Depression and the military

Troy at the You Served Blog has some first hand thoughts on depression resulting from service in Afghanistan.

Simularities between depression and post-traumatic stress disorder

PTSD and depression have similar symptoms and, particularly in veterans, often go hand in hand. Common symptoms are

(For PSTD) symptoms include recurrent recollections or dreams about war, flashbacks that cause you to relive various traumas, and avoidance of any reminders of combat. The condition can also result in emotional numbing (diminished responsiveness to the world around you), intense distress when confronted with reminders of battle, and hyperarousal, a feeling of frequently being on edge and on the alert for new threats.

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Depressed veterans often feel worthless and profoundly sad, but other typical symptoms include poor concentration, lack of interest in social activities, feeling of hopelessness and helplessness, changes in appetite, difficulty sleeping, or oversleeping, unusual irritability, apathy and listlessness, and suicidal thoughts or attempts.

Depression and anxiety disorders

Many vets develop mental problems. The most common is PTSD (Post Traumatic Stress Disorder). That's an ailment that can often be addressed with talk therapy, even group therapy, and various kinds of psychoanalysis.

Psychoanalysis is based on the idea that there is some event, or group of events, in your past that can be pointed to as some sort of cause for your current mental problems. With PTSD that would certainly be the case.

But sometimes that kind of stress can seem to trigger more serious mental disorders. Various irrational fears and feelings are grouped together under the two umbrellas of anxiety disorder (irrational fears) and affective disorders (irrational feelings and depression). When that's the case psychoanalysis probably isn't going to help.

Full blown depression or anxiety is based on a disorder of thought, it doesn't have a "cause" somewhere back in the history of your life. There may be some historical event that seems to have triggered the disorder, and combat stress can certainly be such a trigger. But that event probably didn't really cause anything. The stress just brought the effects of an existing underlying disorder of thought to the surface.

Once the underlying disorder hits the surface you can quickly reach a situation where your brain is essentially re-wired, you begin the make very irrational judgements about life risks and life situations that seem rational to your disordered brain.

You'll almost always need medication to re-wire such a miss-wired brain. And often the medication really won't do the brain re-wiring, it will just free up your brain to be re-wired. Psychoanalysis, looking to the past, won't help.

What probably will help is cognitive therapy. Cognitive therapy helps get the damaged thought processes back to rationality by looking to the short term future, but directly addressing cause and effect -- "If I get on that airplane it might crash, but it probably won't". The disordered brain thinks, "If I get on that airplane it will crash".

Some psychoanalysts do cognitive therapy as part of their bag of tricks. But not many, and even some who claim to do so don't really rely on it. If you suffer from an actual mental disorder rather than PSTD which is traceable to a specific event, then steer away from psychoanalysts who want to talk about your childhood or want to do hypnosis. Those are not serious practitioners of cognitive therapy.