Since 2001, over two million U.S. troops have deployed as a part of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) in Afghanistan. About 1 in 5 return home with combat-related psychological injuries – invisible wounds, such as Post-Traumatic Stress Disorder (PTSD) and major depression.

These injuries make it more difficult for many veterans to adjust back to civilian life, putting them at higher risk for mental illness, unemployment, substance abuse, homelessness, violence, relationship problems, and suicide. About 20 United States veterans take their lives every day.

U.S.VETS created Outside the Wire (OTW) to provide preventative and early mental health treatment to veterans returning from Iraq and Afghanistan. California is home to a large percentage of the nation’s veterans.

Many veterans don’t ask for the help they need. Whether they are frustrated by waiting months for an appointment, or afraid to revisit the memories, about 60 percent of veterans returning from combat duty with PTSD won’t seek treatment. OTW aims to make these crucial services more readily available, by bringing them where many of these veterans already are – on campus.

Record numbers of post-9/11 veterans are going to college with the GI Bill By operating out of community colleges and technical schools throughout Los Angeles and Orange Counties, OTW offers individual and group therapy to student veterans and their families. Strong partnerships with these schools allows OTW to provide comprehensive mental health services through veteran student counseling and resource centers.

By focusing on the specific needs of veterans striving to successfully reenter civilian life, OTW provides unique training opportunities to mental health professionals, including psychology trainees, social work, and marriage and family therapist interns. We are creating a strong network of qualified individuals who can provide care for military personnel and their families as they manage the pressures of combat-related stress and post-war adjustments.

Individual, group, and family therapies offered through OTW include:

  • Cognitive Behavior Therapy Interventions (CBT)
  • Substance Abuse Intervention
  • Parenting Skills Intervention
  • Anger Management Strategies
  • Coping and Problem-Solving Skills

By bringing these preventative and early mental health treatment options to post-9/11 veterans, OTW helps to increase their chances of transitioning successfully to civilian life.

While many of us feel down, sad, or blue from time to time, these feelings tend to pass after a short period of time or a couple of days.  However, if you’re feeling sad to the point where you have a hard time getting up and motivated to go to work, connect with friends or family, or enjoy the things you used to enjoy in your life, then you may meet the criteria for clinical depression.

Common symptoms of depression include:

  • Depressed mood most of the day, nearly every day (sad, empty, hopeless)
  • Loss of pleasure in most or all activities most of the day
  • Significant weight loss or gain (when not dieting)
  • Insomina (not enough) or hypersomnia (too much sleep)
  • Physically agitated or opposite as observed by others
  • Fatigue/loss of energy nearly every day
  • Feelings of worthlessness or excessive guilt
  • Problems concentrating
  • Thoughts of death or thinking about killing self

Many veterans experience symptoms of depression after returning home. These symptoms may range from mild to severe, and there are several different treatment options that may be effective.

We live in a world that is more and more demanding of our time and resources. It’s no surprise that millions of Americans report experiencing some form of anxiety.

Anxiety affects different people differently. For many anxiety includes mental tension, unease, worry, and physiological changes, like an increase in heart rate and blood pressure.  Some can manage it well enough while others become overwhelmed and frozen in fear by it.

  • Common symptoms of anxiety include:
  • Excessive anxiety and worry more days than not
  • Difficult to control the worry
  • Feeling restless or keyed up
  • Difficulty concentrating
  • Irritability
  • Sleep disturbances

PTSD describes a cluster of symptoms that are classified under the category of Anxiety Disorders.

Symptoms of PTSD can vary from person to person due to individual differences and the nature and severity of the trauma. About one in five veterans return home with symptoms of PTSD. You might find yourself hyper-alert to things in your environment. Certain sounds may trigger you to tense up or lash out at others. You might find yourself avoiding people, places, and even fun things you used to enjoy doing. Or you might experience nightmares and have problems sleeping.

Common symptoms of PTSD include:

• Reliving or re-experiencing the traumatic event through nightmares or flashbacks

• Experiencing fear or anxiety when remembering the event

• Feeling keyed up or hyper-aware

• Being quick to anger or easily agitated

• Difficulty sleeping, and problems concentrating

• Negative changes in beliefs and feelings, which may result in disconnecting from friends and family

• Being easily startled by noise

• Avoiding people and situations that remind you of the traumatic event

While it’s normal to experience all or some of these symptoms after a traumatic experience, such as military combat, most people’s symptoms dissipate within a month or so. If your symptoms persist, or if you’re struggling to regain control, then it can be wise to seek out help from a professional to help you get your bearings back and balance your life.

U.S.VETS is the nation’s largest nonprofit provider of comprehensive services to homeless and at-risk veterans.

With 21 residential sites and 9 service centers in 14 cities across 6 states, the District of Columbia and the territory of Guam, U.S.VETS provides vital services such as:

  • Counseling
  • Job placement
  • Case management
  • Employment assistance
  • Drug and alcohol-free housing

For more information about these and other services available to you through U.S.VETS, please visit

Outside the Wire is operated by U.S.VETS, the nation’s largest nonprofit provider of housing and comprehensive support services to homeless and at-risk veterans and their families This program and more are made possible by your generous support. Make a donation today and join us as we serve those who served.