Afghanistan and Iraq proved to be the longest-running conflicts in American history, involving approximately 2.3 million men and women serving in the US military during the period. During these trying times, an estimated 2 million deployments have occurred, with military personnel being deployed either at least once or in multiple assignments.

With the reduction in US military involvement in both conflict areas, a large influx of military personnel separated from military service are returning home and needing to adjust back to everyday life. These heroic men and women may be coming home to families, friends, and communities with little understanding of military culture or the impact that deployment can have on service members and their families.

Challenges Beyond the Homecoming

Reunions can be spectacular; however, reintegration may not be all sunshine and rainbows. Some may not realize that reintegration after deployment can be incredibly difficult. The challenges confronting veterans and their families are indisputably significant, but unfortunately, they may not always be visible. Many veterans may have physical or emotional wounds, and it can be difficult to understand the full scope of these injuries.

Some service members are returning home with physical injuries, including facial wounds, loss of limbs, impaired hearing, and/or traumatic brain injury. Physical wounds such as these can be debilitating, and may require complex medical procedures, rehabilitation and therapy. These injuries can be difficult to treat and require long-term care by the family, creating a significant stressor on both the veteran and their loved ones.

Many veterans return home with less visible changes. It is estimated that approximately 30% of service members who came back from Iraq and Afghanistan are experiencing symptoms of post-traumatic stress disorder (PTSD), anxiety and/or depression. Symptoms of PTSD can be intense and not only impact the individual experiencing them but also those closest to them. Anxiety and depression can affect relationships and career advancement, causing emotional and financial stress in the family.

In recent years, substance use disorder (SUD) has been a growing concern among military service members and veterans. Homecoming military personnel are at higher risk for self-harm, including binge drinking, drug use, and accidental overdose. Like other emotional health conditions, treatment for SUD can be stigmatized, leading some veterans and their family members to turn to substances to self-medicate. Self-harming activities may result in lifelong impairment, requiring long-term care. Fatal self-injury can produce complicated grief and guilt among survivors. All of this can further complicate reintegration and ability to live your life the way you deserve to.

Deployments can lead to unique challenges. Adjustment can be difficult after any type of life change, though adjusting after deployments can be remarkably difficult due to:

• Debilitating military-related physical and emotional trauma
• Social stigma
• Active criticism of why they fought
• Difficulty in reconnecting with family and friends
• Changed family and personal circumstances
• Alienation with civilian life
• Lack of access to community resources and support
• Difficulty in finding employment or readjusting to the civilian workforce
• Lack of support for military children
• Missing the structure of military life

The above challenges are not an exhaustive list of what service members, veterans, and their families are facing. This list, however, illustrates the broad scope of concerns that must be considered in providing an appropriate support network to enable veterans and service members to overcome the challenges of reintegration.

What are the Symptoms of Post-Deployment Syndrome (PDS)?

A conservative estimate confirms that at least 400,000 American troops returned with an array of signs and symptoms that characterize post-deployment syndrome (PDS). PDS can include a variety of conditions such as concussion, PTSD, Major Depressive Disorder, chronic pain, Generalized Anxiety Disorder etc. Some returning service members experiencing difficulties after their combat experience may share their concerns with family members or close friends. Others, however, may not feel comfortable reaching out.

Knowing the symptoms of PDS can be helpful. Symptoms can include:

• Distress responses: sleep problems, restlessness, oversensitivity or hyper-vigilance, and social withdrawal.
• Risky behaviors: substance abuse, self-harm, reckless driving
• Violence: irritability, sudden rage.
• Depression: loss of interest in previously enjoyed activities, loss of sense of wellness and self-esteem.
• PTSD Responses: flashbacks and nightmares, anxiousness.

Barriers to Utilizing Resources Available to Veterans

The United States Department of Veteran Affairs has made available a vast array of health services and programs to benefit veterans who are experiencing emotional health concerns. Unfortunately, a significant proportion of these services remain untapped or under-utilized. Studies indicate that approximately 60% of veterans with emotional health concern do not seek assistance from a professional, while roughly 70% of veterans struggle with symptoms of PTSD and depression on their own.

Several reasons may account for why veterans do not seek treatment for their emotional health challenges. Common responses include:

• Fear of being delayed in returning home
• Fear of being discharged
• Fear of the stigma related to emotional health condition
• Constrained access to care
• Long waiting time
• Lack of qualified health care provider who truly understands the scope of military-related health challenges
• Lack of knowledge of available health resources outside the wire
• Reliance on family and friends for health care

Despite efforts to provide access to appropriate care for reintegrating veterans, hundreds of thousands of those returning home endure both visible and invisible illnesses. Whatever injury a veteran is bringing home with them, counseling can help with reintegration. Counseling may be beneficial as a tool to address intrusive symptoms, improve communication and improve functioning.

How Can Counseling Help?

It is easy to think the difficulty is over once a service member returns home and reunites with family and friends. For many, reintegration can prove to be incredibly challenging.

If you are a military service member, life after deployment can mean a happy homecoming as you put the experience behind you. Adjusting to civilian life, however, can be challenging. You have changed, and so have the people and the circumstances you are returning to. You need time and understanding to adjust. Therapy can help.

Like deployment, reintegration is a major life transition that can be both exciting and challenging. Navigating the transition back home can be a very different experience with the assistance of a professional. Carolina Counseling Services – Fuquay-Varina, NC has independently contracted counselors who specialize in life-changing transitions such as reintegration after deployment. Call Carolina Counseling Services – Fuquay-Varina, NC now and schedule your first appointment.