Can I obtain VA disability benefits for depression?
Yes, VA disability benefits for your depression or other affective disorder may be available.
You will need to prove that (a) you were in the military, (b) your depression or other affective disorder originated or was aggravated while you were on active duty, (c) you were continuously treated for your depression or other affective disorder since leaving the service (unless you are filing your disability claim within one year of leaving the service or your condition has been chronic), and (d) you are currently disabled by your depression or other affective disorder.
About affective disorders and disability
Affective disorders are really more appropriately called mood disorders. An affect is an emotion, manifest and observable in thinking and/or behavior. Mood is a more sustained and pervasive emotional element of mental life. Affective disorders include:
What is mania?
A person with mania has a distinctly elevated mood, usually euphoric or elated. The person has a grossly inappropriate energy and enthusiasm for everything. He or she has grandiose plans that cannot be achieved considering the person’s actual abilities and assets. But the person is not aware of this fact. To strangers, such a person may appear charismatic and dynamic, but to those who know him or her, the person is obviously functioning in an abnormal state.
Dynamic, enthusiastic, and energetic people are not necessarily manic. They are organized and productive while engaging in appropriate behaviors. The manic, on the other hand, has incomplete and disorganized behaviors from grandiose efforts to accomplish goals beyond his or her capacity. Normal people know they will fail at tasks that are beyond their capacity, and apply judgment in taking on tasks. But in mania, the individual characteristically takes on projects beyond his or her ability in a general behavioral pattern affecting every aspect of life, without appreciation of consequences or chances of success. The very high arousal state impairs judgment.
What is depression?
Depression has the opposite characteristics of mania. Instead of being in a euphoric mood, the person has limited activities, interests, and lowered self-esteem. A depressed person sees few possibilities for happiness. This narrowed viewpoint is associated with feelings of hopelessness and even despair. In the extreme case, even the ability to take care of personal hygiene may be impaired.
What is bipolar disorder?
Bipolar disorder is diagnosed when the individual’s mood fluctuates between the extremes of depression and mania. The cycling between depression and mania may be occur within days or instead occur over years.
Advanced brain imaging has established that bipolar disorder is associated with brain tissue loss. Tissue loss increases with age and is also worse in proportion to the number of relapses. Changes are most prominent in areas affecting face recognition, motor coordination, and memory—the fusiform gyrus, the cerebellum, and the hippocampus, respectively. The reason for brain shrinkage is not clear. But this is something the VA rating board should keep in mind, especially if you have a long history of bipolar disorder with multiple relapses. In these instances, you may need neuropsychological testing in addition to a mental status evaluation to evaluate whether you are disabled.
Mania can often be effectively controlled with the drug lithium carbonate. Lithium is potentially toxic and those who take it should have periodic blood levels checked by a medical doctor.
While in the past treatment for bipolar disorder was limited to lithium, now a number of medications can be used:
- The antiepileptic drugs carbamazepine (Tegretol), lamotrigine (Lamictal), and divalproex (Epival, Depakote);
- The antipsychotic drugs olanzapine (Zyprexa) and quetiapine (Seroquel); or
- Various combinations of these.
Tamoxifen (Nolvadex), long used to treat breast cancer, has been found helpful in treating mania in bipolar disorder. Considering all of these drugs, a wide spectrum of side-effects are possible.
Claimants taking these medications should always have their claims reviewed by a physician. A psychiatrist can evaluate both the mental disorder and drug toxicity.
If you are receiving medication, information about side-effects must come from a medical doctor, because a psychologist is not competent to evaluate that matter. However, it is also important for the same kind of information and opinions to be obtained from family or other caregivers, to make sure that nothing is missed. The caregivers live with the claimant; they may have noticed important facts that can be brought to the treating psychiatrist’s attention and to the VA rating board.