The Stress of Serving
In this post, we’re concentrating on major depressive disorder (MDD) in military service members and their families. A 2012 study published in the journal Military Medicine reveals that the prevalence of MDD among military personnel is disproportionately greater than it is among the civilian population. To really appreciate this discrepancy, it is important to understand the distinct links between mental health conditions and the particular kinds of trauma and/or stress experienced by service members. Below are a few issues that we frequently encounter with our military patients:
- The stress of active duty doesn’t always subside after returning to civilian life
- Post-Traumatic Stress Disorder (PTSD) as a lasting effect of a single event or many events, such as witnessing death in combat
- Physical injuries, such as traumatic brain injuries (TBIs), can directly and indirectly influence mental health
- The effort of trying to deal with chronic pain, anxiety, and stress can easily lead to picking up negative coping mechanisms like substance abuse
- The pervasive stigma around mental health issues creates shame for those struggling with depression, leading to attempts to hide one’s emotions and carry on despite personal hardship
Significant Impact on Military Families
Spouses of active and off-duty military personnel often suffer fallout from their partners’ pain. After all, when you love someone, you tend to become attuned to their emotions. Partners of military service members or veterans, particularly those with diagnosed MDD, may experience great stress as they try to live their lives while simultaneously helping their loved one. One survey sponsored by the U.S. Department of Defense (DOD) produced more troubling statistics. Out of the 367,706 military spouses consulted, 85% reported feeling depressed and anxious, 88% said they felt alone, and 92% felt high levels of stress during their partner’s deployment. Another survey also found that military spouses deal with far higher levels of underemployment and unemployment than the general population, influenced by factors like frequent relocation and childcare.
The National Center for Children in Poverty (NCCP) is looking into the effects of military life on children of military personnel across the time spectrum of their service – i.e. pre-deployment, deployment, post deployment, and re-integration with civilian society. Predictably, the data collected thus far illustrates that military life can create a tremendous amount of psychological distress for children in military families.
Check out an excellent list of mental health resources for military families here.
In the previous sections, we discussed some of the most common difficulties faced by service members and their families in dealing with mental health issues such as depression. We now turn to look at what depression is from a clinical standpoint, and how it can manifest in an individual’s thoughts and behavior.
Estimated by the World Health Organization (WHO) to affect more than 300 million people globally, depression is one of the world’s most pervasive health issues. One of the most troubling aspects of Major Depressive Disorder, or MDD, is the significant impact it has on individuals’ ability to function day-to-day and live life the way they want to. According to the National Alliance on Mental Illness (NAMI), depression is the leading cause of disability in the United States, and a staggering 19 million adults in the US, or approximately 8% of the population, have reported experiencing at least one Major Depressive Episode (MDE) in the past year. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines an MDE as a period of 2 weeks or longer in which an individual has suffered any combination of symptoms of MDD nearly every day. According the diagnostic criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of MDD include:
- Deep feelings of sadness and despair
- Loss of interest in activities the person once enjoyed
- Irritability and anger
- Difficulty concentrating
- Sleep disturbances
- Changes in appetite (increase or decrease) and significant weight loss or weight gain not due to other conditions or disorders
- Sexual dysfunction
- Fatigue and lack of energy
- Feelings of guilt and shame
- Persistent thoughts of death
To make matters worse, these symptoms often exacerbate each other. For instance, someone whose anxiety interferes with their concentration may in turn become irritable with themselves. Similarly, an individual who feels shame about struggling with depression can feel a subsequent increase in anxiety, which can interfere with getting adequate sleep, ultimately stressing the body and mind even more. Someone who performs physically demanding work can become sick if food loses its appeal and they don’t get the nutrients they need.
Common methods of treating MDD, such as medication and therapy, are helpful and frequently have positive results. Unfortunately, that is not true for all individuals struggling with depression; thousands of people suffer from “treatment-resistant” MDD, so called because “traditional” treatment approaches have not worked or have lost their efficacy.
Caring for Our Military
At CalTMS, we frequently help military families with treatments for depressive disorders. Transcranial Magnetic Stimulation (TMS) Therapy is approved by the FDA for treatment-resistant Major Depressive Disorder (MDD), and is covered by most major medical insurances. Check out our testimonial page to see what some of our patients have to say about their experience.
TMS Therapy works by stimulating the left dorsolateral prefrontal cortex, an area of the brain involved in emotion and stimulus processing. This stimulation is achieved by passing an electromagnetic coil over the scalp. The coil emits a series of pulses, which are carefully monitored by an experienced TMS Technician administering the treatment. Unlike with “Shock Therapy” or ECT, the patient is awake and alert during treatment, and feels the pulses as a tapping or tingling feeling on the scalp.
TMS Therapy is non-invasive, involves little to no discomfort, and requires no observation period following the treatment, meaning our patients can continue to go about their day without major interruption. TMS Therapy can also be combined with other treatments in the patient’s plan, such as talk therapy and medication, but all treatment plans are customized according to the patient’s individual needs. Patients with seizure disorders and metallic implants are not able to receive TMS Therapy. Patients are advised to always begin by consulting with their primary care physician (PCP), who can make assessments and provide referrals to mental health specialists.
TMS For the Future
Our hope is that, with continued use, research, and technological advancements, TMS Therapy can see wider use. One day, it may be approved to target other mental health conditions, such as combat-related PTSD in veterans and Obsessive-Compulsive Disorder (OCD). At CalTMS, we are working to make TMS Therapy more accessible for many reasons, such as:
- Eliminating stigma surrounding mental illness
- Normalizing speaking out about one’s feelings
- Increasing awareness of mental health options available
- Encouraging individuals struggling with depression to seek help instead of suppressing their feelings or suffering in silence
- Strengthening community resources for both military service members and civilians
- Providing help when Major Depressive Disorder (MDD) no longer responds to other treatments, such as talk therapy or antidepressant medications
- Promoting research into the exciting field of neuromodulation therapy
- Increasing large-scale visibility of the need for better mental health care for military service members and their families
Help Is Available
When someone in a family is suffering with depression or other mental health conditions, they are not alone in their struggle; those who love them and spend time with them will also feel their pain. We have deep love and respect for our service members and their families. All individuals deserve to live peacefully and enjoy life. If you or a loved one is suffering, please contact us to talk about your needs and options.