Suicides, family breakups, depression and social stigma are just some of the hidden legacies of the Iraq war among the more than one million US troops who have served in the campaign.

While nearly 4,000 American troops have been killed in the war and more than 29,000 have been wounded, those who escape physical injury still stand a high chance of developing psychological scars that may stay with them for life.

Some have watched comrades die or witnessed unspeakable carnage, while others may have found it hard to come to terms with the trauma of killing.

A report last month focused on the psychological toll on troops from the 10th Mountain Division> based in New York state, one of the most deployed brigades in the US Army since the September 11 attacks of 2001.

The study, by the group Veterans for America, found that the mental health care provided for soldiers did not meet the psychological burden they had suffered during repeated deployments in Iraq and Afghanistan.

Groundbreaking research suggests genes help explain why some people can recover from a traumatic event while others suffer post-traumatic stress disorder.

Researchers found that specific variations in a stress-related gene appeared to be influenced by trauma at a young age — in this case child abuse. That interaction strongly increased the chances for adult survivors of abuse to develop signs of PTSD.

Among adult survivors of severe child abuse, those with the specific gene variations scored more than twice as high (31) on a scale of post-traumatic stress, compared with those without the variations (13).

The worse the abuse, the stronger the risk in people with those gene variations.

I discussed in an earlier SharePost how the mental health community is beginning to accept the idea that men tend to exhibit depressive symptoms differently than women. Instead of feeling sadness, a man may feel angry or irritable. Instead of losing interest in activities he previously enjoyed, a man may drink too much or engage in risky behavior.

Now that it's easier to recognize depression symptoms in a man we know, our next step is to talk to him about it. However, that's easier said than done. I was involved with a man who went through bouts of depression. It was understandable - he had had a rough childhood and had a parent who was mentally ill. I knew when he was going through a bout - he would drink heavily. But when I would bring up the topic, he would insist that he wasn't depressed - he was just "in a funk."

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For almost 40 years, it has been suspected that folate plays a role in depression. We have a general sense that low folate can cause depressive symptoms, and that treatment with folate (of low folate patients) can help, but it is still debatable whether or not folate supplementation helps people who are not otherwise deficient.

Folate vs. Deplin (R)

Additionally, it is known that some medications, especially seizure meds such as valproate, carbamazepine and to some degree lamotrigine, reduce the amount of available folate. (And so it is always a good idea to be taking a folate supplement if you are on these meds.)

Recently, a new drug l-methylfolate (trade name Deplin), a shortening of the proper name l-methyltetrahydrofolate (MTHF), has been investigated for the treatment of depression. Why? Because folate itself is converted to MTHF, the active chemical that actually produces the results in depression.