Caregiving When Your Spouse Has a Combat Stress Injury

When your spouse returns from a deployment with a combat stress injury or post-traumatic stress disorder, it can affect everyone in the household. To do your best for your spouse — and for you — learn more about combat stress, what resources are available, and most importantly, how to care for yourself.

Combat stress, symptoms and PTSD

What is combat stress? Combat stress is a common reaction to the stressful, dangerous and disturbing experiences of war. It’s often the natural outcome of exposure to one or more traumatic or life-threatening events, or being in a high-stress environment for a prolonged period of time.

What are the symptoms of combat stress? Symptoms of combat stress can begin immediately after a traumatic experience, or can take weeks or months to become apparent. Symptoms most likely to affect family life and relationships include:

• Angry outbursts, irritability or aggressive behavior
• Being constantly on guard or easily startled, loss of confidence and trust
• Loss of positive or loving feelings toward loved ones
• Feeling numb and without emotion
• Flashbacks, nightmares and painful recollections
• Loss of interest in life, mounting sadness, depression or isolation
• Risky behavior such as drug or alcohol abuse and unsafe driving

What is PTSD? When symptoms of combat stress continue without improvement, or even worsen, it may mean the development of post-traumatic stress disorder, or PTSD. PTSD is a medically recognized anxiety condition that can occur after exposure to trauma.

Your service member should get professional help if symptoms continue for more than a few weeks, worsen or interfere with normal daily life. Effective treatments exist — and getting help early can prevent symptoms from increasing or becoming a long-term problem.

Caregiver burden

Ongoing combat stress symptoms create the need for a caregiver. Family members often take up the role and can become overwhelmed. “Caregiver burden” describes the physical and emotional strain of caring for someone with a chronic illness or dysfunction, which can include combat stress and PTSD. Symptoms of caregiver burden include:

• Anxiety, stress, depression, social isolation and health problems
• The belief it’s your responsibility to keep your loved one calm and comfortable
• The feeling that you need to take over all responsibility for finances, child rearing and household upkeep
• The worry that you have to control the circumstances that can trigger symptoms

Here are some suggestions from PTSD experts that have helped families manage the changes in their lives:

• Familiarize yourself with combat stress and PTSD. Start with online resources through the Department of Veterans Affairs’ VA National Center for PTSD.
• Encourage your loved one to get help. Care for combat stress and PTSD is available through the Military Health System. If you’re not sure where to start, talk to a Military OneSource consultant at 800-342-9647.
• Acknowledge your service member has been injured. Combat stress and PTSD are not weaknesses, but injuries. Knowing this can help erase the stigma that prevents many combat veterans from getting the mental health treatment they need and deserve.
• Have reasonable expectations of yourself. Family members often believe they must take care of their loved one’s every need and make everything perfect at home. It is OK to let some things go.

Caring for yourself

Your well-being is also important. If you take care of yourself, you are better able to care for your loved one. Allow yourself time to accept the changes in your life and relationship.

• Resist guilt. Caring for someone with a combat stress injury is a large responsibility; don’t feel guilty if you don’t have all the answers or need to seek help.
• Seek your own support system. You also need a support system — friends and relatives, organized support groups or medical professionals. Whether casual or structured, seek support in safe friends or groups where you will be heard without judgment. The Military Caregiver PEER Forum Initiative offers the opportunity for caregivers to share knowledge, expertise, resources and ongoing support.
• Relax and recharge. Make time for yourself. Step outside, go into a quiet place in the home or even sit in your car for a few minutes to breathe deeply and reset your emotions. Get regular exercise — it’s a positive, healthy way to cope with stress.
• Celebrate happy memories and create new ones. Keep some of your favorite memories in mind, especially when you’re feeling particularly sad or disappointed. Make time for new family traditions, activities and memorable moments.

Communicating with children

If you have children who are exposed to your loved one’s combat stress symptoms, they may be frightened, confused and stressed.

Try to explain the reasons for the combat stress symptoms in a way that’s appropriate for the child’s age and without going into disturbing details. Create opportunities for children to express their feelings, and enjoy occasional outings with your kids so you can focus on one another. Watch for signs of depression in your child and be proactive to get counseling or support for them as well.

More information and support

If you continue to find yourself struggling and feeling overwhelmed, individual counseling or a support group for family members may give you a place to share your feelings and give you the coping skills you need.

You can access free, confidential non-medical counseling services by contacting Military OneSource at 800-342-9647 or by contacting a military and family life counselor through your Military and Family Support Center, or MFLC program. OCONUS/International? View calling options. Non-medical counseling is designed to address issues such as improving relationships at home and work, stress management, adjustment issues such as returning from a deployment, marital problems, parenting, and grief and loss issues.

The counselors available through Military OneSource and the MFLC program can also provide referrals for medical counseling services in your local community. If you need immediate help or are experiencing a crisis, contact the Military Crisis Line (988 and Press 1).

Military OneSource does not provide medical counseling services for issues such as depression, substance abuse, suicide prevention or post-traumatic stress disorder. This article is intended for informational purposes only. Military OneSource can provide referrals to your local military treatment facility, TRICARE or another appropriate resource.