Eating Disorders and Disordered Eating Among Veterans

The blinking digital numbers on the scales seem to be taking forever. I can’t believe I agreed to have dinner with my friends last night.  Now I have to get up an hour earlier so I can get in extra time working out before work.  

The next morning after my workout at the gym, I grab my stuff and head to the shower. I keep replaying seeing the fat rolls on my sides doing the side plank, I knew I shouldn’t have gone out to eat last night. Pinching by sides to confirm what I saw; I know today is going to be a horrible day. 

Walking out of the gym one of the women from my class stops me, “Wow! How do you stay so thin?” she asks me.  

I mumble something, put my head down and pull my oversize sweater down a little further. 

I don’t know why people lie to me. I can see the fat rolls on my sides. Do they think the fake compliments make me feel better? 

Eating Disorders Vs. Disordered Eating 

Eating disorders are psychiatric illnesses that cause severe, frequent, and persistent unhealthy eating habits to develop (Petre, 2017; “Disordered Eating,” 2019).  Eating disorders are typically characterized by an obsession with food, body weight, and/or body shape leading to behaviors such as severe restriction of food intake, uncontrollable food binges, or purging behaviors like vomiting or over-exercising (Petre, 2017).  

Disordered eating refers to a wide range of abnormal eating behaviors that do not meet the criteria for an eating disorder diagnosis (Richman, 2017a). Such behaviors can include an inability to control eating habits; skipping meals to either fast or to eat other foods in excess; obsessive calorie counting; using laxatives to help release food from the body; having an excessive exercise routine; using food to cope with stress; or engaging in “healthier” eating to a harmful extent (Richman, 2017b; “Disordered Eating,” 2019). Like eating disorders, disordered eating is typically associated with higher stress and decreased self-esteem based on body shape or weight (Disordered Eating, 2019). Although disordered eating is far more common than eating disorders, disordered eating behaviors can develop into an eating disorder (Richman, 2018). 

Common Types of Eating Disorders and Disordered Eating Behaviors 

Anorexia Nervosa 

Anorexia nervosa is an eating disorder that is characterized by very restricted eating patterns that lead sufferers to be considerably underweight compared with people of similar age and height. People with anorexia nervosa generally have an intense fear of gaining weight, a distorted body image, preoccupation with constant thoughts about food, and difficulty eating in public (Petre, 2017).  

There are two subtypes of anorexia nervosa:  

Subtype 1 – The Restricting Type 

Those who suffer from subtype 1 lose weight exclusively through dieting, fasting, or excessive exercise (Petre, 2017). 

Subtype 2 – The Binge and Purge Type 

Those who suffer from subtype 2 may restrict food intake for a period of time and then eat large amounts of food, or they may just eat very little. In either case, however, eating is followed by behaviors such as vomiting, taking laxatives, or exercising excessively in order to rid the body of calories (Petre, 2017). 

Anorexia nervosa can be very damaging to the body. Over time, individuals with this disorder can experience the thinning of their bones, infertility, as well as heart, brain, or multi-organ failure and death (Petre, 2017). 

Bulimia Nervosa 

Bulimia Nervosa is an eating disorder that is characterized by frequently eating very large amounts of food in a short period of time, usually until the person becomes painfully full; this is called a binge. During a binge, the person may feel like they cannot stop eating or control how much they are eating.  

Following a binge, individuals with bulimia will induce vomiting, take, laxatives or diuretics, or excessively exercise in order to offset the calories consumed in the binge; this is called a purge. While these symptoms appear very similar to those of the binge and purge subtype of anorexia nervosa, individuals with bulimia usually maintain a relatively normal weight, rather than becoming underweight (Petre, 2017).  

Bulimia nervosa can cause swollen salivary glands, tooth decay, acid reflux, severe dehydration, hormonal disturbances, electrolyte imbalances, stroke, or heart attack (Petre, 2017). 

Binge Eating Disorder and Binge Eating Behavior 

Binge eating disorder is believed to be one of the most common eating disorders in the United States. People with this disorder eat large amounts of food until they are uncomfortably full, often feel a lack of control when binge eating, and do not use any purging behaviors to compensate for the binging (Petre, 2017).  

Binge eating behaviors are a pattern of disordered eating that is less severe than binge eating disorder and does not meet the criteria for an eating disorder. 

People with binge eating disorder and binge eating behaviors are often overweight or obese which increases their risk of heart disease, stroke, and type 2 diabetes (Petre, 2017). 

Avoidant/Restrictive Food Intake Disorder (ARFID) 

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that is characterized by a lack of interest in eating or distaste for certain smells, tastes, colors, textures, or temperatures. This disorder often leads to restricted food intake, weight loss, nutrient deficiencies, and even requires tube feeding in severe cases (Petre, 2017). 

Purging Behaviors 

Purging behaviors can be a pattern of disordered eating but, if severe enough, can also be diagnosed as an eating disorder classified under the category of Other Specified Feeding and Eating Disorder (OSFED). Individuals with purging disorder engage in purging behaviors, such as vomiting, laxatives, diuretics, or excessive exercising. However, they do not restrict their food intake or binge eat (Petre, 2017). 

Orthorexia Nervosa 

Orthorexia Nervosa is a pattern of disordered eating in which a person has an obsessive focus on “healthy eating,” often eliminating entire food groups from their diet that are viewed as unhealthy. This can lead to malnutrition and severe weight loss (Petre, 2017). 

Diagram

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[Graphic compiled and created by Natalie Schroeder] 

Eating Disorders and Disordered Eating in Veterans with Trauma Experiences 

Studies have found that rates of eating disorders, including anorexia, bulimia, and binge eating disorder, as well as disordered eating behaviors, are potentially higher among veterans than among the civilian population (Buchholz et al., 2018; Cuthbert et al., 2020; Slane et al., 2016). 

Several military-associated traumas have been associated with higher prevalence of severe eating disorder symptoms and patterns of disordered eating among both male and female veterans (Cuthbert et al., 2020; Richman, 2017a; Richman, 2017b; Richman, 2018; Blais et al., 2017; Forman-Hoffman et al., 2012; Striegel‐Moore et al., 1999a; Brewerton et al., 2018). 

 These military-associated traumas include: 

Interpersonal violence (IPV) has also been associated with higher risks for developing an eating disorder among both male and female veterans (Huston et al., 2019).  

People who suffer from eating disorders and disordered eating are likely to have experienced multiple traumas in their lifetime.  

Research has found that disordered eating may provide short-term relief from negative feelings or emotions related to trauma, although long-term engagement in these behaviors can lead to severely negative health outcomes (Richman, 2017b).  

Women, in particular, reported disordered eating as a way to change their shape and weight to avoid the attention that may lead to more traumatic experiences (Richman, 2017a; Richman, 2017b; Cuthbert et al., 2020; Forman-Hoffman et al., 2012). 

The Role of the Military Environment on Eating Behaviors 

Studies have found that the military environment may play a significant role in the development of eating disorders and disordered eating patterns in active military personnel.  

Strict military weight and fitness requirements, for example, can lead to the use of disordered eating behaviors to meet these requirements. In addition, needing to eat quickly during basic training, having erratic meal schedules during deployment, and having less appetizing or healthy meal options on military bases can also encourage disordered eating behaviors among military personnel (Richman, 2018; Ashby, 2017; Cuthbert et al., 2020). 

Eating disorders and disordered eating patterns that develop during military service are likely to persist long after leaving.

Eating disorders and disordered eating patterns that develop during military service are likely to persist long after leaving the military (Cuthbert et al., 2020; Richman, 2017).  

The transition from military to civilian life is a very sensitive period, often generating a lot of stress and anxiety. As such, many eating disorders and disordered eating behaviors can also emerge during this transition period (Cuthbert et al., 2020; Richman, 2017; “Eating,” 2016). 

the military (Cuthbert et al., 2020; Richman, 2017).  

The transition from military to civilian life is a very sensitive period, often generating a lot of stress and anxiety. As such, many eating disorders and disordered eating behaviors can also emerge during this transition period (Cuthbert et al., 2020; Richman, 2017; “Eating,” 2016). 

Comorbid Mental Health Conditions 

Multiple studies that have focused on individuals with eating disorders found that sufferers often have additional mental health challenges (Striegel‐Moore et al., 1999a; Striegel‐Moore et al., 1999b; Maguen et al., 2012; Cuthbert et al., 2020; Brewerton, 2007; Higgins et al., 2012; Masheb et al., 2014).  

Such challenges include: 

In addition to the experiential, sociocultural, and psychological factors that contribute to eating disorders and disordered eating behavior, veterans are also faced with a lack of resources.  

As with much of the civilian population, veterans lack access to adequate mental health services (Hester, 2017).  

Research has also found that many veterans live in areas that have fewer supermarkets, fitness facilities, and parks (Zenk et al.,2017).  

These factors are likely to amplify unhealthy habits. 

Resources 

Mental Health Professionals 

Finding a health professional to help treat mental health problems is very important for eating disorder recovery. 

The VA provides mental health services for veterans. To learn more, click here.  

You can also contact your local Veteran’s Service Office. 

To find a psychiatrist near you, click here.  

To find a psychologist near you, click here

To find a counselor near you, click here

For more mental health resources, click here

Treatment Centers 

Treatment Centers 

A professional team that specializes in eating disorders can be one of the most effective resources for eating disorder recovery.  Some treatment centers for eating disorders have specialized programs for military members, such as Eye Movement Desensitization and Reprocessing (EMDR), which can help address the unique needs that servicemen and women may be facing in addition to an eating disorder. Be sure to choose a provider that is a Certified Eating Disorder Specialist (CEDS). 

Click here to find an eating disorder treatment center near you. 

Unfortunately, if insurance companies do not contract for specific services or do not honor treatment recommendations, the cost of eating disorder treatment cost up to $30,000 a month. It is important to understand your benefits. To learn more, click here

There are also scholarships available for clients who are seeking higher levels of care such as Inpatient, Residential and/or Partial Hospitalization Programs. Project Heal is an organization that partners with treatment centers across the United States to sponsor individuals for treatment at their facilities. In addition, many for-profit companies also provide scholarships through their non-profit branches. To learn more about scholarship options, click here

 Support Groups 

Support groups, though not a replacement for treatment, are a free or low-cost way to gain support from others. Click here to find an in-person support group near you. There are also virtual support groups available. Click here to find a virtual support group through the National Eating Disorder Association. 

For more free and low-cost support resources, click here

Eating Disorder Hotline Listings 

National Eating Disorders Association Helpline: 1-800-931-2237 

This helpline offers support Monday–Thursday from 9 a.m.–9 p.m. EST, and Friday from 9 a.m.–5 p.m. EST.   

Hopeline Network: 1-800-442-4673 

You can talk to someone day or night and can also call if you need referrals to eating disorder treatment centers. 

National Association of Anorexia Nervosa and Associated Disorders: 1-630-577-1330 

The hotline operates Monday–Friday from 9 a.m.–5 p.m. CST. Trained hotline volunteers offer encouragement and support to those having problems around eating or binging, as well as assistance to family members who have concerns that their loved one might have an eating disorder. 

Overeaters Anonymous: 1-505-891-2664 

This hotline is available to people worldwide who need a referral to an Overeaters Anonymous support meeting in their area and provides help for people who suffer from anorexia, bulimia, food addiction, or any other type of eating disorder. 

The United Way’s 211.org: Call 2-1-1 

This hotline is available 24/7 and can offer information and referrals to eating disorder treatment organizations in your area. 

Crisis Textline: Text CONNECT to 741741 

This textline helps people with eating disorders and other mental health issues by connecting callers with trained crisis volunteers who provide confidential advice, support, and referrals. The textline is available 24/7, 365 days a year. 

Nutrition Resources 

Nutrition and Food Services (NFS) provides nutritional services for veterans and their families across VHA health care facilities. To learn more, click here.  

The VA also provides Registered Dietician Nutritionists. To learn more, click here

TRICARE is a health care program for service members, veterans, and their families that covers a limited set of services from a nutritionist or registered dietitian. To learn more, click here

Home Base Nutrition Services for veterans provides nutrition counseling for patients seeking support for various topics, including weight-management, diabetes, and the management of food allergies/intolerances. To learn more, click here

Premade meal delivery services, such as Personal Chef To Go can be very helpful for veterans who do not have time to cook, or who don’t have access to healthy food options. To find discounts on premade meal delivery services, click here

Meals on Wheels and Food Pantries may also be an option. 

Fitness 

MOVE! is a weight management program offered through the VA that helps veterans develop healthy eating behaviors and increase their physical activity. To learn more and register, click here. Through TELEMOVE!, veterans who have a busy schedule or who live far from a Veterans clinic can meet with a registered dietician from their own home. To learn more, click here

If you do not qualify for these programs, there are also gyms and fitness centers that offer discounts to veterans. For a list of these facilities, click here

Bariatric surgery includes a variety of weight-loss procedures, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric band (AGB), that are an option for veterans with class II and III obesity. However, veterans must meet specific criteria for a surgical evaluation through the VHA. 

To learn more about bariatric surgery offered through the VHA, click here

The VHA’s strict requirements for bariatric surgery, however, may make it inaccessible to some veterans. In addition, these procedures are not widely offered within the VHA. As of 2020, only 23 of 170 VA Medical Centers offered bariatric surgery (Cuthbert et al., 2020). Furthermore, bariatric surgeries are expensive, and costs may represent a barrier to receiving such surgeries (Cuthbert et al., 2020). If you are unable to get bariatric surgery through the VHA, you can contact your local VSO.  

There are free weight-loss surgery grants available through the Weight Loss Surgery Foundation of America (WLFSA) and there may be free weight-loss surgery clinical trials available as well. To learn more, click here.  

In addition, you may also want to look into raising money for surgery using fundraising resources like gofundme

MST Resources  

Veterans and service members can receive MST care, free of charge, even if they do not qualify for other VA benefits. For more disability benefit information visit the VA’s MST fact sheet, click here and the VA’s Health Care Services for MST fact sheet click here, or contact your local Veterans Service Office.  
 
Safe Helpline  is a confidential system that provides live, one-on-one support and information to MST survivors. You can Call the Telephone Helpline at 877.995.5247, visit the Online Helpline by clicking here, or download the free Self-Care App (iOS and Android).  

Strength and Recovery – Men Overcoming Military Sexual Trauma is a brochure from the VA that provides MST resources.  

Safe HelpRoom Sessions for Military Men is an online community of sexual assault survivors in the military that meets on Sundays.  

1in6 provides free and anonymous weekly chat-based support groups for male victims of sexual assault.  
 
For more MST information and resources, click here and here, or visit Know A Vet’s information and resource page.  

PTSD Resources  

Female Veterans with PTSD should call their local VA and speak to a Women Veterans Program Manager, as well as contact their local Veterans Service Office to be connect to resources in their area.   

To find a local support group for women with PTSD, click here.  

For more PTSD information and resources, visit Know A Vet’s information and resource page. 

Interpersonal Violence Resources 

For help finding a domestic violence shelter in your area, click here

To go to the National Domestic Violence Hotline’s website, click here

To locate domestic violence resources in your state, click here

For more IPV information and resources, visit Know A Vet’s information and resource page. 

For more information on eating issues, click here

Visit Know A Vet? for a list of resources for a wide range of issues and resources by zip code. Your local VSO can help connect you to other veteran or civilian organizations. To find your local VSO visit Know A Vet? and put your zip code in the box toward the top of the home page for your local Federal, State and County resources.  

Watch for future articles from Know A Vet? that will discuss VA benefits for Veterans and their families. 

If this information would help someone you know, show them you are thinking of them by forwarding this email.  If you received this email from someone and would like to receive your own FREE newsletter click here to sign up. 

Article Sources

Ashby, M. (2017). “How Does Military Experience Influence the Obesity Trend Among Retired Veterans: A Qualitative Grounded Theory Study.” ProQuest. The University of the Rockies. Retrieved from search.proquest.com/openview/bffb1dbbceb783e450cd6791b6d2670a/1?pq 

Blais, R. et al. (2017). “Military Sexual Trauma Is Associated with Post-Deployment Eating Disorders among Afghanistan and Iraq Veterans.” International Journal of Eating Disorders. Vol. 50:7 (808-816). doi:10.1002/eat.22705 

Brewerton, T. (2007). “Eating Disorders, Trauma, and Comorbidity: Focus on PTSD.” Eating Disorders. Vol. 15:4 (285–304). doi:10.1080/10640260701454311 

Brewerton, T. et al. (2018). “Sensation Seeking, Binge-Type Eating Disorders, Victimization, and PTSD in the National Women’s Study.” Eating Behaviors, Vol. 30 (120–124). doi:10.1016/j.eatbeh.2018.07.001 

Buchholz, L. et al. (2018). “Rates and Correlates of Disordered Eating among Women Veterans in Primary Care.” Eating Behaviors. Vol. 30 (28–34). doi:10.1016/j.eatbeh.2018.05.002 

Cuthbert, K. et al. (2010). “Eating Disorders and Overweight/Obesity in Veterans: Prevalence, Risk Factors, and Treatment Considerations.” Current Obesity Reports, Vol. 9:2 (98–108). doi:10.1007/s13679-020-00374-1 

“Disordered Eating.” (2017). Women Veterans Health Care. Veterans Health Administration. US Department of Veterans Affairs. Retrieved from www.womenshealth.va.gov/WOMENSHEALTH/OutreachMaterials/GeneralHealthandWellness/Disordered_Eating.asp 

“Eating.” (2016). Know A Vet?. Friends of the Vet Center Inc. Retrieved from www.knowavet.org/?s=eating&submit= 

Forman-Hoffman, V., et al. (2012). “Eating Disorders, Post-Traumatic Stress, and Sexual Trauma in Women Veterans.” Military Medicine. Vol. 177:10 (1161–1168). doi:10.7205/milmed-d-12-00041 

Hester, R. (2017). “Lack of Access to Mental Health Services Contributing to the High Suicide Rates among Veterans.” International Journal of Mental Health Systems. Vol. 11:1. doi:10.1186/s13033-017-0154-2 

Higgins, D., et al. (2013). “Binge Eating Behavior among a National Sample of Overweight and Obese Veterans.” Obesity. Vol. 21:5 (900–903). doi:10.1002/oby.20160 

Huston, J.C., et al. (2019). “Associations between Disordered Eating and Intimate Partner Violence Mediated by Depression and Posttraumatic Stress Disorder Symptoms in a Female Veteran Sample.” General Hospital Psychiatry. Vol. 58 (7–82). doi:10.1016/j.genhosppsych.2019.03.007 

Maguen, S., et al. (2012). “Eating Disorders and Psychiatric Comorbidity among Iraq and Afghanistan Veterans.” Women’s Health Issues. Vol. 22:4. doi:10.1016/j.whi.2012.04.005 

Masheb, R., et al. (2014). “High-Frequency Binge Eating Predicts Weight Gain among Veterans Receiving Behavioral Weight Loss Treatments.” Obesity. Vol. 23:1 (54–61). doi:10.1002/oby.20931 

Petre, A. (2019). “6 Common Types of Eating Disorders (and Their Symptoms).” Healthline. Retrieved from www.healthline.com/nutrition/common-eating-disorders#bottom-line 

Richman, M. (2017b). “Exploring the Link between Trauma and Disordered Eating for Female Vets.” Research Currents. Office of Research & Development. US Veterans Affairs. Retrieved from www.research.va.gov/currents/0217-1.cfm 

Richman, M. (2017a). “Research Links Multiple Forms of Trauma with Eating Disorders in Female Vets.” Research Currents. Office of Research & Development. US Department of Veterans Affairs. Retrieved from www.research.va.gov/currents/0717-Trauma_with_eating_disorders_in_female_Vets.cfm 

Richman, M. (2018). “Study: Demanding, Fast-Paced Military Lifestyle May Cause Women to Adopt Poor Eating Habits.” Research Currents. Office of Research & Development. US Department of Veterans Affairs. Retrieved from www.research.va.gov/currents/0618-Demanding-fast-paced-military-lifestyle-may-cause-women-to-adopt-poor-eating-habits.cfm 

Slane, J., et al. (2016). “Eating Behaviors: Prevalence, Psychiatric Comorbidity, and Associations With Body Mass Index Among Male and Female Iraq and Afghanistan Veterans.” Military Medicine. Vol. 181:11. doi:10.7205/milmed-d-15-00482 

Striegel-Moore, R., et al. (1999). “Eating Disorders in a National Sample of Hospitalized Female and Male Veterans: Detection Rates and Psychiatric Comorbidity.” International Journal of Eating Disorders. Vol. 25:4 (405–414). doi:10.1002/(sici)1098-108x(199905)25:4<405::aid-eat5>3.0.co;2-f 

Striegel-Moore, R., et al. (1999). “Psychiatric Comorbidity of Eating Disorders in Men: A National Study of Hospitalized Veterans.” International Journal of Eating Disorders, Vol. 25:4 (399–404). doi:10.1002/(sici)1098-108x(199905)25:4<399::aid-eat4>3.0.co;2-0 

Zenk, S., et al. (2017). “Weight and Veterans’ Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics.” American Journal of Health Promotion. Vol. 32:3 (779–794). doi:10.1177/0890117117694448 

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Vets Helping Vets: The Value of Veteran-led Assistance and Support

Written by Natalie Schroeder and Andrea Bowling
Researched by Natalie Schroeder

I see the dark clouds coming and I hope I can get home before the downpour starts.  The spray from the passing car splashes my windshield and I turn my windshield wipers on high. As I inch my way up to the crosswalk waiting for my turn to enter the on ramp, I hear a little voice from the back.   

“Mom, why is that guy sitting in the rain?” 

I cannot help but look over to the corner. Quickly my eyes dart away trying not to make eye contact with the man asking for help with a soggy cardboard sign. 

“He is just looking for some money,” I say quickly hoping that will satisfy her.  

“V—E—T….. vet! Mom aren’t you one of those?” she asks in excitement that she read a word by herself. 

“Yes, honey I am,” I answer inching my car forward. 

“Do you know him?” her questions continue. 

“No, I don’t know him,” I say wishing I could get past this corner.  

“Why doesn’t anyone help him?”, she continues in her innocence.  

“What did you want for dinner tonight? Dinosaur nuggets?” I ask turning on to the on ramp.  

Continuing the drive home, I cannot get rid of the uncomfortable feeling of wanting to help but not knowing how.  

Veterans helping other veterans is one of the most valuable forms of assistance out there for former service members. This is because the experiences and challenges that come from being a Veteran are best understood by other Veterans. Service members share a strong sense of camaraderie and trust with one another and, as such, many Veterans are eager to help their brothers or sisters in arms.

When Veterans help other Veterans, both sides benefit. Not only do people receive the help they need, but those who help often gain a deep sense of satisfaction that can be very therapeutic.

The ways in which Veterans provide help to other Veterans are endless. This article provides an overview of some of the Veteran-led assistance programs and resources available to former service members. 

Paralyzed Veterans of America (PVA) was originally founded by a band of service members who came home from World War II with spinal cord injuries. This organization provides information, support, and resources to veterans with disabilities. The help they provide includes medical assistance, legal services, caregiver support, connection to national service officers, and more. To go to PVA’s website, click here.

Fisher House Foundation operates 87 comfort homes across the U.S. where active military and veterans’ families can stay at no cost while a loved one is receiving medical treatment. The foundation also provides the Hotels for Heroes program which offers hotel rooms to the families of service members who are being treatment at authorized medical centers when a Fisher House is not available. To learn more about the programs that Fisher House offers, click here.

Code of Support Foundation has two programs that provide support to military members, Veterans, and their families. PATRIOTlink is a database of free and direct resources for service members, Veterans, families, and caregivers. To learn more about PATRIOTlink, click here. Through the foundation’s Case Coordination program, Peer Navigators provide direct, one-on-one support and assistance with income or housing insecurity, education, employment, financial counseling, and crisis assistance. For more information on the Case Coordination program, click here.

National Veteran Small Business Coalition (NVSBC) is a non-profit trade association that provides support to veteran-owned small businesses. By working with federal agencies and contractors, NVSBC offers first consideration for federal prime and subcontract procurement opportunities to veteran-owned small businesses and aids with verification process. To learn more about their programs, click here

Warriors Ethos provides career mentors, coaches, counseling, and training to help former service members transition to the civilian workforce. Warriors Ethos also provides certification and fellowship opportunities. To learn more about this resource, click here

Veteran familiesfriends, and caregivers can also help one another. 

LOVE OUR VETS – PTSD Family Support Network, LLC is one example. Their website provides a database of national support groups for family members, as well as guidance on suicide prevention, and caregiver advice. 

To access these resources, click here

LOVE OUR VETS is continually looking to build their database of nationwide, peer support groups, so if you know of any ongoing peer support groups for Veteran families, friends, or spouses, send an e-mail containing the name of the group’s contact person, their e-mail and/or phone, website, city, and state to LOVE OUR VETS, or message them on Facebook.  

In addition, LOVE OUR VETS also helps people start support groups in their area. 

If you need help starting a support group, send them an e-mail or Facebook message! 

Visit Know A Vet? for a list of resources for a wide range of issues and resources by zip code. Your local VSO can help connect you to other veteran or civilian organizations. To find your local VSO visit Know A Vet? and put your zip code in the box toward the top of the home page for your local Federal, State and County resources. 

Watch for future articles from Know A Vet? that will discuss how to keep connected after the holidays. 

If this information would help someone you know, show them you are thinking of them by forwarding this email.  If you received this email from someone and would like to receive your own FREE newsletter click here to sign up. 





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It’s Not My Body: Understanding Sex and Gender Issues in the Military

Written By Natalie Schroeder and Andrea Bowling
Researched By Natalie Schroeder


The box in the closet is calling my name. I know my roommates will not be back for a few hours, so I go to my closet and pull down the shoe box with worn edges. I open the lid and see the simple black flats with a delicate bow on the toe.

Walking over to my bed I flash back to high school when me and my friends decided to dress up as girls for Halloween. I laughed a little too hard and made a few too many crude jokes hoping that it would cover up that I felt more comfortable and a little more “me” being a girl.

The term “sex” refers to biological differences between males and females that are determined based on whether their father’s sperm was carrying an X or Y chromosome at the time of conception, as well as a range of chromosome complements, hormone balances, and phenotypic variations that occur at approximately 6 to 7 weeks in the womb, and cause the development of different reproductive cells and organs (Evans & Tolland, 2019; “Boy or Girl?,” 2008; “Gender and Genetics,” 2010; Wizemann & Pardue, 2001).

It is important to understand, however, that biological sex develops along a spectrum that ranges from male to female, but never falls at one end or the other – every person has both ‘male’ and ‘female’ hormones at varying levels within their body (Hess et al., 1997). Furthermore, it is estimated that about 1 out of every 1,500 live births, the child is born intersex – some children are born with neither XX nor XY chromosomes and some are born with XXY chromosomes; other things such as Androgen Insensitivity Syndrome (AIS) and adrenal hyperplasia can also cause a baby to be born intersex (“How Common,” 2008). 

The term “gender” refers to the socially constructed differences in dress, speech, mannerisms, physical attributes, and other stereotypes typically associated with belonging to a certain gender category (Evans & Tolland, 2019).  Gender is also a spectrum – it does not have to be aligned with one’s biological sex and there can be more than two, as many people’s identities and physiological makeup do not fit into two rigid categories. Countries and cultures around the world, such as Canada, Argentina, Australia, Denmark, the Netherlands, Germany, Malta, New Zealand, Pakistan, India, and Nepal, officially recognize additional gender categories outside of the man-woman binary and offer passports that reflect these categories (“Gender X Passports,” 2020).  

Military personnel and Veterans face unique challenges based on their sex and gender identities. While most U.S. military personnel and Veterans are males, over 200,000 females are currently serving in the military and make up about 10% of the Veteran population (“By the Numbers,” 2013; “Facts and Statistics,” 2013). In addition, it is estimated that there are over 3,000 transgender individuals actively serving in the U.S. military and over 134,000 transgender Veterans (Schaefer et al., 2016; “Transgender,” n.d.).  

Males and females each face unique challenges in the military due to both physical and social differences associated with their sex and gender. Transgender individuals, however, often face the specific challenges of their preferred category in addition to the challenges of being a transgender person in the military. 

Graphic Designed by Natalie Schroeder

Military Sexual Trauma (MST) affects service members regardless of gender or biological sex. MST refers to a service member’s experience with sexual assault or sexual harassment during their service (“MST,” 2019).  

About 1 in 4 female veterans and about 1 in 100 male veterans in the VA healthcare system report experiencing MST (“MST,” 2019). Although women are at greater risk of MST, nearly 40% of veterans who disclose MST to the VA are men (“MST,” 2019). Furthermore, over 15% of transgender service members experience MST – 30% of transgender men and 15.2% of transgender women reported some form of military sexual assault in 2018 (Beckman et al., 2018). 

MST Resources 

Veterans and service members can receive MST care, free of charge, even if they do not qualify for other VA benefits. For more disability benefit information visit the VA’s MST fact sheet, click here and the VA’s Health Care Services for MST fact sheet click here, or contact your local Veterans Service Office. 

Safe Helpline  is a confidential system that provides live, one-on-one support and information to MST survivors. You can Call the Telephone Helpline at 877.995.5247, visit the Online Helpline by clicking  here, or download the free Self-Care App (iOS and Android). 

For MST legal services, click here

Male-Specific MST Resources: 

Strength and Recovery – Men Overcoming Military Sexual Trauma is a brochure from the VA that provides MST resources. 

Safe HelpRoom Sessions for Military Men is an online community of sexual assault survivors in the military that meets on Sundays. 

1in6 provides free and anonymous weekly chat-based support groups for male victims of sexual assault. 

For more MST information and resources, click here and here, or visit Know A Vet’s information and resource page. 

PTSD Resources 

Female Veterans with PTSD should call their local VA and speak to a Women Veterans Program Manager, as well as contact their local Veterans Service Office to be connect to resources in their area.  

To find a local support group for women with PTSD, click here

For more PTSD information and resources, visit Know A Vet’s information and resource page. 

Transgender-Specific Resources 

For transgender individuals, the VHA offers transition-related care such as hormone replacement therapy, medically necessary prosthetics (such as binders and dilators), voice coaching, and mental health services. However, transition-related surgical care is not offered by the VHA. To learn more, click here or contact your local Veterans Service Office.  

Some providers offer free or low-cost gender affirming treatment in some states, such as the Kind Clinic and Planned Parenthood

For a Gender Confirmation Surgery Costs and Fundraising Guide, click here

For help and guidance on changing your name on your DD214 Military Discharge Record, click here

Visit Know A Vet? for a list of resources for a wide range of issues and resources by zip code. Your local VSO can help connect you to other veteran or civilian organizations. To find your local VSO visit Know A Vet? and put your zip code in the box toward the top of the home page for your local Federal, State and County resources. 

Watch for future articles from Know A Vet? that will discuss other LGBTQ issues.

If this information would help someone you know, show them you are thinking of them by forwarding this email.  If you received this email from someone and would like to receive your own FREE newsletter click here to sign up. 

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Putting Out the Fire: Information, Tips, and Resources to Combat Tobacco Use

Written by Natalie Schroeder and Andrea Bowling
Researched by Deborah Spivak and Natalie Schroeder 

I pat the pockets of my jacket to make sure I have my lighter. “Hey Sara, are you ready,” I ask over the cubicle wall. “Yep, let’s hurry we have to be back so Hillary can go to lunch,” she replies walking out ahead of me.

As we head to the designated smoking area, I notice the side long glances of the non-smokers. I overhear a snarky whispered comment, why don’t we get the same breaks, I know who is probably saying this but keep walking.

My body starts to feel the excited tension knowing soon I will have my mid-morning smoke. I flick the lighter and feel the rough warm metal as the flame lights the end of my cigarette, and I inhale. I hold the smoke in my lungs close my eyes and feel the tension melting away.

“Wow! I needed this.” Sara tells me. “It has been one long morning.”

“Do you think they will have the stop smoking contest again this year?” I ask her thinking maybe I might try if she does as well.

“Yeah, I am pretty sure they will. Did you want to try it this year? My kids have been bugging again and I know I probably should, but you know how it goes,” she says between drags on her cigarette.

I nod watching the smoke come out of my nose and disappearing.

“Yeah, I think maybe we should give it try what’s the worst that could happen.”

Why Do People Smoke? 

Many people start smoking or using other tobacco products to cope with distress.  

Financial distress is a significant risk factor for smoking. People with low annual household income are more likely to start smoking and people facing financial hardship also have a harder time quitting.  

Individuals suffering from serious psychological distress and other mental health disorders such as chronic DepressionAnxiety DisorderPTSDBipolar DisorderSchizophrenia, or any Addictive Disorder are at a higher risk for smoking. This is due, in part, to the fact that smoking is often used as a means of self-medicating to deal with affective disorders. In addition, Nicotine can improve attention and concentration, making it more attractive to people with attention disorders such as ADD and ADHD. 

People who suffer from physical distress such as chronic health conditions, disability, or physical limitations are also more likely to smoke. 

If you are a current or former military service member, the risks for nicotine addiction are higher. 

Cigarette smoking prevalence is higher among active-duty military personnel than among the civilian population, and the prevalence is even greater among service members who have been deployed. Many service members start using tobacco after they enter the military. The stress of military life, such as family separation, basic training, boredom, and combat can increase the likelihood of tobacco use for relaxation and coping.  

There is a long history of smoking among service members dating back to 1918 when the military and various organizations began providing cigarettes to troops because, as the New York Times once put it, cigarettes could “lighten the inevitable hardships of war.” While the military suspended cigarette rations in 1975, cigarettes continue to be sold, tax-free, in military stores, with the profits from these sales being used to support Morale, Welfare and Recreation activities. Having easy access to inexpensive tobacco products facilitates their use among military personnel. Due to the history, culture, and prevalence of tobacco use among service members, new recruits often feel pressure from their peers to start smoking.

The Risks of Tobacco Use 

The Physical Health Risks of Tobacco Use are Extremely High. 

Tobacco use is associated with increased risk of death from heart disease and stroke. Smoking tobacco also increases your risks for developing lung cancer and chronic bronchitis. Smokeless tobacco is not any safer, as it can cause cancer of the mouth, esophagus, and pancreas, as well as other diseases of the mouth. Vaping has become an increasingly popular trend and many people have used vaping to quit smoking cigarettes, but VAPING IS JUST AS DANGEROUS AS SMOKING. Since 2019, there have been 2,801 cases of vaping lung illnesses reported across the U.S; a third of these patients need breathing machines to keep them alive. For women, tobacco use can result in difficulty getting pregnant, early menopause, osteoporosis, cervical cancer, and breast cancer.

The Mental Health Risks of Tobacco Use are Also High. 

People who use tobacco are more likely than nonsmokers to experience anxiety, panic, stress, depression, or suicidal thoughts. What’s more, smoking tobacco can inhibit the effects of some psychiatric medications, reducing their therapeutic potential. Nicotine also kills brain cells and stops new ones forming in the hippocampus, a part of the brain that handles memory.

The Benefits of Quitting 

There are Many Physical Health Benefits to Quitting Tobacco.

Within a year of quitting, your circulation and lung function will improve, any coughing and shortness of breath will decrease, and your risk of coronary heart disease will be cut in half. After 15 years of tobacco-free living, your risks for coronary heart disease, stroke, and cancer will be the same as that of a nonsmoker. 

There are Also Mental Health Benefits to Quitting Tobacco

Quitting can increase the effectiveness of medications used to treat depression, anxiety, and psychotic disorders. For people battling substance abuse disorders, quitting smoking also increases the chance of quitting alcohol and other drugs.

The Challenges of Quitting 

Many smokers want to quit, but face great physical, psychological, and emotional difficulty in doing so – most will have to make multiple attempts to quit before they are successful.

Nicotine is highly addictive. When you smoke a cigarette or use other tobacco products, the nicotine causes a surge of endorphins and dopamine to enter the brain, improving your mood and reinforcing tobacco use by altering the brain’s chemistry. Common nicotine withdrawal symptoms include intense cravings, increased stress, anxiety, irritability, anger, fatigue, depression, difficulty concentrating, increased appetite, weight gain, constipation, and sleep problems. These symptoms can make quitting extremely hard to do. For strategies to help manage different nicotine withdrawal symptoms, click here. In addition, studies have shown that short bouts of physical activity, like practicing yoga or tai chi, are associated with reduced smoking withdrawal symptoms.

Tobacco users are most susceptible to relapse within the first 4 months of quitting. The causes for relapse vary, but the most common are stress, peer influence, and weight gain. Past experiences of trauma and financial strain are also triggers that can cause relapse for tobacco users. For help managing these triggers and navigating triggering environments, click here. You can also visit the Know A Vet? for information and resources for managing different withdrawal symptoms and triggers.

Get Help Quitting 

Smoking cessation medication such as nicotine replacement therapy, combined with counseling, offers veterans the best chance of quitting smoking.

Nicotine replacement therapy (NRT) can help to ease some of the symptoms of nicotine withdrawal. It can be taken in the form of gum, patches, sprays, inhalers, or lozenges, providing a low level of nicotine without the other chemicals found in tobacco. Many NRTs are over-the-counter medications that can be purchased at any drug store or pharmacy.  

Several studies have shown that seeking counseling after quitting can improve your chances of quitting for good. If you are an active duty or a retired service member, you may have access to cessation counseling, medicines, and other services through TRICARE coverage and Defense Department programs.  For more information on TRICARE coverage for smoking cessation, click here

Check Out These Additional Resources for Support You While You Quit. Go You! 

The CDC’s Quit Guide is a valuable tool to help you as you start quitting tobacco. To view the Quit Guide, click here

Tobacco quitlines can double your chances of quitting, when compared with getting no support at all. Quitlines are typically open Monday through Friday from 9am to 9pm and are available in English and Spanish. Call a quitline today for help making a quit plan, to get individual counseling, or to develop strategies for preventing relapse! 

English: 1-800-QUIT-NOW (1-800-784-8669) 

Spanish: 1-855-DÉJELO-YA(1-855-335-3569

Veterans with health insurance through the VA: 1-855-QUIT-VET (1-855-784-8838) 

SmokefreeVET is a free text message program that provides daily advice and support for people quitting tobacco that can help users stay abstinent from smoking for at least 5 weeks or more. Once you have signed up by texting “VET” to 47848 or clicking here, you will be prompted to pick a smoking quit date. Once you have your date, you will receive automated, encouraging texts from SmokefreeVET two weeks before your quit date and for six weeks after. If you are struggling, you can also text “URGE,” “STRESS,” “SMOKED,” or “DIPPED” to the 47848 at any time to receive additional support. For messages in Spanish, text VETesp to 47848 or click here

Stay Quit Coach is a free mobile app provided by the U.S. Department of Veteran Affairs that can help you develop a customized quit plan. Download the app from your mobile device’s app store today to start receiving motivational messages, interactive tools for dealing with urges, and support to help you stay smoke-free! 

The Anti-Vaping Communications Toolkit, provided by the Military Health System (MHS), includes resources to quit tobacco products, articles about the risks of e-cigarette use, and links to additional resources. Click here to download the toolkit. 

For help quitting smokeless tobacco text “SPIT” to 333888. 

For help quitting e-cigarettes, click here

For even more information, tips, and resources for quitting tobacco, visit these websites! 

Medical News Today: Ten tips for giving up smoking  

Smokefree.gov: Become a Smoke-Free Veteran  

Centers for Disease Control and Prevention: Tips from Former Smokers  

You Can Quit 2 

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Financial Help for Seniors

Written by Natalie Schroeder, Andrea Bowling, and Esther Abass
Researched by Esther Abass and Natalie Schroder

I pull on my extra sweater as I look outside and watch the postman walking through the leaves covering the sidewalk.

I open the door before he gets up the steps.

“Hi, Mr. Sylva how are you doing today?” he asks handing me my mail.

“Pretty well, I think we might get snow next week,” I say hoping to draw out the conversation.

We talk for a minute and then he is back crunching leaves under his feet as he continues his route. I flip through the few pieces of mail and see the utility bill and my heart sinks a little. I put the other mail on the table and open the bill to see how much it will be. Before I can unfold the paper my mind starts going through things I can cut out this next month, I can skip some of my medicine and that will help, and maybe if I just have toast for breakfast.

After legal challenges, they found support

My eyes scan down the bill to the total due and my heart skips a beat.

This can’t be right. I start looking at the detail and my usage is the same as last month, but then I look at the rate, it is down 3 cents per hour. What a relief my bill went down by $20.00, that should be enough to cover my medicine.

If you are having money problems, you are not alone. Over 25 million Americans ages 60 and over are facing financial insecurity. As people retire, their income declines and they begin to live primarily off their retirement savings and Social Security income.  Rising housing and health care bills, diminished savings, and job loss in recent years have made older Americans especially vulnerable to financial struggle and falling into debt.

In the past five years, the share of households having debt, as well as the amount of debt, has increased among people ages 65 to 74 years old. For many elderly households that are in debt, the debt payments make up over 40% of their household income, which doesn’t leave much left to live on. Having debt during retirement can also eat up the assets you’ve accumulated during your life such as your earnings, savings, and the equity in your property, as well as affect the timing of your retirement and Social Security claiming.

Housing debt has been major financial problem for people ages 55 or older, with bankruptcies and foreclosures significantly increasing for this group in the past 20 years. Homeowners threatened with foreclosure should seek legal help immediately. You have the legal rights to try and save your home and an attorney can help you navigate the legal process. However, if you are not able to save your home and it is sold at foreclosure auction to cover your debt, in most states, you are entitled to any excess proceeds from the foreclosure sale. So, if you owed $100,000 against your property, and it sold for $180,000, then you are entitled to $80,000! Lenders do not like to give up this money easily, so this is another reason why getting legal help is important.

Possible sources of legal help are the neighborhood legal services office, a bar association panel of pro bono attorneys, or a program providing legal assistance for the elderly. But BE CAREFUL, there are many predatory law firms out there that will charge you large contingency fees in exchange for their services. Do your research on the legal help you seek out. For a list of free legal clinics in VA Facilities across the country, click here. For more steps on how to avoid foreclosure, click here.

High medical expenses are one reason many people over the age of 65 go into debt. Despite Medicare coverage, older adults still pay high out-of-pocket costs for certain medical services. Individuals with functional or cognitive impairment, for example, often require long-term services and supports that Medicare does not cover.  Due to the lack of coverage, people who have higher out-of-pocket spending for medical care are more likely to report that medical care has increased their credit card debt. In addition, many senior citizens are targets of scam and fraud, especially when it comes to health care, medical bills, and prescriptions. Senior Medical Patrol (SMP) helps individuals detect billing errors and fraud when it comes to Medicare. Access this resource by clicking here.

Providing financial support to children and grandchildren has also increased the likelihood of having debt at older ages. Many states offer kinship care payments to blood relatives who care for children in the foster care system and includes grandparents who care for grandchildren. Click here to see a factsheet of information that will help you navigate the child welfare system and click here for a list of kinship care contacts and programs in your state. Click here to see all of your all of state’s available contacts, support groups, public benefits, educational assistance, and relevant laws for grandparents who care for grandchildren.

Predatory lending practices are another reason why the elderly might find themselves struggling financially. Regulations that once reduced access to loans for people whose financial standing put them at risk of defaulting have been removed, and some lenders have taken advantage of this by granting loans at high interest rates to people who can’t afford them. These predatory lenders are known to target the elderly because they have often amassed a lot of equity in their homes and because they usually live on fixed incomes. According to an article published in The Elder Law Journal, “incidents of debt-collection agencies subjecting elderly Americans to harassing and abusive practices have the potential to occur at an alarming rate.” Click here for tips on how to spot and avoid predatory lenders, as well as what to do if you find yourself a victim of predatory lending.

If you are over the age of 65 and facing financial hardship, check out these great resources!

The Nation Council on Aging (NCOA) has a free service called Benefits Checkup that will give you a report on the financial help available in your area. All you have to do is enter your zip code and answer 8 easy questions. This service has over 2,500 federal, private, and state benefit programs that help seniors, ranging from medication, transportation, housing, food, health care, and income assistance. To access this resource, click here.  

There are many different programs that give financial advice and assistance to people over the age of 65. The website, needhelppayingbills.com, lists programs that are offered by the federal government, the state, the Area Agency on Aging offices, as well as charities or social service organizations. The exact type of senior citizens resources available near you will vary by state, county, and agency. Some of the programsthat are offered for low-income senior citizens and the elderly include government benefit programs, Medicare and health insurance assistance, financial help, home care, food programs, and grants for paying for medications or other bills. To see resources available to you, click here

There are many government income, health, and care programs for seniors, but finding the right one for you can be tricky. The H.E.L.P website offers a guide to eight different monthly income and healthcare programs to help ease some of the confusion. This website offers more information on programs such as Social Security Retirement, Social Security Disability, and Supplemental Security Income, as well as Nursing Home Medi-Cal, In-Home Supportive Services, and the Veterans Aid & Attendance Pension. To access this guide, click here

Senior Discounts

To see a list of companies that offer different discounts to senior citizens for dining, retail, prescription medications, travel, and more, click here! For a list of discounts for Veterans, click here

Verizon Wireless offers lower phone rate plans nationally for subscribers 55 years of age and older! To learn more, click here

There are many city and state programs that offer lower utility rates to people with low-income, as well as seniors. The National Council on Aging has information on energy assistance programs for low-income seniors and adults with disabilities, such as the Low-Income Home Energy Assistance Program (LIHEAP) which provides grants to states that are used to help with energy costs. To learn more about this program, and others like it, click here.  Many states also offer assistance to help low-income households avoid having their utilities shut off. To learn about the programs offered in your area, call the National Energy Assistance Referral Project at 1-866-674-6327 or TTY 1-866-367-6228.  The California CARE program offers a 30-35% discount on electric bills and a 20% discount on natural gas bills for low-income households, to learn more click here. Utility discounts and programs vary by state, so make sure to speak to your utility providers about any discounts you may qualify for. 

Tax Breaks For Seniors

There are also many tax breaks that are offered to people 65 and older, such as bigger standard deductions, a higher tax-filing threshold, property tax breaks, credit for the elderly and disabled, additional IRA deductions, 401(k) catch-up contributions, no early withdrawal penalties, and more! For a list different tax breaks for senior citizens, click here and here. These breaks can vary by state, so consulting with a tax professional is a good idea.  

The Tax Counseling for the Elderly program provides free tax assistance to people ages 60 and older. Every year between January 1st and April 15th, IRS-certified volunteers are available assist with basic tax return preparation and electronic filing. To learn more, click here

The AARP Foundation’s website offers a list of available benefits, by state, for people over the age of 50. To check out the different benefits available in your state, click here. In addition, elderly Veterans may be eligible for a wide range of benefits through the VA, including disability compensation, pension, education and training, health care, home loans, insurance, vocational rehabilitation and employment, and help with funeral expenses. Click here to learn more or contact your local Veterans Service Office (VSO) to find out what benefits you qualify for. Find a local VSO by clicking here! Also, check out the KnowAVet article on discovering your benefits through the VSO

If you found this information helpful, make sure to sign up at KnowAVet for FREE to get notifications for our upcoming articles! 

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Not If, But When! Preparing for Natural Disasters

The Big Cold One, Twister, Toad Strangler, or Tremblor, are all common names for natural disasters that uproot families, destroy homes and lively hood. No matter what part of the country you live in there is always a season that can bring destruction to your front door. Making sure you are prepared for what type of disasters are in your area can bring peace of mind and help restore your life quicker when it is safe to return home.

First step is identifying what disaster can occur in your area along with identifying secondary disasters that could happen because of the initial disaster. For instance, after an earthquake you may have, fires, power outages, additional earthquakes or landslides. Click here  to search the National Center for Disaster Preparedness map to see what the hazard risk is for your county.

Once you have identified what natural disasters are likely to occur for your area review the information from the Red Cross on how to prepare for emergencies and how to safely return home.

Red Cross How to Prepare for Emergency

The National Center for Disaster Preparedness has created an easy 5 step module to walk you through how to prepare for a disaster. You can review the slide show here.

When preparing for a natural disaster, you also need to prepare how you will return and what supplies you will need to return to your normal life. Texas A&M has written an article on what you may need for cleaning up after a natural disaster, click here to read.  Once you are cleared to re-enter your home after a disaster make sure there is not a gas leak and there are no down power lines. Walk your property look for any trees or other debris that could cause future damage or safety hazard. Re-entering your home walk through the house and assess if you feel that the structure is sound. If you see indication that the structure is not safe, leave immediately and contact the building inspector that cleared your structure and your home insurance company, click here for additional information about working with your insurance company after a natural disaster. Before filing your claim with your insurance company be sure to read this article by US News for how to file a claim after a natural disaster and some things that could cost you thousands of dollars, click here.

Once you have assessed that your home is safe and structurally sound, begin by repairing things that if not fixed would cause further damage, such as boarding up broken windows. For a step-by-step instruction on how to safely clean up click here to read the CDC’s Guide. When cleaning and repairing make sure to stay safe and take breaks so you do not get over tired. Reach out to friends and family for help and reach out to your neighbors to check in on them.

Next week our emergency series will cover what to do if an emergency happens when you are out of the country.

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Anxiety, It’s Not Just Sweaty Palms

I feel the hot damp sweat soaking the underarms of my shirt. The cold sweat feels good trickling down the small of my back but also, I know I will be embarrassed walking back to my desk.  Leaning up against the cinderblock wall I turn my face to feel the cold cement dimples against my hot cheek.

Click, squeak…I hear the telltale sign of someone else entering the stairway. Pushing myself away from the wall my legs are barely able to keep me upright as my chest squeezes my pounding heart.

“Hey, man, are you ok?” Some guy asks picking up his pace coming up the stairs.

“Yeah, I am fine. Just need a little bit of a breather,” I reply, not able to look him in the eyes.

“You do not look ok. Why don’t you sit down here, is there anybody I can call?” He says taking my elbow and directing me to sit on the stair.

“No, I will be ok,” I mumble.

“Are you having an anxiety attack? My sister has those, and she tells me it is the worst feeling you can ever have,” he says sitting down next to me.

I just nod and sit there with my head in my hands feeling grateful but mortified that someone has seen me like this.

Everyone experiences anxiety now and then. It is normal to feel a little anxious when preparing for a job interview, studying for a test, or making an important decision. For most, anxiety is a temporary feeling in response to stressful situations. For people suffering from anxiety disorders, however, the worry doesn’t go away. In fact, it can become worse over time.

Recognizing and managing anxiety

Anxiety disorders are characterized by feelings of high anxiety for several days a week, lasting a period of 6 months or longer. Some of the symptoms of an anxiety disorder include irritability, difficulty concentrating, muscle tension, fatigue, difficulty sleeping, difficultly controlling feelings or thoughts of worry, and feeling on edge.

It is hard enough dealing with an anxiety disorder in your own home, let alone in the workplace. There are several types of anxiety disorders, each one with symptoms that can make it difficult to be at work.

People with panic disorder, for example, have recurring panic attacks that can come on without warning or cause. During a panic attack, people can experience rapid heartrate, shortness of breath, shaking, and feelings of impending doom. People with panic disorder often avoid places or situations that could trigger an attack, such as the workplace.

Social anxiety disorder is one of the more common forms of anxiety disorders, characterized by intense fear of, or anxiety toward, social or performance situations. People with social anxiety have a fear of being humiliated, judged, and rejected by other people and experience anxiety in nearly all social situations. Everyday tasks such as grocery shopping, going out to eat, or going to work can be so unbearable for social anxiety sufferers, that they actively avoid social situations. Social anxiety disorder can also manifest as extreme performance anxiety where something like giving a presentation at work can trigger the body’s fight or flight response and cause hyperventilation, heavy sweating, and nausea. In some cases, the fear is so great that it will even cause people to freeze up like a deer in the headlights.

The causes of anxiety disorders differ for each person. Traumatic social or environmental events, brain injury, underdeveloped social skills, family histories of anxiety or mental illness, health conditions such as heart arrhythmias, or even high caffeine consumption can increase the risk of developing an anxiety disorder.

If you have had consistent, severe anxiety for a period of at least 6 months, you should consult with your doctor about being evaluated for an anxiety disorder. If left untreated, anxiety disorders can persist for years, negatively impacting social relationships and work performance.

Treatment for anxiety disorder varies depending on the type of disorder. If you have an anxiety disorder, you should consult with a mental health professional who will work with you to find the right treatment.

Cognitive Behavioral Therapy (CBT) is often very effective for treating anxiety disorders because it “teaches people different ways of thinking, behaving, and reacting to anxiety-producing and fearful objects and situations.” CBT involves identifying, challenging, and neutralizing negative thoughts, as well as confronting fears through cognitive and exposure therapies. Click here to find a CBT specialist near you. For help finding low-cost CBT and other psychological therapies, click here.

Anti-anxiety medications, antidepressants, and beta-blockers can be used to help relieve anxiety symptoms. These medications are only available through a prescription and some may work better for specific types of anxiety disorders than others. You will need to consult with your physician who will usually refer you to a mental health professional who is licensed to diagnose and prescribe medications for your anxiety disorder.

Group therapy and support groups, as well as meditation, are also great resources for managing anxiety. Click here to find group therapy for anxiety in your area. Click here for a list of online support groups, one-on-one support, and other anxiety treatment resources. Click here for a 10-minute meditation for managing anxiety. Click here for a 30-minute meditation for managing anxiety. For more anxiety meditation resources, click here.

If you believe you are suffering from an anxiety disorder, it is important to talk to your doctor. They will be able to help you find the method of treatment that works best for you.

You should also contact your local Veterans Service Office to be connected to resources for treating anxiety.

Check these resources for additional help and support.

For information on and referral to treatment services for anxiety disorder, you can call SAMHSA’s National Helpline: 1-800-662-HELP (4357), TTY: 1-800-487-4889

It is confidential, free, and you can call 24-hours-a-day, 365-days-a-year. SAMHSA also has a behavioral health service locator that can help you find services near you.

Go to Make the Connection’s website here for more anxiety disorder information and resources.

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Success Through Networking?

Facts, Tips, and Resources to Help You Improve Your Networking Skills.

“Are you going to look for a job today?” my mother asks, as I pour some cereal in a bowl.

“It’s almost lunch time are you sure you want to eat that now?” her questions continue to come at me one after another taking me back to when I was interrogated overseas.

All I can do is grunt, fearing if I say more it will be a verbal assault.

I take my bowl back to my room to sit and eat my cereal in the dark and the silence. My mind starts racing why is it so difficult to connect with someone.  I see hundreds of jobs on job boards, why do I not even get a call back.  What am I missing? Networking has become an essential part of career advancement. About 60-80% of jobs are found through networking and, without it, finding the right job can take twice as long.

Transitioning Military: How to Network on LinkedIn

Networking may be even more essential for Veterans and their spouses due to the difficulties that can come from transitioning to civilian life.

Leaving the military often means “leaving a way of life and community behind.” In addition to this loss, Veterans must also adjust to the different attitudes, behaviors, lingo, skills, routines, and practices that are desirable in the civilian work force. Writing resumes that will capture the attention of employers, translating military skills into civilian work force skills, communicating effectively and personably during interviews, and understanding corporate structures, are just some of the challenges Veterans can face when entering the civilian work force.

Networking not only helps people find open job positions, but it is also an important tool for learning more about potential employers and overcoming the challenges of transitioning out of the military. Using your network to learn about potential employers can make you a stronger candidate by helping you understand employer priorities and “align your resume, cover letter, job application, and interview answers with their needs.” Connecting with people who are working in your desired field can teach you about the dress code, terminology, working conditions, and culture of potential employers; helping you to decide which jobs are right for you. Networking can also connect transitioning military personnel and their families to people in their future civilian communities; helping them build a support network even before they arrive.

So, what is networking?  As one U.S. News article puts it, networking is the “art of using human interaction to obtain the information and access that will lead to the achievement of one’s goal.”

Networking can be difficult.  Many people struggle with putting themselves out there and striking up a conversation with strangers. For those who suffer from anxiety, PTSD, or depression, connecting with new people can be especially taxing.  If you, or a loved one, are struggling with networking, don’t worry.  Networking is a skill that can be developed and improved.

Here are 10 tips that can help you become more comfortable and successful when networking.

Networking Tip # 1 – Find a career doing something that you are passionate about.[1]

Think about the things you love to do, find companies who do those things, and connect with people who work for those companies.  If you must have a job, why not get your dream job?  Do not apply for a job you don’t want or connect with people you don‘t like because it will be noticeable in your networking interactions and prevent you from being authentic. Or worse, you could get that job you hate; you could work with those people you don’t like.  That would be miserable, and you would likely find yourself less motivated to give your best work performance. Click here to learn how to find the companies that are right for you.

Networking Tip # 2 – Recognize the importance of online networking.

Develop a web presence that represents the image of yourself that you want to convey to potential employers. Creating online profiles that showcase your experience, accomplishments, and interests can draw employers to you!  Just be sure that your profiles are easy to read and contain searchable keywords related to your desired industry. Also, be sure to customize your profiles and resume to the industry you are interested in working in. For more information on how to create a good online presence, check out this article from inc.com and click here for even more social media tips. Also, LinkedIn is offering a free, 1-year Premium Career subscription and access to over 10,000 courses in business, creative, and technology skills for active service members and U.S. military veterans.  Learn more by clicking here.

Networking Tip # 3 – Reach out to professionals in your desired field.

Try striking up a conversation and asking them if they could tell you more about what they do.  The point is not to ask for help, but to “establish that you are passionate about the industry” and develop a rapport. Worst case scenario, they ignore your message or don’t return your call and while this rejection can be disheartening, do not lose hope.

Getting a job through networking takes time, so be patient!  Click here to learn more about how to build your professional network.

Networking Tip # 4 – Have a positive attitude.

An optimistic outlook will make building your network easier because people are attracted to positivity.  Moreover, it is so important to be positive about yourself.  Don’t let the fear rejection stop you from putting yourself out there.  Don’t undermine your accomplishments or sell yourself short when applying to jobs or creating internet profiles.  Value your failures as the learning experiences that they are.

Networking Tip # 5 – Connect with all kinds of people.

Every person in your network has the potential to enrich your life and you never know when you will meet someone who can open the door to an opportunity, so be very discerning before dismissing a possible new connection.

Networking Tip # 6 – Network with other Veterans.

While all networking connections have the potential to provide access to different information, resources, or opportunities, networking with other military personnel can help Veterans develop a sense of camaraderie in the civilian world by connecting them with people who understand their experience and point of view.

Networking Tip # 7 – Keep networking!

Don’t stop networking even if you have found a job.  An extensive network can give you access to valuable resources that will continue to help you throughout your career.[10]

Networking Tip # 8 – Build up your skills.

If you have the time, take classes, apply for internships, volunteer, or take on freelance jobs. Not only will this enhance your resumes and profiles, but classmates and colleagues are great connections to add to your network.

Networking Tip # 9 – Pay it forward.

Just like you are reaching out to people now, people will come to you for help one day too.  Respond to emails and social media requests; remember that you were once in that same position.  Not only is it the right thing to do, but the people you give advice to may become great assets in the future.

Networking Tip # 10 – Start networking now!

The sooner you start networking, the sooner you will build you network, become part of a community, and discover new and exciting opportunities.

The MOAA Military and Veteran Networking Forum

Networking is a skill that can be improved with practice and, most importantly, help.  There are an ample amount resources out there dedicated to helping people network.

Veteran groups like the Veterans Career Network, can help transitioning service members find jobs. These groups often host networking events that can connect you with business leaders and influencers.  For tips on how to navigate networking events, click here. For a list of networking groups and events, click here.

Mentors are a wonder resource.  To find more networking mentors and search for jobs with military-friendly companies, visit Military.com’s Veteran Jobs section. There are also wonderful mentoring ministries out there such as Career Jump-Start.

For a more detailed guide on effective networking, read The Power Networking Strategy: The Personal Approach to Landing Your Dream Job by Jay Arbetter.

Cisco Networking Academy – Hiring Veterans for Technology Careers

For more career advancement resources, click here.

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Your Circumstance, Your Emergency: Making Sure You’re Ready For Anything

Media and news outlets flood our devices and minds with disasters that occur from around the world to ones that happen in our community. Yet 83% of people do not consider themselves very prepared for an emergency according to Ready.gov.

The first step in making sure you are prepared for an emergency is understanding your circumstances. Some of these factors are where you live, family, financial, medical and unusual situations. The VA has created the Comprehensive Emergency Management Program (CEMP), click here to read how the VA can help in preparing and mitigating emergencies to support and help after an emergency has occurred.  This is a tool that is available to Veterans and their families and can add additional resources for your Emergency Plan.

Where you live impacts how you prepare and for what type of disaster, to what support should be available after the disaster. For example, someone who lives in rural Kansas would have a different emergency plan than someone who lives in downtown Pensacola Florida. Ready.gov details what to consider when creating your emergency readiness plan click here to read their article. Watch for future articles from Know A Vet? that will cover details on types of natural disaster and what you should include in your Emergency Plan for these disasters. 

3 Easy Steps To Prepare For An Emergency

Once you have identified what types of disasters to prepare for, next you should review your family communication plan, special dietary needs, medication, clothing, what everyone can do during an emergency, and what is the plan if your family is not at home when the disaster occurs. The Marines have downloads to help you create a Family Preparedness Plan, click here to read their article and download their printable forms.

Keeping updated copies in your go bag of important papers, such as driver’s license, passports, insurance information, medical information, list of contacts, lists of shelters and community emergency plans, bank information and other financial information will help you get support and access to resources quicker.

Medical situations should always be considered from making sure you have additional medicine for your go bag to making sure you have a generator to run medical equipment. Click here to read the CDC’s article that reviews topics to consider when reviewing your medical aspect of your Emergency Plan.

Last consider any unusual situations that would apply to you and your family, do you have valuables that you would want to secure, pets that need planned for, what sentimental items are the most important to try and get to a safe location, for example getting a quilt that was passed down from your grandmother.

Be More Than a Bystander: Preparing Communities for Disaster | Elizabeth Hardister | TEDxUGA
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Service Dogs: Assistance Animals in the Workplace

“This is Mercy, my service dog, please ignore her she is working right now,” I say, after the normal pleasantries are exchanged.

There was a time when I would hesitate to take control of these situations, because of how people would respond. That ended after an incident where I lost the ability to function due to a PTSD episode where she was unable to alert me because she was distracted by a curious family. If Mercy was focused, she would have been able to warn me and I would have been able control my reactions before it was to the point of no return.

“Let’s go over what accommodations you will need for Mercy or other accommodations,” Beverly the human resource specialist asks me.

As we review what accommodations that I will need and some that would be nice, I feel more confident that this company understands me and the value I can bring to this role, even with accommodations. As a Veteran, having an assistance animal can be very beneficial.  Animals can be trained to help disabled individuals navigate their environment and perform daily tasks. In addition, studies have shown that interacting with animals can also help alleviate PTSD symptoms. Animal Assisted Therapy (AAT) has been shown to improve social interaction and emotional control, provide a greater sense of autonomy and empowerment, decrease depressive symptoms and sleep disturbances, and reduce anxiety and blood pressure. In addition, service animals can assist with performing tasks during a PTSD flashback or dissociative spell, as well as serving as a distraction or tactical stimulation.

PTSD and service dogs: Beneath the surface | Shannon Walker | TEDxMtHood

According to Titles 2 and 3 of the Americans with Disabilities Act (ADA), a service animal is a dog that has been specially trained to perform a function or job for an owner that directly relates to a physical, intellectual, or emotional disability. Service animals are covered under the ADA which permits them to enter virtually all public places and sit with their owners during flights. Service animals may also live with their owners regardless of residential pet policies under the Fair Housing Act and Section 504 of the Rehabilitation Act of 1973. Individuals who have been diagnosed with a physical disability, anxiety disorder such as PTSD, debilitating chronic illness, or neurological disorder affecting at least one limb, typically qualify for a service animal. To get a service dog, you need written documentation from your healthcare provider that you are being treated for a disability and require the assistance of an animal because of it, you also need to reside in a stable home environment with people who are able to help care for the dog, and you need to be physically and cognitively capable of participating in daily pet training.

For more information on how to get a service dog, click here.

For more information on your rights and responsibilities as a service dog owner, click here.

Emotional support animals provide their owners with support and companionship but are not specially trained to support a disability. Almost all types of domesticated animals can be emotional support animals including dogs, cats, birds, rabbits, and more, but the animal must be easy to manage in public places and must not pose a threat to others. Emotional support animals are not covered under the Americans with Disabilities Act (ADA), so they generally cannot enter public establishments and places of business. However, they are covered under the Fair Housing Act and Section 504 of the Rehabilitation Act of 1973, so they can live with their owners regardless of residential pet policies; they can also sit with their owners during flights. There is no official registry for emotional support animals. To certify your pet as an emotional support animal you must be formally certified as emotionally disabled by a psychologist, therapist, psychiatrist, or other certified mental health professional and receive an appropriately formatted letter from your health care provider, known as an ESA Letter, that you can present to landlords and airlines. For more information on emotional support animals, click here. For more information on the ESA Letter, click here.

While certification is free, service dogs and other types of assistance animals are not covered by medical insurance, so the cost of the dog, training, and care, comes out-of-pocket. However, there are resources out there to help. For a list of organizations that work to provide Veterans with service dogs, click here. For information on Veterinary Health Benefits offered through the VA, click here, or contact your local Veteran Services Center.

How veterans and dogs can save each other | David Shade | TEDxRoseTree

Animals in the Workplace

While the ADA prohibits discrimination against individuals with disabilities, employers are not obligated to allow assistance animals into the workplace.

Title 1 of the ADA states that employers must provide reasonable accommodations, meaning that they must provide any modification or adjustment to job duties or the work environment that will enable an applicant or employee with a disability to participate in the application process or to perform essential job functions, but it does not have specific guidelines for employers regarding service animals. Employers are only obligated to consider a request for a service animal, but they do not have to approve the request, especially if doing so would result in undue hardship on the employer or other employees. Instead of allowing a service animal, employers may choose to provide alternative accommodations, however, they do not have the right to tell employees how to treat their medical conditions, so this can be tricky. Employers typically adjust no-animal policies to allow service dogs in the workplace if the employee provides a letter from their healthcare provider stating their need for a service animal.

Unlike service animals, emotional support animals are not covered under the ADA, so there are no provisions or guidelines mandating a certain decision or process. Therefore, employers have no obligation to consider requests for emotional support animals in the workplace and have full authority to decide whether employees can be accompanied by companion animals.

For a list of pet-friendly employers that allow employees to bring their pets to work, or offer other pet benefits, click here and here.

Getting to bring your assistance animal to work is one thing, caring for it while your there is another story. Employers can provide certain accommodations, such as designating bathroom areas for service animals. However, service animal owners are always wholly responsible for their animal, including if the animal breaks or damages company property.

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