Parent Teen Relationships

Number of deployments/most recent deployment Feelings about deployments Ways of coping with these memories/feelings Losses (death of fellow servicemen, seeing civilians affected by war, etc.) Relationship with family and the affect their deployment(s) had on them Support system

When was your last deployment? How long have you been back in civilian life? What has returning to civilian life been like for you? What kind of support are you getting?

Military life is very hard. Military personnel and their families face many unique challenges. Children of military service members are twice as likely to develop psychological problems. Veterans are twice as likely to die by suicide compared to non-veterans. As much as soldiers eagerly anticipate returning home, negotiating the change is not always easy. Because of the number of transitions from war to peace, reassuming a normal lifestyle takes considerable effort and time. PTSD is quite common among veterans, especially those that felt like their life or the lives of others were in danger or that they had no control over what was happening. Symptoms of PTSD include having nightmares, vivid memories or flashbacks of the event that make you feel like it’s happening all over again, feeling numb or losing interest in things you used to care about, or having trouble sleeping or keeping your mind on one thing. Military caregivers are spouses, parents, children and relatives of wounded veterans. The personal impact of providing this care is enormous and can take a toll on the caregiver.

At the end of this section, CITs will be able to: Explore with callers the issues veterans may be facing Understand the factors that contribute to the high rate of veteran suicide Identify protective factors that can keep veterans safe from suicide Educate callers on what a traumatic brain injury is Help people understand why military caregiving is unique

A veteran is any person who served on active duty in the armed forces in the US. Military life is very hard. Some of the unique challenges active military personnel face include: Frequent deployments Extended deployments Deployments to hostile environments Service-related injury Long duty days Weekend duty Frequent military moves Fear of death and/or serious injury Distance from extended family Financial strain Family separations

A 2018 report by the VA reported that 18 veterans die by suicide a day in the US. Veterans are twice as likely to die by suicide compared to non-veterans. More Vietnam veterans have died by suicide than in combat since the war ended. Over 5,400 veterans have completed suicide after returning home from Iraq or Afghanistan as of 2019. In 2012 more US soldiers died from suicide than on the battlefield. Factors that Contribute to Veteran Suicide Combat Stress War-zone Stress Stigma Access to weapons Acute crisis such as failed personal relationships Legal problems Financial or job stress Barriers to healthcare access Post Traumatic Stress Disorder Traumatic Brain Injury Substance Abuse Protective Factors Strong family or community connections Accessible and effective clinical care Skills in problem solving and nonviolent conflict resolution Cultural and religious beliefs that discourage suicide Suicide Warning Signs Unique to Veterans Cleaning a weapon that they may have as a souvenir Visits to graveyards Obsessed with news coverage of the war or the military channel Wearing the military uniform or part of the uniform Becoming overprotective of children Talking about how honorable it is to be a soldier Standing guard of the house; staying up to “watch over” the house; obsessively locking doors and windows

As much as soldiers eagerly anticipate returning home, negotiating the change is not always easy. The sheer number of transitions from war to peace makes the hope of quickly reassuming a normal lifestyle somewhat unrealistic, and for many, a successful change in role takes considerable effort and time. A particular challenge facing a returning war veteran is the need to put aside the ‘survival mode’ which was critical in the war zone and may have become a central feature of the soldier’s identity. Among the perspectives, attitudes, and behaviors that are highly valued in combat are: Heightened arousal. Being on constant alert for danger. Narrowed attention and focus. A hostile appraisal of events. Not trusting people. Making quick, unilateral decisions. Expecting others to obey directives without question. Sticking to a “mission” no matter what. Reacting quickly and asking questions later. Keeping emotions sealed off. A former Marine said “We spent two deployments where you couldn’t trust a single person except the guys next to you.” Back in civilian society now, “We have trouble trusting people.” For many U.S. troops, exposure to killing and other traumas is common. In 2004, even before multiple combat deployments became routine, a study of 3,671 combat Marines returning from Iraq found that 65 percent had killed an enemy, and 28 percent said they were responsible for the death of a civilian. 83 % had seen ill or injured women or children whom they were unable to help. More than half (57%) had handled or uncovered human remains. These are life-changing events. The intense kinship forged among small-unit combat troops can enable them to endure hardship and loneliness. But such close relationships also put them at risk of excruciating grief at the sudden, violent death of a loved comrade, something that happens all too frequently. In a 2013 Wounded Warrior Project survey, of its members, all severely wounded combat veterans, 80 percent said they had a friend seriously wounded or killed in action.

Individuals that have experienced severe trauma or a life-threatening event may develop symptoms of post traumatic stress, commonly known as post traumatic stress disorder, PTSD, shell shock, or combat stress. This is quite common among veterans, especially those that felt like their life or the lives of others were in danger or that they had no control over what was happening. They may have witnessed people being injured or dying, or they may have been physically harmed themselves. Sometimes these symptoms don’t surface for months or years after the event or returning from deployment. They may also come and go. If these problems won’t go away or are getting worse or are disrupting daily life, a veteran may have PTSD. Some factors can increase the likelihood of a traumatic event leading to PTSD, such as: The intensity of the trauma Being hurt or losing a loved one Being physically close to the traumatic event Feeling you were not in control Having a lack of support after the event What are the signs of PTSD? A wide variety of symptoms may be signs of PTSD: Feeling upset by things that remind you of what happened Having nightmares, vivid memories, or flashbacks of the event that make you feel like it’s happening all over again Feeling emotionally cut off from others Feeling numb or losing interest in things you used to care about Becoming depressed Thinking that you are always in danger Feeling anxious, jittery, or irritated Experiencing a sense of panic that something bad is about to happen Having difficulty sleeping Having trouble keeping your mind on one thing Having a hard time relating to and getting along with your spouse, family, or friends It’s not just the symptoms of PTSD but also how someone may react to them that can disrupt their life. They may: Frequently avoid places or things that remind them of what happened Consistently drink or use of drugs to numb their feelings Consider harming themselves or others Start working all the time to occupy their mind Pull away from other people and become isolated What is the treatment for PTSD? If you have PTSD, it doesn’t mean you just have to live with it. In recent years, researchers from around the world have dramatically increased our understanding of what causes PTSD and how to treat it. Hundreds of thousands of Veterans have gotten treatment for PTSD—and treatment works. In therapy, veterans learn how to respond differently to the thoughts that used to get stuck in their head. Counseling can help them understand their thoughts and discover ways to cope with their feelings. Medications can be used to help them feel less worried or sad. These treatments can produce positive and meaningful changes in symptoms and quality of life. They can help an individual understand and change how they think about their trauma—and change how they react to stressful memories. What can be done to help a veteran with PTSD? Veterans with PTSD can adjust their lifestyle to help relieve PTSD symptoms. For example, talking with other Veterans who have experienced trauma can help them connect with and trust others, exercising can help reduce physical tension, and volunteering can help them reconnect with their community. Whether a veteran has just returned from a deployment or has been home for 40 years, it’s never too late to get professional treatment or support for PTSD. Receiving counseling or treatment as soon as possible can keep their symptoms from getting worse. Even Veterans who did not realize they had PTSD for many years have benefited from treatment that allows them to deal with their symptoms in new ways.

Traumatic brain injury, or TBI, can occur when you’ve suffered an impact to the head. The severe form, often caused by a bullet or shrapnel wound, can lead to a coma. Far more common are the mild and moderate forms of TBI, often brought on by close proximity to an explosion such as a mortar attack or roadside bomb. Memory, mood and concentration problems are common symptoms. Headaches, weakness in a limb, problems sleeping, vertigo and loss of balance are also possible signs. Some TBI symptoms may not be very noticeable at first. In fact, there may not be any sign of a problem until months after a veteran has returned from combat. Because of advances in medical care, more servicemen than ever are surviving their wounds, but returning from combat with traumatic brain injuries. Between 10 and 20 percent of Iraq and Afghanistan vets have suffered a TBI. Though invisible and sometimes seemingly minor, brain injury is complex. It can cause a range of problems lasting a short period or permanently. What are the symptoms of TBI? Some symptoms of traumatic brain injury, like loss of consciousness, seizures, and loss of coordination can show up immediately, while the following symptoms may not be noticeable for weeks or months. Changes in personality Headaches Weakness in extremities Sleep disturbances Poor impulse control Anger or violent behavior Suicidal thoughts Treatment for TBI Treatment most often consists of therapy where clients practice skills such as memorization and focus.

Military caregivers are spouses, parents, children and relatives of the wounded veteran. They also include coworkers, neighbors and friends who also take on responsibilities. However, the personal impact of providing this care is enormous. The time required can result in lost jobs and/or lost wages and the physical and emotional toll can be substantial. Why is Military Caregiving Unique? Military caregivers often care for service members or veterans with multiple injuries or illnesses, many of which are severe or require substantial or unique assistance. Military caregivers are navigating complicated health systems necessary to treat the multiple illnesses and injuries from which their loved ones are suffering. In addition, this care may be provided in various locations and by various providers. Military caregivers can face a daunting task even when service members return home without visible wounds. For example, researchers have found that caregivers of veterans with PTSD experience a burden of care on par with caregivers of individuals with dementia. Military caregivers often provide care continuously, day and night. Care may be labor-intensive and caregivers are sometimes the only available knowledgeable or trusted person to provide care. Given the relatively young age at which service members are often wounded, their need for caregiving may extend several decades.

What are 3 challenges for people in the military? What are some of the factors that contribute to veteran suicide? What is PTSD? What is a TBI How come military caregiving is unique?

You've been back from Afghanistan for a few years and have struggled to readjust back to civilian life. You are grateful to not be at war anymore, but miss the comradery that came with being a solider. You aren't sure where your place is in the civilian world. You feel like none of your army skills transfer over to your every day life. You've been drinking a lot because you are unemployed due to an injury you sustained while in the war. Sometimes, when you're drinking, you think you will never be able to live a normal life and will never fit back in with society. You wonder what is the point of living at all. If the CO asks, tell them you have thought about suicide . You wonder where you can meet other Veterans who have gone through what you are going through. Your husband is in the military and you have moved around with him for the last 10 years. You feel lonely because each time you make friends it's time to move again. You are constantly in strange surroundings and no place has felt like home. Your husband is gone a lot of the time leaving you to care for you 3 children by yourself. Your family all live far away. You feel isolated. When you bring this up to your husband, he tells you this is the life you agreed to. You want to know what resources are available to help you. Your father is an Iraq War Veteran who's health has been rapidly declining over the last few months. You don't understand why this is happening. Your dad is relatively young and had been in good shape. When he came back from Iraq in 2011 his personality seemed to have changed. He was angry, lashed out at people -- including you--, and has had trouble sleeping. You know war is traumatic. But you thought your Dad was okay. You want to know what kind of resources there are for Veterans and their families.