Veterans

Information for Returning Veterans and Their Loved Ones

For veterans returning home, this may be a period of mixed emotions . While potentially being a time of relief and reunion with loved ones, it is also a time of adjustment, and may bring about associated difficulties. This is normal, and the suggestions and information below may help with the adjustment period. However, we at the Counseling Center would also like NDSU students to know that if you are a veteran who has returned home and find that with time you continue to experience difficulty adjusting, overwhelming stress, or emotions that feel too heavy to cope with, our counselors are available to lend additional support through the adjustment, recovery and healing process. We welcome you to contact the Counseling Center for an appointment should this turn out to be the case.

Resilience in a Time of War

Reprinted from the American Psychological Association's Help Center, www.apahelpcenter.org

Homecoming Can Be Stressful
Reunion with family often is idealized as a quick, smooth return to "normalcy." The reality may fall short of that ideal.

Those returning from military service are often hit right away with a laundry list of problems, including bills, family disputes, and expectations that family interactions and intimacy will spring back to pre-war levels.

Stress and anxiety can be the result of culture shock, with the quick flight from the foxhole to the front porch and no time to decompress en route. It may take some service members and family members time to readjust -- and the failure to effectively manage during this period can create a great deal of stress, anxiety, frustration, and anger.

Returning to work creates other tensions for National Guard members and reservists. Employers of those who had been deployed may tend to underestimate how long it will take someone who's been away to shift gears. Some employers may feel that they kept jobs open to do their part for America--now they want to get back to business as usual. Fellow workers may want to talk about the war when the returning employee wants to forget. Or conversely, fellow workers may not provide an opening for a service member who needs to talk.

Stress Will Be More Difficult For Some
How much stress returning military personnel experience may be affected in part by:

The extent to which their duty was dangerous (even if they were only awaiting this danger)
Death or serious injury in their military unit
Possibility of exposure to chemical warfare or other weapons of mass destruction
Length of time they spent overseas
Exposure to dead and wounded (including enemy combatants and civilians)
Past trauma that can be heightened by the stress of war
Degree to which family dynamics have changed during their absence, such as a child's or spouse's increased dependency or independence

Families have been stressed, too. The families of deployed personnel have had their own set of problems during the conflict, such as:

Fear for the deployed family member's safety
Disruption of established patterns and routines
Decreased income and financial worry
Negative reactions from children to sudden changes in the family environment
Need to develop new resilience skills, renew family relationships, make new friends, and join support groups
Being overburdened by new roles and responsibilities

Many families will continue to have pressures during the homecoming period, including:

Being second-guessed for decisions made during a member's absence during war
Having conflict over new relationships-- such as a new baby and new friends
Experiencing shifts in decision making
The fact that family dynamics can never return to what they were before deployment

There Are Many Roads To Resilience
The number and intensity of stressful experiences notwithstanding, most returning personnel and their families should be able to bounce back successfully.

Even those who have learned resilience skills, however, should not expect homecoming to be effortless or free of emotion. It is quite normal to experience days or several weeks of mild to moderate symptoms of depression, anxiety, and anger, even if the initial homecoming was full of joy.

Children, for example, reassured with the safe return of a parent or sibling, may now feel they can express some of their negative feelings of fear or anger over what they may have experienced as abandonment.

Normal Is What Works for You

There are no standard or normal stages for homecoming. The process varies from person to person. Understanding that homecoming has its own brand of stress is a first step in the process of a long-term successful reentry for military personnel, their families, and the community.

10 Tips for Resilience During Homecoming

Early in the process, identify people who can help--a friend, clergy, mental health professional, financial advisor--and seek help if needed. Some of these sources can supply emotional support, while others can provide direct help with day-to-day problem solving. Resolve to be open about problems and work on resolving them together, either with family members or those professionals who can help.
Dismantle big problems into manageable small parts. Then, attack and solve these parts as a means of rebuilding confidence. A step-by-step approach can eventually resolve the larger problem.
Be an active player, not a passive victim. Social involvement through religious organizations, hobby groups, exercise clubs, social groups, etc., helps individuals rejoin the community.
Don't put off solving problems. Begin to work on problems immediately; inaction can reinforce the feeling that a problem is out of your control.
Don't seek solace in drugs or alcohol. This not only fails to resolve the problems at hand, but creates new ones.
Recognize that family readjustment problems are normal. Don't blame others for your distress, and don't blame yourself excessively.
Keep things in perspective. Cynicism or excessive pessimism about life and the future can become self-fulfilling and have a negative impact on you and others. Keep things in perspective-- not every problem is a catastrophe. Although it sounds simplistic, a positive outlook helps raise morale and increase resilience.
Recall how you met past challenges and use the same strategies to meet the stresses of homecoming. By facing current problems with an eye to solutions, you are more likely to achieve a sense of progress, of "getting ahead" with life.
Realize that the stress of homecoming can magnify other daily stresses, so make allowances for yourself and your family.
Accept as inevitable some setbacks in the return to "life as normal"--whether they are emotional, financial, physical, or job-related. At the same time, be aware that the skills of resilience can help you bounce back.

Warning Symptoms Checklists
It is important to recognize the symptoms of stress that has not been effectively managed. Following is a checklist of warning symptoms for those who have come home.

Guilt about actions or shame over some failure
Excessive drinking or drug use
Uncontrolled or frequent crying and other extreme reactions to events that normally would be handled more calmly
Sleep problems (too little, too much)
Depression, anxiety, or anger
Too much dependence on others
Verbal or physical family violence
Stress-related physical illness (headache, backache, gastrointestinal problems, poor stamina)
Inability to escape from horror scenes remembered from the war
Difficulty concentrating
Suicidal thoughts or plans

Families, too, may exhibit symptoms of stress that has not been dealt with effectively. Following is a checklist of warning symptoms for families.

Inability to resolve family conflict
Isolation of members from one another
Overdependency and clinging of members
Use of one or two family members (often children) as scapegoats
Disciplinary or academic problems of children

Asking For Help
If you (or a family member) continue to feel stress, anxiety, or frustration or experience any of the negative signs of coping discussed here, asking for help can be one of the quickest ways to recover a sense of control and balance. For many people, using the skills of resilience will help with the homecoming. But for families and individuals who are unable to perform the functions of daily life because of stress or trauma, seeking the help of a licensed mental health professional, such as a psychologist.

Mind/Body Health: The Effects of Traumatic Stress
Reprinted from the American Psychological Association's Help Center, www.apahelpcenter.org. APA is grateful to Paul J. Rosch, M.D.. President, The American Institute of Stress, for his help in developing this fact sheet

What Is A Traumatic Stress Reaction?
People who experience or witness horrible events such as school shootings, combat, rape, torture, natural disasters, accidents or other things in which their physical safety and life -- or the safety and life of others -- was in danger have experienced a traumatic stress. People who are repeatedly exposed to life or death situations, such as EMT and rescue squad workers, police officers, fire fighters and medical personnel on burn wards or trauma units where stress levels and mortality rates are high also witness trauma. Anyone who has experienced these things has experienced a shock and, even if all ultimately escape danger, the people who lived through the event may feel like life “just isn’t the same anymore.” People may experience a variety of reactions, many of which are understandable in the context of experiencing or witnessing traumatic events such as the hurricanes. Experiencing physical or emotional symptoms in response to a traumatic event is normal and is called a traumatic stress reaction.

Physical Symptoms of Traumatic Stress
Anyone affected by the hurricanes or other traumatic stress may experience:

Fatigue
Being easily startled
Headaches
Sweating
Gastro-intestinal problems

Emotional Symptoms of Traumatic Stress
Those affected by traumatic stress may feel:

Fear
Anger
Guilt
Anxiety
Reduced awareness
Feeling like you are numb or not part of the world
Helplessness
Hopelessness

What is PTSD?
PTSD stands for Post Traumatic Stress Disorder. This is similar to a stress reaction and, in fact, many people who have experienced a traumatic event do develop PTSD. Those with PTSD may experience many of the same emotional and physical symptoms as those with a traumatic stress reaction. Those with PTSD, however, experience trauma along with intense fear, helplessness or horror and then develop intrusive symptoms (such as flashbacks or nightmares). Their symptoms will last more than a month and get in the way of normal life.

Traumatic stress is not uncommon. In fact:

About 70 % of U.S. adults have experienced a severe traumatic event at least once in their life and one out of five go on to develop symptoms of PTSD.
Approximately 8% of all adults have suffered from PTSD at any one time.
If you include children and teens, an estimated 5% of all Americans will develop PTSD during their lifetime or more than 13 million people.
About one in 10 women will develop PTSD symptoms during their lifetime or double the rate for men because they are much more likely to be victims of domestic violence, rape or abuse.
Almost 17% of men and 13% of women have experienced more than three traumatic events during their life.

The Mind/Body Connection
Suffering traumatic stress can affect your emotions as well as your body and the two are so connected that it can be hard to tell the difference. For instance, traumatic stress can cause you to lose concentration, forget things, or have trouble sleeping. It may be difficult to determine on your own whether these symptoms are because you do not feel well physically or because you are still upset. Traumatic stress also can lead you to eat in unhealthy ways or to eat foods that are not healthy, and those eating patterns can affect how you sleep or how your stomach feels. Stress can cause headaches, but the pain from the headaches can also make your stress worsen.

Because the body and the mind work in concert, traumatic stress can cause a cycle that makes it seem like the body and mind are working against one another, worsening symptoms like pain and fatigue.

Coping With Traumatic Stress
There are things you can do to help yourself if you have suffered traumatic stress as a result of an event such as a school shooting.

Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.
Ask for support from people who care about you and who will listen and empathize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma.
Communicate your experience in whatever ways feel comfortable to you - such as by talking with family or close friends, or keeping a diary.
Find out about local support groups that often are available such as for those who have suffered from natural disasters. These can be especially helpful for people with limited personal support systems.
Try to find groups led by appropriately trained and experienced professionals such as psychologists. Group discussion can help people realize that other individuals in the same circumstances often have similar reactions and emotions.
Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs.
Establish or reestablish routines such as eating meals at regular times and following an exercise program. This can be especially important when the normal routines of daily life are disrupted. Even if you are in a shelter and unable to return home, establish routines that can bring comfort. Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.
Help those you can. Helping others, even during your own time of distress, can give you a sense of control and can make you feel better about yourself.
Avoid major life decisions such as switching careers or jobs if possible because these activities tend to be highly stressful.

When Should I Seek Professional Help?
Many people are able to cope effectively with the emotional and physical demands brought about by a natural disaster by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers help educate people about common responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.

With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance. A qualified mental health professional such as a psychologist can help such children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.