Common sufferers of depression include U.S. veterans. Those who go through combat are subject to traumatic experiences, both physical and emotional, and these experiences can lead to depression and PTSD upon the return home. Veteran depression is prevalent, and those seeking help can try treatment.

Mental health treatment has come along way since the inhuman institutionalization those in the mid twentieth century faced. Psychiatric hospitals are available, although they are very different from the institutions that dominated the perception of mental illness in the past. However, many suffering from mental illness don’t seek hospitalization. Instead, patients may be referred by a primary care physician to a mental health professional.

When seeking such help, patients can receive various forms of therapy, sometimes multiple methods of therapy work together. Whatever it be, Transformations is here to help you with your mental health journey. Transformation offices offer Transcranial Magnetic Stimulation (TMS) therapy by means of NeuroStar, an FDA approved treatment method. If you have previously tried one or more antidepressant without success, you may want to consider TMS for treating your depression. Read on to find out why.

PTSD and Depression in Veterans

According to the National Center for Post-Traumatic Stress Disorder, around half of Vietnam vets showed symptoms of PTSD at some point. Frank Schoenfeld of the Veterans Affairs Hospital in San Francisco said in the overall group of veterans who have PTSD, about 45 percent of those have depression. So while PTSD may be a more commonly discussed aftermath of combat, depression deserves equal attention because of the amount of veterans it affects.

PTSD in Veterans

Veterans say that adjusting to civilian life following combat can be difficult for a variety of reasons, often because of a change in one’s state of mental health. According to the U.S. Department of Veteran Affairs, 12 percent of Gulf War veterans and 15 percent of Vietnam veterans suffered from Post-traumatic stress disorder (PTSD) at some point in their lifetime. Veterans are more likely to develop PTSD than others—only seven to eight percent of the entire population will experience PTSD.

Another notable contribution to post-traumatic stress in veterans is military sexual trauma (MST), which is sexual harassment or assault that occurs while one is in the military. According to the VA, 23 percent of women reported sexual assault while in the military, while 55 percent of women and 38 percent of men experienced sexual harassment during their service.

PTSD occurs after a veteran experiences trauma. There are some different factors regarding the trauma that can affect the severity of symptoms:

• The intensity of the trauma
• The length of the trauma
• Amount of control during the event
• Amount of help sought out soon after the event
  

Some of the symptoms of PTSD include:

• Reliving the event. This causes the veteran to experience a flashback of the trauma-inducing event and experience the same emotions again. There is sometimes a trigger for the person from external stimuli, but that is not always the case.
• Feeling numb. This is a kind of a coping mechanism for the veteran, in which he makes himself feel nothing so as not to feel the pain and fear he felt with the trauma.
• Avoiding. This is when the veteran avoids situations with stimuli similar to that of the event, in this case combat.
  

Some other ways to tell if you or a loved one is suffering from PTSD are if the person is acting irritated, jumpy, nervous, dejected, and angry following combat. If you see this happening to a loved one, it can be difficult to understand why they may be acting this way, but it’s important to understand that this is part of the process for many veterans and you should consider getting professional help for this person.

In addition to professional treatment, there are a few ways a veteran can ease the transition back to civilian life. Exercise is useful for releasing physical tension, in addition to the well-known health benefits it provides. Speaking with other veterans—especially those who suffer from symptoms of PTSD—can help you understand that your symptoms are viable. Talking is key, whether that be to other veterans or your friends and family, to help you process your symptoms.

Symptoms of Depression

Veterans with PTSD often see depression overlap with their symptoms. Similarly to PTSD, depression is not a one size fits all condition, as it affects each individual differently. Furthermore, the symptoms a vet experiences may be different than that of someone else who didn't serve. While symptoms vary from one person to the next, there are some common signs of depression in veterans you can look out for:

• Feeling sad or hopeless
• Disinterest in life’s activities
• Gaining or losing weight
• Excessive or difficulty sleeping
• Feeling lethargic
• Feeling guilty
• Problems in relationships with others
  

If you experience symptoms of PTSD and depression, you could also be experiencing anxiety—a study by Ginzburg et al showed that cases of PTSD, anxiety, and depression in veterans were more common than cases of PTSD by itself or a combination of PTSD and anxiety.

It can be difficult to pay attention to your feelings and ask yourself why you are feeling a certain way, but it’s important to understand what you’re going through after your service to figure out how to treat potential problems.

If you find that you experience these symptoms following your deployment, it’s important to allow yourself to feel what you’re going through and rely on the comfort of loved ones to help you work through it. It is normal to feel out of sync with people around you soon after you get home, but that will ease with time.

Should all of this become too much for you to handle, don’t hesitate to seek professional help. There is no reason to feel ashamed to do so, because so many others who served in combat share that experience. Depression is a treatable condition.

TMS Therapy for Veteran Depression

According to a 2017 study by Mi et al, veterans may respond differently to treatment for major depressive disorder than the average civilian. Compared to others, the veteran population showed a greater proportion of those who were not efficiently responding to pharmacological and psychotherapy treatment. When a patient doesn’t improve with psychotherapy and antidepressant medication—having tried at least two antidepressants at the appropriate doses—then they may be suffering from treatment resistant depression (TRD).

The FDA recently approved the use of Transcranial Magnetic Stimulation Therapy (TMS), a safe and noninvasive treatment method, for treating veterans with TRD. At Transformations, we use NeuroStar, a brand of TMS that specializes in targeting under-active brain areas associated with depression. In addition to being noninvasive, NeuroStar is non-systemic, meaning that because it is not consumed orally, NeuroStar does not course through the body in the bloodstream.

During a treatment session, the TMS technician or physician will place a magnetic coil on your head in order to administer magnetic pulses to the targeted brain areas. Side effects are minimal compared to those of antidepressants, so no more nausea, weight gain, or dizziness. Treatment is largely painless (some patients experience a headache following a treatment session, but those can be helped with over the counter pain relievers and eventually subside over the course of treatment).

TMS is not the same as electroconvulsive (shock) therapy.

Treatment sessions last anywhere from 20-50 minutes and administered five days a week for five to six weeks. You will be fully wake for the procedure—and because there’s no anesthesia administration, patients are able to drive themselves home following a treatment session.

If you or a loved one are a veteran suffering from depression following combat, speak to a medical professional about treatment. If it is a true medical emergency, please call 911. In addition to reaching out to your physician or a mental health professional, there is a Veteran Crisis Line that offers free support 24/7. Call 1-800-273-8255 and press 1, chat online, or text 838255.

It is not uncommon for veterans to suffer from conditions such as PTSD and depression following combat, so there’s no need to believe your feelings are invalid and that you will just work through it. If you have tried antidepressants and psychotherapy alone, talk to a medical professional about a prescription for TMS therapy at Transformations.

What other questions do you have about treating depression in veterans? Let us know in the comments!