Depression can be a temporary thing that is mild and it can be a life long debilitating struggle. Some cases of depression come on because of things that we experience such as the loss of comrades arms during military combat. Other cases of depression start for no apparent reason. Years ago professionals referred to depression triggered by external events as exogenous depression. Depression that came on for no apparent externa reason was called endogenous depression. It used to be the case that psychiatrists believed that these we two distinct types of depression requiring different treatments. It turns out that no matter what brough on a case of depression the same medicines and treatments are effective. Nevertheless, these two characterizations of depression are still useful when trying to help. Endogenous versus exogenous depression in veterans is still a useful distinction.
Depression and PTSD
About half of veterans suffering from PTSD also suffer from major depressive disorder. This is long lasting, severe depression that need not have developed specifically from a single traumatic or sad event. Major depressive disorder replaced (years ago) the term endogenous depression. The point is that vets with major depressive disorder are more difficult to treat than those with mild cases of depression and are more likely to have chronic and/or recurring episodes of severe depression. This fact, by itself, makes these vets at greater risk for suicidal ideation, suicidal planning, and committing suicide. While the specific treatments and medicines use to treat those with major depressive disorder are the same as for milder depression they are typically used at higher doses and for much longer duration.
Psychedelic Medicines For Treating Major Depression
We have written about the promise that psychedelic medicines like MDMA and psilocybin hold in treating PTSD. These medicines also appear to be useful in treating major depression when other standard and powerful treatments have failed. As with treating PTSD, treatment with psychedelic medicines for depression is done by professionals, uses pharmaceutical grade medicines, and shows benefit with just a dose or two instead of constant dosing with strong medicines for weeks, months, or years. As with treatment of PTSD, psychedelic medicines for depression facilitate talk therapy, change the power of negative neural connections in the brain, and last for months up to five years after a single dose or two combined with therapy.
Depression That Precedes Military Service
Individuals with a history of major depression can serve in the military but need to have proof of 36 months free from depression and without medicines before entering service. It will be of use to a therapist to know if a depressed vet has a history of depression prior to their military service. However, such a history does not change the mode or duration of treatment. If a person has a longer history of depression the therapist will be on the alert for recurrence of symptoms and likely to keep a patient under their care for longer than someone with no prior history. A practical consideration in this regard is that a person who has a pre-military history of depression may not be eligible for treatment in the VA system for their condition which can make treatment more expensive and difficult.
At No Fallen Heroes we are dedicated to preventing veteran suicide. Depression and especially severe depression is a major risk factor for suicide by veterans. We are excited about the possibilities represented by treatment with psychedelic medicines and other new treatment modalities. Social isolation is a contributor to depression in veterans so the first thing you can do with a friend or acquaintance who is a vet is stay in contact and be open to talking about anything that is bothering them.
