A Guide for Military Personnel – Page 1

RETURNING FROM

THE WAR ZONE

Produced by the National Center for PTSD

November 2005

A Guide for Military Personnel

ON BEHALF OF A GRATEFUL NATION

WELCOME HOME!

This pamphlet is provided to assist military service members and veterans, like you,

with your return from the war zone. The days and weeks after your return from overseas

duty will be a transition. During this time, service members often describe a range of

emotions from excitement and relief, to stress, tension or concern. All of these emotions 

are a normal part of a healthy transition from a war zone back home. You may also feel

distant, uninterested, or be overly critical and impatient with others. These types of

behaviors and feelings are normal combat stress reactions. This pamphlet, describes

these normal reactions and how normal reactions can become problematic. You will

learn about ways to cope with the return home, and if problems arise, ways to find

assistance.

Healthy adjustment in the days and weeks following homecoming includes taking time

to become reacquainted with family and friends. Talk and listen to family and friends in

order to re-establish trust, intimacy and openness. This guide contains information that

will allow you to better communicate with these important people.

This pamphlet was created to assist active duty and veteran military service members to

positively cope with their adjustment during their transition back to civilian life. Because

many service members will face redeployment back to overseas duty, it is especially 

important to address these transition difficulties during your time home.

This guide also describes war zone experiences and reactions that may cause

difficulties during your homecoming experience. Some service members have real

difficulties and struggle with their transitions back home. This pamphlet helps service

members identify when combat stress reactions become a problem. Information is 

provided about ways to obtain assistance to positively cope with combat stress

reactions.
A Guide for Military Personnel – Page 2

EXPERIENCES IN THE WAR ZONE

During your deployment, you may have taken part in missions and operations that

exposed you and your military unit or company to stressful or life threatening

experiences. You may have been shot at, seen the death or injury of civilian and

enemy combatants, or even witnessed the death or injury of other American personnel

or people you knew. You or members of your unit or company may have been injured

as a result of bombings, blasts, weapons or accidents. And, all of these experiences

and others occurred in a hot, dry desert environment without any of the normal comforts

of home.

Frequent Combat Experiences Reported by Members of the U.S. Army, 2003

Afghanistan Iraq

Being attacked or ambushed 58% 89%

Receiving incoming fire 84% 86%

Being shot at 66% 93%

Seeing dead bodies or remains 39% 95%

Knowing someone seriously injured or killed 43% 86%

WHAT IS A COMBAT STRESS REACTION?

Service members respond to traumatic situations in different ways. Some report feeling

upset or “keyed up”. You may continue to think about events that occurred in combat,

sometimes even acting as if you are back in a combat situation. These “combat stress

reactions” (also called acute stress reactions) can last for days or weeks and are a

normal reaction to combat experiences. Most service members who experience combat

stress reactions will recover. Others, however, continue to struggle with the memories of

their combat experiences and their reactions to it. You may begin to have problems in

your relationships with family or friends, or troubles at work or with finances. Your sleep

may be very disrupted. If you continue to experience these reactions and if it begins to

cause you problems, you should seek help to learn how to cope. If you do not get

treatment early your condition may turn into a prolonged combat stress reaction, also

known as posttraumatic stress disorder or PTSD.

WHAT ARE THE SYMPTOMS OF PTSD?

You may have heard of PTSD, in relation to combat experiences or traumatic

situations, but have questions about what it means exactly. Basically, PTSD is a set of

reactions that can be normal immediately following a traumatic event such as combat,

but when these reactions continue long after the combat or traumatic event has 
A Guide for Military Personnel – Page 3

finished, it can become PTSD. PTSD varies widely in how severe it can be, from mild

and short lasting to severe and chronic. These reactions can cause problems in getting

along with family and friends, functioning on the job or at school, or adjusting to the

transition back to civilian life.

There are three primary types of reactions or “symptoms” that make up PTSD.

Remember, immediately following a traumatic experience, symptoms are commonly 

experienced by most people. If these symptoms persist months after the event, they 

may indicate more serious conditions.

1. RE-EXPERIENCING

Continuing to think about combat or feeling as if you are still in combat

2. AVOIDANCE AND NUMBING OF EMOTION

Not wanting to discuss the traumatic event, feeling detached from others, or feeling shut

down emotionally

3. AROUSAL

Having a hard time relaxing or feeling “on guard,” feeling jumpy, unable to sleep, unable

to concentrate, excessive concerns about security, or getting angry easily

1. RE-EXPERIENCING. After returning from combat, you may continue to think about

things that happened in the war zone. You may have nightmares about events that you

have witnessed or actual combat situations. At times, you may feel as though you are

actually back in the war zone. Some report that upsetting images of the war zone can

flash into their minds making it difficult to think or concentrate. Sometimes, these

images are “triggered” by reminders, such as sights or sounds or smells that remind you

of your combat experience.

2. AVOIDING REMINDERS AND NUMBING OF EMOTIONS. It seems normal to not want to

think about distressing thoughts and to avoid upsetting reminders. However, individuals

with combat stress reactions or PTSD often go to great lengths to prevent memories or

discussions about their past experiences. You may avoid any reminders of the

experience. You may withdraw emotionally or physically from family and friends. You

may even become angry when asked to talk about your feelings or behavior. You may 

use alcohol, drugs, or prescription medications to avoid thinking or feeling.

3. AROUSAL. Besides re-experiencing and avoidance, you may have difficulty letting

your “guard down.” You may have excessive concerns about your safety or the safety 

of a loved one. You may feel jumpy or easily startled. You might find yourself closely

examining people or places to look for signs of danger or attack. Feeling keyed up can

also make it harder to sleep and concentrate and you may become irritable,
A Guide for Military Personnel – Page 4

Although most veterans do not develop

PTSD, a sizeable minority will have PTSD

for some period of their life. Preliminary

findings suggest rates of PTSD will be at

least 18% for Iraq veterans and 11% for

Afghanistan veterans.

PTSD is treatable. Acting early can prevent PTSD from becoming worse and causing

problems in your career and relationships. Read on, to see what types of treatments 

are available.

HOW OFTEN IS PTSD DIAGNOSED IN VETERANS?

Among American Vietnam theater veterans 31% of the men and 27% of the women

have had PTSD in their lifetime. Preliminary findings suggest that PTSD will be present

in at least 18% of those serving in Iraq and 11% of those serving in Afghanistan. PTSD

has been observed in all veteran

populations that have been studied,

including World War II, Korean conflict,

Vietnam, Persian Gulf, Operation

Enduring Freedom and Operation Iraqi

Freedom veterans. It also has been

found in United Nations peacekeeping

forces deployed to other war zones 

around the world. PTSD is not only a problem for veterans, however. It occurs both in

adults and children who have been exposed to extremely stressful situations (such as

assault, rape, disasters or serious accidents), men and women, Western and nonWestern cultural groups, and at all socioeconomic levels. A national study of American

civilians conducted in 2005 estimated that 7% of people have had PTSD in their lifetime.

WHAT CAUSES COMBAT STRESS REACTIONS OR PTSD?

Mental health professionals do not know why some people have PTSD reactions to

traumatic situations and other people don’t, but we do know that it does NOT say 

anything about the strength or character of the person suffering. Again, there is no

relationship between how strong a person is and these symptoms; many people who

are brave or strong end up with PTSD symptoms after experiencing trauma.

PTSD is not a result of something you want or choose. In fact, we know that most

people would not choose to have PTSD. Life factors that are related to PTSD include:

greater exposure to life threatening situations, experiencing traumatic events in the

past, and not having supportive people in your life. Remember, combat stress reactions

are simply reactions that you sometimes experience after life-threatening situations and

are things you can often deal with given help.

OTHER COMMON REACTIONS

DEPRESSION. Depression involves feeling down or sad more days than not, and losing

interest in hobbies or activities that used to be enjoyable or fun. You may feel low in

energy and be overly tired. Depression also involves a feeling of hopelessness or

despair, the feeling that things are never going to get better. Depression may be
A Guide for Military Personnel – Page 5

especially likely when you have had personal losses connected with deployment such

as the death of close friends. Because of this, it is important for you to get help for

depression if you, or others notice that you seem to be feeling down most of the time or

less interested in things you used to enjoy.

SUICIDAL THOUGHTS. War experiences and combat stress reactions, especially personal

loss, can lead a depressed person to think about hurting or killing themselves. Suicide is

a permanent solution to a temporary problem. Thoughts about hurting or killing yourself

indicate that you need assistance now. Contact the National Suicide Prevention Lifeline

www.suicidepreventionlifeline.org for more information or dial 1-800-273-TALK (8255).

In the case of an emergency, call 911.

ANGER OR AGGRESSIVE BEHAVIOR. Anger and irritability, symptoms of combat stress

reactions and PTSD, are often related to loss of control or fear; if you are physically 

tense you tend to be angry as well. A typical example is over-reacting with anger to a

slight provocation. Frustration over the inability to control PTSD symptoms (feeling that

PTSD symptoms "run my life") and thinking about things that happened at the time of

trauma (the unfairness of the situation) can also lead to anger. You may be especially

over-protective of kids, or have angry reactions to normal child behaviors. These

reactions may actually be your own fears about possible dangers the children could be

exposed to. Anger can lead to a slew of problems, such as poor thinking and decisionmaking, ruined relationships, dismissal from jobs, legal and financial problems,

incarceration, and health problems.

Although anger is a natural and healthy emotion, intense feelings of anger and

aggressive behavior can cause marital, relationship, and family problems, job problems,

and loss of friendships. Because angry feelings keep people away, they also stop you

from having positive connections and getting help. During this transition, it may be

important to learn how to cope with anger so that your anger doesn't lead to trouble.

Anger that is expressed in helpful ways is healthy anger. The energy from anger can be

channeled in healthy ways to help us reach goals, work harder, and solve problems in

healthy ways.

If anger or aggressive behavior is related to threatened or actual violence, it is

especially important to seek care from professional counselors (chaplains, behavioral

health, primary care, nursing, family assistance program) to address the anger and

combat stress reactions.

ALCOHOL AND/OR DRUG ABUSE. “Self-medicating” by drinking or abusing drugs is a

common way many cope with upsetting traumatic stress reactions. This is often related

to other readjustment concerns, as you try to deal with the difficult thoughts, feelings,

and memories related to your war zone experiences. You may be using drugs or alcohol

to numb yourself. When you want to avoid the memories or feelings associated with

combat, alcohol or drugs may seem to offer a quick solution, but they actually lead to

more problems. If you notice that you are beginning to lose control of drinking or drug

use, it is important to get appropriate care.
A Guide for Military Personnel – Page 6

SELF-BLAME, GUILT, AND SHAME. Sometimes service members, in trying to make sense

of their war experiences, take too much responsibility for bad things that happened. As 

you try to make meaning of what happened, what you did or did not do, or for surviving

when others didn’t (sometimes referred to as survivor guilt), experiencing guilt and selfblame is common. Military personnel, like you who have been faced with moral

dilemmas or been through difficult combat situations, may even feel as if you have

committed a moral or religious transgression, even if you were following orders.

Cognitive restructuring is a technique that can help you evaluate the accuracy of your

thinking and may help with symptoms of guilt and self-blame.

WAYS THESE REACTIONS MAY INTERFERE WITH YOUR LIFE

EFFECTS ON YOUR FAMILY LIFE

Getting into arguments and fights with family members and other people, often for minor

reasons, can happen because of the angry or aggressive feelings that are common

after a trauma. In addition to having more family conflict, those who return home from a

war zone often feel disconnected or detached from others. Sometimes this has to do

with your not feeling able to tell other family members about what happened, not

wanting to intrude on them by speaking about the realities of the war zone, or just

thinking that no one will be able to understand. Sometimes this is related to your having

difficulty in feeling or expressing positive feelings. Sometimes feelings of wanting to be

alone or needing to avoid family gatherings can make you become isolated from your

family, with a loss of support, understanding, and intimacy.

Because the symptoms of PTSD change how you feel and act, traumatic experiences

that happened to you can affect everyone else in the family. Family members react to

the fact that their loved one has gone through a trauma. At the same time, trauma

symptoms can make you difficult to get along with or cause you to withdraw from the

rest of the family. It can be very hurtful and confusing for everyone in the family when

these changes occur.

Effects of PTSD on the Family

• Vietnam veterans with PTSD are between three and six times more likely to

divorce than Vietnam veterans without PTSD.

• Veterans diagnosed with PTSD, compared to those without PTSD, are more

likely to be violent with partners and children, with rates as high as 63% for some

type of physical violence in the past year.

• Partners of Vietnam veterans with PTSD reported markedly reduced satisfaction

in their lives and greater demoralization compared to partners of Vietnam

veterans not diagnosed with PTSD.
A Guide for Military Personnel – Page 7

Many individuals who return home from a war zone will have difficulty reconnecting or

maintaining close relationships, especially at first. PTSD symptoms can make things

even worse. If you notice problems with your relationships, it can be helpful to find out

ways to improve how you are all communicating. Problems with family relationships or

relationships with other people should not be overlooked. Initial difficulties can turn into

marital separation and divorce, family violence, and caregiver burden. Communication

is essential to working through these problems. You may want to consider talking to a

counselor for support and assistance.

EFFECTS ON WORK FUNCTIONING

Adjusting back to life at work after experiencing a trauma or being in a war zone can be

a very difficult experience. For some people, going back to work is made harder by

changes that have happened on the job during your deployment. Following the

exhilaration of deployment, you may find you lack interest in your job. You might have

had to quit your job before deployment. You might be returning to get your first civilian

job and have difficulty finding a job or a career to get started in. Some of the symptoms 

of PTSD, such as feeling irritable or “on edge” or having a hard time sleeping or relating

to people, make going back to work seem very difficult or even an impossible

undertaking. This may be made worse by your worries that an employer or future

employer might not want to work with somebody who is dealing with symptoms of PTSD

or other combat stress reactions.

EFFECTS ON OTHER FUNCTIONING

There are many other aspects of your life that may be influenced by your experience in

the war. There may be financial issues that may be adding to stress at work or home, or

to the need to find a job. Sleep is often disrupted. Getting a full night of sleep is

important to maintaining a healthy and happy life.

All of these reactions and difficulties are common for people who experience PTSD or

combat related stress reactions. It is important to be able to recognize these difficulties,

and get treatment in order to prevent them from becoming larger problems in your life.

WHAT YOU CAN DO TO HELP YOURSELF

Most combat stress reactions go away over time. Only a minority of military personnel

will have reactions that continue and develop into PTSD. Taking action and getting early 

treatment for your concerns can help prevent your reactions from growing into

problems.

Educate yourself on the normal reactions to traumatic events and the facts about PTSD.

Find ways of improving your relationships and how you communicate, find and practice
A Guide for Military Personnel – Page 8

ways of properly coping or make connections with others who experience similar

problems. There are many services available to help you, even before problems occur.

DON’T ALLOW STIGMA TO GET IN YOUR WAY

A study of soldiers returning from Iraq found that only 40% of service members 

experiencing war related stress reactions said they were interested in receiving help. In

many cases this was due to concerns about what others would think, and how it would

influence their military career.

Seeking assistance for these ‘invisible injuries of war’ is a sign of strength. 19,000

Afghan/Iraqi War Veterans have already sought help from the VA Readjustment

Counseling Services (Al Batres, BBC News). Veterans who have had counseling report

that getting help early was key in feeling good again. Getting help allowed things to get

back to normal in their careers and on the home front.

We understand your concerns about seeking help, but encourage you to find the

strength to do so. Do not allow career concerns or fear of stigma to prevent you from

taking action to help you and those who care about you. There are VA Medical Clinics,

Vet Centers, and many other avenues to assist you with recovering and finding

solutions to problems.

TREATMENT FOR PTSD

The good news is that there are effective treatments for PTSD and the other problems

mentioned above. Treatment for PTSD is really very practical and involves common

sense steps. You have regular conversations with a trained counselor, in order to think 

about your situation and how you want to change it. You learn more about what PTSD

is and how it’s affecting you. You work with counselors and other veterans to get

support while you make gradual changes that are important to you. Sometimes,

medications may also be beneficial.

Many veterans receive treatment for PTSD in Veterans Affairs (VA) PTSD treatment

programs and Readjustment Counseling Service Vet Centers. Others get help in

general mental health clinics within VA. In the usual type of outpatient treatment you

would come into a clinic for individual appointments and perhaps group sessions.

For the most severe cases of PTSD, residential treatment, where the veteran lives in

the treatment program for several weeks, is often recommended.

Wherever you seek help, treatment usually focuses on the following activities:

• Being assessed. Treatment typically begins with a detailed assessment of

problems you’re facing, symptoms you have, and other difficulties in your life.
A Guide for Military Personnel – Page 9

• Setting goals. You and your counselor decide what you want to accomplish to

improve your life and what changes will help you achieve those things.

• Learning about PTSD. Through discussions with your counselor and classes

with other veterans, you’ll learn what PTSD is and how it affects you and your

loved ones.

• Learning coping skills or “tools.” There are a lot of skills that can help you in

recovery, including skills for lowering physical tension, skills for communicating

more effectively with family and friends, and skills for handling anger and conflict

with others.

• Connecting with other veterans. VA PTSD treatment often involves having more

contact with other vets like yourself. As part of treatment, you talk with other

service members and veterans, learn from their experiences, and give support to

them - Veterans helping veterans.

• Participating in support groups. Veterans in PTSD treatment often meet regularly 

with other vets, to discuss how they’re doing, get feedback and support, develop

friendships, and help each other.

• Looking at yourself. Treatment often involves learning to notice what you are

thinking and feeling, how you act with other people, and what situations or

thoughts trigger your distressing emotions.

In addition to these very common parts of treatment, you and your counselor may

decide to include some other activities:

• Taking medications. Treatment also usually involves consulting with a doctor

about possible medication. Sometimes, medications can reduce the anxiety,

depression, irritability, or insomnia often associated with PTSD. They can also

make it easier for you to participate in other counseling activities.

• Telling your story. Talking about what happened to you and how you feel about it

can be painful. But talking about your traumatic experiences can be very helpful

to recovery if you are able to talk to someone you learn to trust and take a fresh

look at your experiences and your opinions about them. Often, this kind of

therapeutic talking takes place over many discussions, and gradually, you may 

find that your memories become more controllable, and maybe a bit less painful

or frightening.

Treatment may last a few weeks or months or for several years. Usually, contact with a

counselor is more frequent at first, and gradually becomes less regular as you learn

different strategies of how to deal with your thoughts, feelings, memories, and

relationships. You can re-contact your treatment program and go in more regularly if

you have a setback or if your problems begin to get to be too much again.
A Guide for Military Personnel – Page 10

COMMON THERAPIES USED TO TREAT PTSD

COGNITIVE-BEHAVIORAL THERAPY (CBT) has been shown to be the most effective

treatment for PTSD. CBT involves working with your cognitions, or thoughts, to change

your emotions, thoughts, and behaviors. There are several types of CBT:

• Exposure therapy uses careful, repeated, detailed imagining of your trauma

(exposure) in a safe, controlled environment, to help you face and gain control of

the fear and distress that was overwhelming in the trauma.

• Cognitive Restructuring is an approach in which you identify and examine

upsetting thoughts about your trauma, challenge those thoughts, and replace

them with more balance and accurate ones.

• Stress Inoculation Training reduces symptoms through anxiety reduction

techniques, teaching you coping skills, and correcting your inaccurate thoughts

related to the trauma.

If your help is necessary or helpful in any counseling activity, willing family members

need to offer to participate

MEDICATION can reduce PTSD symptoms as well as the anxiety, depression, and

insomnia you often experience with PTSD. Several kinds of medication have been

tested and shown to cause improvement in symptoms, and some others have shown

promise. Medication can help relieve distressing symptoms and make it possible for

you to participate in other types of talk therapy that have been shown to be effective.

TALKING TO YOUR DOCTOR ABOUT PTSD

You may find it helpful to talk with your primary care physician about any symptoms you

have --- even if he or she does not ask you about them. PTSD is related to physical

health problems. You can help your doctor understand you better and plan your

treatment by sharing this crucial information about yourself. Keep in mind that your

primary care doctor will not be an expert on the emotional or psychological after-effects

of war trauma, but still may be helpful in other ways.

At first, it may seem hard to discuss your experience(s), although it will become much

easier with time and practice. Because it may be difficult for you to discuss what

happened to you, and the symptoms that you suffer, here is a quick checklist that you

can complete and show to your doctor. It may help you to begin to talk about the

symptoms you are experiencing.
A Guide for Military Personnel – Page 11

Quick Checklist of Trauma Symptoms

Check those symptoms below that you experience (that may or may not be related to a traumatic event) and make some

notes as needed:

I experienced or witnessed a traumatic event during which I felt extreme fear, helplessness, or horror.

The event happened in (day/month/year)__________________________.

What happened?__________________________.

1) I have the following symptoms of “re-experiencing” or "reliving" the traumatic event:

 Having upsetting and intrusive thoughts about the event

 Having bad dreams or nightmares about the event or something similar

 Behaving or feeling as if the event were actually happening all over again ("flashbacks")

 Having a lot of emotional feelings when I am reminded of the event

 Having a lot of physical sensations when I am reminded of the event (e.g. heart races, pounds, or "misses a

beat"; sweating, hard to breathe, feel faint, feel like I’m "going to lose control")

2) I have the following symptoms of avoiding reminders of the traumatic event:

 Avoiding thoughts, conversations, or feelings that remind me about the event

 Avoiding people, places, or activities that remind me of the event

 Having difficulty remembering some important part(s) of the event

3) I have noticed that since the event happened:

 I have lost interest in, or just don’t do things that used to be important to me

 I feel "detached" from people or I find it hard to trust people

 I feel emotionally "numb" or I find it hard to have loving feelings even toward those who are emotionally close to

me

 I have a hard time falling or staying asleep

 I am irritable and have problems with my anger

 I have a hard time concentrating

 I think I may not live very long - so why plan for the future?

 I am "jumpy" and get startled easily

 I am always "on guard"

If medication treatment is being discussed, you might like to ask some of these questions:

• ”How is this medication supposed to help me?”

• “How will it affect my symptoms?”

• “How long will I have to take it?”

• “Can I stop it if I don’t like it?”

• “How will we know if it is working or not?”

• “What will happen if it doesn’t work?”

• “What are the side effects of the medication?”

• “How will it affect my other medications that I’m taking?”

• “Why do I need to go for counseling if I’m receiving medication treatment?”

• “How will medication treatment fit in with my PTSD counseling?”

• “How will medication affect my substance abuse recovery?”
A Guide for Military Personnel – Page 12

WHERE TO GO FOR HELP

VA SERVICES

Once you have departed from your military service, you are eligible to receive cost-free

health care and readjustment services through the Department of Veterans Affairs for

any conditions related to your combat service for two years following active duty. After

two years, services are still available for a co-pay based on income. If you serve in the

National Guard or Reserves and were deployed to a war zone, you are eligible for the

same benefits. It can be important to access these services early if you think you may

have PTSD. You must enroll to be eligible for these services so do it today. Fill out an

application online at: www1.va.gov/health_benefits/

VA HEALTH CENTERS. VA health care centers are located across the country, and range

from small, local clinics (CBOCs) to large hospitals. At these facilities, you can receive

help for any health problem, both physical and mental health. Many VA facilities have

experts in PTSD and related problems who you can talk with.

VET CENTERS. Vet Centers are another great resource for getting help after returning

home. Vet Centers are located throughout the country and are primarily focused on

helping veterans readjust to life after deployment. They offer readjustment and mental

health counseling, and provide veterans and their families with resources for the

experiences associated with post-deployment.

To access care at a VA or Vet Center, you will need to establish your status as a

combat veteran by showing the Enrollment Coordinator at your local facility one of the

following pieces of evidence when you apply for care, or any time.

• Your DD 214 indicating service in a designated combat theater of operations; or

• Proof of receipt of the Afghanistan Campaign Medal; Iraq Campaign Medal;

Armed Forces Expeditionary Medal; Kosovo Campaign Medal; Global War on

Terrorism Expeditionary Medal (does not include Global War on Terrorism

Service Medal); or Southwest Asia Campaign Medal; or

• Proof of receipt of Hostile Fire or Imminent Danger Pay (commonly referred to as

“combat pay”) after November 11, 1998; or

• Proof of exemption of Federal tax status for Hostile Fire or Imminent Danger Pay 

after November 11, 1998.

For more information about veterans benefits, or to locate the VA nearest you, call 1-

877-VETS or go to www.vba.va.gov/EFIF. For Vet Center information, call 1-800-827-

1000 or go to www.va.gov/rcs.

VETERAN SERVICE ORGANIZATIONS (VSOS)

Another great resource for individuals returning from a war zone are Veteran Service

Organizations (VSO). These organizations specialize in providing resources and
A Guide for Military Personnel – Page 13

assistance to military servicemen and women following deployment, and help bring

individuals with similar experiences together. These groups are large organizations,

such as the American Legion and Veterans of Foreign Wars, and smaller VSOs that

may be organized by branch of service, religion, ethnicity, war zone theater, purpose, or

many other categories. To find out more information or become involved with one of

these organizations, check out www.va.gov/vso.

IN CLOSING

We hope you have found this pamphlet informative. Learning what to expect upon

returning from a war zone, and about combat stress reactions and PTSD is an important

first step to being able to recognize when to get extra help. We want to emphasize that

most combat related reactions are not permanent. In many cases, they will go away

over time on their own. When they do continue, effective treatments are available. In

most cases cognitive behavioral therapy (with or without medication) can either

eliminate or at least improve stress reactions, alleviate functional problems, and help

stop family disruption.

Many returnees hesitate to receive mental health treatment for fear that it will hurt their

image or even ruin their military careers. But remember, combat stress reactions are

like any other physical injury from war. There is a range of how severe these invisible

injuries are, just like there is a range of how severe physical injuries are. With early 

proper treatment, you may avoid problems that impact your relationships and career. If

problems do persist, treatment may help you continue with or return to your military

career or job and lead a happy, well-adjusted life.

For more information about stress-related disorders see our Web site

www.ncptsd.va.gov