Veterans’ Mental Health and the Impact of Stigma

Veterans sacrifice a great deal to serve their country and, due to the stressors and other aspects of their service, may experience mental illness and the stigma associated with it. This page explains what stigma is, describes mental illness among the Veteran population, discusses the prevalence of addiction among Veterans, and also looks at treatment options.

What Is Stigmatization?

Stigmatization occurs when society’s general attitude toward an issue skews negative, making those who are experiencing the issue feel ashamed.¹ Addiction and mental illness have stigma associated with them because of inaccurate and harmful beliefs that exist.²

How people speak about those with psychiatric conditions can also cause stigma. Stigmatizing terms used to describe those with addiction include “addict”, “abuser”, “junkie”, and “drunk”.² Terms used to describe actions related to addiction include “habit”, “dirty”, and “clean”.²

Stigma can develop in other ways. Experiencing violence or abuse by a relative who has a substance use disorder (SUD) or other addiction issue can, for example, lead a person to incorrectly believe that everyone who has an addiction issue is dangerous.³ Lack of scientific understanding of addiction also generates stigma because the general population tends to consider conditions as either biological or behavioral when, in fact, they are much more complex.³ Addiction is a medical condition, and is not considered to be a behavior a person can and should control on their own.⁴

Public stigma often leads to self-stigma, where the person internalizes those societal messages and feels ashamed of their condition.¹ It also leads to structural stigma or the loss of opportunities.¹ Examples include employers being reluctant to hire someone with a specific condition or landlords being hesitant to rent to a person for the same reason.

How Many Veterans Suffer from Mental Illness?

As many as 50% of Afghanistan and Iraq war Veterans have been diagnosed with a mental health condition.⁵ These mental health disorders often co-occur with SUDs. This can be the result of Veterans using substances to cope with the mental health conditions they face. They may also have a genetic predisposition to addiction or may use substances to cope with the stressors associated with active duty and adjusting to civilian life.⁵

Veterans with Mental Illness

Veterans may face several mental health conditions.⁵ Severe depression, characterized by low mood or lack of interest, is chief among them. Depression brings symptoms such as guilt, problems with concentration, lack of energy, appetite problems, and suicidal thoughts.⁶

Veterans may struggle with anxiety, which includes panic attacks or generalized anxiety disorder (GAD).⁵ GAD is characterized by uncontrollable worry about multiple issues and symptoms such as sleep problems, muscle tension, and irritability.⁶

Post-traumatic stress disorder (PTSD) is another mental health condition many Veterans face.⁵ PTSD arises from an experience that causes severe injury or threat to life.⁶ In addition, it involves intrusions such as nightmares, avoidance of situations that bring up memories of the trauma, negative thoughts and mood, and high reactivity such as anger or being easily startled.⁶

Mental health conditions are common among the Veteran population due to experiences of:⁵

Once a Veteran returns from service, adjusting to civilian life can be challenging. Even though the Veteran is physically at home, their mind and emotions may still be focused on their previous experiences or environment. This can lead to feelings of isolation and depression because they are around others who don’t understand what they have endured.⁷ Veterans must also integrate back into family life.⁷ In addition, Veterans may have difficulty entering the workforce if their only employment has been in the military.⁷

Mental illness can lead to suicide for some Veterans, and death by suicide among Veterans typically exceeds the rate of suicide among the general population.⁵ Past research shows that more than 20% of suicides involve Veterans, with the suicide rate for this population 1.5 times greater than that for non-Veteran adults.⁵ Suicidal behavior in the military is often preceded by substance use.⁵

Veterans and Addiction

Substance use disorders are more prevalent among Veterans compared to the general population; more than 10% of Veterans have a SUD diagnosis.⁵ The Veteran population has substance use risk factors including:⁸

Mental illness and addiction often co-occur because individuals may use drugs or alcohol as a way to cope or numb themselves from physical and emotional pain.⁹ They may use drugs to improve sleep, avoid difficult thoughts and emotions, and distract themselves from their problems.⁹

Opioid pain medications are extremely addictive and have a high risk for overdose.⁵ These drugs are sometimes prescribed to Veterans to help treat pain related to active duty; however, their addictive nature coupled with mental health challenges puts Veterans at increased risk for addiction.⁵ What’s more, the stigma associated with PTSD further impacts Veterans and their use of substances.

Stigma Around PTSD

Post-traumatic stress disorder has its stigmas due to the lack of understanding and preconceived notions of the condition.¹⁰ Such prejudice can hinder compassion for those who struggle with the disorder.

Public stigma can lead to self-stigma where a Veteran may remain silent about having PTSD.¹⁰ Stigma can also result in being harassed or bullied by others, social isolation, and belief that their situation cannot improve.¹ This can keep them from seeking treatment and, in turn, worsen their symptoms, lead them to deny there’s a problem, or hide it from others.¹⁰

How Many Veterans with PTSD Seek Treatment?

Some studies suggest that the rate of PTSD among Afghanistan and Iraq Veterans is as high as 30%.¹¹ However, approximately half of Veterans with mental health conditions seek treatment.¹² Research shows that Veterans who perceive a higher level of mental health stigma are less likely to seek treatment.¹² They may also see a mental health condition as a sign of weakness or feel that they can handle it on their own.¹¹

Lack of treatment not only leads to worsening symptoms, but some research has linked PTSD with suicidal ideation and behavior.¹¹ Suicide risk increases after leaving active military service and, sadly, about 20 Veterans die by suicide every day.¹¹

Addiction and Veterans Mental Health Treatment

Despite the difficulties with mental health and addiction that Veterans may face, treatment is available, and recovery is possible. Turning to a primary care provider or a Veterans Affairs (VA) physician who is familiar with your medical history is a good place to start. Because they are familiar with your medical history, this medical professional can make individualized recommendations for types of rehab programs. Consulting with a therapist or addiction specialist is another good starting point.

Different levels of treatment are available depending on the severity of the illness and individual needs. Medical detoxification (detox) is for someone who is physically dependent on a substance.¹³ As opposed to quitting a drug abruptly, detox involves supervision by medical providers who help remove a substance from the body and administer medications for withdrawal symptoms.¹⁴ Detox alone is not considered comprehensive treatment, but the safe removal of the substance before starting a rehab program.¹³

Inpatient or residential programs involve living at a treatment facility and receiving care 24 hours per day.¹³ These programs may be recommended for someone with severe addiction or serious mental illness.¹³

Different outpatient treatment programs are available that vary in intensity of their services.¹³ Intensive outpatient programs (IOPs) may be recommended for those who have a condition of higher severity but do not need 24-hour care.¹⁵ IOPs involve attending treatment services a few times per week for a few hours at a time.¹⁵ They also offer programs during the day, in the evenings, and on weekends to help meet scheduling needs.¹⁵ Outpatient counseling usually involves meeting with a therapist once or twice a week at their office. This may be recommended for someone with a mild addiction or mental health condition.¹⁵

Behavioral therapy is part of most treatment settings and is an important part of recovery as it provides coping skills and facilitates insight into emotions and behaviors.¹³ Support groups and 12-Step programs also play an important role in helping people achieve and maintain sobriety.¹³

AAC is here to help you find a treatment program. Our admissions navigator can connect you with programs that the VA covers. You can also use the AAC treatment directory to locate a rehab facility. Our admissions navigators can help verify your insurance or you can verify your health insurance coverage using our verification form.

Start your recovery journey today. Call us at . We are happy to help and are available 24/7.