Heightened Risks Perpetuated During Deployment

Among high-risk families for PTSD, military families endure especially challenging stressors due to extended deployments that often last for a year or more. During these periods, families must naturally adapt to the absence of the deploying service member spouse with new roles, rules and hierarchies. These adaptations may manifest into new parental styles of discipline as the children age, and life circumstances may also influence how the remaining spouse will manage finances and organize other family activities. Meanwhile, if the service member spouse is deploying for combat operations, they will likely be exposed to multiple traumatic events including near-death experiences, perhaps witnessing the death of close friends, and often observing human atrocities that they would simply prefer to forget.

An Altered Home Life is Inevitable. The Soldier’s Reaction, Understandable

When the service member spouse returns home, reintegration is inevitably met with some tension based on how the roles, rules and hierarchies have changed. Hierarchies, in particular, may subvert prior leadership roles the service member spouse had held—and, since leadership is such an intrinsic facet to the identity of military personnel, the returning service member spouse may perceive the role-shifts as disrespectful and likely internalize his/her role as being dispensable.

If PTSD is another factor influencing this reintegration, then the family problems can deteriorate quickly. Relational conflicts elevate anxiety within the family and exacerbate the psychological health of the returning service member spouse. It is reasonable to assume that some measure of post-traumatic stress will be present when the service member returns. Some studies indicate that nearly 20 percent of returning service members will suffer from a clinical diagnosis of PTSD, and another 40 percent will report “stress-related symptoms” that impair their adjustment to returning home and “significantly compromise reintegration into a full, productive life” (Jonas, O’Connor, Deuster, Peck, Shake, & Frost, 2010, p. 6).

PTSD Symptoms Are Prevalent Among the Undiagnosed

Even if service member does not meet clinical criteria for PTSD, families must appreciate that almost every combat-related deployment will result in exposure to emotionally traumatic events. In addition, when service members remain in high-stress and high-risk environments over a period of weeks to months, the absence of sleep and reinforced hypervigilance will likely result in more anxiety, irritability and an inability to relax (Hoge, 2004, as cited in Department of Veterans Affairs and Department of Defense, 2010, p. 63; Peterson, Luethcke, Borah, Borah, & Young-McCaughan, 2011, p. 165).

Recognizing the Signs of Post-Traumatic Stress Disorder

How does the family respond when they suspect that their returning service member spouse/parent is suffering from PTSD? Perhaps the first thing to keep foremost in every family member’s mind is simply an awareness of the intense experience that their returning service member spouse/parent may have endured. Does he seem to isolate himself from the family? Does she avoid crowded places and choose not to join the family on shopping trips, baseball games or swim meets? Is he having trouble sleeping at night? Has sleep become such a problem that she decides to move out of the bedroom that she shared with the spouse? Does he seem to be drinking every evening, and usually having more than four drinks every night? Does he seem irritable and not willing to communicate? Does she become violent or seem to explode into anger? Does he seem disinterested in hobbies or activities that were previously enjoyable? Have arguments and increased distancing between the returning service member and her spouse become apparent?

Insist When They Resist

If your service member spouse still resists, let them know that you still intend to seek treatment for yourself and possibly the family. There are multiple points of access for quality behavioral health specialists that are trained in PTSD, including: Military OneSource (http://www.militaryonesource.mil; 1-800-342-9647); the Department of Defense Peer Support Outreach and Call Center (https://www.betherepeersupport.org; 844-357-7337), the Coaching into Care Program offered by the Department of Veterans Affairs (http://www.mirecc.va.gov/coaching; 888-823-7458); or even self-referral through your TRICARE benefit. A good family therapist will not only help you with adjusting to the return of your service member spouse, they can also provide guidance on how to assist in their recovery. They may even encourage you to bring your children to one or more sessions. In addition, your seeking of treatment will likely be an encouragement for him to join you in couples therapy. Couples therapy can often be an excellent conduit for your service member spouse to develop an initial rapport with a therapist and to reduce the stigma associated with mental health services. Through this couples work, they will almost certainly come to realize the need to work on their own individual issues.

The Value of Recognition

The most important thing to remember within the family is just how deeply the service member spouse/parent connects with the value of loyalty to his or her “unit.” The ultimate unit for the service member is the family—at the heart of their service to country, they have been willing to give the greatest of sacrifices to ensure liberty, freedom and safety for their family and future generations. Make sure they know how much you appreciate that fact, how much they mean to you, and how proud you are of their service to our great Nation. Valor and honor are deeply ingrained in the spirit of the Soldier, Sailor, Airman, or Marine. When they understand just how hard you will fight for them, recovery and healing begins.