Our nation’s veterans have multiplied over the years and others earn that status every day. Many who served in the Persian Gulf War find themselves now in mid-life. Frequently, veterans don’t take the time to heal after their selfless service to their country. Many end up not only physically injured, but also mentally wounded from their time in the service. As a result, they medicate with drugs and alcohol and don’t get the sort of professional help they need.

Eventually, it catches up to them.

Stories of veterans suffering from mental anguish and the tragedies that ensue almost always forget to include the pain they carry with them. Good treatment for mental health or substance use disorders comes from clinicians who understand a soldier’s battle scars — and not just the kind that come from shrapnel.

“Witnessing death, destruction and torture; experiencing unexpected and, at times, continuous threats to one’s life; or participating in hostilities and killing can potentially lead to mental health problems,” wrote Hans Pols, et al., in a historical review of psychiatric treatment in the military published in 2007 in the American Journal of Public Health.1

After the Vietnam War, the US military and others around the world finally began to understand the importance of mental health, particularly on the front lines. Today, “Combat stress control teams staffed by specialist mental health professionals are responsible for prevention, triage and short-term treatment with the purpose of retaining manpower and maintaining operational efficiency,” Pols, et al. writes.

“Unfortunately, research has not adequately supported approaches with a focus on frontline intervention.”

Fortunately, help is available when veterans get home. Regardless of where veterans may be in their lives, they deserve better than suffering every day with substance abuse problems or mental distress such as nightmares and anxiety.

“Gulf War Syndrome” Tops Emotional Struggles

While the most common problem among enlisted people returning home is Post-traumatic Stress Disorder (PTSD), many also suffer from unspecified “syndromes.” These syndromes share a set of symptoms common to enlisted personnel deployed to certain war zones.

For example, what has been dubbed “Gulf War Syndrome” includes symptoms such as fatigue, cognitive impairment (difficulty thinking), headaches, depression, anxiety, insomnia, dizziness, joint pain and shortness of breath. Pols, et al. says these symptoms have been blamed on everything from environmental hazards to side effects from vaccinations, but a definitive cause remains uncertain.

Enlisted personnel returning from the wars in Iraq and Afghanistan also have begun to exhibit these symptoms, according to a recent VA study of more than 300 enlisted people.

“This condition appears to be similar to that experienced by many Gulf War veterans, in terms of the symptoms, but we don’t really know if it’s the same condition,” Dr. Lisa McAndrew, the study’s lead author, said in a VA news release.2

Still, other veterans suffer from a mental disorder known as “moral injury,” which, unlike PTSD, cannot be treated with anxiety medication. Moral injury is emotional conflict brought on by doing something that goes against your moral grain, such as taking someone’s life.

“There is now an extensive evidence base for the efficacy of trauma-focused cognitive behavior therapies (talk therapy) administered to individuals or groups of veterans,” according to Pols, et al. “Soldiers most in need of mental health care do not seek it because of fear of embarrassment, difficulties with peers or officers or interference with career opportunities within the military.”

Afraid to Ask for Help, Many Suffer Silently

Those concerns are extremely valid, as the US Department of Veterans Affairs warns, rather frankly, on its website.

“Patients themselves may have several incentives to minimize their distress: to hasten discharge, to accelerate a return to the family, to avoid compromising their military career or retirement,” the VA explains on its National Center for PTSD page. “Fears about possible impact on career prospects are based in reality; indeed, some will be judged medically unfit to return to duty.”3

Another blunt warning on the page: “Some may think that the information obtained if they receive mental health treatment will be shared with their unit commanders, as is sometimes the case in the military.”

The good news is that active duty and returning service members can take solace in knowing there are programs like Valley Hospital’s Freedom Care, which offers specialized care for military patients in the Phoenix area.

Freedom Care provides comprehensive, evidence-based treatment for those experiencing substance use, abuse or dependence, depression, military sexual trauma, combat-induced PTSD/trauma, military-related chronic pain or co-occurring mental health and substance abuse disorders.

“The possibility exists that mental health providers can reduce long-term family problems by helping veterans and their families anticipate and prepare for family challenges, involving families in treatment, providing skills training for patients (and, where possible, their families) in family-relevant skills (e.g., communication, anger management, conflict resolution, parenting), providing short-term support for family members and linking families together for mutual support,” the VA describes as an ideal scenario.

“More generally, the returning soldier is in a state of transition from war zone to home (which can take several years or longer), and clinicians must seek to understand the expectation and consequences of returning home for the veteran.”

1. Pols, H., et al. American Journal of Public Health. War and Military Mental Health: The U.S. Psychiatric Response in the 20th Century, Dec. 2007. Retrieved 10 May 2017.
2. U.S. Department of Veterans Affairs. National Center for PTSD. Treatment of the Returning Iraq War Veteran, 23 Feb. 2016. Retrieved 10 May 2017.
3. U.S. Department of Veterans Affairs. Research Currents. Study: Symptoms of ‘chronic multi-symptom illness’ may be common in Iraq, Afghanistan veterans. 13 May 2016. Retrieved 10 May 2017.

Written by David Heitz