Common issues

People often come to us believing they can only experience mental health problems if they are 'weak'. Sometimes people fear there is something wrong with them.

Veterans often wait for many years before they feel able to seek help for mental health difficulties. Others might worry we will not understand what they are going through.

In fact, we know mental health difficulties are a normal reaction to life experiences, including trauma and adjusting to civilian life. We will work with you to understand what we think is contributing to your difficulties and discuss what you would like to change.

The following pages describe some of the mental health problems we often see here at our service. We can provide help and treatment for these problems, recommend strategies you can put into place to help you manage, or help you access other NHS services for treatment and support.

If you have any reservations about coming in to see us, we are happy to have an informal talk on the phone. Call us on 020 3317 6818.

Many people experience adjustment problems because of a difficult change or stressful event in their lives.

Veterans may have adjustment difficulties after deployment, but other non-military stresses can also cause adjustment problems. Many veterans have difficulty adjusting to civilian life after leaving the forces, but for some people this lasts longer than the usual period of transition.

People who are experiencing adjustment problems often describe feeling overwhelmed or have difficulty coping, feel low in mood or have physical symptoms such as difficulty sleeping, tension or heart racing.

People who experience or witness traumatic or life-threatening events may develop symptoms of post-traumatic stress, commonly known as PTSD. Events which can contribute to PTSD include those where you felt as if your life or the lives of others were in danger or you felt you had no control over what was happening, witnessing others being injured or dying or being physically harmed yourself.

PTSD can develop soon after a traumatic event. However, it may develop many months or even years later. PTSD is a natural human reaction to having experienced traumatic or life-threatening events. These could include events during military service or at other times in your life, including childhood.

People with a diagnosis of PTSD usually experience a range of symptoms, including:

• Having unwanted memories or nightmares of the traumatic event
• Feeling as though you are reliving the event
• Having a strong emotional or physical response to reminders of the event
• Avoiding thinking or talking about the event or avoiding things, people or places that reminds you of the event
• Engaging less with activities you used to enjoy and socially withdrawing
• Having feelings of guilt or shame
• Having negative thoughts about yourself, others or the world in general
• Feeling angry and irritable
• Feeling very jumpy
• Constantly looking out for possible threats or danger
• Difficulties concentrating or sleeping;
• Constantly feeling anxious or on edge
• Suicidal thoughts.

Contrary to common myths, there is treatment available for PTSD. Trauma-focused Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitization Reprocessing (EMDR) are both recommended by the National Institute of Clinical Excellence (NICE). There is good evidence that they can help reduce the symptoms of PTSD.

Anger is a natural response to some situations; it is part of your body’s way to prepare to ‘flight or fight’ and is part of being human.

As part of military training, you are taught to use aggression in a specific way in response to threats, so this can make anger an even more common difficulty for veterans. However, when anger is too easily triggered or happens too often it can become a problem. It may lead to harm to yourself or others around you.

Sometimes when we feel angry we may try to suppress or ‘bottle up’ our feelings, but this can lead to expressing our anger in different ways, such as getting very angry very quickly about small things. Often this can have a negative effect on relationships with others.

Anxiety is a feeling of unease or fear that we experience when we are nervous about something. It can involve many symptoms including a sense of dread, feeling restless, and raised blood pressure.

Anxiety is our body’s normal reaction to stressful events. However, anxiety can become a problem if it gets in the way of living your life, by for example, worrying all the time about things or stopping you holding down a job.

Feeling sad is often a normal human reaction to events, but when these feelings do not go away naturally and begin to interfere with your life, this is described as depression.

Depression can present itself in many different ways. It may include a range of problems affecting your feelings (such as feeling numb or helpless), your behaviour (avoiding social situations), your thoughts (such as lots of negative thoughts or thinking about suicide) and your body (such as changes in appetite, problems sleeping and having no energy).

There are many possible causes of depression, for example, loss, difficult life events, childhood experiences, side effects of medications and diet, amongst others. It can also occur alongside other problems such as post-traumatic stress disorder.

Often people use alcohol or drugs to cope with difficult situations or emotions. However, using too much alcohol or drugs can damage your health, get in the way of leading a normal life and make it more difficult to recover from other mental health difficulties. Problems related to alcohol use are the most common amongst veterans.

Some services will not accept people who are using drugs or alcohol. However, we do not exclude anyone because of this.