Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Understanding Post Deployment
Stress Symptoms:
Helping Your Loved Ones
Families and friends of returning■ Overly Watchful orservice members often wonder what
Hypervigilant — oversensitivity
Service members who have a difficult time
to expect after their loved one comesor anticipation about things inafter their combat experience often reveal
home from a combat zone. Theythe environment (e.g., noise andtheir troubles to those they trust most—
may ask what is “typical” and whenphysical objects) that are viewed
they should become concerned.
as a threat to personal safety.
their family or close friends. This can be
The question is often “at what point■ Social Withdrawal — avoiding
communicated by what theyshould I be worried about myfamily or friends, always wanting
say or what they do.
husband or my son?” or “how can I
to be alone, avoiding social
encourage my wife or my daughter toactivities that they used to enjoy.
get the help I think she needs since
The majority of returning service
returning from deployment?” Service members who havemembers are likely to have some of the distress responses
a difficult time after their combat experience often reveal
described above.
their troubles to those they trust most— their family orclose friends. This can be communicated by what they say
Risk Behaviors
or what they do. Increased drinking, anger, irritability, orIndividuals returning from combat deployment canreckless driving, for example, can be especially frightening
sometimes start or increase the frequency of behaviors thatfor combat veteran families, and confuse or trouble theircompromise their health and the health and safety of thosechildren.
around them. Examples include:
What are the warning signs that may signal problems?
■ Cigarette Smoking — often starts or increases in theIf there is a problem, how can we bring it up? How can wecombat zone, and continues or increases upon return
encourage them to get help? This fact sheet recognizes yourhome.
important role in helping your loved one when they come■ Alcohol Use — although alcohol use is not allowedhome.
during deployment, it is available and may be used bysome service members. Upon return, alcohol use may
Distress Responses
start or continue as a misguided means of reducing
It is not uncommon for people who have been involved
stress.
in high stress situations to have what are called distress■ Reckless Driving — Returning veterans experience aresponses. Distress responses may be physical or emotionaltransition from the intensity of driving in a war zone toin nature. Symptoms of distress are usually mild, and go
routine driving in a civilian setting. Stress and alcoholaway after several weeks. If these problems (described
are other factors that contribute to risky driving.
below) last longer than a month or two months after
returning home, a medical professional should be consulted.
There are effective treatments today that are readily available More Serious Problems
There are conditions that cause more serious problems
from primary care physicians or mental health providers.
for
returning service members and their families and■ Sleep Problems — difficulty falling asleep, stayingfriends. Some of these conditions are:asleep, or waking early and not being able to get back to■ Violence — When irritability or anger turns intosleep.
violence there is risk both for the service member■ Restlessness — being jittery, fidgety, or showing a highdegree of nervous energy.
Continued

WARNING SIGNS
Symptoms that require medical attention include:■ Strong desire to avoid other people that continues
for weeks or months after return.
■ Increased jitteriness or jumpiness that does not go
away after return home.
■ Headaches or unexplained changes in personalityor thinking.
■ Unsettling memories or flashbacks touncomfortable wartime events that continue aftercoming home.
■ Sense of sadness, guilt, or failure that does notimprove.

and the family. Mixing anger with alcohol can beparticularly troublesome since the individual loses theability to understand their behavior or its consequences.
Conflicts that become violent need to be recognizedby family who should seek outside help. Violent
behavior can be caused by physical and emotional
problems which require medical assessment, and can betreated. When violence occurs in families, children are
particularly at-risk and need to be protected. Families
are urged to get help quickly.
■ Post traumatic stress disorder (PTSD) is a condition
that results when traumatic experiences (e.g., combat)
lead to lasting symptoms: nightmares, flashbacks, andunsettling memories of the trauma. Other symptoms
that are experienced and can be noticed by others
include excitability, nervousness, over anxiousness,
hypervigilance, and avoidance of people or social
situations that can remind a person of the traumaexperience. Symptoms of PTSD are serious and require
medical attention, but there is good news. PTSD is atreatable problem and combat veterans can recover. Butleft untreated, PTSD can lead to problems in day-to-day
living, both for veterans and their families.
■ Depression is different from normal humanunhappiness. Depression is a deep, unchanging,prolonged, and painful sadness that does not respondto attempts to help a person “cheer up.” It includes
a loss of interest in things one was previouslyinterested in, including family, hobbies, friends,and work. Depression typically leads to changes inindividual functioning (difficulties with appetite,
sleep, concentration, and enjoyment of activities oncea source of pleasure), as well as a loss of a sense ofwellness and self-esteem. There are excellent treatments
available for depression.

■ Angry outbursts, irritability, family arguments,or physical fighting that is out of character andcontinues.
■ Changes in alcohol use — drinking more and more
often, guilt about use, inability to decrease or stopuse, or family member concerns about use.
■ Risk-taking behaviors — reckless driving or otherrisky activities that have health consequences.
■ Thoughts of death or a wish to no longer be living(this is serious. Family and friends should call adoctor or 911 immediately).

■ Traumatic Brain Injury (TBI) is a condition that

results when service members are exposed to explosive
events in the combat theatre. While many combat
veterans may be aware that they have suffered froma head injury, some who sustained mild injury maynot. Symptoms of mild TBI can include headaches,
impulsive behavior, angry outbursts, changes inpersonality, or slowed thinking. These symptoms
can sometimes be difficult to distinguish from otheremotional conditions. As TBI symptoms can cause
problems in the lives of combat veterans or their families,
it is important to bring any concerns to the attention of ahealthcare provider.

Seeking Help
It is often difficult for veterans with combat related
emotional or behavioral problems to seek the help theyneed and deserve. People often feel ashamed and view theirsuffering as a sign of personal weakness. They may thinkthey can ‘snap out of ’ or ‘tough it out’. Family and friends
can help by pointing out that emotional problems are nodifferent from medical problems and must be diagnosed
and treated like any medical condition (e.g., a cough, sorethroat, or sprained or broken ankle.) It is also important tolet the person know that their health affects the health andwell-being of the entire family and should not be neglected.
The good news is that medical treatments today are very
effective for helping with these problems. Our military
supports help-seeking, especially early on before problems
worsen and interfere with quality of life.
Resources
Many resources are available to veterans through theDoD, Veterans Affairs (VA), and community agencies.
When appropriate, service members and their families

should seek out help from health care professionals who
have experience in the treatment of combat stress relatedproblems. Sometimes a chaplain, a good friend, or a trusted
member of your unit can make it easier to arrange for theright kind of help. Service members living in more remotelocations (e.g., National Guardsmen, reservists, or those
who have left active duty status) should reach out to VA
or local (TRICARE) healthcare providers in the civilian
community where they live.

Additional Information:
https://www.militaryonesource.mil/
https://www.ptsd.va.gov/
https://www.cstsonline.org/

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org