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Collateral Damage: Combat Vets, PTSD and How to Get Help


One soldier returns home from a tour in Afghanistan, where he saw a great deal of combat. He takes time to unwind, reacquaint himself with his family and then finds a good job and picks up his life pretty much as it was before going off to serve his country.

A second soldier comes home from combat and has difficulty fitting back in. He may be anxious, fearful, depressed and have trouble concentrating or sleeping. Television reports of combat or a war movie he comes across while channel surfing may set him off, triggering either erratic behavior or withdrawal from friends and loved ones.

Which one has Post-Traumatic Stress Syndrome?

The answer is, maybe both. Something is clearly bothering the second soldier, but the seemingly fine first soldier could have a delayed onset of PTSD.
So how can you tell if a friend loved one or friend is experiencing a post-traumatic reaction – and what can you do about it?

First of all, reactions to trauma are actually very “human” in the context of combat or a dramatic event, such as Superstorm Sandy, which hammered the East Coast in October 2012. Events like that may shake us to our psychological core.

It is especially hard for combat vets; the brave men and women were threatened with physical harm every day. Some 600,000 combat soldiers will return from Iraq and Afghanistan in the years to come. Some statistics suggest that our veterans are not receiving the support and services they need to make this transition. A survey of more than 700 returning vets indicates that 56 percent said they wanted or needed mental health treatment, and 50 percent of those reported that the treatment they received was “minimally adequate.” The unemployment rate is higher for vets than non-vets, and the Veterans’ Administration recently reported that a vet dies by suicide every 80 minutes.

While not everyone experiences or copes with stress and trauma in the same way, common reactions include anxiety, fearfulness, depression, inability to concentrate, involuntary replaying images of part of traumatic events, difficulty sleeping or a need to constantly scan one's environment for threats or danger. Reactions may be ongoing or triggered by some reminder of the event, such as time-of-year anniversary, or sensory reminders such as smells, sounds, or images of a traumatic event.
There is a difference between traumatic events and post-traumatic reactions and their timelines are different. Traumatic events represent a direct or perceived threat to an individual's well-being. The other important defining factor of traumatic events is that they are out of the realm of human expectation like Hurricane Sandy; no one sees them coming – the unimaginable has happened. And while soldiers are trained for combat, nothing can completely prepare them for the reality of war. Many traumatic events have a beginning, middle, and an end. In the moment and directly after the event, our reaction is protective – it helps us to cope and survive the event. For some, the reaction to a traumatic event is immediate; for others, the reaction to a traumatic event occurs with some distance from the event.

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There are a number of reasons why someone may have experienced a reaction right away vs. someone who is just becoming aware of their reactions or someone who is unsure if they are experiencing a reaction to a traumatic event.

The reasons include: what happened during the event; what other demands or additional events popped up in life surrounding the event; prior experiences with coping with stressful or traumatic events and a personal network of resources and relationships that will help someone resolve his or her reaction to the event.
So what can you do if you think you or someone close to you is experiencing a post-traumatic reaction?

First and foremost, be easy on yourself or your friend or loved one. Don’t panic. Remember that our reactions to these events, while uncomfortable, are a universal reaction to being threatened.

Our post-traumatic reactions heal best in safe spaces. If you are still under threat, removing yourself from the source of the threat is the first thing to do. Seek out support for yourself or the loved one from your family, other friends, and other people you can trust. If your reactions to a trauma continue to interfere with your health and well-being, seek out a counselor who is experienced in treating trauma.

Lastly, these symptoms do not represent a personal failing of the person experiencing trauma-related stress. This is a predictable emotional response to a physical and/or psychological threat. You can get better: the emotions someone feels after a trauma do not have to stay with you forever.

You have an opportunity to resolve these issues for yourself or a loved one. The longer you wait to address these feelings and issues, the more complicated it can become to resolve them.

Seeking help doesn’t make you weak. It doesn’t make you crazy. It simply makes you human.

Dr. Earle is an Associate Dean at the Touro College Graduate School of Social Work who has counseled veterans, hurricane victims and 9/11 survivors for post-traumatic stress.