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Military discharge due to depression (Fighting the bigger battle)

In this article, we will talk about military discharge due to depression. To understand this phenomenon, we will first understand what is a military discharge, when is it granted, what is the prevalence rate and causes of depression among military personnel in service, and upon discharge. 

What is a military discharge?

A military discharge, granted to military personnel, is a release from their oath to serve the nation.  The reasons for discharge can be varied, the most common one being the satisfactory completion of training or service period. Some other reasons for discharge could be demerits/punishments, criminal act, the poor quality of the person’s work, humanitarian or medical reasons, substance abuse, and dependency issues, inability to comply with suggestions for treatment or counseling.

Every country has its own set of directives based on which a serviceman is discharged. Based on the reason, the decision to re-enlist the person into service or the quality of benefits they get after discharge is taken.  

Designated mental health conditions for which a military discharge is granted 

The military may discharge for “other designated physical and mental conditions” servicemembers who have conditions that do not qualify for a disability discharge, but “that potentially interfere with an assignment to or performance of duty….” 

The following symptoms may be noticed or brought to the attention of the supervisor or the command and maybe then considered for discharge:

  • frequently depressed, or find yourself crying;
  • have feelings of helplessness;
  • lack self-confidence or feel worthless;
  • have difficulty controlling temper; act violently, or desire to;
  • have ever thought, even fleetingly, of suicide;
  • tend to feel out of control;
  • have trouble concentrating, or “space out”;
  • have physical problems for which there are not obvious physical answers (headaches, pre-ulcerous conditions, rashes, etc.);
  • have difficulty sleeping;
  • have disciplinary problems in which you were not able to act as you wanted to;
  • have difficulty completing tasks or handling stressful assignments.

Statistics of military personnel with depression in-service and post-service period 

Researches have been done with military personnel on their mental health and many do state that depression is more likely to be seen among military service members than civilians. Estimates state that up to 14% of members in the military experience depression during their service tenure.  

A research study was done over almost a period of two decades with retired army veterans in the UK and a comparison was made between the number of death by suicide for army veterans and the general population. Although the overall suicide rates of army veterans were not higher than the general population, the results of deaths by suicide among army veterans were concerning. 

The risk of suicide in men aged 24 years and younger who had left the Armed Forces was approximately two to three times higher than the risk for the same age groups in the general and serving populations (age-specific rate ratios ranging from 170 to 290). The risk of suicide for men aged 30–49 years was lower than that in the general population. The risk was persistent but may have been at its highest in the first 2 years following discharge. The risk of suicide was greatest in males, length of service period and the rank of the member in the army were influential factors. Sadly, the rate of contact with specialist mental health was lowest in the age groups at greatest risk of suicide (14% for those aged under 20 years, 20% for those aged 20–24 years).

Causes of depression among military personnel while in service 

History of abuse before joining the military 

Any kind of abuse, physical, verbal, sexual can push one towards a very delicate state of mental health which can be pushed over the edge with one trigger or blow which is often in the military service.  

History of mental health crisis before joining the service 

Having a history of mental health crisis renders one more vulnerable to the development or worsening of the existing disorder/challenge after joining the service. 

For this, a thorough mental health screening before joining or at the time of joining needs to be done by a qualified professional. 

Combat experiences and PTSD 

Traumatic events, such as military combat, assault, disasters, or sexual assault can have long-lasting negative effects such as trouble sleeping, anger, nightmares, being jumpy, and alcohol and drug abuse. When these troubles don’t go away, it could be PTSD (Post Traumatic Stress Disorder). 

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.

About 45% of people with PTSD also have depression.

Traumatic brain injuries (TBI) and depression

Difficult combat situations or training periods can lead to injuries to the brain, spinal cord or the nervous system causing TBI. Concussions, contusions, lacerations to the brain are often very dangerous and need immediate supervision. In the case of TBI, many people are then left with an altered state of brain functioning mainly to do with some dysfunction with their neurotransmitter production. This often leads to depression. 

People with TBI may also at times experience physical disabilities which again can lead to depression. 

Deployment in other countries 

Deployment in other countries has also been stated as a cause of depression among army personnel. Dealing with harsh climatic conditions or facing/witnessing extreme living conditions, war/combat situations leads to depression among personnel. 

Family life disruption 

Serving the nation many months and years away from the family causes disruptions in the relational ties of army personnel. Many times the marriage doesn’t work out well, the growing ages of their children are missed, important family events are missed. This leads to added stress and even depression when the family’s support is not as expected by the person in service.  

Causes of depression in the military discharge 

All of the reasons stated above are applicable to depression in military discharge. That is, having PTSD or TBI renders one more vulnerable to depression, having a problematic family life again leads to extreme unhappiness, etc. 

But over and above these factors important causes of depression after serving in the armed forces can be:

Difficulty transitioning into life as a civilian

Living as a civilian means lesser challenges compared to army life. Being around people who do not relate or understand what it is like being in the army may feel nobody understands the struggles they have withstood to be where they are. 

Transitioning also includes getting adjusted to family routines which might be very different from the routines in the military. Families may have created new routines during absences and both the family and the veteran will have to adjust to changes.

Difficulty finding jobs 

For service members taking a discharge before their serving tenure is complete, it is difficult to find jobs outside the military life. They are often hampered by the difficulty of converting skills gained in wars to private-sector jobs. They also are not well versed in establishing networks to get a private-sector job. Plus there is a culture of treating veterans as charity cases which leads to no or low paying jobs only being available for them. This leads to depression among veterans.

This situation is changing though. Companies are providing extra benefits for people who have served in the military. A fact to appreciate is that even educational institutions provide easy access to courses for continued learning for ex-military members.

What is the need of the hour?

Research and more information

Little is known about why particular military personnel is more susceptible to mental health crisis than others, the prevalence of alcohol and drug misuse and comorbid mental illnesses among current and ex-servicemen/servicewomen, the prevalence of diagnosed mental health problems among army members, factors that could boost the accessibility of mental health professionals to army members, social and family support influences on resettlement and transitioning for ex-service personnel, the impact of deployment on soldiers, etc. 

These are just some known issues that need attention. There might be many more factors that need to be studied. Information leads to better management and services. 

Improve conditions and clauses in the military with regard to access to mental health care and the process of approaching mental health care worker

The confidentiality clause between a patient and a doctor is not applicable to military situations. The absence of confidentiality in the military medical system deserves special emphasis. Soldiers and sailors often assume that their discussions with doctors and other mental health professionals will remain private. Unfortunately, reports of evaluations and treatment are often available to commands and may be used in virtually all military administrative and disciplinary proceedings. 

Statements or misstatements in psychiatric reports can lead to accusations of fraudulent enlistment, accusations of malingering or making false statements, and disciplinary action, or involuntary discharge for violation of military regulations. For example, soldiers who reveal illegal drug use to military psychiatrists normally face involuntary discharge.

Reduce the stigma related to having mental health challenges being an army member or an ex-army member 

Being army personnel involves living up to a certain idealized image of oneself. Having a mental illness is looked down upon or ridiculed after having served in the armed forces. 

Reducing the stigma will lead to increased confidence in seeking help from a professional.

Have training to make the transitions to civilian life easier 

Young men who leave the UK Armed Forces were at increased risk of suicide. This may reflect preservice vulnerabilities rather than factors related to service experiences or discharge. Preventive strategies might include practical and psychological preparation for discharge and encouraging appropriate help-seeking behavior once individuals have left the services.

Conclusion

In this article, we talked about depression in military discharge. To understand this phenomenon, we first looked at what is a military discharge, when is it granted, what is the prevalence rate and causes of depression among military personnel in service, and upon discharge. We also discussed what is to be done so as to reduce the rate of depression upon military discharge. 

Frequently asked questions: Depression in the military discharge

Can you serve in the military when you have depression?

Most countries do not have proper screening and diagnosis of mental health disorders for army members. Acknowledgment of a mental health crisis is a big challenge to date. Countries have different official directives too. In the US, a person with a depressive disorder must be stable, without treatment or symptoms for a continuous 36 months, to be eligible to enlist.

Does joining the military change your personality?

Yes. Studies do indicate a shift in the personality factors like honesty, agreeableness, openness to experience levels pre and post-military service.  

What are the challenges that veterans face?

Common problems include posttraumatic stress disorder, depression, anxiety, problematic alcohol use, and thoughts of suicide. Many veterans suffer from more than one health condition. In addition, many women and men experienced sexual trauma, including harassment and assaults, while in the military.

What we recommend for depression

Professional counselling

If you are suffering from depression then ongoing professional counselling may be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you live a more fulfilling life.

References:

https://www.mentalhealth.org.uk/sites/default/files/the-mental-health-of-serving-and-ex-service-personnel.pdf

https://girightshotline.org/en/military-knowledge-base/topic/other-designated-physical-and-mental-conditions-discharge

https://consumer.healthday.com/encyclopedia/depression-12/depression-news-176/depression-and-ptsd-in-veterans-645003.html

https://nlgmltf.org/programs-and-services/military-law-library/memos/military-psychiatric-policies/

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