Headstrong Project
4 min readFeb 24, 2017

Mental Fitness Is Important for All Combat Veterans

All veterans I speak with worry that what they experienced in combat does not merit seeking care — that they have buddies who have lost legs, have seen more combat, and had it worse than they did. I always agree and say, but do you want to be the best version of yourself, for you, for your family and friends? They say yes.

That is what we do at Headstrong — we use techniques that are proven to help folks achieve peak mental fitness, and that success spills into their school or work life, their relationships and their futures.

A Nervous System Out of Sync with Civilian Life

Being deployed to a war zone as 18 years old has considerable impact on one’s brain and nervous system. The average person’s brain is still growing until age 25 — events and experiences that are extreme and out of the ordinary produce physical changes in the brain and nervous system. These changes, or “invisible wounds” of war affect our veterans who are trying to function in a civilian world with a nervous system keyed up for battle.

This can look like not getting enough sleep to performing well at school or work, being on high alert, going from 0 to 100 with anger, and being unable to slow down. PTS is an anxiety state that results from having an overactive sympathetic nervous system. All soldiers learn about the part of their brain that is responsible for fight or flight. The constant threat of a combat environment results in nervous systems that are running on a higher “idle” than civilians. Training and the level of hyperarousal that one experiences in combat is what keeps soldiers alive. It is very useful in that environment.

Source: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161405; Scenario 1: Minimum deployment to intense combat zones, i.e. 1% of military personnel Scenario 2: Twice the current policy, i.e. 2% deployment to intense combat zones Scenario 3: Significantly larger than the current policy, i.e., 5% deployment to intense/combat zones.

There is an expectation that a veteran can simply return to civilian life seamlessly after their service — especially if there are no visible physical impairments. While some do, many veterans find this transition difficult. While their bodies may have returned to safety, their minds are still experiencing the trauma of war. Veterans often say that living with PTS means constantly anticipating something terrible. This anticipation can cause anxiety, confusion, isolation from loved ones, and a sense that these feelings will never get better.

It’s like living in both the past and the present at the same time. The great news is that the brain continues to change and grow with treatment. A trained trauma therapist and a veteran can work together to re-calibrate the overactive nervous system, stabilizing, then metabolizing traumatic memories, and finally re-integrating to life outside of combat.

My Experience as A Clinician

I have dedicated my life to mental health and the stigma surrounding it. I ran an AIDS program for 20 years before I started working with veterans. I worked with patients who had AIDS in the 1980s. I saw patients dying every day, and I couldn’t really do anything but try to help manage my patients’ terror. It was devastating, but it helped me learn all about trauma; I know trauma now, and I know how to treat trauma.

AIDS and PTS are similar in that both conditions are highly stigmatized, and rising epidemics among a small subset of the population. However, unlike with AIDS in the 80’s and 90’s, patients with PTS can now fully recover through proper consultation and treatment.

Working with Headstrong through the Weill Cornell Medical College has been a rewarding challenge, and one that has provided me with much hope. Veterans who have risked their lives for their country come into my office and receive limitless, individualized care. Headstrong has created an opportunity for these veterans to seek cost-free assistance with experienced clinicians like myself without the wait time, forms, overhead costs, and other hurdles that patients experience with existing programs.

Issue at Hand

Over 300,000 Iraq and Afghanistan veterans report symptoms of PTS, and the VA estimates that we lose 20 veterans a day to suicide — about 1/5 of all suicides every day. Too often veterans feel pressure to “tough it out” and hold in their feelings. Suppressing these feelings, numbing them with alcohol and drugs, neglecting their mental fitness, and avoiding treatment often results in consequences like loss of employment, loss of relationships, and even suicide.

We need to empower organizations like Headstrong who prioritize mental health for our country’s veterans. Once a veteran reaches out to Headstrong, we reach back out to the veteran within 48 hours. Reducing wait time is key in providing immediate assistance to veterans struggling with PTS, especially those who have finally decided they want help.

I understand that it’s not particularly exciting or easy to talk about seeking treatment for PTS. And it’s even harder when veterans are entrenched in the warrior mindset and believe that seeking treatment is a sign of weakness. However, we have to change this narrative because it prevents veterans from seeking effective treatment that makes them feel way better.

With more than five years of experience working with Headstrong’s veterans, I know that we absolutely have the means to treat and cure PTS, quickly and effectively. The road to mental health is not the easiest, but our combat veterans are strong, determined, and trained to complete any mission, especially when it comes to becoming the best version of themselves that they can be.

By Gerard Ilaria, LCSW, Clinical Director at Headstrong