therapy have helped to change his thinking.

The cognitive skills Carlos learned while in therapy have helped to change his thinking.

SHOW TEXT VERSION
PRINT TRANSCRIPT

And, faith, faith came in, you know, and I started having faith. And my thinking started to change. And today, when I went to this program, that’s what it’s all about. Thinking, the way we think. Cognitive skills, and I mean, it’s very, very valuable information, you know, to understand the way we think and it’s helped me understand a lot of things, you know, about myself and accept myself. And, you know, understand that some of the things, there’s nothing I can do about it. And I have to accept them instead of fighting them. I could just deal with them, do the next right, next best thing, or just live with it, you know. Deal with it. Instead of getting angry, or fighting, every, cause that used to be me, you know, I used to fight everybody for any reason. And all of the time, you know, I was always arguing and fighting about everything and anything, you know. But, some of the courses that I attended were PT, anger management, coping skills, and then I did the PTSD class. That was pretty neat because I had a psychologist that I was working with. We did a group session and then we did a one on one. That kind of helped a lot.

And I guess, I think now that I mention it, I think he may have suggested that I needed more help and that’s how I wound up in this program, which has been, it’s been like a blessing for me you know. To finally understand, you know, where I’m at and what’s going on. And my past and my present and then my future, you know. All I have to do is take what I know and stay occupied. Keep my mind busy. Stay positive and, and, and, and keep moving forward, you know. I cannot stay, lay around the house, like I used to, get depressed and eat and watch TV and do nothing but, you know, laying around or drink, stuff like that. I can’t do that, you know. And that’s been instilled in my mind, and that’s the wrong thing to do. So, you know, this program has taught me a lot of things about myself and the way to think. And that’s what I’m very grateful to have learned so much, you know. And even though I struggle with memory, you know, I’m thinking that, well hey, well see I have all of these notes that I can always refer back to, and keep myself, reminding myself of my weaknesses, and add something to it to kind of inspire me or give me new thoughts or good thoughts, good ideas. And just, you know, live one day at a time that way. And I don’t think I’ll have a problem doing that. Now that I have become self-aware. 

And, like I mentioned, you know, a lot of people that I see, a lot of Veterans, you know, they don’t have this type of understanding. Nobody teaches you that. So, to be, to learn about cognitivity, you know, and the way we think, the way people in general should think, you know, it’s very valuable information, you know, that I think a lot of the Veterans, you know, because I hear that there’s a lot of Veterans suffering, you know, on the streets, you know, cause they’re just making the wrong choices. They don’t have information to decide to make a different choice, and so in their own mind, it’s like my mind, it was a one-track mind, you know, and it’s all anger and not caring, is the way I felt. I wish to be. And now, I know better, you know. Have to care, you know. And in life, you know, moments come around that make you feel, you know, powerless or whatever, you know, but that’s only a moment, you know, tomorrow’s a different day. And I’m not the only one that goes through situations. There’s other people that going through it, so that’s something that’s very valuable to understand and not get bogged down in that stuff, not stop caring or not doing what have to do for my own being, you know. And for my family, cause I still have family, and this program has allowed me to bring back my family, you know.  Slowly but surely, they’re coming around. They see those changes on me, you know, in me. And the progress, the way I did, you know. I’m really very lucky, you know, the head injury program, and I’m fixing to complete it, you know. And, I still like it some but I think it, what it is, is opening up, you know, to share my story like I’m doing now. I think that will really, really benefit me, to share my story with other people and they can see that they too suffer.

 

 

 

Mary says the biggest “magic bullet” for her was dialectical behavior therapy (DBT).

Mary says the biggest “magic bullet” for her was dialectical behavior therapy (DBT).

SHOW TEXT VERSION
PRINT TRANSCRIPT

But it’s, I’ve learned it. You know and like I said, probably the biggest magic bullet I got was DBT. And it took a long time, but it finally started. It was like, “I know what this means.” You know, I actually did it in my life for real and I’m like, “Oh, my god,” you know? And then I, I went to group and I told them about what happened, you know, and about how I used the skill. I go, well I can’t remember which one it was. But there’s a skill and I used that skill. You know and it was a really stressful situation. And I was so proud of myself and everybody’s going, “Yay, yay,” you know? And it just made it feel so much better, you know, because they’re struggling the same way I am. And I applaud their efforts and they applaud mine. And we give each other that support we need. And you know, we’re not getting it from home. We’ve got, they’re not friends, but they are friends. They’re not somebody I talk to every week on the phone. But if they’ve got a problem, I’m one of those people they call before the call to the VA, you know, because, “I’m not sure where I’m at right now and I just need somebody to talk to.” And I’ve gone down that road with them too, you know? And, and that has been wonderful. You know it’s just been amazing and just, being able to trust in myself. And it’s not like I’m just going to jump out there and do something - think it through very carefully, very meticulously and then I do it. You know, and so it’s what I’ve taught myself how to do.

 

Sam worked with a psychologist who helped him to develop tools to cope with his memory loss and make his life easier.

Sam worked with a psychologist who helped him to develop tools to cope with his memory loss and make his life easier.

SHOW TEXT VERSION
PRINT TRANSCRIPT

She was very easy to talk to. Like, I mean she’s a psychologist. Like I don’t know what they do, but it made it very – actually, she’s the only psychologist that I was actually able to benefit from, would probably be the best way. But she was very forgiving when it came to like punctuality and stuff like that. Like she would call me like a half hour before, like, “Hey, you remember,” because she knew I had TBI and was like, “Hey, you remember that you have this?” I’ll be like, “Oh yeah, I’ll be there shortly. Sorry.” She worked with me very well. And she also put me in contact with like groups with the U of O that were doing TBI studies and stuff like that, to help you start developing counter measures to your TBI. I’m like, “Oh yeah, I’d love to do that,” and it really did help a lot.

Yeah, because I didn’t really start – my wife is like, “Hey, you should probably,” not because of the anger, because of the forgetfulness, like it was that bad, “You should probably go talk to a psychologist,” because I didn’t know how to approach it. I’d be like, my brain’s physically been altered to the point where I can’t remember stuff. Like is there any sort of thing that would help me? And I was trying to find a cure instead of, you know where you work through it; I forgot what you call it – instead of a way to deal with it. I was like, “I want a cure. Give me a new brain.” But then I talked to the psychologist and was like, “There’s nothing we could do about it, but what we can do about it is help give you tools necessary to make your life a lot easier.”

Some Veterans found support in group therapy, especially with other Veterans. As one person explained “I like one-on-ones. But I think I like groups more because I just feel that, you know, if I can bond with somebody that has the same thing, I feel a lot better, you know.” In addition to teaching coping skills, they described the benefit of the ongoing camaraderie of other Veterans.

 

Steven likes group therapy with other Veterans who have had similar experiences more than his one-one-one sessions.

Steven likes group therapy with other Veterans who have had similar experiences more than his one-one-one sessions.

SHOW TEXT VERSION
PRINT TRANSCRIPT

I gel, I gel pretty much, I gel pretty well in groups because I can relate pretty well with other people that might be having a lot of the same issues and stuff like this. I like one-on-ones. But I think I like groups more because I just feel that, you know, if I can bond with somebody that has the same thing, I feel a lot better, you know. There I have another, I have like another outlet to talk to if I can’t talk to my wife, you know? We can exchange numbers and get to know one another and get to talk, talk to each other and stuff. I feel better in that environment.

One of the Veterans we talked to has a service dog who is with him all of the time and helps manage his anxieties. He told us that since getting the dog is able to get out the house and “enjoy his life again.”  

 

Matt has a service dog who helps him to cope with anxieties, especially when going to public places.

Matt has a service dog who helps him to cope with anxieties, especially when going to public places.

SHOW TEXT VERSION
PRINT TRANSCRIPT

She helps with my stability. Just kind of helps with my anxieties.

I: What are the things that you feel anxious about?

Oh I just, I don’t like being out in public that much. Since I got her I’ve started enjoying my life again, being able to do stuff. It’s gotten to where I can actually go sometimes to different events without her. If I’m with my wife and my son, we’re good.

I: How did you get her? How did that, how did you figure out that that was something that could be helpful?

My wife did a lot of research on it, different uses for service dogs, and she just said one day, “You know what, we should try to get you a service dog to help you with your anxiety and help you actually walk around without having to have a cane with you all the time. She helps keep me focused on things so if I start wandering off to some place where I shouldn’t be going in my mind, she’ll distract me and bring me back to reality. That’s all. We were at event at Mall of America for Veterans and there was a guy there that trains service dogs. Talked to him. He helped us find, well we found her on Craigslist and he checked her out before we even said “Yah, we’ll take the dog.” And he did all the training, with me and the family. It was really good. We got her when she was six months old, which was what I wanted. I didn’t want to go somewhere, get a dog that’s like two or three years old and then have to get the dog to learn to listen to me, and then I’d have to go home, go through the whole process over again so the dog would listen to my wife and kid. That’s why they train right along with us, with the owner, so we know she listens to them as well as to me.

Being hospitalized for mental health and substance abuse issues

Several of the participants recounted periods of inpatient hospitalization for treatment of mental health or substance abuse issues. Richard described seeing the “white spots in my brain that are permanently damaged and simply won’t get better,” noting that he then “grieved that loss,” which was a key part of being able to move on. “I needed mental health care for that.  And so, I voluntarily checked into a top-notch psychiatric hospital.”

 

Richard learned to separate the psychological damage from the physiological damage, grieve the loss, and move on.

Text only
Read below

Richard learned to separate the psychological damage from the physiological damage, grieve the loss, and move on.

HIDE TEXT
PRINT TRANSCRIPT

And, sure you grieve the loss. And seeing the MRIs and the white spots in my brain that are permanently damaged and simply won’t get better. But then I grieved that loss and that was key. I needed mental health care for that. And so, I voluntarily checked into a top-notch psychiatric hospital. My dad’s well-to-do, so, on occasion he decided to be my father - visit every 10 years or so, yeah, he helped with that. And that’s where I learned to separate the psychological damage from the physiological damage, grieve the loss, and move on. Again that’s, that’s where words are formed and all of the sudden, you know, I started on Newsweek, and dadada.

After returning from Vietnam and struggling with both TBI and PTSD, Frank started “using booze” to cope with his symptoms, explaining that “this works for a day or so, but then it comes back, and exacerbates the condition even more.” He eventually had 30-day inpatient stay where he went through substance abuse treatment and “learned so much” about the causes of PTSD and TBI as well as about “the C-word: coping mechanisms.”

 

Although Frank struggled with substance abuse in the past, he went through treatment and now takes part in a weekly PTSD group.

Although Frank struggled with substance abuse in the past, he went through treatment and now takes part in a weekly PTSD group.

SHOW TEXT VERSION
PRINT TRANSCRIPT

And I was using booze to cover it. And it works for a day or so, then it comes back; it exacerbates the condition. And I’m saying this for the benefit of who’s watching this interview. I’m not saying anything you do not know, but this, this knowledge is power. And I’m more than happy to participate in this, because if people could benefit from my experiences, which this project is all about – that’s what happened to me. I did a short stay at American Lake, and then the thirty-day at Seattle VA. And you know, I learned so much. Then we had, you know, follow-ups, outpatient treatment. And you go from heavy to moderate, you know, to light. Now I go to a weekly PTSD group at the Roseburg VA. And, you know, I go on vacation, miss sessions. No problem. It’s – but it behooves us in that group to check in. We establish a bond, and we know each other after years of doing this. We know each other and there’s always a telephone. Now I learned that in AA. I went through AA for a while. And that telephone; pick up the telephone. It can weigh ten thousand pounds. Pick it up and call somebody. And that’s, when we first got back home, we did not do that. We isolate, you know, we, because that shows weakness. You know, we cry alone and because nobody else is, “Nobody’s going through this shit. I’m nuts. What’s happening with me?” And all that. And so, the education was a lifesaver.

Not getting help right away

Many of the Veterans we talked to said it took some time before they got help – either because they didn’t know there were services available, had a “tough it out” mentality, or because they didn’t realize they needed help. One Veteran said that he isolated himself when he first got home and did talk about how they he was feeling, “because that shows weakness,” but has since learned that others were going through similar struggles and wished he had sought help earlier. John said that when he first got out, “I had no help. I had nothing, nobody.” When he was first discharged, Kevin recalled getting his discharge papers and being told “If you think something there’s something wrong, then go to the VA,” but it wasn’t until several years later that a psychologist recognized his need.

 

John didn’t receive counseling after his accident and it took ten years before he felt he was starting to stabilize emotionally.

John didn’t receive counseling after his accident and it took ten years before he felt he was starting to stabilize emotionally.

SHOW TEXT VERSION
PRINT TRANSCRIPT

It took me probably a good ten years before I got up where I felt like I was emotionally starting to stabilize. I had no help. I had nothing, nobody. Four years after my accident I went into Kaiser, and they said, “Well you got your counseling after your accident.”  I’m like, “What counseling?  I didn’t get any counseling.”  “Well, you should have been counseled.” I said, “No, I got nothing.”  They just said here you go, don’t do anything weird, it will take eight years for your face to heal up and your swelling to go away, and just take it easy.

 

Kevin sees a psychologist at the VA who helps Veterans and only Veterans and recognized that he was in need.

Kevin sees a psychologist at the VA who helps Veterans and only Veterans and recognized that he was in need.

SHOW TEXT VERSION
PRINT TRANSCRIPT

I see a psychologist here that helps Veterans and only Veterans. That’s her job. That’s her, she set up a thing called Welcome Home Vets. And she recognized my need, that I was one of those Veterans that just got forgotten about completely. I mean after, when I got out of the service I had an option. They said, when I got my discharge papers, all they said to me was well, and I, I knew I was hurting but I couldn’t put anything together. I, I couldn’t get any medical care. But anyway, they said, they handed me my discharge papers and said, “If you think there’s something wrong, then go to the VA.” And I said, “What, am I supposed to be hurt? Am I hurt?” I don’t know because no one’s told me, definitively. Well, so I just went on with life, OK.

 

Scott realized he needed to push the envelope a little bit to get more help.

Scott realized he needed to push the envelope a little bit to get more help.

SHOW TEXT VERSION
PRINT TRANSCRIPT

And so – and I, and I kind of realized that hey, you have to like, you’ve got to push the envelope a little bit and, and then that’s how you get, you get more help. So, it was like fall-ish of this yeah that I started really pursuing it more and started going to the psychologist again regularly in like December. Because I had my one-year post-deployment screening like, “Hey, how’s it going?” You know? And I was like, “Hey, I’m like not quite getting as much help or getting to the bottom of this more as I’d hoped I would.” And, and after that you know, that’s when it’s been, a lot more has been happening. And so that is what led to doing the neuropsychological, like the full evaluation. Because I’ve also just felt like I, aside from the TBI, I’ve just felt like maybe I have a, like some psychological oddities as a result of service. And I don’t, I don’t need to go into that I guess since that’s not really the focus of this. But, so I wrapped that type of stuff into TBI and that’s why they did the full neuropsychological testing.

Mental health professionals with and without a military background

Several of the Veterans highlighted the benefit of working with counselors who have military backgrounds, and thus have “some idea” of what they have been through. Others told us that although they initially distrusted their psychiatrist, they have since learned that “just because they don’t have combat experience doesn’t mean they don’t understand the issue.”    

 

Sarah finds it more helpful to talk with counselors who have military backgrounds and some idea of what she has been through.

Sarah finds it more helpful to talk with counselors who have military backgrounds and some idea of what she has been through.

SHOW TEXT VERSION
PRINT TRANSCRIPT

My counselor at the VA up in Washington was a very well versed and gave me a lot of good coping mechanisms. He was really young, no military background, which I think, I’ve heard, kind of from both spectrums. I’ve heard from some of my friends who are like, “I want to go to somebody that has absolutely no idea what I’m talking about so I can just like verbal vomit and be done.” And then I’ve heard from some people who are like “I don’t want to talk to somebody who has no idea what I’ve been through.” I think for me, I kind of fall in that side of the spectrum of it. It’s really hard to like go in and talk to somebody who, like, has a relative who’s in the military but hasn’t ever been there. And I think it’s just because of the way that I function.  I have a hard time asking for help. And I hate putting that on somebody else. Even if it’s their - rationally I know it’s like their job to sit and listen to me. But just some of the stuff is so traumatic and messed up and out there, and like I hate putting that on another person.

 

Miguel says that just because a counselor hasn’t been in combat doesn’t mean they don’t understand the issue.

Miguel says that just because a counselor hasn’t been in combat doesn’t mean they don’t understand the issue.

SHOW TEXT VERSION
PRINT TRANSCRIPT

I mean, a few years back I tried to seek counseling because I was having marital issues. The combat stress started catching up to me. But then they wanted to utilize re-exposure therapy and I wasn’t ready for that - it kind of made me upset. The psychiatrist was really good - at first because I didn’t like him because he was a young, young guy, I didn’t know what, he knew what the hell he was talking about, but he did. And that’s where I get, that’s where we have the misconception. Just because somebody hasn’t been through combat doesn’t mean that they don’t understand and aren’t qualified to give you treatment. So that’s where I’ve learned, you know. That’s where I try to explain to other Veterans, you know, just because they don‘t have combat experience doesn’t mean they don’t understand the issue.

(See also: Medications for Mood, Concentration & Thinking; Coping Strategies for Day-to-Day Life; Strategies for Managing Pain & Vertigo; Services & Programs for Veterans)