Warzone stress leaves its impact on everyone in the family. We are seeing that not only are the troops affected by this stress, but also their families. Mansfield et al. (2010) conducted a study using 250,000 mental health records of spouses of deployed soldiers and compared them to spouses whose soldiers had not been deployed. They found significant increases in depression, anxiety, sleep, adjustment issues and acute stress and a significant increase in mental health services when the soldier had been deployed more than eleven months.
With this type of data I want to know, "Who are they coming home to?" Is there a strong and firm foundation with which they feel comfortable, safe and secure, or do their family members have unresolved issues that will no doubt compound the stress fractures that already exist? Loved ones also need to establish social support systems and get professional help so they are better prepared to take on the challenges associated with their returning warrior. It is not only important for themselves, but also for their children and, of course, for the returning service member.
The objectives are to gain a better understanding of what to expect, to be able to build empathy and compassion. Our warriors are becoming war weary and their family life is affected as well. I have been told many times that it is, "easier being the warzone than it is to come home." The civilian responsibilities overwhelm them and turn them away from those who may offer support.
The cycle begins with feeling alone, as if they no longer fit in. It is hard for them to relate to their peers or love their families out of fear of losing them. Many are eventually diagnosed with the "invisible wounds of war" such as PTSD, depression, and traumatic brain injuries or with more visible physical wounds. These adjustments are difficult at best and pervasive, and create changes in mind, body and spirit. Our warriors see life from a different set of lenses. What may be important to a loved one just doesn't seem so in their eyes.
Many of our warriors never thought they would live long enough to make it back home and find doing so overwhelming. Some just wait for the other shoe to drop and have hard time seeing a future. It is difficult for them to have relationships and they can't get close to people. This goes back to the buddies they lost down range. They are often haunted with survivor guilt and a sense of betrayal, and are not readily willing to share these feelings with others until trust is formed.
A quote I find poignant is by David O. Mackay,
"The most difficult of life's battles are the ones we fight in the silent chambers of our soul."
Their soul is where our warriors go and they may feel they cannot seem to move forward, despite their incredible drive to live in the warzone. Warriors are hard driving, well trained and self-reliant. But in the battles they fight in "the silent chambers of their soul" they may feel defeated, demoralized, hopeless and alone, all the while enduring this with a great deal of shame and the fear of being found out.
When we look at the staggering rate of increasing suicides among our active duty military and veterans there are many contributing factors that are unique to each person. I also see common issues of failed relationships, legal and financial issues in addition to the high stress of wartime operations in Iraq and Afghanistan, which may lead to self-medication. The older veterans are also being triggered by seeing the young troops going to war and coming home with wounds and heavy hearts from their wartime experiences. This reminds them of days gone by when they were young warriors as well.
The stigma within the military of getting help is a contributing factor to avoiding treatment. Even though the military has made good strides in urging our troops to seek assistance, there is still trepidation on the part of the troops for fear being labeled as incapable, being passed up for promotion, seen as weak by their peers, losing their security clearance, etc. To reduce these stigmas we must talk about how stress affects our military personnel and normalize these reactions. Educating the military, community, educators, employers, law enforcement, and loved ones is the first step in changing how our military service members view themselves.
A great deal of relief and a sense of hope comes from not feeling alone. In my new book: Through the Woods and Over the Hill -- The Aging of America's Warriors, I encourage them to avoid carrying the burdens of life alone. It is vital that they share their story, this is a rite of passage. These stories are sacred territory and it is a great privilege for those of us who are entrusted with these experiences.
If you are overwhelmed and don't know which way to turn, reach out to a close friend, your clergy or another veteran and they can help you navigate the system.
Hotlines are an anonymous way to reach out and find someone to support you. These options are increasing in popularity. If you are feeling vulnerable and uncertain of what you might do, do not leave this to chance, reach out by calling 1-800-273-TALK (1-800-273-8255) (en Español 1-888-628-9454) 24 hours a day to speak with someone who can help.
Mansfield AJ, Kaufman JS, Marshall SW, Gaynes BN, Morrissey JP, Engel CC. Deployment and the use of mental health services among U.S. Army wives. N Engl J Med 2010;362:101-109
This post is part of a special Huffington Post series, "Invisible Casualties," in which we shine a spotlight on suicide-prevention efforts within the military. Every weekday in September, we'll feature a different blog post by someone who is either an expert in the field, who has been affected by a suicide, or who has contemplated suicide. To see all the posts in the series, as well as original reporting, audio and video, click here.
If you or someone you know would like to contribute to our series, send an email to firstname.lastname@example.org.
And please, if you or someone you know needs help, call the national crisis line for the military and veterans, 1-800-273-8255, or send a text to 838255.
Follow Dr. Bridget Cantrell on Twitter: www.twitter.com/DrBridget