Counseling

Post Traumatic Stress Disorder (PTSD) is a type of anxiety disorder that occurs when a person has either witnessed or experienced a traumatic event. A traumatic event involves actual or threatened serious injury or death, such as child abuse, combat stress, domestic violence, etc. The person’s response to the trauma involved intense fear, helplessness, or horror. The traumatic event is persistently experienced (nightmares, distressing thoughts, feeling as if the past event were occurring in the present). There can be an inability to recall important aspects of the trauma or avoidance associated with thoughts, feelings, or activities related to the trauma. Increased arousal not present before the trauma, such as difficulty falling asleep, hypervigilance, and angry outbursts are other symptoms that can suggest PTSD. These symptoms might be evident soon after the traumatic event. However, it can also take months or years to manifest. In addition to witnessing war, death, and experiencing a constant threat to one’s safety, repeated deployment to combat zones and shorter time between tours increases a service member’s rate of developing PTSD, especially if there was a prior history of childhood trauma.

Veterans and their loved ones face numerous stressors (family conflict, military stigma, financial stress, etc.) and are at an increased likelihood of developing an anxiety disorder. Symptoms of anxiety can manifest into other types of disorders other than PTSD. One form of anxiety is Panic Disorder, where a person experiences repeated panic attacks with either the persistent concern about having another attack, worrying about the implications of the attack (ex: fear of having a heart attack), and/or a change in behavior as a result of the attack. Symptoms of a panic attack can include the following: heart palpitations, sweating, shaking, shortness of breath, feeling of choking, chest pain, nausea, dizziness, fear of losing control or going crazy, and fear of dying.

Another type of anxiety disorder is Obsessive-Compulsive Disorder where an individual has recurrent and persistent anxious thoughts that drive them to engage in repetitive behaviors (compulsions) aimed at reducing the anxious thoughts. Examples include repeatedly checking the stove to make sure it is turned off, or locking and re-locking the front door, resulting in ongoing tardiness at work and jeopardizing employment. Usually the person realizes the behaviors are excessive and unreasonable, but still has difficulty changing them.

General Anxiety Disorder is a form of excessive anxiety and worry persistent occurring more days than not at least six months about a number of situations. Symptoms can include feeling restless, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance. All anxiety disorders cause significant distress or impairment in social, occupational, or other important areas of functioning.

Depression is more than just feeling “the blues” or sad. It is a common, yet serious illness that interferes with a person’s daily participation in activities. There are different types of depression, such as Major Depressive Disorder and Dysthymia. Major Depressive Disorder includes difficulties with sleep, eating, work, play, concentrating, feeling bad or like a failure, and/or thoughts of suicide. The symptoms of Dysthymia are not as severe as Major Depression to cause a significant disability in life functioning, but can definitely impact a person’s quality of life and level of enjoyment. Depression is a treatable condition that can positively respond to either talk therapy or a combination of talk therapy with medication.

A service member or their family does not have to be an “alcoholic” or “addict” to benefit from some assistance with stopping or reducing their use of alcohol or drugs. There are several different reasons why individuals use alcohol or drugs with as many interventions to assist them. Some veterans or their loved ones start out with an occasional beer or glass of wine to celebrate a victory or perhaps cope with feelings of anger or sadness. A friend or military buddy might have provided something a drug as a “pick me up” to escape the realities of war, grief, or loss. There could have been a family history of substance use which made it easier to engage in drinking or experiment with drugs. At some point, the alcohol or drug use begins to interfere with the ability to manage in the areas of work, relationships, and/or the daily activities of living. Physical or emotional cravings can set in and the substance becomes pursued as a needed means of coping with stress, depression, anger, or even physical withdrawal. Therapy can provide assistance with learning other ways of coping with problems, cravings, and even relapse, whether a person is currently abusing the substance, struggling to maintain sobriety, or already in the stages of dependence.

Service members and their families face numerous challenges. The emotional impact of serving in combat and then having to readjust to civilian life can be stressful. The skills needed to survive in protecting one’s country are usually not the same as those that are needed to have successful relationships with families and friends on the outside. Families have typically gone for long periods of time without seeing their loved one, making it challenging and confusing at times to readjust to the relationship upon the service member’s return. For example, a spouse or partner may have had the full responsibility of running a household and making decisions while the service member was deployed. Upon return from service, the couple now has to learn how to make daily decisions together in a mutually respectful manner. These communication challenges, in addition to coping with feelings of depression, irritability, or employment/financial stressors further strain family and other relationships.

Feelings of grief and loss are prevalent in military life. Service members can witness ongoing combat resulting in sudden, multiple deaths, at times of a close friend in their own squad or platoon. Family members cope with their grief of not seeing a loved one for months or years at a time, holding onto the hope they will soon be reunited. Feelings of grief and loss move through different stages at different times; depression, anger, bargaining, denial, and acceptance. The emotions experienced are individualized and take time to heal from.

TRAUMAtic Brain injury (TBI)

Traumatic Brain Injury whether or not associated with lasting functional impairment is an injury to the brain. The exact nature of the symptoms depends upon the type and severity of the injury. Injuries include penetrating injuries, closed head injuries and exposure to blasts.Disruption in brain functioning can include a decreased level of consciousness, amnesia or other neurological or neuropsychological abnormalities. TBI may be diagnosed as mild,moderate or severe dependent upon diagnostic criteria.Mild TBI includes loss of consciousness ( for less than 30 minutes), memory loss ( for less than 24 hours) and no persistent neurological deficits. Symptoms are usually resolved by three months post injury; however, there is some indication that symptoms may last 6-12 months or longer and require ongoing medical treatment. Common physical problems following mild TBI include headache and musculoskeletal pain, disturbances in eye movements and equilibrium visual disturbances and fatigue. A head injury that results in loss of consciousness for more than 30 minutes, memory loss for more than 24 hours and persistent neurological deficits is likely to be diagnosed as moderate to severe.  TBI and will generally require rehabilitation services.

What can I do if a person I know seems to be struggling ? (Mental Health First Aid)

Assess for risk of suicide or harm, Listen non-judgmentally, Give reassurance and information, Encourage self-help and other supportive strategies, & Seek professional help.

What should I do if I am struggling ?

Tell others what I need, Identify sources of support, Take care of my self, Use previously helpful coping strategies, & Seek Professional Help.

There have been stories of both men and women in the military experiencing sexual abuse and/or harassment by another member. This sexual trauma is further complicated when it is experienced by a service member having to continually live and work with their perpetrator, who could be the same individual responsible for protecting them in battle or helping with a career advancement. It is not uncommon for a veteran to never disclose the abuse, for fear of not being believed and further harassed, until no longer serving as an active member. The untold stories of abuse and feelings of unresolved shame increase the veteran’s likelihood of relationship problems, substance use, and mental health issues.