Traumatic experiences - such as receiving incoming fire or knowing someone seriously injured or killed - are common among service members deployed to hostile environments. These experiences can impact the lives of service members and their families upon their return. If your family member had similar experiences while deployed, he or she is not alone.
Reactions to Traumatic Experiences Vary
Everyone reacts to these types of traumatic experiences in different ways. Some service members may feel upset or angry even after they return home. Others may relive memories of traumatic events. These reactions are common combat stress reactions, also known as acute stress reactions. Most service members who experience these reactions will recover naturally over time. Below is a table of common reactions:
|Thoughts||Relives bad memories||Has trouble concentrating||Contemplates death or suicide|
|Feelings||Sad/Guilty/ Abandoned||Angry/Annoyed/Irritable||Paranoid/Anxious/ Nervous|
|Behaviors||Uses drugs or drinks too much||Avoids situations related to trauma||Has trouble sleeping|
However, these thoughts, feelings and behaviors could also indicate more serious problems, including severe depression, post-traumatic stress disorder, traumatic brain injury or a combination of these. These conditions can cause problems for service members in getting along with family and friends, functioning on the job or at school or adjusting to the transition back to civilian life. Fortunately, there are lots of ways to get support. This article contains information that you and your family can use to help cope with psychological health issues.
Overview of Psychological Health Issues
- Anger or Aggressive Behavior: Although anger is a natural and healthy emotion, it can be expressed in unhealthy ways. Frustration over the inability to control emotions and reactions can make a service member angry. Thinking about traumatic events can also lead to anger. Intense feelings of anger and aggressive behavior can cause marital, relationship and family problems, as well as difficulties at work.
- Anxiety: Service members commonly report feeling anxious or nervous when returning home. This can lead a service member to withdraw from their family or friends, and can lead to problems at work.
- Guilt or Shame: Self-blame is not unusual among those who have been through difficult combat situations, as service members try to make sense of their war experiences. Service members may take too much responsibility for events that occurred, for what they did or did not do, or for surviving when others did not.
- Depression: Service members suffering from depression feel down or sad frequently, and may lose interest in hobbies or activities that used to be enjoyable. Depression can interfere with the ability to work, sleep, eat or interact with others. If your family member has these kinds of symptoms and this is affecting activities at home or duties at work, encourage your loved one to talk to someone at a local doctor's office or clinic.
- Traumatic Brain Injury (TBI): Symptoms of TBI can include constant headaches, confusion, dizziness, changes in mood or behavior, trouble remembering, repeated nausea or vomiting, and problems with seeing or hearing. If your family member had a blow or shock to the head and has one or more of these symptoms, he or she could be suffering from the long-term consequences of TBI. If the symptoms persist, encourage your loved one to talk to someone at a local doctor's office or clinic.
- Post-Traumatic Stress Disorder (PTSD): If you have a family member who continues to experience the reactions in the Common Combat Stress Reactions table above for months after returning home, it may indicate PTSD. Psychological health professionals do not know why some people experience PTSD while other people do not. They do know that it does NOT say anything about the strength or character of the person who experiences symptoms.
- Suicidal Thoughts: War experiences and combat stress reactions can lead depressed people to think about hurting or even killing themselves. If you think your family member may be feeling suicidal, contact the Military Crisis Line at 800-273-8255.
Use the Resources Available to You
The military is committed to supporting the health, well-being and job performance of military personnel. The military and other external organizations can suggest ways to cope with psychological health issues to get your family back on track faster. The following table provides several resources. Additional websites are available via the "Resources"page.
|Websites and Organizations|
|Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) Outreach Center
|National Military Family Association
|Military Crisis Line
|National Caregiver Support Line
|Coaching into Care
|Fact Sheets and Guides|
|Department of Defense PTSD and TBI Tips for Treating[PDF 34KB]|
|Department of Veterans Affairs National Center for PTSD|
|RAND Corporation: Post-Deployment Stress: What Families Should Know, What Families Can Do [PDF 532KB]|
|Tips for Communicating with People with TBI and PTSD|
How Else Can I Help?
Adults can help their family member by researching and understanding some of the stressors and emotions a service member may experience while deployed. Family members' most important role is to be genuine, loving and supportive. You and your family have many ways to get help - some of them listed in this article - and there are some simple things you can do immediately to support your loved one.
- Be prepared for change. Family members may need to adjust to a new family pattern that works for all involved. Spouses or partners should be ready to get accustomed to sharing control of important family tasks or decisions.
- Avoid being judgmental. Your loved one may be hesitant to admit that he or she has a psychological health problem, possibly because your loved thinks it will hurt his or her career. This mindset can be a barrier to service members to seek the treatment they need. Keeping an open mind will help create a safe environment that may encourage service members to talk more openly and seek help.
- Keep a positive attitude toward treatment and readjustment. Family members should be ready to learn and accept new skills or tools for coping used by the service member.
- Take care of yourself. It's important to remember that you'll be best able to help your loved one if you take care of yourself. For suggestions on how to take care of yourself in these situations, refer to "Caring for Yourself While Helping Support Your Service Member."
- If necessary, encourage your loved one to seek help. If your loved one is using harmful methods to deal with stress - such as drinking, drugs, withdrawal and isolation, or showing strong emotions that threaten the family - consider encouraging him or her to seek assistance.
Getting your loved to seek treatment is not always easy. Many service members hesitate to receive psychological health treatment for fear that it will hurt their career or make them appear weak. According to the Department of the Army's Mental Health Advisory Team V report, the top reasons against receiving mental health services are "My unit membership might treat me differently," "I would be seen as weak," and "Members of my unit might have less confidence in me."  Family members may have to encourage their loved one to seek counseling and treatment by emphasizing that it's for the entire family's benefit. Treatment can lead to better physical health and job performance for your loved one, while improving your family's relationships.
A variety of treatment options are available for PTSD, depression and TBI. For more information about specific treatment options and coping strategies for your family member struggling with a psychological illness, refer to Active Duty: Coping and Support. If you or your family member wants to get care, entry into the medical system may depend on current military status:
- If your family member is on active duty, he or she can go directly to the unit's military medical provider. He or she can contact a mental health provider through routine TRICARE channels and can specify either a civilian or military provider.
- If your family member served in a theater of combat operations and has since left the military, he or she may be eligible to receive care at a local VA medical treatment centerfor up to five years following discharge. Call 877-222-8387 for more assistance. 
- If your family member is a reservist or in the National Guard, he or she can contact the unit or a nearby unit to find out about local resources. He or she can also find out about treatment options at a local VA medical treatment center or can contact Military OneSource (800-342-9647) to learn about eligibility through TRICARE Reserve.
 Post-Deployment Stress: What Families Should Know, What Families Can Do" [PDF 532KB], RAND Corporation, Center for Military Health Policy Research. Last accessed May 24, 2013.
 "Operation Iraqi Freedom 06-08: Iraq and Operation Enduring Freedom 8: Afghanistan," Office of the Surgeon Multi-National Force Iraq and the Office of the Command Surgeon and the Office of the Surgeon General U.S. Army Medical Command, Feb 2008, page 53.