With this blog post, I want to discuss the unique mental health challenges that our veterans face. In so doing, I hope to clear up some of the misperceptions that many non-vets have about these patriots.

Let’s get to the biggest misperception right away: That all veterans have posttraumatic stress disorder (PTSD), or are otherwise damaged in some way. This is wrong, and it’s time we got past it.

Before we get to the other misperceptions, a quick pause to mention my “bonafides” in discussing these issues surrounding our vets. First, though I didn’t serve, I come from a military family, so I’ve been around veterans all my life. Second, I spent several years working with veterans in the VA hospital system in Washington, D.C., as an addiction psychiatrist. Finally, we regularly see vets at the addiction treatment center here in Florida where I am the chief medical officer.

The Situation With Veterans as I See It

The statistics don’t lie. Veterans do have higher PTSD rates than non-vets. They also have higher rates of depression and substance use disorder. Most concerning of all, their suicide risk is higher as well.

There are several reasons for these heightened risks, and not all of them stem from the experience of combat. In fact, most don’t. There are other aspects of military life that also drive up mental illness risk for veterans.

5 Reasons Why Re-entry Into Civilian Life Can Be Difficult

1. I-can-handle-it stoicism: This has always been the mental ethos in the military, and it always will be. It serves active duty and reservist personnel well, but isn’t always a successful strategy for veterans, especially those who return to civilian life with mental health issues. For vets who run into trouble, it’s so important that they ask for help. But, because of the stoic mindset they absorbed in the military, many are not able to do that. Their go-to response is to try and power through their issues alone, which doesn’t always work.
2. Loss of purpose: A serviceperson’s primary task is to defend the United States and its interests, so it’s hard to get more purposeful than that. When veterans leave the military and lose that higher calling, it can be difficult for them to find meaning.
3. Less deference and social standing: After years in uniform, servicepeople get used to being addressed as “ma’am,” “sir,” “Senior Airman,” “First Lieutenant,” “Major,” and so on. That becomes part of their daily experience, as do the responsibilities and deference that come with their standing. When that disappears after a person leaves the military, it’s no surprise that a vet’s sense of self can be negatively affected.
4. Different social habits: Alcohol is a big part of the social scene in the military. Military personnel use alcohol to deal with stress, boredom, and loneliness, but also as a way to bond. However, when they leave the military, especially those who have been in the armed forces for years or even decades, many have a difficult time adjusting to new social norms and environments.
5. Loss of community: The military is very tight-knit. People in uniform will tell you that they would die for each other and for their country. In combat areas or in overseas deployments especially, your colleagues become more than friends. They become family. When that sense of community is lost once a person leaves the military, it can be an alienating experience.

What We Can Do to Help Our Veterans

In my experience, what veterans need most is to be seen and heard—and, hopefully, to be understood.

My advice if you work with veterans in a clinical setting or have a vet in your life is to do your homework. Learn the basics of military life. Familiarize yourself with the different branches and the cultures of each. As much as is possible, be aware of the issues that veterans faced during active service and once they return to civilian life. This will help you find common ground.

It may take a little time to earn a veteran’s trust, but it will happen if you make the effort to meet them halfway.

7 Things Veterans Want You to Know

PsychArmor is a nonprofit organization that promotes military culture awareness. The organization offers the following truths from a serviceperson’s perspective:

1. We are not violent or dangerous.
2. We do not all have PTSD.
3. It is hard for us to ask for help.
4. Our military service changes us, and we wouldn’t have it any other way.
5. Our families serve with us.
6. We would die for each other and for this country.
7. We sacrifice to serve something greater than ourselves.

During their time in the military, servicepeople deal with certain realities and challenges that civilians will never experience. Once they leave the service, some veterans struggle to gain a foothold in civilian life. When that happens, it is our duty to support them.

If you’re a veteran who is struggling, please contact the Veterans Crisis Line. If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.