Mental Health Issues and Substance Abuse Among Service Members and Veterans

Approximately 7.6 percent of the U.S. population are military veterans. The total number of veterans is expected to decrease from currently about 20 million to fewer than 14 million in the next two decades, “mainly because of the passing of the World War II generation and the transition to an all-volunteer military,” explained Nicholas Buchli in his recent presentation as part of the Williamsburg Place Lecture Series. Buchli is a mental health specialist and a U.S. Navy veteran who served as a Fleet Marine Force hospital corpsman on active duty for 9 years, including 4 tours serving in a healthcare role supporting Marines and sailors in Operation Iraqi Freedom and Operation Enduring Freedom.

U.S. forces are still predominantly male and due to frequently changing deployments, service members move ten times more often than their civilian counterparts, thus putting enormous stress on themselves and their families. “Two million children had a parent deployed since 9/11. It can become an absentee parent situation,” said Buchli. 

Unsurprisingly, the worst impact on mental health comes from combat—and not only for service members themselves. According to the Department of Defense, there were 4,424 total deaths (including both killed in action and non-hostile) and 31,952 wounded in action as a result of the Iraq War. As a rule of thumb, each of those casualties had a severe emotional impact on at least ten other people, primarily family members, and loved ones. 

Due to the nature of their profession, our men and women in uniform face an elevated risk of developing mental health issues or a substance use disorder (SUD). Multiple deployments, combat exposure, and related injuries can be extreme stressors that may increase the risk of self-medicating mental health problems with drugs and alcohol. Like their civilian counterparts, they risk addiction to opioid pain relievers prescribed after a physical injury. Nearly one in four active-duty service members had at least one prescription for an opioid at some point in 2017, according to Defense Department data. 

PTSD and Depression

“The most severe mental health consequences of military deployments include posttraumatic stress disorder (PTSD), major depression, substance abuse, and suicide,” said Buchli. The prevalence of PTSD varies from conflict to conflict. 11–20 percent of service members deployed in Afghanistan or Iraq suffer from PTSD. For the 1991 Gulf War, that number is 12 percent. The official figure for Vietnam veterans is 15 percent, but many experts believe that number is closer to 30 percent because of incomplete reporting and missing diagnoses. 

The Veterans Health Administration (VHA) provides various resources for PTSD patients, including cognitive behavioral therapy (CBT), prolonged exposure therapy, eye movement desensitization and reprocessing (EMDR), as well as prescriptions for antidepressants.

Depressive disorders are marked by feelings of intense sadness, hopelessness, and other symptoms. “Depression and PTSD share similar symptoms,” explained Buchli. “Many reports state that more than half of those suffering from PTSD also suffer from depression.” The VHA provides various resources for patients suffering from depression, including cognitive behavioral therapy for depression (CBT-D) and vet center counseling. 

PTSD and Depression

Suicide and Substance Abuse

The first two major consequences of repeated combat deployments—PTSD and depression—are major drivers of the other two: substance use disorder and suicide. Suicides among members of the military have been in the headlines lately. “While suicide remains a rare event among U.S. troops, 325 active-duty members died by suicide in 2018, the highest number since the Defense Department began collecting the data in 2001 and exceeding a record set in 2012,” reported in August. The suicide warning signs are basically the symptoms of PTSD and depression, said Buchli. “Hopelessness, anxiety, sleeplessness, substance abuse, withdrawal from family, and risky behavior.” If you are a veteran in crisis or concerned about one, you can connect with the Veterans Crisis Line to reach a caring, qualified responder. The VHA also provides suicide prevention coordinators and other resources. 

One of the warning signs of suicidal ideation is substance misuse. Just like many civilians, service members attempt to self-medicate trauma (PTSD) and depression with drugs and alcohol. There is also a well-known drinking culture in the military and despite the efforts of the defense department, it is not disappearing anytime soon. Dangerous “binge drinking is actually up in the military,” Buchli said, “and as a result of increased binge drinking, alcohol-related incidents, and drunk driving are on the rise as well.” This kind of risky behavior can easily escalate into a career-ending alcohol addiction. 

The Farley Center is proud to be able to help men and women in uniform who struggle with substance use disorders. Members of the U.S. military who develop health problems can rely on a healthcare program known as TRICARE. Farley has a lot of experience working with the command structure and healthcare provisions of the US military. A significant percentage of Farley patients have TRICARE coverage. The Farley team knows TRICARE really well and can help clients with any question they might have. 

To reach the Veterans Crisis Line to talk with a caring, qualified responders dial (800) 273-8255 and press 1. 

If you or someone you know is struggling with substance use and could benefit from addiction treatment services, please contact The Farley Center at Williamsburg Place at 800.582.6066 or fill out our admissions request form.