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COMMON ISSUES FACING VETERANS
Life after the military can pose many challenges to veterans and family members. For some, returning to civilian life may feel like another battle that poses a variety of challenges that must not only be fought, but also understood and accepted in order to be successfully overcome.
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Life after the military can pose many challenges to veterans and family members. For some, returning to civilian life may feel like another battle that poses a variety of challenges that must not only be fought, but also understood and accepted in order to be successfully overcome. There are many factors involved in a veteran’s readjustment to civilian life, some of which include:
- Understanding and abiding by civilian legal standards that may be different from military standards.
- Coexisting with cultures, values, and norms different from those of the military.
- Dealing with authority figures.
- Re-establishing and even re-evaluating relationships with family and friends.
- Finding a new career path.
- Pursuing college/university education.
- Locating a new home.
Other factors of readjustment may even be a bit more complex. They may even be so complex for the individual veteran, that they prevent a progressive and positive readjustment towards a bright future. Depending on the individual veteran and whether or not he/she has the benefit of a positive support system, these intrinsic matters can be crucial to his/her overall transition and successful development. Such issues of concern include:
- Veteran’s relationship with him/herself, their sense of identity, purpose, and self-worth.
- Reassessment of life goals and ambitions, followed by setting and achieving personal/professional goals.
- Coping with “starting over” in society. No longer holding the respect and authority afforded by a particular rank and/or billet, ultimately being regarded as “Joe Smith” versus “Sergeant Smith, the Platoon Sergeant.”
- Psychological effects of traumatic experiences, which may inhibit personal and professional growth. Examples include PTSD, survivor’s guilt, depression, and inclinations towards substance abuse/addiction.
- Physical handicap as a result of injuries sustained in combat. Such injuries may include disfigurement, amputation, and scarification.
As a whole, transitioning out of the military can be a very difficult experience, contrary to the common illusion of “everything being gravy in the civilian world.” The reality is that the civilian world abides by many standards that are seemingly opposite of those of the military. A few comparisons of these phenomena are:
| Civilian Individuality Purchasing all essentials Fragmented social structure Limitless morals/values |
Military Unit Cohesion Issued essentials Organized social structure Uniform morals/values |
It is therefore imperative that veterans and family members work alongside one another for the overall long term benefit of everyone. Gaining an understanding of issues pertaining to a veteran’s transition is important not only for the veteran but also the family as well. Many veteran service organizations such as the Department of Veterans Affairs, Veterans of Foreign Wars (VFW), Disabled American Veterans (DAV), American Legion, and numerous others specialize in supporting those veterans transitioning from active duty to civilian life. Services range from veterans benefits processing, clinical treatment, life coaching, and confidential one-on-one consulting.
LINKS AND RESOURCES
Department of Veterans Affairs
Vet Centers
American Legion
Veterans of Foreign Wars
Disabled American Veterans
AMVETS
Wounded Warrior Project
Hire Heroes USA
National Coalition for Homeless Veterans
Mesothelioma & Veterans
FAMILY REINTEGRATION
A veteran’s military experience can have a tremendous impact on not only the veteran, but also his/her family. Combat deployments typically lasting a year or more, sustaining injuries (both physical and psychological), and losing fellow comrades can drastically impact the veteran and ultimately, alter family dynamics and the individual attitudes of the veteran, spouse, children, and/or parents.
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A veteran’s military experience can have a tremendous impact on not only the veteran, but also his/her family. Combat deployments typically lasting a year or more, sustaining injuries (both physical and psychological), and losing fellow comrades can drastically impact the veteran and ultimately, alter family dynamics and the individual attitudes of the veteran, spouse, children, and/or parents.
From the perspective of the family, the veteran may appear to have different habits, personality, or even behave as a completely different character than before. He/she may even appear to be a stranger. The veteran however, may also view his/her family as strangers. Their ethics, morals, and values may seem to be different and at times, contradict his or her own. The veteran may even feel closer to those whom he/she served alongside with; those who he/she feels understand him/her most, rather than his kin.
Definitions of “family” and standards by which families should function may have become different, and at times, completely opposite. Such drastic differences in conceptions can lead to broken relationships and even isolation. What the family accepted and practiced as normal behavior may not be viewed in the same light from the veteran, and vice versa.
It is therefore imperative that both the veteran and family members gain an understanding of these differences and the impact upon each individual. A progressive re-acquaintance with one another may be required to co-exist, and ultimately, reintegrate the veteran and family as one.
CURRENT ISSUES VETERANS AND FAMILY MEMBERS DEAL WITH INCLUDE:
- A spouse who must become the breadwinner because the veteran has an irreversible brain injury.
- Children robbed of the parent they once had.
- A veteran who has returned from the war but can’t resume his former life. Along with the visible injuries, it will take time for all of the unseen wounds of war to be healed.
- Still grappling with the loss of a spouse, a young mom needs to move off her military-home base within days of laying her husband to rest.
- An 18-year-old guardsman was living with his mom and dad before serving a yearlong deployment. He returns and ends up homeless because he can’t go back to acting like the boy his mom and dad still expect him to be.
- Upon her return from Iraq, where she suffered a traumatic brain injury, an Army reservist can no longer adequately take care of her children.
- A young veteran returns home and can’t see how he can possibly resume his schooling—his wife just had their first child and he has to work to pay the mortgage.
LINKS AND RESOURCES
Veterans Family United Foundation
Wounded Warrior Project
Military Spouse Resource Center
Veterans Family Fund
MILITARY SEXUAL TRAUMA
Military sexual trauma is both sexual harassment and sexual assault that occurs in military settings. As in civilian life, both men and women can experience military sexual trauma and the perpetrator can be of the same or opposite gender.
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WHAT IS MILITARY SEXUAL TRAUMA?
Military sexual trauma is both sexual harassment and sexual assault that occurs in military settings. As in civilian life, both men and women can experience military sexual trauma and the perpetrator can be of the same or opposite gender. Sexual harassment is defined as unwelcome verbal or physical conduct of a sexual nature that occurs in the workplace or an academic or training setting. It includes gender harassment, “put downs” based on gender, unwanted sexual attention, offensive remarks about sexual activities or of one’s body, and sexual coercion, defined as implied special treatment for sexual cooperation. Sexual assault is defined as any sort of sexual activity between at least two people in which one of the individuals is involved against their will. Physical force may or may not be used.
Are There Unique Aspects of Sexual Trauma Associated with Military Service?
Sexual trauma associated with military service most often occurs in settings where victims live and work. In most cases, victims must continue to live and work closely with their perpetrators, often leading to an increased sense of feeling helpless, powerless, and at risk for additional victimization. In addition, sexual victimization that occurs in these settings often indicates that victims are relying on their perpetrators (or associates of the perpetrator) to provide for basic needs including medical and psychological care. Similarly, because military sexual trauma occurs within the workplace, this form of victimization disrupts the career goals of many of its victims. Perpetrators are frequently peers or supervisors responsible for making decisions about work-related evaluations and promotions.
Most military groups are characterized by a tight level of unit cohesion, particularly during combat. Because organizational cohesion is so highly valued within the military environment, divulging any negative information about a fellow soldier is considered taboo, causing many victims to be reluctant to report sexual trauma. Many victims say there were no available methods for reporting their experiences to authorities. Many have had their reports ignored, or even worse, have been blamed for the ordeal. Having this type of invalidating experience following a sexual trauma is likely to have a significant negative impact on the victim’s post-traumatic adjustment.
What Type of Psychological Responses are Associated with Military Sexual Trauma Victimization?
Given the range of sexual victimization cases (ranging from inappropriate sexual jokes or flirtation, to pressure for sexual favors, to completed forcible rape), there are a wide range of emotional reactions reported by veterans in response to these events. Even in the aftermath of severe forms of victimization, there is not a universally singular manner in which victims respond. Instead, the intensity, duration, and trajectory of psychological responses all vary based on factors such as the veteran’s previous trauma history, their appraisal of the traumatic event, and the quality of their support systems following the trauma. In addition, the victim’s gender may play a role in the intensity of post-traumatic reactions. While the types of psychological reactions experienced by men and women are often similar, the experience of sexual victimization may be even more stigmatizing for men than it is for women. This is due to the victimizing experiences having an emasculating effect to the prescribed male gender role. Accordingly, men may experience more severe symptomalogy than women, may be more likely to feel shame about their victimization, and may be less likely to seek professional help.
LINKS AND RESOURCES
Women Veterans Health Care: Military Sexual Trauma
Military Sexual Trauma: Stories From Survivors
Military.com: Sexual Trauma
POST-TRAUMATIC STRESS DISORDER
Post traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or experience.. During this type of event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening.
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WHAT IS POST TRAUMATIC STRESS DISORDER (PTSD)?
Post traumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or experience.. During this type of event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening. Anyone who experienced a life-threatening event can develop PTSD. These events can include, but are not limited to:
- Combat or military exposure
- Hostile fire
- Sustaining injuries
- Witnessing the death of comrades
- Being captured
- Sexual or physical assault
After the event, you may feel scared, confused, or angry. You may also experience difficulty sleeping, concentrating, and/or experiencing emotional peace. In other instances, you may experience recurrent and intrusive recollections of the event(s). You may also act or feel as if the traumatic event were recurring (DSM IV), and/or react physically to internal or external cues that resemble an aspect of the traumatic event (i.e. physical reflexes). If these feelings don’t go away or if they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.
DEVELOPMENT OF PTSD:
- Since psychology had not gotten off the ground by the time the Civil War had ended and because psychological phenomena were just beginning to be understood, researchers today argue that only in retrospect can one study PTSD in members of the Civil War (Talbot, 1996). What is known of the Civil War stems from personal narratives, letters, and diaries of the veterans. Coupled with this lack of understanding was the cultural tendency to push this psychological phenomenon under the rug so to speak.
- In World War I, “shell shock” was considered a psychiatric illness resulting from injury to the nerves during combat. The large proportion of WWI veterans in the European population meant that the symptoms were common to the culture, although it may not have become popularly known in the US. The overwhelming mental fatigue was diagnosed as “soldier’s heart” and “the effort syndrome”. The official designation of “Post Traumatic Stress Disorder” did not come about until 1980.
- With few exceptions, up until DSM-IV, most combat veterans were diagnosed with “shell shock”, which didn’t warrant long term treatment. Other combat veterans were merely diagnosed with “bad nerves” which not only didn’t warrant long term treatment, but also induced a “get over it” attitude from the military and medical communities. This type attitude was personified in the movie “Patton” when General Patton, played by George C. Scott, threatened apparently uninjured military hospital patients with malingering.
- Although now a formal medical diagnosis, PTSD continues to be a phenomenon of intense study and scrutiny, particularly due to the variety of recently discovered factors such as traumatic brain injuries (TBI) that may cause or exacerbate PTSD. Widespread onset of TBI has fueled an ever growing rate of reported cases of PTSD among veterans deployed to Afghanistan and Iraq.
- Recent studies indicate reported cases of PTSD, depression, and anxiety increasing over time following deployment to combat theaters:
3- 4 Months post deployment – 15-17%
3-12 Months post-deployment – 19-21% (same group)
- As of May 2008, the percentage of those veterans diagnosed with PTSD or other mental illness is 41.1%
LINKS AND RESOURCES
National Center for PTSD
Mental Health Self-Assessment Program
Department of Veterans Affairs
Vet Centers
Wounded Warrior Project
Vets 4 Vets
TRAUMATIC BRAIN INJURY
Traumatic brain injury (TBI), also called “acquired brain injury” or simply “head injury,” occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
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WHAT IS TRAUMATIC BRAIN INJURY?
Traumatic brain injury (TBI), also called “acquired brain injury” or simply “head injury,” occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
What are the symptoms of TBI?
Symptoms of TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.
Is there any treatment?
Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include ensuring proper oxygen supply to the brain and the rest of the body, maintaining adequate blood flow, and controlling blood pressure. Imaging tests help in determining the diagnosis and prognosis of a TBI patient. Patients with mild to moderate injuries may receive skull and neck X-rays to check for bone fractures or spinal instability. For moderate to severe cases, the imaging test is a computed tomography (CT) scan. Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support.
What is the prognosis?
Approximately half of severely head-injured patients will need surgery to remove or repair hematomas (ruptured blood vessels) or contusions (bruised brain tissue). Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the individual. Some common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness). More serious head injuries may result in stupor (an unresponsive state) but one in which an individual can be aroused briefly by a strong stimulus, such as sharp pain; coma, a state in which an individual is totally unconscious, unresponsive, unaware, and unarousable; a vegetative state, in which an individual is unconscious and unaware of his or her surroundings, but continues to have a sleep-wake cycle and periods of alertness; and a persistent vegetative state (PVS), in which an individual stays in a vegetative state for more than a month.
LINKS AND RESOURCES
National Institute of Neurological Disorders and Stroke
Traumatic Brain Injury.com
SUBSTANCE ABUSE
Every year, thousands of troops depart from military service and rejoin their families and civilian communities. Given the demanding environments of the military and traumatizing experiences of combat, many veterans experience psychological distress that can be further complicated by substance use and related disorders.
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SUBSTANCE ABUSE AMONG VETERANS
Every year, thousands of troops depart from military service and rejoin their families and civilian communities. Given the demanding environments of the military and traumatizing experiences of combat, many veterans experience psychological distress that can be further complicated by substance use and related disorders. Research indicates that male veterans in the general U.S. population are at an elevated risk of suicide. In addition, among veterans of the wars in Iraq and Afghanistan who received care from the Department of Veterans Affairs between 2001 and 2005, nearly one third were diagnosed with mental health and/or psychosocial problems and one fifth were diagnosed with a substance use disorder.
What are the current findings of substance abuse among our veterans?
- Combined data from 2004 to 2006 indicate that an annual average of 7.1 percent of veterans aged 18 or older (an estimated 1.8 million persons) suffered from substance use disorders last year. One quarter of veterans aged 18 to 25 met the criteria for substance use disorder in the past year compared with 11.3 percent of veterans aged 26 to 54 and 4.4 percent of veterans aged 55 or older. There was no difference in findings between male and female veterans.
- From 2004 to 2006, approximately 1.5 percent of veterans aged 18 or older (an estimated 395,000 persons) had co-occurring serious psychological disorders and substance use disorders.
- An estimated 3.5 percent of veterans used marijuana in the past month compared with 3.0 percent of their non-veteran counterparts in 2003. Among both groups, heavy use of alcohol was more common than illicit drug use.
- Heavy use of alcohol was more prevalent among veterans than comparable non-veterans, with an estimated 7.5 percent of veterans drinking heavily in the past month compared with 6.5 percent of their non-veteran counterparts. An estimated 56.6 percent of veterans used alcohol in the past month compared with 50.8 percent of their non- veteran counterparts in 2003. Heavy use of alcohol was also more prevalent among veterans, with an estimated 7.5 percent of veterans drinking heavily in the past month compared with 6.5 percent of their non-veteran counterparts.
- An estimated 13.2 percent of veterans reported driving while under the influence of alcohol or illicit drugs in the past year compared with 12.2 percent of comparable non-veterans
LINKS AND RESOURCES
National Survey on Drug Use and Health
Department of Veterans Affairs
Substance Abuse & Mental Health Services Administration
References:
- “Serious Psychological Distress and Substance Use Disorder among Veterans”. The NSDUH Report. National Survey on Drug Use and Health. November 1, 2007.
- “Substance Use, Dependence, and Treatment among Veterans”. The NSDUH Report. National Survey on Drug Use and Health. November 10, 2005.
- “Alcohol Use and Alcohol-Related Risk Behaviors among Veterans”. The NSDUH Report. National Survey on Drug Use and Health. November 10, 2005.