With the recent announcement that the U.S. will withdraw all its forces from Afghanistan by September 11th of this year, we thought it was a good time to look at the issues that veterans may face adjusting to life post-deployment. Over 2.2 million troops - men and women - have served in the conflicts in Iraq and Afghanistan since 2003. While many service members readjust to life after being deployed, many do not.

An Assessment of Readjustment Needs of Veterans, Service Members and Families by the Institute of Medicine of the National Academies found that many service members returning from the conflicts in Iraq and Afghanistan “report that their experiences were rewarding, and they readjust to life off the battlefield with few difficulties. Up to 44%, however, return with complex health conditions and find that readjusting to life at home, reconnecting with family, finding work, or returning to school is an ongoing struggle...These military personnel often have more than one health condition. The most common overlapping disorders are PTSD, substance use disorders, depression, and symptoms attributed to mild TBI.

Common Challenges Facing Soldiers Readjusting To Life At Home

Soldiers face unique challenges when they separate from military service and return to civilian life. Even the most resilient find adjustment somewhat stressful; unfortunately these challenges are also associated with mental health disorders like PTSD, depression and anxiety.

Post-Deployment Adjustment Challenges Include:

• Relating to civilians who do not know or understand what they’ve experienced in the field.

• Families may have created new routines during deployment. 

• A returning vet may have never applied or interviewed for a civilian job, and needs to figure out how to translate their military skills into civilian terminology for a resume.

• Or if returning to a job, they may need to catch up, learn new skills, or adjust to a new position.

• No clear chain of command or hierarchy outside the military; they don’t know where to go for help.

• Learning how to buy clothing, groceries and other seemingly mundane civilian needs, and having to negotiate the overwhelming choices of civilian shopping outside the PX.

• Adjusting to subtle nuances in social conversations and workplace lingo that are unfamiliar.

These are just a few of the logistical adjustments that returning soldiers must make, never mind the emotional adjustments they face, such as losing an immediate support group of fellow troops, recovering from the loss of friends who died overseas, feeling isolated and alone among people who don’t understand what they experienced, feeling challenged by a new civilian job, having to renegotiate family relationships, and dealing with good and bad memories of deployment. And this commonly (and understandably) leads to problems with mental health.

Mental Health Issues Among Returning Veterans

They call them “war’s invisible wounds.” While physical wounds are easy to identify, the psychological wounds of war are often not as easy to spot. Multiple studies have found a link between combat experiences and mental health issues related to military service. And it's not just soldiers who suffer - one study found that lengths of deployments are associated with more emotional difficulties and mental health problems among military children and spouses too. Below are three of the most common mental health issues associated with returning soldiers.

Post-Traumatic Stress Disorder (PTSD)

Traumatic war-time events such as military combat and violent accidents or deaths in the field involving themselves or unit members can have long-lasting negative effects such as trouble sleeping, anger, nightmares, feeling constantly jumpy, and alcohol and drug abuse. Many vets find that these symptoms are in fact Post-Traumatic Stress Disorder (PTSD). A JAMA Psychiatry study found the rate of PTSD to be 15 times higher in returning veterans than in civilians.

Depression & Anxiety

Overall, the rate of depression in returning vets is 5 times higher than for civilians.However, research has found that depression is currently one of the most prominent health conditions among female veterans, who experience higher rates of depression than their male counterparts. Women who have been exposed to combat during deployment or witnessed the injury of unit members and civilians in war zones are especially vulnerable to depression and anxiety — all of which makes readjustment that much harder. Over half of all female veterans have needed to access mental health treatment with a primary diagnosis of depression and/or anxiety disorder.

Suicide

Suicide is a particular concern that has emerged for veterans, who experience a 50% higher incidence than the general population. And like depression and anxiety, female veterans have an 80% higher incidence of suicide than male veterans. A recent study of active-duty soldiers and veterans found that 3% of men and 5.2% of women reported suicidal ideation in the previous year. And of those who reported suicidal ideation, 8.7% also reported a recent suicide attempt. This is a trend that must be stopped.

Tips For Acclimating Upon Return 

These are just a few tips to help with the transition from deployment to civilian life:

• Allow yourself to feel all kinds of emotions. Give yourself permission to feel the way you feel, even if it’s uncomfortable. Go easy on yourself and give readjustment time to unfold.

• Talk about how you’re feeling with family and friends. Your loved ones may not know how to ask about your experience, but talking about your feelings can be an important part of the readjustment process. 

• Try not to overbook yourself. You may have lots of things on the post-deployment to-do list, but give yourself time to ease back into your routine. And give yourself a break if it doesn’t all feel comfortable right away.

• Limit your use of alcohol. Drinking too much can confuse your thinking, cloud judgment, and exacerbate mental health disorders.

• Watch spending. It's very common to want to celebrate your return with a new car or electronics, but those bills can catch up quickly and cause extra stress at a time you don’t need it.

Most importantly, know when to seek help. If you or a loved one are feeling signs of stress — either physical or emotional — seek expert help from a behavioral health specialist as soon as possible. (And if you or a loved one are suicidal, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1). 

Consider Telebehavioral Health

Telemynd supports veterans and their families. Through our national partnership with TRICARE, we’re able to offer you and your beneficiaries access to licensed therapists or psychiatrists from the convenience and privacy of your own home. Request an appointment online or call our live support for assistance in scheduling care today!

Sources
Institute of Medicine of the National Academies
U.S. Department of Veterans Affairs
American Psychological Association