Depression in the Military

The Military and Mental Health
Introduction
The military provides an opportunity for men and women to serve their country. However, in the conduct of that service there are certain risks that can damage the mental health of military servicemen. Those risks can be associated with PTSD incurred from situations in combat, abuse, drug addiction, or lack of a positive value system that causes a soldier to deteriorate from within as he has nothing beyond his duty in the military to give him meaning or to sustain him through the long hours, months and years. Some servicemen go to their doctors for assistance and end up being overprescribed medications that only exacerbate their issues and further the decline of their mental health (Snow & Wynn, 2018). If not treated, service-related depression can lead to suicide—and as Kang et al. (2015) show, suicide risk among veterans returning from the Middle East has been increasing exponentially in recent years. One way that leaders have been trained to deal with military service-related depression is through the use of positive psychology and resiliency training (Reivich, Seligman & McBride, 2011). This paper will discuss a more positive way to treat mental health issues such as service-related depression among military servicemen and will include a discussion of positive psychology theories as well as spiritual factors from a biblical worldview.
Depression
Service-related depression is common among servicemen in today’s military in spite of the core values and vision that military leaders promote and teach to new recruits and soldiers (Bonde et al., 2016). One of the major reasons for this is that soldiers lack resilience—i.e., the ability to bounce back from adversity. Instead of taking a mental or emotional hit and bouncing back, they stay down and develop depression, mired in a pit of self-doubt, negative thoughts and feelings, and isolation (Reivich et al., 2011). Depression is particularly dangerous in the military because servicemen tend to seek ways to self-medicate, whether through prescription drugs given them by military doctors or by alcohol. This creates, however, a recipe for a downward spiral that can cause further mental health problems.
The key to treating depression in the military is to acknowledge and to understand what is causing it. For that reason, the Army has developed the Master Resiliency Training program (MRT), which focuses on the key aspects that have to be developed by soldiers so that they can maintain a positive frame of mind and increase their ability to bounce back when adversity strikes (Griffith & West, 2013). The MRT program is rooted in the theory of positive psychology put forward by Seligman: positive psychology focuses essentially on the art of human flourishing—i.e., on that which makes life worth living (Seligman & Csikszentmihalyi, 2014). 
One of the big problems with soldiers in the military is that they have no sense of how to flourish as human beings. They have no real reason to live. They have no sense of why life is worth living. They have no sense of the value of life. They are in many ways like emptied-out vessels that are somehow still operating and going through the motions, but mentally and emotionally speaking they are dried up wells. In such shape, it is no surprise that so many servicemen end up becoming depressed during their time in the military: they are devoting themselves to a service, which necessarily entails a degree of self-sacrifice, and yet they do not understand the noble ideal or value in such service. When they fail to find a mental or emotional stimulus or reward for their work (that is to say, they enter into the “dark night of the soul”), they end up in a state of depression with no way of getting out.
The spiritual factors of depression can include a loss of hope, a loss of faith, or a loss of a sense of charity or love—i.e., the sense of or value in showing empathy, sympathy or care to other persons (Bonelli, Dew, Koenig, Rosmarin & Vasegh, 2012). Faith, hope and charity are also known as theological virtues, which means they are ultimately related to the essence of God. Faith is rooted in the memory and is based on reason: one hears the message of salvation and responds by believing; hope is rooted in the desire and helps to motivate the will, which is where love is rooted. Love is an act of the will and it depends upon hope (as opposed to despair), that is to say it depends upon the belief (the faith) that there is something good awaiting the good in the next life. These three spiritual virtues help to keep people from becoming completely materialistic and seeing life as meaningless (Bonelli et al., 2012). Through the promotion of these spiritual factors, one can refrain from falling into the pit of depression.
However, even if one is aware of spirituality or has spirituality, it is no guarantee that one will not struggle with depression. Some people may have a melancholic personality or disposition: they will tend to focus on their feelings and thoughts more than people who have other personalities or dispositions—such as the phlegmatic temperament or the sanguine or choleric temperaments. Too much melancholia, though, can be bad for the mind and heart and a soldier who is melancholic may quickly find himself struggling with depression and unable to get out of it. This is one reason melancholic personalities are often attracted to sanguine personalities: sanguine people are very outgoing and typically full of mirth. Their personality is a natural complement to the melancholy personality. The former helps to bring the latter out of himself and the latter helps to keep the former from flying away into too much levity. In any event, the personality types of people should be considered when it comes to depression as well—especially if a depressed soldier begins to look around for or seek support: if “help” comes from someone who has the wrong kind of personality or does not show the kind of outgoing and positive nature that the melancholic personality is in need of it could send the person spiraling even further.
Theoretical Perspectives
Positive psychology is the idea that healing can begin by discovering ordinary human strengths and virtues. It is consistent with the idea of having a spiritual life in the sense that those with a spiritual life tend to focus more on higher, transcendent spiritual goals rather than on the here and now, which is where depressed people often focus. The depressed person is often too caught up in the everyday struggles, thoughts and feelings, allowing them to dominate his mood, viewpoint, and motivation. There is no regulation of the emotions, and even if the cause of the depression is unknown the individual who is suffering from it can find a way out through the use of positive psychology. Focusing on positive emotions can make a big difference in the life of a depressed person (Dolphin, Steinhardt & Cance, 2015).
Of course there are other options that can work: Zoteyeva, Forbes and Rickard (2016) for example show that music-based regulation of the emotions can help to military servicemen and veterans manage their mental health issues more effectively. It is a technique that focuses on using music as a means of elevating the patient out of himself (i.e., out of his own thoughts and negative feelings) and using that elevated moment as a teaching tool for how to regulate one’s emotions and keep oneself from remaining in a negative place mentally speaking. In this theory of music-based emotion regulation, the idea is that music is the conduit by which the self is awakened and the rational side is given the opportunity to exert influence over the emotional side. In cases of depression it is typically the problem that the emotional side has gained control of the mind and body and the rational side—the logical side—has been displaced and has no way of getting back on top.
For that reason, an emotional cue or trigger is often needed in order for the person to be able to get out of the headlock that the negative emotions have the person in. The emotional trigger can come by way of something like music, according to Zoteyeva et al.’s (2016) theory, or it can come by way of communication with another person and the building out of a social support system. The social support system approach necessitates having another person or persons that one can talk to, which is why the Army has taken to developing leaders who are trained in MRT and can offer that kind of support to soldiers who are undergoing depression.
Through MRT, “the Army is leveraging the science of psychology in order to improve our force’s resilience” (Casey, 2011, p. 1). MRT focuses on strengthening a person’s self-awareness, self-regulation, optimism, mental agility, character strengths, and connections. The key to this training is to help people understand what their potential is, get them socializing and relating to others more so that they are not so wrapped up in themselves, and assist them in spotting and addressing their own biases, which prevent them from actually engaging with others in a meaningful manner. MRT has a seen a lot of positive outcomes when implemented and is thus recommended as a suitable approach for helping with depression stemming from a soldier’s military service (Reivich et al., 2011).
Another theoretical perspective that could be used to shed light on the issue of depression in the military is Maslow’s theory of human motivation and his hierarchy of needs model, which stipulates that every person has a hierarchy of needs that have to be met before the person can attain a level of self-actualization (Maslow, 1943). According to Maslow’s theory, to motivate people, one needs first to make sure their physiological, safety, social, and esteem needs are met in that order. People need food, shelter, safety, security, companionship, affection, and self-esteem—and then once their confidence is built up they can begin to be self-motivators—i.e., they can be self-actualized. Such people rarely are affected by depression because they have mastery over themselves, can engage in self-regulation, and are very resilient. Maslow’s theory essentially aligns with the positive psychology theory and the theory of using music to elevate a person’s mood so as to allow the logical side a chance to breathe and gain some control over the individual’s behavior.
Biblical Worldview
From a biblical worldview perspective, depression is not something that should be found in a person who has faith in Christ. Philippians 4:8 provides a suitable framework for people living in this world and what they should occupy their thoughts with: “Brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.” In other words, from a Biblical perspective, one should not be worrying or fussing over things that are beyond one’s control. Instead, one should ever be mindful of the higher things—the noblest ideas, doing what is right, always being recollected in the spirit of Christ. The Bible also offers a vision of hope for those who struggle with maintaining an optimistic outlook: “The LORD himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged” (Deuteronomy 31:8). Psalm 34:17 provides the same sort of reminder that when in times of trouble or peril, one need not be afraid because God is ever by the side of those who have faith in Him: “The righteous cry out, and the LORD hears them; he delivers them from all their troubles.” Likewise, Psalm 40:1-3 offers these words of encouragement:  “I waited patiently for the LORD; he turned to me and heard my cry. He lifted me out of the slimy pit, out of the mud and mire; he set my feet on a rock and gave me a firm place to stand.  He put a new song in my mouth, a hymn of praise to our God. Many will see and fear the LORD and put their trust in him.” These words should fill one with hope and strength because they show that in adverse times and situations one is not alone but rather God is at one’s side so long as one remains true to God and His laws.
St. Paul admonishes the Christian to stay united to Christ at all times, for so long as one’s heart and mind are united to Christ, nothing can harm the individual: “For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord” (Romans 8:38-39). So long as one is united with Christ, nothing else matters, which should be food for thought for the Christian soldier. Whatever one is suffering—whether it is home sickness, isolation and loneliness, some trauma or emotional issue—one can remember that Christ has overcome even death itself, and so one should not lose heart. Additionally, whatever one is suffering, no one has ever suffered more than Christ suffered during His Passion. He sweated blood in agony at knowing what was waiting for him in the coming hours while in the Garden of Gethsemane. He was tortured and crucified—not for any fault of His own but that He might atone for the sins of others and satisfy the Father.
Thus, to be depressed is to lose sight of this conviction and to lose hope and faith in the love that God has for all souls in peril. When an individual fails to recognize that God is there waiting to help, if only the suffering soul would ask or even just only the light of God’s love to shine through into his soul, he essentially cuts himself off from the mystical body of Christ. Christ came to save men, not to see them perish. He also instituted a Church that could carry on Christ’s mission following Christ’s ascension into Heaven. Therefore, the Church and indeed all Christians have a duty to shine forth God’s love to others, just St. Paul writes in his letter to the Corinthians: “Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves receive from God” (2 Corinthians 1:3-4). To comfort others is to be comforted by God, and to wallow in one’s own depression is to avoid all comfort and to close oneself off from God’s grace.
St. Peter also has words that cut to the heart of what it means to suffer for Christ: “Dear friends, do not be surprised at the fiery ordeal that has come on you to test you, as though something strange were happening to you. But rejoice inasmuch as you participate in the sufferings of Christ, so that you may be overjoyed when his glory is revealed” (1 Peter 4:12-13). To be a Christian means to accept suffering in whatever form it comes. It means being willing to submit to the pains that come one’s way to and to accept them as though a gift from God. Suffering can draw one nearer to God because it has a way of separating man from the attachments to this world that do not actually facilitate him on his path or journey to Heaven. Suffering can thus be seen as a cleansing mechanism that allows one to pull away from the things of the world and to focus more on the things of God. As St. Augustine put it in City of God, there are two cities—the city of man, which focuses wholly on material happiness—and the city of God, which focuses on the things of God, the cultivation of virtue, and union with Christ. One must choose which city he is going to live in: the former leads inevitably to death; the latter contains in it the promise of live everlasting. For the suffering soul, the latter choice should be the most attractive one.
Conclusion
Depression can be a serious affliction for soldiers in the military. Many soldiers and veterans returning from service in the Middle East suffer from serious mental health issues. For some it stems from trauma, while for others it stems from a lack of faith, hope and charity—i.e., a religious conviction that a greater good exists and that God is there watching over one in spite of all the suffering one might feel every day. Treating depression is important because if untreated it can cause a person to slip into isolation and even into suicidal behavior. Positive psychology theory and the theory of the hierarchy of needs are two ways that many find to be helpful in treating depression. The Army itself has incorporate positive psychology into its MRT training programs to help soldiers become more resilient. From a Biblical perspective nothing is more helpful than a strong faith in Christ.
References
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