Returning home from combat can be a very daunting challenge for returning Veterans, according to Dr. Matthew Friedman, the Executive Director of the Department of Veterans Affairs (VA) National Center for PTSD. Anger, insomnia, anxiety, pain, nightmares and interpersonal difficulties, all common symptoms of Post Traumatic Stress Disorder (PTSD), can also be common experiences for Veterans transitioning back to the lives and families they had spent months away from overseas.
"It can be an extremely difficult experience," Friedman explained. "You go from an environment where your primary focus is survival but you are trained extensively for it and you have group cohesion and the general support structure of your platoon, company, battalion and so on to help you deal with troubling emotions and symptoms and keep it contained."
"Focusing specifically on National Guard and Reservists who return to a civilian environment, when you come home, there is no formal support structure anymore. There is no training for the daily routine. You have spent a year or more away from family and friends, a spouse and perhaps children, and managed a very different set of responsibilities."
"Also, while you were deployed, your family underwent some important transformations to fill the gaps left by your absence. At the time of reunion, you can't just flip an off switch and instantly go back to the way things were before your deployment. People need time to grow back together, to become reacquainted and adjust to the changes each has experienced so that they can develop a new normal."
Symptoms experienced during readjustment after a deployment may often resemble those seen in PTSD. But for most Veterans, they are temporary and will diminish within weeks or months. Indeed, Post Traumatic Stress (PTS) is a nearly universal response to traumatic events, but the symptoms go away for most people. In fact, VA estimates only 11-20 percent of US Iraq and Afghanistan Veterans develop PTSD.
So how does a Veteran know if their nightmares, pain, trouble sleeping, anger and interpersonal difficulties are PTS or full blown PTSD? Like any medical condition, it requires diagnosis. Fortunately for today's Veterans, VA and the Department of Defense are screening for PTSD immediately after deployments, months afterward, and also during routine clinical visits.
"Persistence and severity are the keys to suspecting the problem and to diagnosing it," Friedman said. "It's like the difference between a cold and a pneumonia. They share many of the same symptoms, but if your cold is extremely severe and hasn't gone away in more than a week, something more is at work in your body and you should get checked."
VA does ask Veterans about their current mental health during every medical visit to VA's national network of health care facilities. However, with walk-in Vet Centers and mental health programs at hundreds of communities across the Nation, Veterans are encouraged to come to VA whenever they feel more support may be needed.
"The best thing Veterans can do when they experience symptoms of PTS is to get as much information as possible. As with any challenge, knowledge and preparation will make a big difference," Friedman said. "Knowing what to expect will help Veterans and their loved ones identify when issues are going deeper. When you find you can't function, have trouble with work or school, you can't sleep, are constantly jumpy and on-guard, feel uncomfortable without a firearm, can't accept the love and support from family and friends, those are signs you may have more than typical readjustment stress."
One resource that will help Veterans understand PTSD is in the Public section on this website. This section features materials to better understand PTSD, guides to assist Veterans in readjusting to civilian life and a link to find VA PTSD treatment options in the communities where Veterans live. Another resource Friedman recommended for newly-returned Veterans and their families is the Department of Defense site, afterdeployment.org.*
"The single greatest resource Veterans need when they return home is social support," said Dr. Laurie Slone, Associate Director for Information and Communication at VA's National Center for PTSD. "Understanding and patience from loved ones are key, but the Veteran needs to put forth effort to maintain those bonds as well. All parties will benefit from knowing what to expect during reintegration. Although sometimes Veterans feel like withdrawing, it is important to make use of the support of loved ones."
According to Friedman, there is no definite answer as to why some Veterans develop PTSD and others do not. All Veterans, though, have the capability to learn more about PTSD, so they can recognize when it might be present and can seek help before the disorder takes too high a toll on the lives Veterans fought for.
"When a Veteran is returning from war, there is this fantasy on both sides, the family and the Veteran," Friedman explained. "There is this idea that once they get back together, everything will be great. The reality is that war-zone and home-front experiences during deployment have affected both the Veteran and his/her family. Sometimes, such changes are very dramatic and difficult to overcome without assistance. Adjustments need to be made for people to grow back together and weave into a new existence. When that reality is in sight, when the challenge is identified correctly, then the Veteran has the opportunity to adapt and overcome."