Military life is stressful; depression screening brings help

By Kimberly Buckingham, PhD, Defense Centers for Public Health - AberdeenOctober 4, 2023

Screening for depression can be a lifesaver
Feeling down, hopeless, tired, irritable, or having trouble concentrating? When you feel more than just sad, getting screened and seeking support and treatment for depression can help reduce the intensity and duration of symptoms. Many resources are available for service members, family members, civilians, retirees, and veterans. (Defense Centers for Public Health – Aberdeen graphic illustration by Joyce Kopatch). (Photo Credit: Joyce Kopatch) VIEW ORIGINAL

ABERDEEN PROVING GROUND, Md. – Military members and their families experience unique stressors associated with military life that may negatively influence psychological and social well-being and contribute to behavioral health symptoms, which can include depression. Additionally, some evidence suggests that veterans with past combat and deployment experiences are another military group that may be at risk for depression and posttraumatic stress disorder, or PTSD.

Depression is more than feeling sad. While anyone can feel sad or low sometimes, these feelings usually pass with a little time. Depression is a medical condition that can cause severe symptoms that affect how you feel, think, and handle daily activities such as sleeping, eating or working. It can interfere with daily life and normal functioning and can adversely impact a service member’s ability to carry out duties. It is an illness that can affect anyone—regardless of age, race, income, culture or education.

Example stressors associated with military life include:

  • Separation from family and friend support systems; extended time away from home;
  • Frequent relocations, known as permanent change of station, or PCS;
  • Experiencing the intense stress of combat or other trauma;
  • Perceived stigma surrounding behavioral health;
  • Meeting physical fitness standards;
  • Legal concerns, such as a pending uniformed code of military justice action;
  • Disrupted sleep cycles;
  • Competing for promotion;
  • Family circumstances such as spousal employment and childcare;
  • Quality of life concerns about housing, finances, food insecurity, or access to healthcare;
  • Substance misuse; and
  • Feeling alone or isolated.

The Defense Centers for Public Health – Aberdeen 2022 Health of the Force report shows active-duty Soldiers experience depression as well as other behavioral health disorders. Primary behavioral health categories include adjustment disorders, anxiety disorders, mood disorders, PTSD and substance use disorders.

Anita Spiess, a senior behavioral health epidemiologist at the DCPH-A says, “Mood disorders, which are for the most part depressive disorders, are diagnosed in approximately 4 percent of the active-duty Army. The rate of diagnosis among women is double that among men.”

Additionally, a 2022 military study published in Military Psychology found an “association between reported financial, spousal employment, and childcare changes associated with the pandemic and probable clinical depression and generalized anxiety in U.S. Army Soldiers.”

“Because mood disorders like depression can have a large impact on the Soldiers and their units, it’s important to identify and address military and other stressors that may contribute to behavioral health conditions,” says Spiess.

Spiess and her co-workers in the DCPH-A Behavioral and Social Health Outcomes Practice Division plan to publish findings from their more in-depth analyses later this year.

The value of screening

 Research has shown that treatment services, such as counseling and medication, can reduce depression symptoms and decrease risk of negative outcomes like substance abuse and suicidal behaviors.

“Early identification and treatment of behavioral health concerns among Soldiers is a priority for the Army,” says Spiess.  “Soldiers who seek and receive treatment for behavioral health concerns may be less likely to experience negative outcomes and decreased readiness.”

The first step towards early detection is depression screening, which can identify at-risk individuals, who are then encouraged to seek support from community resources and clinical treatment.

During the annual Periodic Health Assessment, service members are screened for depression as well as deployment-related health concerns; primary care appointments are scheduled as needed. The Military Health System and the Veterans Administration also provide recommended screening for depression at least annually, with more frequent screening for several high-risk populations, such as those experiencing congestive heart failure, significant losses, and chronic medical illness; and pregnant or postpartum women. Family Members and beneficiaries have access to behavioral health screening during primary care visits.

A call to action

“Depression can affect your body as well as your mind, says Army Lt. Col. Melissa Boyd, a licensed clinical psychologist and behavioral health advisor at the DCPH-A. “Trouble falling or staying asleep, headaches, an upset stomach, chest pain, fatigue, and muscle tension are some of the common physical symptoms a person can experience when depressed.”

Boyd recommends physical activity to ease physical pain and discomfort.

“If you are depressed, it can sometimes be hard to get the energy to exercise, says Boyd. “But during exercise, natural chemicals, known as endorphins, are released to your brain, making you feel good, improving your mood, and enhancing your overall sense of well-being.”

In addition to exercising to reduce symptoms, the DCPH-A team recommends that all Soldiers, family members, civilians, retirees, and veterans who suffer from feelings of depression get screened and seek support and treatment. It takes courage to seek help but, as with any illness, early medical diagnosis and treatment for depression may help reduce the intensity and duration of symptoms.

Signs of depression can include:

  1. Little interest or pleasure in doing things;
  2. Feeling down, depressed or hopeless;
  3. Trouble falling or staying asleep, or sleeping too much;
  4. Feeling tired or having little energy;
  5. Poor appetite or overeating;
  6. Feeling bad about yourself or that you are a failure or let others down;
  7. Trouble concentrating on things, such as reading or watching television;
  8. Difficulties initiating daily tasks, or feeling sluggish;
  9. Feeling restless or fidgety; and
  10. Thoughts that you would be better off dead, or planning to hurt yourself.

Depression can be a serious illness that may impact physical health, quality of life, family well-being, and readiness. If you or someone you know is experiencing or struggling with symptoms of depression, resources are available through the Military Health System, your primary care provider, or your local community.

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