How to deal with PTSD and depression among veterans.

Everyone feels sad at times, but these feelings will usually go away in a few days. If you are unable to cope with this feeling, or it begins to interfere with your daily life, it may be a sign of depression.

Depressive disorder can affect anyone. It can have many effects. A feeling of intense sadness or hopelessness, or that someone loses interest or joy in activities they used to enjoy. People with depression may experience guilt, unworthiness, or low self-esteem, and they may begin to avoid being around people.

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Veterans, PTSD and depression

Did you know that there is a link between post-traumatic stress disorder (PTSD) and depression? Many veterans struggle with more than just PTSD when they return home from active duty. In fact, veterans who have PTSD often have concomitant mental disorders such as depression. When combined, PTSD and depression can lead to even more serious consequences, including addiction and suicidal ideation. I am one of those who “discovered” my PTSD through the symptoms of depression. Simply explained: I contacted my doctor for depression (Or actually an even simpler cause: sleep problems) The doctor asked if I had served abroad. The answer was naturally yes, without me in any way thinking this had anything to do with me having trouble sleeping. She sent me to a psychologist and this psychologist pressed the right buttons. The conclusion was PTSD and depression.

What is depression?

Depression, also known as major depressive disorder in chronic cases, is a mood disorder that can affect the way you think, behave and feel. Depression can be caused by hormonal imbalances, genetics and environmental factors. For example, if depression occurs in your family, you may already have a higher risk of developing symptoms. If you also have PTSD or other mental health challenges, your chances of becoming depressed increase significantly.

The symptoms of depression vary depending on the type of depression you have. However, the most common symptoms are as follows:

  • Persistent and intense sadness
  • Emotional numbness
  • Struggling with personal hygiene
  • Pain in the body
  • Changes in appetite
  • Negative thoughts
  • Increased use of alcohol or drugs
  • Suicidal thoughts and suicide attempts
  • Feeling depressed and down most of the day on a daily basis;
  • Lack of interest in previously enjoyed activities;
  • Difficulty getting through the day and completing daily tasks;
  • Varying weight;
  • Inability to sleep or sleep too much;
  • Feels tired and lethargic;
  • Lack of energy, less active, movements feel slowed down;
  • Experiencing feelings of worthlessness, guilt, no self-confidence;
  • Lack of concentration;
  • Inability to make decisions;
  • Concerned about the thought of death or wanting to hurt oneself.

 

According to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) when someone experiences at least five of the symptoms mentioned above for a period of at least weeks or more, the doctor may diagnose depression (with the exception of other diseases).

The link between PTSD and depression

PTSD can have a significant impact on the lives of veterans. As mentioned above, a common symptom of PTSD involves avoiding specific situations or locations. This is a strain on family and friendships, which makes the veteran isolate himself. Isolation leads to loneliness and this in turn often triggers depressive symptoms.

All too often, veterans struggle with thoughts of suicide. Unfortunately, veterans have an increased risk of committing suicide, especially in situations where they have PTSD and depression. (link)

In addition, it is not just the social aspect of PTSD that has an impact on veterans. PTSD is a mental illness that changes the way your brain works. Any changes in the brain physiologically or hormonally can cause a chemical imbalance. Then this chemical imbalance can lead to depression.

When PTSD or depression (or both at the same time) remain untreated, the veteran can often resort to self-medication to avoid or “numb” the painful symptoms. Drug abuse unfortunately increases the symptoms and increases the chances of having health consequences and suicidal thoughts. A vicious circle is created.

How PTSD is linked to depression

PTSD and depression share similar symptoms in that both disorders affect your emotions, your mood, result in a lack of interest in things and have an impact on your energy level. In fact, having PTSD increases your chances of depression and vice versa.

One of the most common symptoms of PTSD is depression, there is a strong connection between the two and it is quite possible to suffer from both disorders at the same time. According to medical research, almost fifty percent of people diagnosed with PTSD also suffer from depression. The chance of someone with PTSD developing depression is three to five times higher than someone without PTSD. It is more likely that someone who suffers a severe depressive disorder experiences stress and anxiety in addition to depression. The two disorders even share some common symptoms such as:

  • Lack of interest in things;
  • Sleep problems;
  • Fast to get angry;
  • aggressive behavior.

Despite the similarities, there are also some strong differences between the two disorders. Someone with PTSD is likely to experience peaks in anxiety levels when faced with certain things, people or places. These act as triggers associated with the trauma they witnessed or endured. For example, someone who was raped in a bar may experience anxiety attacks when walking near a bar, or they may be physically unable to enter a bar without looking back to the attack. Unlike PTSD, depression is not necessarily related to a specific event or issue. While some circumstances can lead to depression, symptoms can fluctuate regardless of what is happening in a person’s life. For example, if someone falls into a depression after the death of a loved one, they will be sad and depressed no matter where they are or what they do.

 

 

What are the 17 symptoms of PTSD?

Although this blog post is about depression and PTSD, it is in its place and reminiscent of what PTSD really is. Here I reproduce 17 good examples of symptoms of PTSD. All retrieved from cumberlandheights

Life is unpredictable. Unfortunately, for many of us, that means that grief and trauma can arise at any time. When a person is exposed to danger, violence, illness or the threat of injury, they can potentially carry that trauma with them for years to come.

  1. Intrusive Thoughts

Intrusive thoughts are perhaps the best-known symptom of PTSD. What do intrusive thoughts look like? A person going about their day is suddenly confronted by unwelcome, distressing memories of what happened to them. This may happen in a related setting – for example, a person who has gone through a car accident may begin to panic in a vehicle – or out of the blue.

 

  1. Nightmares

Trauma survivors regularly deal with nightmares. Research from the U.S. Department of Veterans Affairs (the VA) has indicated that 71% to 96% of those with PTSD may have nightmares. Those with co-occurring mental illnesses are also at higher risk for vivid, disturbing dreams.

 

  1. Avoiding Reminders of the Event

PTSD changes the way a person lives their life. One of the major effects of trauma is avoidance. For example, someone who nearly drowned will probably avoid swimming again. However, they might even avoid taking baths or going to the beach because it reminds them too much of what happened. These avoidant behaviors can be debilitating, and those who are dealing with them are encouraged to seek professional trauma treatment.

 

  1. Memory Loss

Traumatic events impact the brain’s functioning. While many people assume that this is due to a physical brain injury, it’s frequently a case of the body attempting to cope with what has happened. The hippocampus, amygdala and prefrontal cortex are strongly associated with stress and memory. When something traumatic happens, memory loss occurs as a natural defense mechanism. Without proper treatment, these memories may resurface at any time, resulting in significant distress.

 

  1. Negative Thoughts About Self and the World

People who have been through trauma see the world differently. They may feel hopeless and live with a “foreshortened future” – an inability to visualize future milestones or old age. It’s also common for them to see themselves in a bad light. One of the 17 symptoms of PTSD is a negative perception of the self and the world at large. Client-centered therapy seeks to build a person’s self-esteem after a traumatic incident, reassuring them that they are worthy of success and healing.

 

  1. Self-Isolation; Feeling Distant

After something terrible happens, it’s difficult to connect with others. People with PTSD may have a hard time being around people for a few different reasons. These include potential triggers, as well as an inability to relate to their friends. If you have been through a traumatic event and feel like your loved ones just don’t understand, we encourage you to speak with a professional therapist who specializes in trauma treatment.

 

  1. Anger and Irritability

PTSD creates a state of hyperarousal. This means that the brain is kicked into a state of “fight or flight” at the slightest urging. Hyperarousal results in strong emotions like anger, as well as general irritability on a day-to-day basis. Those who have been traumatized may lash out at others, even if they don’t fully understand why.

 

  1. Reduced Interest in Favorite Activities

Negative life events make it difficult to enjoy once-loved activities. The mood changes, sleeplessness and avoidance associated with PTSD mean that a person might feel unmotivated and uninterested in their work and hobbies.

 

  1. Hypervigilance

After a traumatic event, the body enters a state of hypervigilance. This increased alertness ensures that a person is always prepared for any other threats. However, this state of extreme awareness is exhausting and upsetting for trauma sufferers, making it among the most upsetting of the 17 symptoms of PTSD.

 

  1. Difficulty Concentrating

Hyperarousal and anxiety also take away one’s ability to concentrate. Individuals who have undergone a traumatic event struggle to readjust at work, home and school because their minds are often elsewhere.

 

  1. Insomnia

Insomnia is another typical symptom of PTSD. To go to bed, a person has to let their guard down, which is especially difficult for hypervigilant trauma sufferers. Additionally, the nightmares they may face at bedtime can make sleep an unattractive proposition. Many people who have experienced trauma struggle to sleep, and they may turn to alcohol or drugs in order to calm their minds. However, this approach can result in issues with substance use disorder.

 

  1. Vivid Flashbacks

Flashbacks are different from intrusive thoughts. Those who have flashbacks may feel as though the traumatic event is happening all over again. Memories can become so vivid that they seem to be happening in the current moment. This can cause people to panic, resulting a sudden, aggressive response. They may be triggered by something as subtle as someone’s cologne or a certain tone of voice. Those who have flashbacks are encouraged to ground themselves through the five senses – naming five things they can see can be a calming distraction.

 

  1. Avoiding People, Places and Things Related to the Event

Any reminder of a traumatic event can catalyze a flashback. That’s why many trauma sufferers become reclusive, avoiding people, places and things related to what happened. While this may make sense on paper, this behavior can actually be problematic. “Just trying not to think about it” is a coping mechanism that can actually worsen one’s symptoms over time.

 

  1. Casting Blame

Self-blame is especially common after a traumatic event. People with PTSD may blame themselves for what happened, especially if it resulted in the injury or death of a loved one. However, they may also assign blame to others who were associated with what happened. For example, after a boating accident, the traumatized person may point the finger at the driver of the boat. They might also assign blame themselves for not calling out or warning the driver in time.

 

  1. Difficulty Feeling Positive Emotions

Anger, sadness and guilt are the emotions primarily associated with PTSD. However, this condition also dampens a person’s ability to regulate positive emotions. Researchers have found that victims of domestic violence struggle to engage in goal-directed actions, control impulsive behaviors and accept their positive emotions while in a good mood.

 

  1. Exaggerated Startle Response

A key aspect of hypervigilance is an exaggerated startle response. One of the 17 symptoms of PTSD is caused by the constant feeling of being “on guard.” A small noise may cause a victim of trauma to become jumpy.

 

  1. Risky Behaviors

Finally, risky behaviors are especially common among those who have undergone trauma. Individuals with a high number of adverse childhood experiences (ACEs), for example, are more likely to try substances at a younger age and to develop an addiction. Combat veterans fall into this category too – they have higher levels of addiction than the general population. Risky behaviors can include drug abuse, alcoholism, unsafe sex, high-adrenaline activities and behavioral addictions (gambling, shopping, etc.). Those who are coping with their trauma through “compulsive comfort-seeking” should seek professional treatment as soon as possible.

 

The meaning of life

 

 

Veterans of various service eras completed an Internet survey about combat exposure, posttraumatic stress disorder (PTSD) symptoms, depression, guilt, and meaning in life. Results of a hierarchical regression indicated that younger age; higher levels of combat exposure, depression, and guilt; and lower meaning in life predicted greater PTSD severity. The interaction between meaning in life and depression also was significant, with a stronger inverse relation between meaning and PTSD at lower levels of depression. Meaning in life may be an important treatment concern for veterans with PTSD symptoms, particularly at higher levels of functioning.

Treatment Options For PTSD And Depression

 

Although PTSD and depression are two separate disorders, they can be treated in a similar way and use similar treatment methods.

Treatment for the two mental disorders has a common goal: to reduce the severity of the symptoms and help the patient to regain the quality of life.

I experienced being well taken care of by the health service but soon discovered that PTSD does not go away on its own. The first thing we had to do according to my therapist was to get rid of the depression. Also, something that is easier said than done.

But it eventually disappeared. (It took 2 years in my case) Then we started the treatment of PTSD. This is like taking apart an onion, according to the psychologist. He was absolutely right. My PTSD is still with me 35 years later and over 10 years after I stopped treatment.

But I live perfectly ok with PTSD given the right conditions. I medicate myself with training and projects and ensure a very rigid routine life. (Sleep at the same time, get up at the same time, eat routinely. Avoid things that give me anxiety. (Easier said than done). At least I try to avoid tasks that I know will take a lot of energy.) Beyond that, it means living an influence on good and evil, but that is life itself.

Treatment Options Include.(From Better help):

Medications:

Depending on the severity of your situation, your symptoms and what you’re going through, the doctor will prescribe medications like anti-depressants, anti-anxiety medications, sleeping pills or a combination of all three. There is no one pill combination that works for everyone so the doctor will work with you to find the right dose and combination to treat you. This may take some time and involve trying out several types of medications and see their effect. There are also new treatments underway

Talk therapy:

When it comes to treating PTSD and Depression, this is one of the most effective treatment methods, as it provides more than just a Band-Aid solution and will arm you with the tools you need to successfully manage your illness long term. The most popular type of psychotherapy used is CBT – Cognitive Behavioral Therapy. CBT yields results fairly quickly with the patient seeing the therapist for between five to twenty sessions. 

The goal of CBT is to identify and assess the negative, harmful thoughts and experiences the patient is going through and either change their pattern of thinking or arm them with the necessary skills and strategies in order to overcome and manage their challenges and deal with difficult situations in a positive manner.

The beauty of CBT is that it is a suitable treatment option for all ages and can be done online with a therapist as well as in person.

In addition to individual therapy sessions, the doctor may also recommend group counseling sessions. Group therapy helps the patient discuss what they’re going through, their feelings and emotions with people who can relate and share similar stories. It is often a lot easier to speak about what you have been through with someone who can relate to your situation. Group therapy helps to provide that support and can help you feel less alone.

Finally, couples and family therapy may also be recommended since what you’re going through may be having a negative impact on your family or adding stressors to your relationships. Family therapy helps your family members better understand the illness and what you are going through and provides them with an outlet to share their pain.

Changes In Lifestyle:

These are non-medical things you can do to promote a healthier lifestyle such as exercising, eating balanced, nutritious meals, meditation and yoga, taking up a pleasurable activity, sleeping well, etc. All these things are designed to make you feel better, give you things to look forward to and will over time help to decrease the negative symptoms of PTSD and Depression.

Because the two illnesses mirror each other so closely and have similar treatment methods, the mental health professionals who specialize in and treat PTSD are usually trained in treating depression and vice versa.

Seek help in time

Why is it important to seek help right away? When it comes to any kind of mental disorder or illness, early intervention is always best and yields more positive results. Left untreated for a long period of time both PTSD and Depression will likely lead to chronic complications. 

The symptoms will worsen, the quality of your life will decrease steadily, you may have a difficult time holding down a job, maintaining social and familial links and chances are high the people you love the most will also suffer from the blowback of what you’re going through.

Seeking treatment will help you deal with all these issues and get back to your normal self.

What is PTSD?

Post-traumatic stress disorder, PTSD, sometimes known as shell shock or combat stress, is an anxiety disorder that can occur in people who have been exposed to particularly frightening and horrific experiences such as aggravated violence, abuse, war and concentration camps, disasters, torture, rape, serious accidents or serious crimes (such as armed robbery).

Mobilization, or fight-or-flight, occurs when you need to defend yourself or survive the danger of a combat situation.

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