TMS THERAPY
FDA-cleared, non-medication depression treatment
Veterans & Mental Health: How to Help
Daniel Hageman
The stress of military service and deployments takes a toll on both soldiers and their families. With higher rates of depression, anxiety, and posttraumatic stress disorder (PTSD) as compared to civilians, it’s unfortunately all-too-common for our veteran
The stress of military service and deployments takes a toll on both soldiers and their families. With higher rates of depression, anxiety, and posttraumatic stress disorder (PTSD) as compared to civilians, it’s unfortunately all-too-common for our veterans to struggle with their mental health during and after their deployments.
Similar to the obstacles that civilians face when accessing mental healthcare, the Government Accountability Office (GAO) reported that among veterans, key barriers to receiving mental health treatment include:
- Stigma and beliefs about mental health care
- Logistical challenges to accessing mental health care
- Concerns about the quality of health care they’re receiving
Many veterans avoid seeking help out of concern of appearing “weak” or “damaged.” But the truth is that many millions of Americans have depression , and according to veteran and host of the VetStory podcast Rod Rodriguez, “in the veteran community, one in three veterans suffer from some sort of depression.” Rod recently had Col. (Retired) Geoffrey Grammer , MD, Greenbrook’s Chief Medical Officer and Bill Leonard , Greenbrook’s founder, on an episode of VetStory to discuss depression among veterans and how TMS Therapy can be an effective treatment option when medications haven’t helped.
The need for effective depression treatment is apparent. According to 2019’s National Veteran Suicide Prevention Annual Report , in 2017 veterans made up 7.9% of the U.S. adult population but represented 13.5% of all adult suicides. Because a mood disorder (such as depression) is present in an estimated 60% of people who die from suicide, one way to prevent suicide is to be on the lookout for signs of depression and encourage people to seek treatment. Though a diagnosis should be made only by a qualified medical professional, symptoms of depression include:
- Fatigue or decreased energy
- Insomnia or excessive sleeping
- Changes in weight from decreased or increased appetite
- Persistent aches or pains, headaches, cramps, or digestive problems
- Depressed mood and feelings of worthlessness or guilt
- Difficulty thinking, concentrating, or making decisions
- Loss of interest in activities
- Thoughts of self-harm or suicide
If you’ve noticed these symptoms in someone you know, encourage them to seek help. That can be easier said than done, especially with a veteran who doesn’t want to appear as anything less than strong. Sometimes, flat-out asking someone “Are you depressed?” can be met with denial or hostility because it feels like an accusation.
Greenbrook’s Dr. Grammer says that in situations like these, you can try a different approach with someone who’s reluctant to get treatment. He says that “For some people, hearing ‘ you’re depressed’ can seem nebulous and make it hard to integrate into their decision-making process. What you can do instead is focus on the particular symptoms that are impacting a person’s life with statements like ‘I’ve seen that you’re not sleeping well ,’ ‘ You’re not eating well,’ ‘You seem tired all the time, ’ or ‘ You don’t look like you’re feeling well.’ No one wants to feel bad, so if you ask them how they’d like to feel and they respond that they’d like more energy or they would like to not feel sad all the time, that can be a way of motivating people. You can tell them ‘ If you want to feel differently, let’s go figure out what’s wrong. Let’s figure out why you’re not where you want to be, and let’s get you in to see someone.’ ”
For more, visit the U.S. Department of Veterans Affairs Mental Health resources. If the situation is potentially life-threatening, get immediate emergency assistance by calling 911, available 24 hours a day.
The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.
Always consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. 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Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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