Your loved one has finally made it home from a long deployment. You have been waiting for months and dreaming about this day, but when it finally arrives, something has changed. The person who came home is somehow different from the person who left.

Your loved one may be suffering from post traumatic stress disorder (PTSD), an anxiety disorder caused by direct exposure to a traumatic event such as military combat. Previously referred to as "shell shock" or "battle fatigue", many doctors believed that PTSD symptoms subsided shortly after the soldier left the battlefield. This belief changed as many Vietnam War veterans developed delayed symptoms months and sometimes years after returning to civilian life.

The first step to take in helping your loved one is to recognize the signs of PTSD. PTSD symptoms consist of three categories: reexperiencing, avoidance and numbing, and increased arousal.

Reexperiencing symptoms are nightmares, intrusive thoughts or images, and flashbacks. For example, being stuck in a traffic jam on the highway sets off images of driving on an Iraqi dirt road in a convoy, seconds before hitting an improvised explosive device (IED). This dissociative state can be triggered by the smell of exhaust or vehicles driving close by. It can last for a few seconds up to several days.

Avoidance and numbing is used to protect against these disturbing reexperiencing symptoms. Service members may avoid activities, people, or situations that awaken disturbing memories such as other soldiers they deployed with, driving, or war movies. Family members might notice their loved one withdrawing and feel as if they returned home from war a completely different person.

Symptoms of an increased state of arousal are hypervigilance, being easily startled, irritable or angry, and having difficulty sleeping or concentrating. Loud noises, such as gunshots or a backfiring car, could trigger a dissociative state.

If you recognize any of these symptoms in your service member, encourage him or her seek help immediately from the base medical center. This may be difficult since mental toughness, physical endurance, and courage are valued in the military culture. They may fear that they could harm their careers or will be perceived as weak or malingering if they seek help.

Isolation and attempting to manage their trauma alone can only exacerbate the symptoms. This disconnect from their social support system prevents them from being aware of the prevalence of PTSD and places them at a greater risk for a more chronic form. According to the Veterans Affairs (VA) National Center for PTSD, approximately 30 percent of Vietnam veterans and 20 percent of veterans from the wars in Iraq and Afghanistan have developed PTSD. With the increase in frequency of deployments in the last seven years, the number of service members being diagnosed with PTSD continues to steadily rise.

The military has made tremendous strides in acknowledging, assessing, and treating active duty service members and veterans with PTSD. Service members no longer have to repress their trauma for fear of being perceived as weak and with treatment and with your support, can reclaim their lives.


Sources:

National Center for PTSD: https://www.ptsd.va.gov/public/index.asp
Department of Veterans Affairs (2004). VA/DOD Clinical practice guideline for the management of post-traumatic stress. Washington D.C.: Department of Defense.