Returning from the War Zone

A Guide for Families of Military Members

1

September 2010

Your service member is home! 

You’ve wondered, worried, felt sad, proud, 

and lonely. You may have had sleepless nights 

because you were afraid for your loved one’s 

safety in the war zone. But now you can breathe 

a sigh of relief. You and your service member 

have served our country well, and can enjoy 

spending time together again.

Reunions Can Be Happy and Stressful

Although reunion is a happy time, it can also 

bring considerable stress — stress you may not 

expect. You and your service member have had 

different experiences during the deployment 

period, and you all have changed as a result.

For example, you’ve all had to learn new skills 

as you took on additional responsibilities. It 

can take time to rebuild intimacy, and you may 

need to re-examine common goals. Even if your 

service member has been called up before, you 

may find that new challenges will arise with 

each reunion. In order to make the homecoming event as happy as possible, it helps to 

know what kinds of challenges you might face 

and if your expectations are realistic.

This Guide Discusses:

■ What are common reactions 

to war? . . . . . . . . . . . . . . . . . . . . . . . . . . page 2 

■ What common issues do families 

of returning service members 

experience? . . . . . . . . . . . . . . . . . . . . . . page 3

■ How can you prepare for this 

reunion? . . . . . . . . . . . . . . . . . . . . . . . . . page 5

■ How can you positively cope with 

the transition? . . . . . . . . . . . . . . . . . . . page 7

■ What are warning signs that your 

service member might need 

some outside help? . . . . . . . . . . . . . . . page 8

■ What are treatment options 

for PTSD and other mental 

health problems? . . . . . . . . . . . . . . . . . page 9

■ Where can you and your service

member go for help? . . . . . . . . . . . . . page 13

You are not alone. Many families 

wrestle with reintegration issues. The purpose 

of this guide is to help you work through some 

problems you might encounter.

NOTE:

Throughout the Guide, you 

will find live underlined links 

to more information on our 

website: www.ptsd.va.gov
2

Common War 

Zone Experiences

Your service member’s time in 

the war zone will affect him or her for a long 

time. Experiences in the military and during 

deployment have helped make your service 

member more responsible, a better leader, 

and team player. He or she may have received 

incoming fire. Or witnessed the death or injury 

of friends or other military personnel, civilians, 

or enemy combatants. Your loved one may 

have received very serious injuries as a result 

of a bombing, mine blast, improvised explosive 

device (IED), or accident.

Being in an unfamiliar setting and an 

unfamiliar culture may have complicated these 

experiences. All the while, your loved one was 

in full military mindset. It can be difficult to 

change back to a “civilian” mindset upon 

returning home.

WAR ZONE EXPERIENCES REPORTED BY MEMBERS OF THE 

U.S. MILITARY IN IRAQ

Being attacked or ambushed 60%

Receiving incoming fire 86%

Being shot at 50% 

Discharged weapon 36%

Seeing dead bodies or remains 63%

Knowing someone seriously injured or killed 79%

Percentages are based on a sample of troops serving in Iraq in 2006.

These statistics are presented to help family members know what their service member may 

have experienced in the war zone. You may find that your service member does not want 

to talk about this. They may want to leave these memories in the past. They may fear it will 

change the way family looks at them. Or, they may not want families to be exposed to what 

they experienced in any way. Often times they want to keep work and family life separate. 

Knowing why your service member may get upset when asked about their experiences can 

help you better understand and handle their reaction.
3

Common Reactions to Trauma

Each service member will have 

their own experiences. However, understand 

that almost all service members will need time 

to readjust after being in a war zone. This can 

be especially intense during the first months 

at home. These common stress reactions are 

a normal part of readjustment. The reactions 

do not, by themselves, mean that your service 

member has a problem, such as posttraumatic 

stress disorder (PTSD), which may require mental health treatment.

Most returning service members will successfully readjust to life back home. It may take 

a few months, but, for most, life will stabilize 

following demobilization.

Below are common physical, mental/

emotional, and behavioral reactions that your 

service member may experience, and that you 

can show you understand.

Common Physical Reactions

■ Trouble sleeping, overly tired 

■ Upset stomach, trouble eating

■ Headaches and sweating when thinking of 

the war 

■ Rapid heartbeat or breathing

■ Existing health problems become worse

Common Mental and Emotional Reactions

■ Bad dreams, nightmares

■ Flashbacks or frequent unwanted memories

■ Anger

■ Feeling nervous, helpless, or fearful 

■ Feeling guilty, self-blame, shame

■ Feeling sad, rejected, or abandoned 

■ Agitated, easily upset, irritated, or annoyed 

■ Feeling hopeless about the future

■ Experiencing shock, being numb, unable to 

feel happy

Your service member may have unwanted 

memories of the war zone. If something happens that reminds them of a war experience, 

they may have a range of reactions, from intrusive images and thoughts, all the way to a feeling of reliving their experiences (“flashbacks”) 

that are so realistic your service member will 

feel they’re back in the war.

They may get irritated or react more 

strongly to common family issues. Anger 

and aggression are common war zone stress 

reactions. Even minor incidents can lead to 

over-reactions.

Common Behavioral Reactions

■ Trouble concentrating

■ Being jumpy and easily startled

■ Being on guard, always alert, concerned too 

much about safety and security

■ Avoiding people or places related to the 

trauma 

■ Too much drinking, smoking, or drug use 

■ Lack of exercise, poor diet, or health care

■ Problems doing regular tasks at work or 

school

■ Aggressive driving habits

Understanding the 

Military Mindset

Most service members coming from war 

zones will have stress reactions. But only a 

small number will develop PTSD. The Army 

produced the “Resilience Training” program 

(https://www.resilience.army.mil/) and 

the Navy and Marine Corps produced the 

Combat Operational Stress Leaders Guide 

(www.usmc-mccs.org/LeadersGuide)

to help service members and families understand how a wartime mindset is useful at 

war but not at home. 
4

Aggressive driving is also extremely common among service members returning from 

conflicts in the Middle East. This is because your 

service member may have been trained in “nondefensive driving” to avoid explosive devices 

in the war zone. Non-defensive driving is full 

speed ahead, unpredictable, and deliberate, 

which is not necessarily safe back home. While 

your service member will want to drive, they 

may want to reduce or take greater care in their 

driving for a few weeks until they feel more confident with defensive driving. This is particularly 

true if they are feeling edgy, impatient, or upset.

Many families and service members also 

report positive reactions to deployment, 

such as:

■ New maturity

■ More appreciation for family and family time

■ More focus on spending quality time with 

those they love

■ More dedication and belief in their job and 

mission

■ More sense of confidence and pride in 

themselves and their family

Service members can grow closer to their 

core values or their spirituality. This is often why 

many wounded service members want to return 

to deployment. They want to continue to serve 

their country and work with their fellow service 

members. It is important to know that positive 

and negative reactions can co-exist for service 

members.

paul knew that a lot of soldiers had it so much worse than he did. He was not certain 

if it was the 12 months in Iraq that had made him feel so numb.

When he first returned from deployment, he felt fine, and was happy to be home. 

However, over the seven or eight months since his return, he realized that something had 

changed for him and his family. Paul had trouble being involved with his family. He did 

not enjoy being a father to his two daughters, 7 and 5, anymore. He didn’t feel close to his 

wife. Little things made him jumpy and angry. He was tired all of the time. He also knew 

that he was not comfortable talking about any of this with Lisa, his wife of 9 years. When 

she would try to confront him, he would look down at his hands and start playing with his 

fingernails, doing anything to avoid eye contact with her.

He just thought that there was no way that she could understand what he had been 

through and the guilt that he was feeling now. Besides, they didn’t seem to need him 

anymore.

MORE INFORMATION...
5

Preparing for Your 

Service Member’s Return

You and your service member

are about to enter the post-deployment stage.

This is the period after troops have returned 

home when families must readjust to life 

together. Each reunion is different. If your service member has been deployed before, you 

all might think you “know what to expect.” But 

later deployments might not be easier. Your 

service member could experience different or 

added stress in the course of their duties. Or 

home life might have changed with a new child, 

illness, or something else. Any of these factors 

can make deployment experiences different, or 

harder.

When your service member returns 

home, you may feel like you hardly know one 

another. It takes time to rebuild intimacy and 

to relearn how to rely on one another for support. Everyone’s plans for the future, dreams, 

and expectations may be different because of 

changes that have occurred in the war zone, 

at home, or in both places. You may also need 

to renegotiate roles. For instance, you may not 

want to give up the independence you were 

able to achieve while your service member was 

deployed.

Planning ahead is ideal, but you can still 

prepare for your service member’s return by 

taking at least some of the following steps:

■ Educate yourself about what to expect and 

think about how you’ll cope.

■ Discuss with your service member before 

their return how you’ll handle balance of 

work, home responsibilities, and leisure time 

for both of you.

■ Talk to other people who have experienced 

the return of service members.

■ Take care of yourself. Live the healthiest 

lifestyle possible.

■ Remember that each reunion may be 

different.

Partners

There is usually a “honeymoon” phase shortly 

after demobilization, but it will probably be 

temporary. Your children have grown. Your service member has been through traumatic experiences. You have had to face new situations in 

your service member’s absence. You might also 

feel angry because you had to handle so much 

on your own while they were away.

Do men and women 

experience re‐entry 

differently?

Both men and women often feel that no one 

understands what they’ve been through. 

After deployment, men and women often 

have different ways of re-entering the family. 

To cope with stress, men tend to isolate 

themselves. They might seek support outside 

the home from old friends or military buddies. 

Women tend to try to share their feelings and 

experiences with their partners. But they can 

become easily frustrated or irritable if they 

feel support is inadequate. Their male partners 

may come to resent or misunderstand those 

negative feelings. Then, they find it hard to 

provide the support that she really needs.

Your life has changed, too. You may have 

developed new relationships. You may be feeling pride in what you were able to accomplish 

while they were away. Issues of infidelity may 

have arisen. You may need to talk about each 

other’s commitment to the relationship.
6

Children

Prepare children to be with your returning 

service member. Kids may have different needs 

now. They might take awhile to warm up to the 

service member, especially if they were very 

young when he or she left.

Children react differently depending on 

their age:

Infants (12 months and younger) may react 

to changes in their schedule, physical environment, or the caretaker’s mood and availability.

They may show apathy, refuse to eat, or even 

lose weight.

Toddlers (1-3 years) may sulk, cry, throw 

temper tantrums, or not sleep well if their caretaker is having problems or is not available.

Preschoolers (3-6 years) may react with 

toileting issues, thumb sucking, sleep problems, 

clinginess, and separation anxiety. They may 

also be irritable, depressed, aggressive, or complain about aches and pains. They might think 

their parent was deployed because “I was bad.”

School age children (6-12 years) may be 

irritable, aggressive, or whiny. They may get 

stomach aches, headaches, etc. Very often, 

preschool and school-age children also worry 

about the safety of the parent at home.

Adolescents (13-18 years) may be irritable, 

rebellious, etc. Adolescents may also not like 

new family roles and responsibilities after the 

deployed parent returns home.

To help with all ages, you can:

■ Provide extra attention, care, and physical 

closeness.

■ Understand that they may be angry (and 

perhaps rightly so).

■ Discuss things. Let kids know they can talk 

about how they feel. Accept how they feel 

and don’t tell them they should not feel that 

way.

■ Tell kids their feelings are normal. Be 

prepared to tell them many times.

■ Maintain routines and plan for upcoming 

events.

Parents

Parents and other family members of service 

members must make many of the same readjustments as partners. They, too, will have to 

realize that everybody has grown and changed.

Their relationship with the returning service 

member will also be different. While they take 

time to get reacquainted, they will need to be 

aware of boundaries. It’s easy for parents and 

others who have cared for a service member in 

the past to fall into old patterns. They want to 

take care of their loved one again in ways the 

person no longer needs or wants.

jenny could not wait to see Brad again. He had been away from their family for 

almost a year and she was relieved that finally he was going to come home. She was proud 

of the fact that they had all survived and that she had managed to keep things together at 

home for their two young sons.

But it was hard when Brad first arrived. The younger son, Harry, didn’t even recognize 

Brad and he cried when Brad tried to take him in his arms. That made Brad angry and 

for a while after that, he wouldn’t even try again to interact with the boys. He also didn’t 

seem interested in her, even though she had tried so hard to fix up for him and show him 

how much she cared. When she would reach over to pat him on the knee or try to hug him, 

she could feel him pull away and it hurt her to think that he no longer loved her.

But Jenny was determined to give him time to get the war out of his mind. She 

contacted the chaplain on base and learned of a new program to help reunite families. 

They went on a weekend retreat together and finally Brad began sharing, connecting 

with his wife again. It was not easy and he still felt uncomfortable with all of the talk but 

gradually things began feeling a little like their old relationship. n

MORE INFORMATION...
7

Healthy Coping

Here are some tips to help your 

family to cope:

Reconnect:

■ Make sure that your service member has 

the opportunity to spend one-on-one 

“downtime” with every family member and 

significant friend.

■ Provide support to your service member to 

interact with others, and also spend time 

alone as needed. Some time with war zone 

comrades is good but balance with family is 

also important.

■ Experiment with different communication 

styles. Your service member has been 

used to operating in the military “need-toknow” mode. They may need to relearn the 

importance of sharing information. Don’t 

be afraid to ask about the war or how your 

service member is doing. Know that they 

may not want to talk at first. You may have 

to approach talking indirectly. You can 

arrange activities that foster conversation 

instead of watching movies or television.

Examples are walking together, working on 

a project together, or playing a game.

■ Express confidence that you will be able to 

work things out, and make a happy home 

for yourselves again.

Share and renegotiate roles:

■ Be prepared for changing 

household roles (and new 

personality traits).

■ Talk about what skills each 

of you now has, and which 

responsibilities you’d both prefer.

(These may now be different.)

■ Compromise if necessary. Both 

of you should feel that needs are 

understood and respected.

Take care of yourself by doing 

healthy things to relieve stress:

■ Exercise, including yoga.

■ Meditate, do breathing exercises.

■ Get enough sleep (8-9 hours per night).

■ Drink alcohol only in moderation — it’s 

important not to use alcohol as a way go to 

sleep, as it can interfere with deeper sleep 

cycles, or as a way of avoiding experiences 

or reactions that may need to be faced to 

be resolved. Using alcohol for these reasons 

tends to lead to more problems in the 

long run.

Try not to:

■ Pressure your service member to talk. They 

may never feel comfortable talking with 

you about their deployment experiences.

Rather then pushing them to do so, offer 

alternative strategies, such as talking with 

peers, or relieving deployment stress in 

other ways besides talking about it.

■ Stop him or her from talking.

■ Make statements that might be perceived as 

judgmental (for example, don’t say things 

like, “what you had to do is so awful!”).

■ Tell your service member what they 

“should” do.

■ Use clichés or easy answers (for example, 

try not to say things like “war is hell” or 

“now that you’re back, you can put it behind 

you”). Instead, let them know that you feel 

for what they went through, you love them, 

and you’re there for them whenever they 

need anything.

■ Give your service member advice without 

listening thoroughly.

■ Rush things. It takes time to become 

reacquainted and comfortable with one 

another again.
8

Seeking Help

You are now aware of some common stress reactions that your loved one may 

be feeling after deployment. Remember that 

reintegration takes time and patience.

However, problems that last for months 

can affect relationships, work, and overall wellbeing if not treated. Your service member may 

be coping with stress by drinking, doing drugs, 

withdrawing, and isolating. Or they may be having sudden emotional outbursts. If so, it’s probably time to encourage them to seek outside 

help:

Warning Signs

What are signs that your service member needs 

outside help? You should consider getting help 

if they are having significant distress in these 

areas: 

■ Family and social relationship troubles 

— frequent and intense conflicts, poor 

communication, inability to meet 

responsibilities

■ Work, school, or community issues 

— frequent absences, conflicts, inability to 

meet deadlines, poor performance

■ Frequent or severe depressed or angry 

moods — especially if there is a possibility 

that they are going to hurt someone else or 

themselves

■ Frequent intrusive thoughts or images 

of war zone experiences. Being regularly 

hyperalert or on guard

If your service member’s reactions are 

causing significant distress or interfering 

with normal functioning, they might benefit 

from seeking help. Admitting that they have a 

problem, however, can be tough. Your service 

member:

■ Might think they should cope on their own

■ Might think others can’t help

■ Might believe the problem(s) will go away 

on their own

■ Is embarrassed to talk to someone about it

Emotional or psychological problems 

are not a sign of weakness. Injuries, including 

psychological injuries, affect the strong and 

the brave just like everyone else. But stigma of 

mental health issues can be a huge barrier for 

people who need help. Remind your service 

member that finding solutions to problems is a 

sign of strength. Getting assistance from others is sometimes the only way to solve something. Knowing when and how to get help is 

actually part of military training.

The Defense Department also encourages 

people to seek help. For this reason, it has 

changed requirements on its security clearance form. Applicants no longer have to report 

mental health care they have received in the 

past seven years if it was related to service in a 

military combat zone.

GETTING HELP: TIPS FOR 

STARTING THE CONVERSATION 

WITH YOUR SERVICE MEMBER

■ Let them know you are interested in 

hearing about their experiences and 

feelings.

■ Help your service member put feelings 

into words. Ask, “Are you feeling angry? 

Sad? Worried?” Don’t argue or interrupt.

Repeat what you hear to make sure you 

understand, and ask questions if you 

need to know more.

■ Tell your service member how you feel 

about them. They may not realize how 

much you care.

■ Suggest that they visit a chaplain.

Even if your service member is not 

religious, they might benefit from such 

a meeting. Religion will be discussed 

only if the service member requests 

it. Conversations are confidential and 

do not become part of your service 

member’s medical record.

■ Encourage your service member to 

reach out to other veterans, including 

Vietnam veterans, who can relate to 

their feelings.

■ Share your own knowledge about PTSD 

but do not attempt to diagnose the 

symptoms of your service member.

■ Ask how you can help, and keep asking.

■ Recommend that they read “Returning 

from the War Zone: A Guide for Military 

Personnel (PDF)”. It contains useful 

resources for service members who are 

seeking more information about PTSD.
9

PTSD (Posttraumatic Stress Disorder)

Many of the common reactions to experience 

in a war zone are also symptoms of more serious problems such as PTSD. In PTSD, however, 

they’re much more intense and troubling, and 

they don’t go away. If these symptoms don’t 

decrease over a few months, or if they continue 

to cause significant problems in your service 

member’s daily life, it’s time to seek treatment 

from a professional.

PTSD is a treatable condition that is diagnosed by a healthcare provider. PTSD is a serious disorder that can occur after a person has 

been through a traumatic event.

Symptoms of PTSD

Re-experiencing

Bad memories of a traumatic event can 

come back at any time. People may feel the 

same fear and horror they did when the event 

took place. Sometimes there’s a trigger: a 

sound, sight, or smell that causes them to have 

a stress reaction, or to relive the event. For 

instance, many veterans react to burning scents 

or loud noises with anxiety or anger.

Avoidance and Numbing

People with PTSD will try hard to avoid 

things that might remind them of the traumatic 

event they endured. These include crowded 

places, situations (like shopping malls) where 

there are too many choices, or certain types 

of terrain (hot, dry places). They also may shut 

down to prevent feeling pain and fear. Others 

use numbness so they can cover distress over 

their reactions.

Hypervigilance or Increased Arousal

Those suffering from PTSD may operate on 

“high-alert” at all times, often have very short 

fuses, and startle easily. Sleep problems, anger, 

and difficulty concentrating are additional 

arousal symptoms.

Factors Contributing to PTSD

How likely is your service member to get PTSD? 

This depends on many factors, such as:

■ How severe the trauma was

■ If they were injured

■ The intensity of their reaction to the trauma

■ Whether someone close to your service 

member died or was injured

■ How much their own life was in danger

■ How much they felt they could not control 

things

■ How much help and support they got 

following the event

Steps to Solving the Problem and 

Getting Help

Treatment involves several steps:

■ First, a professional will evaluate the 

symptoms with a full interview.

■ Next, the person often receives education 

about PTSD and other conditions, including 

symptoms and how they can affect people.

■ Finally, a treatment approach is selected 

that best fits the person’s needs, which 

could include therapy, medication, or a 

combination of both.

There are good treatments available for 

PTSD. Cognitive-behavioral therapy (CBT) 

appears to be the most effective. Exposure therapy is a CBT where you talk about your trauma 

repeatedly until the memories are no longer 

upsetting. Cognitive therapy is another CBT. It 

helps you identify trauma-related thoughts and 

change them so they are more accurate and less 

distressing.

For more information on PTSD 

treatments, see the NCPTSD 

fact sheets: 

n PTSD Treatment Programs in the U.S. 

Department of Veterans Affairs

n Treatment of PTSD

n Finding and Choosing a Therapist
10

HOW PTSD AFFECTS FAMILY MEMBERS

ptsd can make somebody hard 

to be with. Family members of a person with 

PTSD may experience the following: 

1. Sympathy: You may feel sorry for your 

loved one’s suffering. This may help your 

service member know that you sympathize 

with them. However, be careful that you 

are not treating them like a permanently 

disabled person. With help, they can feel 

better.

2. Negative feelings: If you believe your service member no longer has the traits you 

loved, it may be hard to feel good about 

them. The best way to avoid negative feelings is to educate yourself about PTSD.

Even if your loved one refuses treatment, 

you will probably benefit from some support. You’ll find more resources beginning 

on page 13.

3. Avoidance: You may be avoiding the same 

things as your service member in order 

to reduce their reactions. Or, you may be 

afraid of his or her reaction when you do 

things without them. One possible solution 

is to slowly start to take part in a few different activities. At first, you can let your service member stay home if he or she wishes, 

but in the long run you should negotiate 

a plan so that you can do things together.

Seek professional help if your service member continues to avoid many activities, or if 

he/she frequently prevents your going out.

4. Depression: This is common among family members when the person with PTSD 

causes feelings of pain or loss. When PTSD 

lasts for a long time, you may begin to lose 

hope that your family will ever “get back to 

normal.” If your usual coping strategies and 

supports don’t bring relief over time, seeking treatment is recommended. Many of the 

same treatment strategies that help with 

PTSD are also effective for depression.

5. Anger and guilt: If you feel responsible 

for your service member’s happiness, you 

might feel guilty when you can’t make a 

difference. You could also be angry if they 

can’t keep a job or drink too much, or 

because they are angry or irritable. You and 

your loved one can get past this anger and 

guilt by understanding that the feelings are 

no one’s fault.

6. Health problems: Consistently feeling 

anger, worry, and/or depression over a long 

period of time can have a negative impact 

on health. Additionally, unhealthy habits 

such as drinking, smoking, and not exercising can get worse when trying to cope with 

PTSD symptoms in a family member.

For more information, see the NCPTSD fact 

sheets: 

m When a Child’s Parent Has PTSD 

m Partners of Veterans with PTSD: Common 

Problems

MORE INFORMATION...

How common is PTSD

in OEF/OIF military 

personnel?

About 7% of U.S. civilians have PTSD in their 

lifetime. According to research following 

the early years of the current conflicts in 

Afghanistan and Iraq, 11-20% of veterans 

developed PTSD.
11

Other Treatable Mental Health Problems

PTSD is not the only serious problem that can 

occur after deployment. Watch out for signs of 

these other conditions in your service member.

Depression: We all experience sadness or feel 

down from time to time. That’s a normal part of 

being human. Depression, however, is different.

It lasts longer and is more serious than normal 

sadness or grief. Common symptoms include:

■ Feeling down or sad more days than not

■ Losing interest in hobbies or activities that 

used to be enjoyable or fun

■ Being excessively low in energy and/or 

overly tired

■ Feeling that things are never going to get 

better

Suicidal Thoughts and Suicide: War experiences and combat stress reactions, especially 

those caused by personal loss, can lead a 

depressed person to think about hurting or killing themselves. If your service member is feeling this way, take it seriously, and get help. Call 

the Suicide Hotline 1-800-273-TALK (8255).

Violence and Abuse: Abuse can take the form 

of threats, swearing, criticism, throwing things, 

conflict, pushing, grabbing, and hitting. Here are 

a few warning signs that may lead to domestic 

violence:

■ Controlling behaviors or jealousy

■ Blaming others for problems or conflict

■ Radical mood changes

■ Verbal abuse such as humiliating, 

manipulating, confusing

■ Self-destructive or overly risky actions; 

heated arguments 

Substance Abuse: It’s common for service 

members to “self-medicate.” They drink or 

abuse drugs to numb out the difficult thoughts, 

feelings, and memories related to their war 

zone experiences. While alcohol or drugs may 

seem to offer a quick solution, they actually 

lead to more problems. At the same time, a 

vast majority of people in our society drink.

Sometimes it can be difficult to know if your 

service member’s drinking is actually a problem.

Warning signs of an alcohol problem include:

■ Frequent excessive drinking

■ Having thoughts that they should cut down 

■ Feeling guilty or bad about drinking

■ Others becoming annoyed or criticizing 

how much the person drinks

■ Drinking in the morning to calm nerves

■ Problems with work, family, school, or other 

regular activities caused by drinking

WAYS FAMILY MEMBERS CAN 

HELP SOMEONE WITH PTSD:

■ Tell your loved one you want to listen 

and that you also understand if they 

don’t feel like talking.

■ Learn as much as you can about PTSD.

The National Center for PTSD has many 

fact sheets related to helping a family 

member with PTSD. Visit the center’s 

website (www.ptsd.va.gov) to learn more 

about what you can do for your service 

member.

■ Go with your loved one to visit the 

doctors and/or chaplain and participate 

in their treatment.

■ Give your loved one space, but keep 

encouraging them to have contact with 

family and friends and to do fun things.

Withdrawal symptoms may make them 

hesitant to be around other people, but 

keep trying because social support is 

important. ■

What Percentage of Veterans 

Have Received Help for 

Mental Health Problems?

m 47% of all veterans have sought 

services at VA

m Top 2 reasons: Muscle and Joint Problems and 

Mental Health

m Of the 48.5% who have sought mental health 

care:

n 53.3%: PTSD problems

n 37.8%: depression

(VA data as of 01/2010)
12

Concussions or Mild Traumatic Brain Injury 

(mTBI): Explosions that produce dangerous 

blast waves of high pressure rattle a person’s 

brain inside the skull and can cause mTBI.

Helmets cannot protect against this type of 

impact. In fact, 60% to 80% of service members 

who have injuries from some form of blast may 

have mTBI.

Symptoms associated with mTBI can parallel those of PTSD, such as: 

■ Insomnia

■ Impaired memory

■ Poor concentration

■ Depression

■ Anxiety

■ Irritability, impatience, or impulsiveness

Symptoms that are specific to mTBI are:

■ Headaches

■ Dizziness, nausea, and vomiting

■ Fatigue

■ Noise/light intolerance

■ Blurred vision

Most service members with mild TBI do not 

need special care and the symptoms typically 

abate on their own over time. After a year, 

approximately 10% will have enduring problems.

Referral for care should be made when a 

service member:

■ Has dizziness, headaches, and nausea

■ Is obviously not thinking clearly 

■ Has severe and enduring arousal

■ Complains of not being able to feel pleasure 

or that they are depressed

■ Is behaving in an intensely detached manner

■ Can’t do their job

■ Has suicidal or homicidal wishes or intent

WAYS FAMILY MEMBERS CAN HELP THEMSELVES

EVEN IF YOUR LOVED ONE does not seek 

treatment, you should find out as much as 

you can about PTSD because your partner’s 

behavior will affect you, too. For instance, 

if your partner is triggered by something in 

their environment, do not say anything that 

may make them feel either that you don’t 

understand (i.e., laughing it off), or feel 

ashamed for the length of time they’ve been 

back and still reacting, as it can make them 

close off.

Another example is anger. While it is a normal 

reaction to trauma, it can hurt and frighten 

other people. If your service member gets 

angry often, you can set up a time-out 

system:

■ Agree that either of you can call a timeout at any time.

■ Agree that when someone calls a timeout, the discussion must stop right then.

■ Decide on a signal you will use to call a 

time-out. The signal can be a word that 

you say or a hand signal.

■ Agree to tell each other where you will 

be and what you will be doing during the 

time-out. Tell each other what time you 

will come back.

While you are taking a time-out, don’t focus 

on how angry you feel. Instead, think calmly 

about how you will talk things over and solve 

the problem. After you come back:

■ Take turns talking about solutions to the 

problem. Listen without interrupting.

■ Use statements starting with “I,” such as 

“I think” or “I feel.” Using “you” statements 

can sound accusing.

■ Be open to each other’s ideas. Don’t 

criticize each other.

■ Focus on things you both think will work.

■ Together, agree which solutions you will 

use.

If anger leads to violent behavior or abuse

(see symptoms above), it’s dangerous. Go 

to a safe place and call for help right away 

(national toll-free Domestic Violence hotline: 

1-800-799-SAFE [7233]). Make sure children 

are in a safe place as well.

Know and acknowledge that your service 

member’s anger is not directed at you or your 

children. Explain to your children the reasons 

for your service member’s difficulties, without 

going into graphic details. It is important to 

let children know that they are not to blame.

If necessary, find your own sources 

of support. The family resources listed on 

page 13 can provide support for you and your 

children if you think you need it. Keep looking until you find the right support. Also, plan 

to reach out to your military community. Let 

people in; don’t be afraid to talk to a neighbor or other families who are familiar with the 

deployment cycle.
13

Where Can My Service Member — and Our Family — Find Assistance?

Family Support Programs:

Family Assistance Centers: Located at armories across the states, these centers were created by the National Guard but exist to assist 

all members and families of all branches of 

military. For instance, if your son or daughter is deployed from Arkansas but you live in 

Miami, you can still go to any Florida FAC and 

receive assistance. To find the location nearest you, visit www.jointservicessupport.org/

ResourceFinderSearchFilter.aspx.

Army Community Services (ACS):

www.armymwr.com

US Air Force Services Agency: 

www.afsv.af.mil

LIFElines: www.navy.mil/local/lifelines

Air Force Reserve Family Readiness: 

800-223-1784, ext. 7-1243 (7 am–5 pm) 

(ext. 7-0089 after duty hours) 

www.afrc.af.mil/library/family.asp

Marine Corps Community Services (MCCS): 

www.usmc-mccs.org

Army OneSource Family Programs and 

Services: 

https://www.myarmyonesource.com/

familyprogramsandservices 

Family Readiness Groups (FRG): Army units 

have groups of volunteers structured to 

help with communication to the families of 

deployed troops. Your FRG should contact 

your family but if it doesn’t, you can locate 

them through your service member’s unit.

Other Resources for Families:

Chaplains and Other Religious Leaders: Every 

VA Medical Center and military establishment has a chaplain on staff that can provide 

assistance. All information exchanges with a 

chaplain are confidential.

Navy Fleet and Family Support Services: 

www.cnic.navy.mil

Provides a direct link between families and 

the Navy Command.

Strong Bonds, Building Ready Families: 

www.strongbonds.org

Offers specialized programs for single 

soldiers, couples, and families.

Sesame Street “Workshop”: 

archive.sesameworkshop.org/tlc

Bilingual (English and Spanish) multimedia 

outreach program for military families with 

children between the ages of 2 and 5 who are 

experiencing deployment, multiple deployments, or a parent that is changed due to a 

combat-related injury.

Military Families at Real Warriors:

www.realwarriors.net/family

Real Warriors, a program by the Defense 

Centers of Excellence (DCoE), provides 

readings and resources to support military 

families before, during, and after a deployment. The DCoE Outreach Center provides 

24/7 help, and there is a message board for 

discussions about issues related to military 

families.

VA Services:

The U.S. Department of Veterans Affairs

VA is the largest healthcare system in the U.S., 

with facilities located in every state. VA is now 

offering more services for family members, 

such as healthcare services to eligible TRICARE 

family members, bereavement counseling for 

parents, spouses, and children of Armed Forces, 

reservists, and National Guardsmen personnel 

who died in the service of their country, family 

and marital counseling, and caregiver support 

groups for spouses of veterans with disabilities and chronic illnesses. Service members are 

urged to complete VA Form 10-10EZ to sign 

up, even if they think they’ll never use these 

services.

Healthcare: 877-222 VETS (8387)

Benefits: 800-827-1000

 www.va.gov
14

VA Medical Centers

The VA services soldiers/airmen, including 

the Guard and Reserves. Veterans can receive 

free services for military-related problems for 

the first five years following deployment, and 

co-pay based on eligibility after that. The VA 

has many community-based outpatient clinics 

(CBOCs) located in the community in addition 

to their medical centers. Find a facility near you.

Each medical center has:

■ An OEF/OIF Program Manager to help all 

recent returnees

■ Health and mental health services, including 

mental health practitioners trained in state 

of the art Cognitive Behavioral Treatments 

for PTSD

■ Women Veterans Program Manager

■ Social Work Services

■ VA Chaplains

Vet Centers

Readjustment Counseling Service

Toll-free: 800-905-4675

Assist veterans and their family to making a 

successful postwar adjustment, offering: 

■ Readjustment counseling (including PTSD 

treatment)

■ Marriage and family, benefits, bereavement, 

alcohol and drug counseling 

■ Job services and help obtaining services at 

the VA and community agencies

There are no co-payments or charges for Vet 

Center services, and services are completely 

confidential.

www.vetcenter.va.gov 

Other Federal, State and

Community Resources:

Military OneSource 

(user id: military; password: onesource)

This resource helps military members, veterans, 

and families deal with life issues 24/7. Service 

members and family members can call in and 

speak to a master’s-level consultant who can 

answer almost any question, no matter how big 

or small.

Toll-free (in the US): 800-342-9647

Toll-free (outside the US): (country access 

code) 800-342-9647 (dial all 11 numbers)

International toll free: 800-464-8107 

www.militaryonesource.com

■ “Returning from Deployment” publications

Veterans Service Organizations (VSOs)

VSOs can help you to complete necessary 

paperwork and to navigate the VA system. They 

include organizations such as the American 

Legion, the VFW, AMVETS, Disabled American 

Veterans (DAV), and more.

Directory of Veterans Service Organizations: 

www1.va.gov/vso

State Resources: 

All states have a variety of programs and 

resources for veterans and their families. Most 

states have an information and referral line such 

as dialing 2-1-1 (www.211.org) to see what your 

state offers. Or call your local:

■ Agency or Department of Health and 

Human Services

■ State’s Office of Veterans Affairs (NASDVA) 

www.nasdva.net

■ Veteran representatives in the offices of 

legislative officials

■ Employer Support of the Guard and 

Reserves (ESGR) www.esgr.org

■ Veterans Transition Assistance Program 

(TAP) www.turbotap.org
15

For More Information:

n Homecoming After Deployment: Dealing with Changes and Expectations (PDF)

www.ptsd.va.gov/PTSD/professional/manuals/manual-pdf/iwcg/iraq_clinician_guide_app_j9.pdf 

n Homecoming After Deployment: Tips for Reunion (PDF)

www.ptsd.va.gov/professional/manuals/manual-pdf/iwcg/iraq_clinician_guide_app_j10.pdf

n Coping With Traumatic Stress Reactions 

www.ptsd.va.gov/public/pages/coping-traumatic-stress.asp

n Resilience Training (formerly BATTLEMIND):

https://www.resilience.army.mil

n Leaders Guide for Managing Marines in Distress:

www.usmc-mccs.org/LeadersGuide/Deployments/CombatOpsStress/generalinfo.cfm

n War-Zone-Related Stress Reactions: What Families Need to Know (PDF)

www.ptsd.va.gov/professional/manuals/manual-pdf/iwcg/iraq_clinician_guide_app_j7.pdf

n Mental Health Effects of Serving in Afghanistan and Iraq

www.ptsd.va.gov/public/pages/overview-mental-health-effects.asp

n Managing After-Deployment Concerns

www.afterdeployment.org

This Guide was created by the VA National Center for PTSD 

in June, 2009, and last updated September, 2010.

The Center conducts research and education on trauma and PTSD.

Their website offers extensive information on coping, educational materials, 

and more for a variety of audiences, including veterans and their families, 

providers, researchers, and others.

www.ptsd.va.gov

Closing Thoughts

■ Most returning service members will 

experience common stress reactions during 

and after reintegration.

■ Even if problems persist, your service 

member is not alone. The most recent 

national study of adults found that 46% of 

people in the U.S. have had a mental health 

problem. Military members were included in 

this survey. It is very common and expected 

for service members and families to have 

readjustment challenges. Learning about 

these challenges, as well as the different 

types of combat stress reactions and more 

enduring problems (such as PTSD), is a step 

toward recognizing when help is needed.

■ Your service member — and you — can feel 

better. Mental health providers can treat the 

problems discussed in this publication.

■ It’s a sign of health and maturity to admit 

you and/or your service member have a 

problem and take action.