After the terrorist events of Sept. 11, 2001, Americans can perhaps better grasp the lingering mental effects of feeling under siege, of having personal safety threatened by fear-provoking terrorism. they may not fully appreciate what war can do to the psyche – particularly of those who are already vulnerable because of underlying emotional disorders.
“In some ways, stress is stress – especially for those who have experienced assault, rape, snipings, air accidents,” says Lawrence Lehmann, MD, chief consultant for mental health with the Department of Veterans Affairs. “But there are frightening and terrible things that happen in war. It’s different in combat. You yourself may actually have to shoot back.” Lehmann cites a similarity among military combat veterans and those serving on police and fire forces. “Your buddy is killed or injured even though you’re there to try to help them,” he notes. “Your mandate is to help, to protect and serve people. There’s a commonality.”
At-risk troops can be vulnerable to violent outbursts – including self-directed violence – in the early stages of “reintegration” to home life as a civilian or as an enlisted soldier back in the States. Reintegration is a time of change, when shifting responsibilities and different stressors can weigh heavy on a soldier’s mind. Sometimes their stress is based in unrealistic expectations for homecoming, according to military reintegration counselors. Simple pleasures like rest, showers, money, sex, leave, shopping, food and alcohol are baseline expectations of returning troops. Yet some of these may go unfulfilled. The result can be frustration, stress, anxiety and depression. And while military reintegration training programs are in place for all those those coming home, that training can’t actually solve problems but can only spur personnel to seek appropriate help when problems do arise.