Re-entering civilian life following military service presents a unique suicide risk for veterans. Therapists summarize quality of life for veterans from the following unique suicide risk factors:
- Veterans’ heightened access to firearms
- Transition challenges after separation from service, especially during the first year
- Post Traumatic Stress Disorder (more commonly referred to as PTSD)
- Traumatic Brain Injury (commonly referred to as TBI)
Understanding these factors as they relate to a veteran’s military service and their post-service environment forms a basis for identifying who is at risk of suicide or other veteran mental health issues. Understanding these factors also instructs how to design intervention efforts to save lives.
The Military’s Suicide Prevention Approach
The military’s suicide prevention approach is a combination of support services, discussions related to suicide, restricting access to lethal methods of self-harm, and the all-important follow-up with veterans’ families. The military relies on its community’s sense of responsibility for each other. The military asks each member of the veteran community to call the suicide & crisis hotline if they see another member of the military community starting to show warning signs of suicide. Those warning signs include:
- Social isolation from friends and family
- Threatening self-harm
- Increasing substance abuse
- Talking about feeling hopeless for the future
The military adopts the public health approach to suicide prevention. Sometimes talking to someone is the most important first step.
Why TBI Results in Suicide
Veterans suffering from TBI – often the result of combat during military service – exhibit strong links to suicidal thoughts and actions.
The immediate effect of TBI is loss of consciousness, abnormal sleepiness, recurrent headaches, mental confusion, and nausea. TBI victims have trouble thinking, understanding language and social situations, and suffer from memory loss. All of which may be temporary or permanent. The most severe TBIs result in long-term physical disabilities, mobility dilemmas, and muscle coordination problems. TBI sufferers may endure mood swings, anxiety, and personality instability. In addition, TBI may cause seizures, lead to infections, and signal other serious medical conditions. Based on these potential impacts, it is not difficult to understand that TBI manifests significant changes in the activities of daily life. Recovery is unique to every patient and depends on the severity of the TBI. Chronic pain, memory loss, and cognitive and physical decline are a recipe for suicidal thoughts and actions.
Why PTSD Links to Suicide
PTSD, too, is often the result of combat or other traumatic events that took place during military service. PTSD’s immediate effects include flashbacks, nightmares, and uncontrollable intrusive thoughts replaying the traumatic event. PTSD victims experience severe anxiety, depression, and hopelessness. These effects make it difficult for PTSD victims to maintain personal relationships. They start to engage with personal relationships to a lesser degree, which causes increased stress for spouses, partners, children, and friends. The chronic nature of these symptoms harms a veteran’s quality of life and complicates the management of activities of daily life.
Newer treatments to decrease the risk of suicide for PTSD sufferers have shown improvement in suicide rates where the treatment includes the addition of cognitive processing therapy (CPT). Studies show that CPT is effective in treating PTSD and aiding suicide prevention. CPT decreases PTSD symptoms and has shown CPT therapy’s effectiveness over five years. Given the effectiveness of CPT on both PTSD and suicidal thoughts, the Veterans Administration (VA) and Department of Defense (DOD) recommend CPT as the preferred treatment for PTSD.
Conducted over 12 sessions, CPT focuses on how the veteran’s thoughts, feelings, physiology, and behavior become interconnected. First, traumatic events disrupt a patient’s belief system. Then, a new belief system appears linked to the patients’ negative emotions and disruptive PTSD symptoms. The therapist and patient work to identify the components of the new abnormal and unhealthy beliefs. In this way, the patient acquires the essential skills to protest the negative ideas and create a more positive approach to relationships, the world, and hope for the future.
How Transition Challenges Link to Suicide Risk in Veterans
Re-entry into civilian life brings about intense transition challenges. These challenges affect emotional, psychological, and practical issues, including:
- Relationship issues between family and friends,
- Long-term unemployment, problems navigating the civilian job market, and difficulty translating military service skills into civilian jobs
- Financial difficulties,
- Feeling a loss of purpose
- Missing the more structured military environment, and
- Post-service mental health issues.
Undeniably, in addition to the emotional and psychological issues, heightened access to firearms makes it more likely that veterans will act on their suicidal thoughts with fatal consequences.
Military Life Engenders Resilience in Veterans
On the positive side of the equation, veterans re-entering the civilian sector after the end of military service possess unique resilience qualities. Resilience in veterans directly results from the lessons they learned during their military service. Those resilience factors are the result of the following strengths gained during military service:
- Sense of belonging to an exceptional group of people, a team member
- Social support system that continues even after separation from service
- Coping strategies learned in service
Vet Centers help maintain that sense of belonging to an exceptional group. Also, social media networks exist specifically for veterans, such as RallyPoint, that provide veterans access to a worldwide internet community. Social website LinkedIn provides a free Career Premium subscription for veterans.
Social support systems that continue after discharge from the military include VA comprehensive healthcare, Vet Crisis Line, National Call Center for Homeless Veterans, and VA social workers.
Military members learn coping strategies during their military service, including:
- Developing strong relationships among family, friends, and fellow service members
- Self-care practices, such as eating healthily, getting enough sleep each night, daily exercise regimens, and relaxation techniques
- Maintaining routines even after trauma
- Managing time to prevent feeling overwhelmed
- Seeking help from professionals (chaplain, therapists, and medical providers) and support groups (faith communities, for example)
At the same time, veterans learn to avoid:
- Substance abuse, which increases access to lethal suicide methods
- Social Isolation, which increases feelings of loneliness and hopelessness
- Suppressing emotions (complicates mental health issues)
Post-Service Mental Health
Many veterans develop serious post-service mental health issues. For example, veterans often suffer from post-service depression. This type of depression leads to psychological and emotional distress. Victims of post-service depression experience long-lasting feelings of sadness, hopelessness, and lose interest in favorite activities. They may have difficulty sleeping, concentrating, and may negatively modify eating habits.
Veterans with post-service depression often isolate themselves from family and friends, making it difficult to maintain healthy marital relationships and other family ties. Their declining mental health can make it difficult to find regular employment or remain employed over the long term. Given the circumstances facing returning veterans, post-service depression makes re-entry into civilian life difficult.
Early identification of post-service mental illness, combined with early-stage treatment by psychology professionals, is essential to ensure positive outcomes.
Choosing the Right Therapist for You
Refinery Counseling Services, LLC is a woman-owned, veteran-owned, and minority-owned private therapy practice. Our therapists understand the unique issues that veterans face after leaving the military. We understand the sacrifices veterans made during service, especially those who experienced combat trauma and the continuing physical and emotional pain many still feel.
Research is essential when it comes to picking a therapy practice. When you select a therapist, you want someone who not only sympathizes with the challenges you face from your service experience but is also aware of the hurdles acclimating to civilian life puts in your path.
Our therapists can help you navigate challenge areas, such as:
- Post-traumatic stress disorder (PTSD)
- Psychological side effects from Traumatic Brain Injury (TBI)
- Military sexual trauma
- Survivor’s guilt
- Anxiety
- Depression
- Anger management
- General readjustment to civilian life
- Helping to redefine personal relationships
Research the potential therapy practice’s stated mission. Refinery Counseling Services’ mission is to empower all our clients throughout their process of personal change and mental health development. We practice compassionate care and commit ourselves to community engagement for all individuals in our care.
We believe that all people can grow and heal. We promise to provide support and resources to make that happen for you.
Take the Next Step
If you, a loved one, or a friend faces mental health struggles due to a return to the less structured civilian life, please contact us today. A phone call or email makes it easy to schedule a consultation with one of our therapists to assess your situation. Your therapist will review your background, inquire about your needs, and ascertain the goals you want to achieve. That is our way to determine the best course of treatment for you.
To learn more about how Refinery Counseling Services treats veterans reintegrating into civilian life, we invite you to read our February 20, 2025, article entitled “How Refinery Counseling Supports Women, Veterans, and Families with Faith and Care.”
Read More About It
If you would like to read more about coping with transitions after military service, you might enjoy the August 11, 2025, article entitled “For Veterans: Coping with Life Transitions After Service.”
