War-Zone-Related Stress Reactions: What Families Need to Know

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7th May, 2007

Learn about what you need to know and ways you can help your loved one coming home from the war zone.

Military personnel in war zones frequently have serious reactions to their traumatic war experiences. Sometimes the reactions continue after they return home. Ongoing reactions to war-zone fear, horror, or helplessness are connected to posttraumatic stress and can include:

  • Nightmares or difficulty sleeping
  • Unwanted distressing memories or thoughts
  • Anxiety and panic
  • Irritability and anger
  • Emotional numbing or loss of interest in activities or people
  • Problem alcohol or drug use to cope with stress reactions
  • How traumatic stress reactions can affect families

Family members are often impacted by these common stress reactions. Ways that family members are influenced can include:

  • Stress reactions may interfere with a service member's ability to trust and be emotionally close to others. As a result, families may feel emotionally cut off from the service member.
  • A returning war veteran may feel irritable and have difficulty communicating, which may make it hard to get along with him or her.
  • A returning veteran may experience a loss of interest in family social activities.
  • Veterans with PTSD may lose interest in sex and feel distant from their spouses.
  • Traumatized war veterans often feel that something terrible may happen "out of the blue" and can become preoccupied with trying to keep themselves and family members safe.
  • Just as war veterans are often afraid to address what happened to them, family members are frequently fearful of examining the traumatic events as well. Family members may want to avoid talking about the trauma or related problems. They may avoid talking because they want to spare the survivor further pain or because they are afraid of his or her reaction.
  • Family members may feel hurt, alienated, or discouraged because the veteran has not been able to overcome the effects of the trauma. Family members may become angry or feel distant from the veteran.

The important role of families in recovery

The primary source of support for the returning soldier is likely to be his or her family. Families can help the veteran not withdraw from others. Families can provide companionship and a sense of belonging, which can help counter the veteran's feeling of separateness because of his or her experiences. Families can provide practical and emotional support for coping with life stressors.

If the veteran agrees, it is important for family members to participate in treatment. It is also important to talk about how the posttrauma stress is affecting the family and what the family can do about it. Adult family members should also let their loved ones know that they are willing to listen if the service member would like to talk about war experiences. Family members should talk with treatment providers about how they can help in the recovery effort.

What happens in treatment for PTSD

Treatment for PTSD focuses on helping the trauma survivor reduce fear and anxiety, gain control over traumatic stress reactions, make sense of war experiences, and function better at work and in the family. A standard course of treatment usually includes:

  • Assessment and development of an individual treatment plan
  • Education of veterans and their families about posttraumatic stress and its effects
  • Training in relaxation methods, to help reduce physical arousal/tension
  • Practical instruction in skills for coping with anger, stress, and ongoing problems
  • Detailed discussion of feelings of anger or guilt, which are very common among survivors of war trauma
  • Detailed discussions to help change distressing beliefs about self and others (e.g., self-blame)
  • If appropriate, careful, repeated discussions of the trauma (exposure therapy) to help the service member reduce the fear associated with trauma memories
  • Medication to reduce anxiety, depression, or insomnia
  • Group support from other veterans often felt to be the most valuable treatment experience

Mental health professionals in VA medical centers, community clinics, and Readjustment Counseling Service Vet Centers have a long tradition of working with family members of veterans with PTSD. Couples counseling and educational classes for families may be available. Family members can encourage the survivor to seek education and counseling but should not try to force their loved one to get help. Family members should consider getting help for themselves, whether or not their loved one is getting treatment.

Self-care suggestions for families

  • Become educated about PTSD.
  • Take time to listen to all family members and show them that you care.
  • Spend time with other people. Coping is easier with support from others, including extended family, friends, church groups, or other community groups.
  • Join or develop a support group.
  • Take care of yourself. Family members frequently devote themselves totally to those they care for and, in the process, neglect their own needs. Pay attention to yourself. Watch your diet and exercise, and get plenty of rest. Take time to do things that feel good to you.
  • Try to maintain family routines, such as dinner together, church, or sports outings.
  • If needed, get professional help as early as possible, and get back in touch with treatment providers if things worsen after treatment has ended.
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