When I got back from Afghanistan, I was angry. At the time I didn’t feel angry, exactly—it never felt like something was wrong. Anger is oftentimes something you can see in others (“That is an angry person”) but to you, it’s normal. But something definitely was wrong. I’m not even sure why that was the case. It’s not like I was securing downed helicopters in Mogadishu. But something about the sense of importance of what I was doing, combined with the realization of how small my part was in such a big undertaking, the rigid social hierarchy, and the astounding sense of utter monotony punctuated by moments of almost preposterous excitement, and then it just ends. Suddenly you’re back at home doing things like mowing the lawn or waiting on hold to sort out a billing error with the electric company.
For me it was a lot. My brain just handled it by making me angry and unpleasant. I look back on my behavior and demeanor when I got home with a lot of regret and embarrassment, but I am also pretty annoyed at how the Army handled the whole thing. You couldn’t say anything or you’d get flagged as nondeployable, and so mostly I would get blackout drunk with guys I went there with and we’d laugh about it all, but one thing it did not do was get me back to normal.
Later, as a civilian, in those early years it felt basically impossible to get mental health care through the VA system. I don’t know why that is the case, but if I’d broach the issue, every doctor I had was pretty unconcerned about the whole thing, casually dismissive of the idea of therapy. That was a long time ago, and I’m sure part of it was simply the overwhelming number of men who came back with serious-business PTSD—the sorts of men who ended up killing themselves in VA parking lots because there was no help forthcoming, or at least, it felt like there wasn’t.
So I paid out of pocket for help, and it worked, though it took time. Early on, my civilian doctor put me on antidepressants and anti-anxiety medicine. And that, plus a couple years of therapy with a psychologist, really helped me. I felt stupid early on, because a lot of time, when you’re talking to a therapist, it feels like you are a farmer complaining about the weather. Today, I’m not on any medications, and I still do therapy with a VA psychiatrist.
The VA mental health system, as I’ve experienced it, has improved immeasurably. I’m not a Zen master or anything, but I can honestly say I just don’t get that upset about the little things anymore, and I feel happier than I’ve felt in my life. It took work, the same way the only way to build muscle is to go to the gym as a lifestyle choice, think before you eat, and be consistent. In the case of mental health, it’s about paying attention to the things you tell yourself, thinking before you act, and to keep working at it. (Incidentally, resistance training and regular cardio are also a fantastic combination you can do for your mental health, and are vital to my own journey.)
I share all this because it is wintertime now, and “seasonal affected disorder” (or winter blues, or whatever you might call it) can be a real thing. I don’t know how the military handled mental health for veterans in the second half of the War on Terror (anecdotally I’ve heard that it improved), but I suspect for anyone who served in the first half, if your experience was similar to mine, you gave up trying to get help a long time ago. Consider this piece an encouragement for you to reconsider.
In the VA system, the path to therapy has become straightforward. First, ask your doctor. Be direct about what you want and why you want it. (It’s not like you’ll ever see that doctor again, so no need to feel embarrassed.) Have him or her make a referral to VA mental health services. Everyone’s experience will vary based on what you are seeking help for, but for me, there were first multiple sessions during which a psychiatrist evaluated me. A lot of it was just answering questions. Among the things to expect, he or she might ask to speak to close friends or family. Afterward, I set up regular psychotherapy sessions. (If you’ve never done it before, it’s just like on TV.)
There are a ton of other services out there now that veterans can use, as well. First, though, check out the VA website to see what they offer. It’s surprisingly thorough and reassuring. They can help with everything from depression and anxiety to medication management to couples therapy and grief counseling. This is seriously expensive stuff in the civilian world, but you’ve already paid for the opportunity to use it in the VA system. In addition, there are peer support groups, which are not replacements for therapy, but great for connecting with other people, online and in-person, to just talk about things. (I have never tried them, but I have heard great things.)
Depending on your nearest VA center, you might expect to have long stretches between sessions. (That has not been my experience with the New Orleans system, which is superb, but I suspect that larger cities, or military towns, might have availability issues.) But the VA provides telehealth services for psychotherapy, which has undoubtedly helped that problem immeasurably. If, however, you do have long waits between sessions—even virtual ones—there are private, free services out there like Give an Hour, which also offer peer-led support groups.
If you take nothing else from all this, know that VA mental health isn’t only for the man who had his leg blown off by an IED. That man does need help, but this isn’t a competition. The U.S. government is plenty big enough to accommodate veterans with a range of experiences in the combat zone.
Know also that if you’re like me, fifteen years removed from the war, you’re not sitting on a sofa talking endlessly about your squad. You’ve moved on from all that. You’re not blaming your drinking or marital issues or attention issues on the war, any more than if you got the flu tomorrow, you’d tell your doctor, “Well it all started in 2001…” You are working through your issues today, taking them at face value today. You’ll sort out the causes in therapy.
I had intended this piece to be one of those lists of “10 Mental Health Services You Might Not Know About,” or whatever, but the truth is there are so many, and they are all so easily available, that you may as well just make an appointment and tell your doctor what you want. The more important point is that the VA is doing some great work these days, after doing (what seemed to me) like some pretty lackluster work for a long time. So if you have a friend or loved one who could use this as a push to just talk to someone and see what’s out there, please pass it along. The VA mental health system is better than it used to be, and can really help you in ways you might not expect.
