Combat veterans are having an increasingly difficult time adjusting to civilian life after separating from the military. This stressful time also affects their families and loved ones. In the past, trauma wasn’t as well understood as it is today, and services weren’t available to veterans to help with this transition period. The armed forces have made strides in addressing the issues many veterans and families face when acclimating back into civilian life.
This article will discuss:
- How to help a veteran adapt to civilian life.
- The stigma surrounding mental health treatment affecting military service members and veterans.
- Treatment services available to veterans.
- How to practice self-care for family members of veterans.
PTSD and substance use disorders (SUDs) are treatable conditions, and with support, veterans and their families can work to overcome the stigma and the disorder.
Helping Your Veteran Adapt
Combat veterans are at higher risk than civilians for developing SUDs, whether during service or after.1, 2 When a person has a co-occurring disorder, it means that they have an SUD and a mental health disorder, such as PTSD, anxiety, or depression.1, 2
- Between 82-93% of Iraq and Afghanistan veterans with an SUD had a co-occurring disorder, with 63% having an SUD and PTSD.2
- Just over 10% of veterans seeking care at Veterans Affairs (VA) centers for the first time exhibit enough symptoms to be diagnosed with an SUD.2
- 9% of veterans who served in Iraq and Afghanistan developed PTSD after being deployed.3
- Veterans with an SUD are 3-4 times more likely to be diagnosed with PTSD or depression.2
- Nearly all veterans with an SUD have a co-occurring disorder.2
Why is There a Social Stigma Around PTSD in Veterans?
Military culture has traditionally stigmatized seeking treatment for SUDs and co-occurring disorders.2, 4 While enlisted, concerns about being viewed as weak, different, less reliable, and fear of experiencing negative career consequences often present a barrier for active service members seeking treatment, and persist after separation.2, 5, 6
Veterans with substance use and/or PTSD may exhibit drastic changes in their behavior and emotional state.7, 8 If you think your loved one may be struggling with substance use, there are some signs to watch for. These include:7, 8
- Changes in energy levels, sleeping patterns, or eating habits.
- Drinking or using substances in larger amounts.
- Giving up hobbies that they once enjoyed.
- Having difficulty taking care of responsibilities at home, school, or work.
- Inability to stop using or drinking, even after it has created issues with physical health, mental health, or social relationships.
- Legal or financial difficulties related to substance use.
- Mood swings.
- Neglecting personal hygiene.
- Spending time with different friends.
- Taking risks.
- Experiencing withdrawal symptoms when use is stopped.
PTSD develops after exposure to trauma, such as in combat.7 Some of the behavioral warning signs that a veteran is experiencing PTSD can include:7, 9
- Avoiding anything or anyone that reminds them of the trauma.
- Becoming severely distressed when reminded of the trauma.
- Difficulty experiencing positive feelings, such as happiness or love.
- Excessive response to being startled.
- Flashbacks of traumatic events.
- Inability to concentrate.
- Losing interest in activities that were once enjoyable.
- Negative emotions (feeling scared, angry, guilty, or ashamed).
- Sleep difficulties (dreaming about the trauma, sleeping restlessly, trouble falling or staying asleep).
It can be distressing when someone you care about is experiencing symptoms of PTSD and you may not know what to do. You can learn how to help your loved one. You can learn about PTSD to understand what causes it, what your loved one is going through, and how it can be managed through treatment.10
Offering to attend medical or psychiatric appointments with them can demonstrate your support.10 You can offer to listen, but be aware that they may not be willing or able to talk about their experiences.10 Encourage them to participate in activities with family members or friends.10 Asking your loved one how you can help may be the best way to show them support.10
Veteran Addiction Treatment
The VA offers effective addiction treatment that caters to the unique needs of veterans.11 Inpatient and outpatient treatment are available based on the needs and preferences of the veteran.11 VA rehab centers offer services including:11, 9
- Medically managed detox and stabilization.
- Individual counseling sessions.
- Group counseling sessions.
- Medication-assisted treatment.
- Couples therapy.
- Family counseling.
- Self-help meetings.
- Relapse prevention.
- Anger management.
- Addressing co-occurring health issues, including PTSD, depression, and chronic pain.
Treatment for PTSD, alcohol abuse, or addiction to other substances may not always be readily accessible at a nearby VA. If a veteran meets specific eligibility requirements, they may be able to utilize a program known as community care.12 This means that a veteran can access treatment services from a local provider within the community, and it is paid for by the VA.12
American Addiction Centers (AAC) is an approved community care provider.13 AAC has several facilities that offer a Salute to Recovery program, which is tailored to meet the needs of veterans and addresses addiction and PTSD, as well as other mental health disorders.14 Several staff members are veterans themselves. 14
Self-Care for Family Members
When dealing with a loved one who has an SUD or co-occurring disorder, it is especially important to practice self-care.10 Attending individual and family counseling sessions can help you understand more about these conditions, how they affect others, and how to cope with it.10, 15 The VA offers the following tips for families to practice self-care:10, 15
- Be sure to attend a support group.
- Be patient. Change sometimes happens slowly.
- Don’t put your life on hold. Participating in hobbies and social activities can allow you to re-center yourself.
- Ensure that you have social support, which can come from family, friends, spiritual or religious leaders, or members of the community.
- Focus on good times you’ve had rather than only thinking about negative experiences.
- Know that it’s okay to experience your emotions, which can include anger, fear, helplessness, or frustration.
- Make sure to take care of your physical health by eating healthy, exercising, getting enough sleep, and going to the doctor as needed.
- Set aside a little bit of time to be alone without focusing on your daily pressures and stress.
Veteran Health and the Impact on the Family
Experiences during military service, SUDs, and PTSD can have a big impact on the spouse and/or children of a veteran.15, 16, 17 The spouse of a veteran may experience:3, 15, 16
- Domestic violence, including physical and verbal abuse.
- Less satisfaction in their marriage.
- Mental health disorders, such as depression.
- Relationship issues leading to divorce.
- Stress, especially when taking on more responsibilities around the house.
- Stress-related health concerns.
Children of veterans with SUDs and/or PTSD are also affected, and they can experience:15, 16, 17, 18
- Behavioral issues, such as aggression or hyperactivity.
- Mental health disorders, such as anxiety and depression.
- Physical and verbal abuse and or neglect.
- Trouble at school.
Care of Military Service Members, Veterans and Their Families
When a loved one returns from combat with issues like addiction and/or PTSD, it can be scary, overwhelming, and frustrating. However, effective treatment is available, and you can all benefit from receiving services, whether through the VA or a community care provider. Things can get better with the right help.
- Saxon, A.J. (2011). Returning veterans with addictions. Psychiatric Times, 28(7).
- Teeters, J.B., Lancaster, C.L., Brown, D.G., & Back, S.E. (2017). Substance use disorders in military veterans: Prevalence and treatment challenges. Substance Abuse and Rehabilitation, 8, 69-77.
- Goff, B.S.N., Crow, J.R., Reisbig, A.M.J., & Hamilton, S. (2007). The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction. Journal of Family Psychology, 21(3), 344-353.
- Acosta, J.D., Becker, A., Cerully, J.L., Fisher, M.P., Martin, L.T., Vardavas, R., … Schell, T.L. (2014). Mental health stigma in the military.
- Dingfelder, S.F. (2009). The military’s war on stigma. Monitor on Psychology, 40(6).
- Psychological Health Center of Excellence. (2019). Reducing military mental health stigma to improve treatment engagement: Guidance for clinicians.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th). Arlington, VA: American Psychiatric Publishing.
- American Society of Anesthesiologists. Opioid abuse.
- U.S. Department of Veterans Affairs. (2020). PTSD basics.
- U.S. Department of Veterans Affairs. (2020). Helping a family member who has PTSD.
- U.S. Department of Veterans Affairs. (2019). Treatment programs for substance use problems.
- U.S. Department of Veterans Affairs. (2019). Community care.
- American Addiction Centers. (2020). AAC is a community care provider.
- American Addiction Centers. (2020). Salute to recovery.
- U.S. Department of Veterans Affairs. (2020). Partners of veterans with PTSD.
- U.S. Department of Veterans Affairs. (2020). Effects of PTSD on family.
- U.S. Department of Veterans Affairs. (2020). When a child’s parent has PTSD.
- Smith, V.C. & Wilson, C.R. (2016). Families affected by parental substance use. Pediatrics, 138(2), 1-13.