War-Zone-Related Stress Reactions: What Families Need to Know
A National Center for PTSD Fact Sheet
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
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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.
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A returning war veteran may feel irritable and have difficulty
communicating, which may make it hard to get along with him or her.
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A returning veteran may experience a loss of interest in
family social activities.
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Veterans with PTSD may lose interest in sex and feel distant
from their spouses.
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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.
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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.
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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:
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Assessment and development of an individual treatment plan
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Education of veterans and their families about posttraumatic
stress and its effects
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Training in relaxation methods, to help reduce physical
arousal/tension
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Practical instruction in skills for coping with anger, stress,
and ongoing problems
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Detailed discussion of feelings of anger or guilt, which
are very common among survivors of war trauma
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Detailed discussions to help change distressing beliefs
about self and others (e.g., self-blame)
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If appropriate, careful, repeated discussions of the trauma
(exposure therapy) to help the service member reduce the fear associated
with trauma memories
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Medication to reduce anxiety, depression, or insomnia
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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
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Become educated about PTSD.
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Take time to listen to all family members and show them
that you care.
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Spend time with other people. Coping is easier with support
from others, including extended family, friends, church groups, or other
community groups.
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Join or develop a support group.
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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.
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Try to maintain family routines, such as dinner together,
church, or sports outings.
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If needed, get professional help as early as possible, and
get back in touch with treatment providers if things worsen after treatment
has ended.
Related Fact Sheets
Family coping with war
Coping when a family member has been called to war
Homecoming reactions
Homecoming after deployment: Dealing with changes and expectations
PTSD
and relationships
Describes how trauma and PTSD can have significant effects on relationships
with others
The effect
of PTSD on families
Provides information about the effects of PTSD on family members, and how
to cope with the effects
References
Matsakis, A. (1996). Vietnam wives: Facing the challenges of life
with veterans suffering posttraumatic stress. Baltimore, MD: Sidran.
Mason, P.
(1999). Recovering from the war: A woman's guide to
helping your Vietnam vet, your family, and yourself. High Springs, FL: Patience Press.
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