Dealing with hidden wounds of war
By Amy Buttell Crane . Bankrate.com

For soldiers returning from war, the transitions can seem surreal. One day they're patrolling the streets of Baghdad and the next day they're hailed as heroes by loved ones and local media. The majority of service members serving overseas complete their tour of duty without visible injuries. But whether they are exposed to the horrific realities of war through actual combat or the stress of working near or in a combat zone, many bear invisible scars.
As soldiers grapple with the psychological disconnect between the war front and the home front, they must also readjust to their predeployment routines with both their families and their employers, whether their employers are civilizians or part of the services.
And with many service members returning to Iraq or Afghanistan for second and even third tours of duty, access to medical services upon their return is even more vital as the military makes more of an effort to identify and treat service members at risk for developing post-traumatic stress disorder, or PTSD.

"Many experience acute PTSD symptoms in the first three months or so that interfere with their day-to-day life, while others will be fine for six months or longer and then start having panic attacks, insomnia and other symptoms," says Kathleen Hall, a stress and work-life balance expert and author of "A Life In Balance: Nourishing the Four Roots of True Happiness."

Coping with PTSD
Early studies estimate that 18 percent of Iraq war vets and 11 percent of Afghanistan war vets are at risk for post-traumatic stress disorder, according to the National Center for Post-Traumatic Stress Disorder, a department of the federal Department of Veterans Affairs. A 2004 study published in The New England Journal of Medicine pegs the incidences of some type of mental health problem stemming from combat at nearly 30 percent. These mental health problems include depression, anxiety and PTSD.
Raymond Crowel, vice president of mental health and substance abuse services for the National Mental Health Association, explains that service members in combat for extended periods of time "witness all kinds of traumatic events, including the loss of friends. Couple this with the unpredictability of fighting a war in another country, frequently in an urban environment where you are going house to house and not knowing who is friend and who is foe, leaves these service members at heightened risk for PTSD."
If you're back from a combat deployment and wondering if you're experiencing PTSD, readjustment counseling services at regional VA centers offer free information, diagnosis, counseling and referrals. You can contact your regional VA center by going to www.va.gov/rcs or by calling (800) 905-4675.

Because there is no one-size-fits-all solution for soldiers who believe they might be suffering from PTSD, a number of treatment options are available, including individual counseling, group counseling and alcohol/drug assessments, as well as assistance in applying for VA benefits.

Depending on the severity of symptoms, both inpatient and outpatient services are available. Many PTSD specialists combine therapy with antidepressants and other medications. Common physical symptoms include insomnia, headaches, chest pain, dizziness and gastrointestinal problems.

Veterans who believe that their PTSD is severe enough to qualify as a service-related disability must apply for disability benefits through the Veterans Benefit Administration. While the Veterans Benefit Administration takes into account medical information provided by clinicians treating vets, those doctors aren't in charge of making the actual disability determination.

For family members and employers
Because veterans who experience PTSD frequently have significant readjustment problems, family members may notice an increase in irritability, anxiety and difficulties at work and in resuming the normal functions of day-to-day living.
Although the military is putting more resources into identifying and treating mental health problems stemming from combat, many returning active-duty and reserve personnel are reluctant to seek professional help, either within the military health care system or outside of it.

A New England Journal of Medicine study noted that 65 percent of service members surveyed wouldn't seek help for PTSD or other mental health problems stemming from combat for fear of being perceived as weak, while 41 percent were too embarrassed to seek help and 25 percent didn't believe mental health care was effective. This pervasive attitude places the burden of identifying PTSD in many cases on family members, employers and others who interact with affected vets.