Duncan, James

Most people likely know about and understand the short-term outcomes of reunion following deployment, for example, the honeymoon period that service members may experience when reconnecting with their loved ones. However, many people may not be aware of some of the long-term outcomes that impact some service members following deployment and lasting well into the transition into civilian life as a veteran. In this brief family article, I have put together some information based on research and my own experiences associated with life transitions following deployment and more broadly following military service. Deployment and Homecoming When I was in Iraq serving as a Lead Convoy Commander, I was struck by an improvised explosive device on my very first training mission. I was able to finish the mission successfully, but that situation left me with a mild traumatic brain injury as well as post-traumatic stress disorder (PTSD), which I carried with me throughout the remainder of my deployment, after my deployment, and throughout my time as a veteran. Research has shown that service members dealing with combat situations during deployment may be at higher odds for persistent PTSD. As the word ‘persistent’ indicates, managing PTSD may be something that could be a continuous process for years to come and is something that is associated with not only mental health, but also physical health, and relational health. Life immediately following deployment can be a time marked not only with joy during reintegration, but also turbulence as service members deal with the real effects of combat. Personally, I can attest to both joy and distress upon my return home from my second deployment to Iraq in 2008. I experienced joy through connecting with the love of my life immediately upon stepping foot off the plane that brought me back home and proposing to her in the airport parking lot while still in uniform (luckily for me she said yes! And in case you are wondering, I had one of her friends help me find the engagement ring and had it shipped to me in Iraq). Those happy moments, however, were also accompanied by some difficult times stemming from my combat experiences. I struggled opening up to my friends and family about what I went through and resisted thoughts about seeking professional help. Recent research has shown that I am not alone in my experiences, as many service members and veterans report similar thoughts and feelings. Substance Use and Social Support For many service members, alcohol is something partaken responsibly. However, research has shown that for some service members, alcohol and other addictive substances are used in a maladaptive manner to try and cope with a variety of issues or problems such as PTSD. I tried coping with what I had seen and been through in Iraq by hazardously drinking alcohol. For the first several months following my return home drinking alcohol was something I did on a daily basis. However, I can also tell you that although I was using alcohol as a way to cope, it was not very effective and created feelings of loneliness and isolation between myself and my family. On a more positive note, my wife provided me with excellent social support and helped me recognize early on that alcohol was not an appropriate way to fix my problems. In fact, my wife encouraged me to seek out a health care professional for help. I reluctantly agreed. One reason I was reluctant to seek out professional help was due to my lack of knowledge about different programs and resources available. For example, at the time I was diagnosed with PTSD, I was still active duty Air Force. However, I was getting ready to transition out of the military. I was not sure if I should be going to a primary care facility on the military base or if I should be going to a Veterans Affairs hospital because my service obligation was almost up. I am not alone in feeling this way. Research has shown that other transitioning veterans report a lack of knowledge about resources available to them. As some already know, there are important resources (e.g., employment and educational opportunities) that are easily accessible, but others resources (e.g., mental health, financial issues, or even social support) are also available. I believe that social support from friends, family, and peers is probably one of the most important resources to consider when transitioning out of the military. Based on personal experience and research, having meaningful social connections can foster positive outcomes. As I mentioned earlier, social support from my wife encouraged me to seek help for mental health. Some service members and veterans may prefer to talk with fellow peers, more so than with family, and that is also a great avenue for facilitating social connectedness. In fact, in a recent study, it was found that two out of the top three social resources used by recently transitioned veterans to civilian life were 1) programs promoting connections with other veterans, and 2) programs for veterans with disabilities. Research has shown that lack of support systems is associated with negative outcomes such as persistent PTSD symptoms. This is but one of many reasons why I think social support whether formal (like a peer veteran group at the Veterans Affairs hospital) or informal (like gathering with friends through leisure avenues such as video games) is extremely important in helping promote positive outcomes. From personal experience, I can speak to how both formal and informal social resources have positively impacted my life. Unfortunately, I personally know many other veterans that have struggled, and continue to struggle, with service-related health issues, as well as perceptions of stigma and feelings that they do not have others they can rely on. Grief and Resources When thinking about other veterans who still may need help identifying and accessing resources, an important topic that comes to my mind is grief. I know for some service members grief can occur when dealing with the loss of fellow service members when deployed. I think it is also important to think about grief for veterans transitioning into civilian life. I recently learned that a friend of mine, who happened to be one of my bunk mates during my deployment to Iraq, committed suicide. I feel that I have been experiencing grief in response to this incident because I have been preoccupied a lot lately with thinking about this unfortunate situation. For us to have been deployed to a combat zone, but make it back mostly in one piece, it breaks my heart that this fellow veteran had gone through so much and passed away in the manner that he did. I cannot personally speak for what that veteran was going through physically, mentally, and emotionally, but I can say research has shown that social support can facilitate positive well-being and help encourage individuals to seek help. I think it is important to remember that it is ok to seek out resources, regardless of the situation you might be facing. Whether you feel it is something small or large, whether it is to get help in managing something specific like grief and/or PTSD, or if it is to simply get help with improving your lifestyle habits. In most scenarios, resources exist, and if you do not know where to find them, do not be afraid to ask someone. A good place to start is militaryonesource.mil and/or va.gov. References Armenta, R. F., Rush, T., Leardmann, C. A., Millegan, J., Cooper, A., & Hoge, C. W. (2018). Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans. BMC Psychiatry, 18(1). https://doi.org/10.1186/s12888-018-1590-5 Aronson, K. R., Perkins, D. F., Morgan, N., Bleser, J., Vogt, D., Davenport, K., Copeland, L. A., Finley, E. P., & Gilman, C. L. (2019). Going it alone: Post-9/11 veteran nonuse of healthcare and social service programs during their early transition to civilian life. Journal of Social Service Research. Advanced online publication. https://doi.org/10.1080/01488376.2018.1493410 Charney, M. E., Bui, E., Sager, J. C., Ohye, B. Y., Goetter, E. M., & Simon, N. M. (2018). Complicated grief among military service members and veterans who served after September 11, 2001. Journal of Traumatic Stress, 31(1), 157-162. doi:10.1002/jts.22254. Advance online publication. https://doi.org/10.1080/01488376.2018.1546259 Derefinko, K. J., Hallsell, T., A., Isaacs, M. B., Salgado Garcia, F. I., Colvin, L. W., Bursac, Z. ,… Klesges, R. C. (2018). Substance use and psychological distress before and after the military to civilian transition. Military Medicine, 183, (5-6), e258–e265. https://doi.org/10.1093/milmed/usx082 Derefinko, K. J., Hallsell, T. A., Isaacs, M. B., Clovin, L. W., Salgado Garcia, F. I., & Bursac, Z. (2019). Perceived needs of veterans transitioning from the military to civilian life. The Journal of Behavioral Health Services & Research, 46(3), 384-398. https://doi.org/10.1007/s11414-018-9633-8 Perkins, D. F., Aronson, K. R., Morgan, N. R., Bleser, J. A., Vogt, D., Copeland, L. A., Finley, E. P., & Gilman, C. (2019). Veterans’ use of programs and services as they transition to civilian life: Baseline assessment for the veteran metrics initiative. Journal of Social Service Research.

Family Story

https://militaryreach.auburn.edu/afterdeployment.jsp