Disabilities and Depression

I contemplated whether I should co-mingle these two topics as they can be light years apart and not related. But, the fact that medically speaking, they can be referred to as co-morbid, made me keep them together. While depression can certainly stand alone like the cheese, it is very directly attached to other disabilities, injuries, and illnesses.

First, let’s define depression. “Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called a major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.”

We all know what a disability is. So, how are the two intertwined and what do we do to work our way through this? In this case, we are talking about the depression that can naturally come from having a disability, injury or illness, here forward just referred to as disability. Generally, the disability comes first and as a result, the depression follows. The biggest issue involves only treating the underlying disability, not addressing the associated depression which only makes the disability worse. As we all know from recent reports, stress is an underlying cause of poor healing and exacerbated injuries.

So how did we get here? We were once on top of our game. Now we are broken to some extent, it’s their fault, it’s impossible to get my claim approved, the VA care sucks, nobody understands and nobody cares. I see this every day in my research, over and over. Again, in most of these cases, the disability and its inherent processes caused depression. The government has not made it easy and their processes, or lack thereof, may be to blame for both the disability and the co-morbid depression.

Let’s start from the beginning, Chapter 2, our military service. Somehow or some way we get injured or incur an illness caused by or exacerbated by our life in uniform. The battle now begins. If we don’t document this, the battle is mostly lost already. Knowing how few injuries I reported in my career, including multiple TBIs and a fractured hyoid bone (look that up), all potentially fatal, I can only imagine what others who trained and fought harder than I did never reported. But, let’s assume you have been seen by your Warrior-healer, and he hasn’t been busy losing your shot records, again (you know who you are). Or the engagement was documented by Operations. A few years down the road we decide to transition to Chapter 3, our life after Service. The military and the VA still do not have the same electronic medical records system so all documents must be on paper. Who even does that any more? Even Amazonian native tribes have access to the telegraph system. But the largest employer in the country can’t speak to the largest health care provider in the world. A new system is on the way with a contract recently let, but years in the making.

So, we go to our final medical appointments and are so happy to get out at this point, we feel fine. And if you are like the dumbest SGM in the world, you promptly misplace those records anyway in your final PCS move. Then we file whatever paper copies we have with the VA and pray there was sufficient documentation to justify our disability. Then, we have to go to an appointment to do the same thing we just did while out-processing. Except, it’s by really old Dr’s who are being paid crap to get through a stack of records for the day to keep ahead of the 150,000 backlogged claims. How did that go? So, we spend another year waiting and appealing and documenting and waiting and stressing and waiting until we finally get that letter that says our horrifying degenerative arthritis at 40 years old is not the military’s fault.

But, they will help you with treatment, as long as you don’t make too much money so you can pay for your own health insurance to cover the treatment for not being able to hear out of your left ear because of explosions because you were told it’s normal for your age. I guess I missed in my biology class that it is normal to not hear out of one ear while the other works perfectly. But, I skipped school a lot. If you are still reading this, and aren’t depressed from this stupid process, God bless you. Can you imagine going to your private Dr and being treated this way? Now can you see how disability can cause depression?

Hey, this is no problem, Big Sarge. I got this. In Chapter 2, I was taught to face out, take a knee, change my socks and drink water. FIDO, F*** it and Drive On. While that may work for fatigue and minor booboos, it does not work for depression. Depression must be treated. What are the two most popular evidence-based methods of treating depression? Medication and Cognitive – Based Therapy. Annnnd 19 million Warriors just collectively groaned because what are the two things that Warriors hate the most, besides a barracks thief? You guessed it. Talking with someone about their feeeeelings and being a zombie from taking pills. It’s witchcraft, voodoo, stupid, a waste of time and some other choice words I shall not name. Well, my brothers and sisters, it is not.

Let’s talk first about the medication used to treat depression. These meds are not designed to necessarily cure your depression, rather provide a safer way to feel better, called harm reduction, than self-medication like alcohol, drugs, risky behavior, promiscuity, or self-harm. These meds are very tricky and act differently for each person. The various meds along with various prescription amounts combined with an unseen foe that they are supposed to attack with subjective symptoms make it hard to get right the first time, second time or even third time! So, sometimes we will feel groggy, like a zombie or just want to lay around all day and fight our Warrior discipline that is telling us to go mow the lawn, the right way. Give it time to level you out. You will find your peaks and valleys not so far apart and a general feeling of calm.

What proper, prescribed medication will also do is help you get to some cognitive-based therapy. It will bring you up enough to make the decision to help yourself. You have had the courage and desire to do it all along but the depression has stood in the way. Now, the meds lighten that load enough, hide the depression enough to just get you there. The reason for your depression needs to be addressed, not just self-medicated through or even just take meds to cover it up. This is where the courage of a Warrior roars. This is where we make our money. In our military operations, we spend most of our time rehearsing the Actions on the Objective. The things we do when we meet the enemy in a place of our choosing. Well, cognitive-based therapy is the place of our choosing. The enemy is depression! The objective is feeling better. So, let us work on what we do when we meet the enemy. We rehearse therapy, over and over. How many times have rehearsed actions on the OBJ in Chapter 2 of our life? Thousands? Until we got it right, for good?

Well, now it’s time to rehearse our cognitive-based therapy, over and over. It is basically understanding your depression, specifically the thoughts that cause it, how it make you feel bad, and then change the way you respond to those thoughts. Reprograming the brain housing group to operate more effectively and without interruption. That is this layman’s definition. Please seek someone who is more than a Combat Life Saver for the actual concept and process. But you get the point! Along with creating the disability, whether it be a messed up back, tinnitus, loss of appendage, pain in appendage, PTSD or anything else, we must treat the co-morbid depression.

Look, I’m not in your shoes. I have my share of crap, you have yours. You are different than me, I am different than you. I respond differently to treatment and meds than you do. I don’t know what you are going through, you don’t know what I am going through. But what I do know is this, if left untreated, depression will ruin you life just as quick as your disability. It will erode you as a Warrior, taking your family, friends, fitness, fun, faith, employment and community along with it. It will tear down your pillars of life like they were sand in the ocean. You have it in you to work to resolve this pain and suffering, to ditch this bug infested monkey on your back. So, let’s get it done Warrior.

Are you the family or friend of a Warrior who has depression along with some disability? If so, please understand the difficulty that this Warrior is going through. Your task, love them and help them get to help. I hate talking about my feelings, so you may have to drag me there, kicking and screaming like an over-caffeinated two-year-old. But get them there you must. I hope this has shed some light on the subject enough that you can help yourself or help someone who needs it and that you will share this with all your friends. Taking care of our Warriors who hurt because of service is all of our responsibility. So, let’s all get smart about this. See you on the objective!

—SGM DTB—