Our military veterans sacrifice so much in service to our country. Unfortunately, the consequences of their deployment are not always concluded once they get back to "the world." A significant number of veterans will face a variety of re-entry challenges such as job loss, and financial and marital problems; in addition, many vets will experience certain "adjustment disorders."

Symptoms of adjustment disorders may include: temporary or chronic mood swings e.g., disillusionment, anger, malaise or depression, remorse, disorientation, panic attacks, hypervigilance; mild mempry loss; sleep, social and occupational impairments; difficulties adjusting to physical disabilities; which in turn can adversely affect their family relations, employment, and quality of life. Unfortunately, the military does not provide sufficient resources for veterans to reenter civilian society.

A substantial number of veterans are in need of job training, various kinds of counseling, physical therapy, and recreational outlets - with one notable addition...a communal support system. Due to the extreme nature of their experiences, veterans respond best with other veterans with whom they can relate. WASP is a veteran-centered support service that brings veterans together, while mentors and coaches provide them with the neccessary hard and soft skills needed to readjust to civilian life.

Most soldiers will only experience the mild to moderate forms of deployment-related stress. Most of these stress reactions, although unpleasant in the short term, do not result in long-term problems. In some cases, however, the stress from combat events can cause more serious problems that require additional help.

Generally, there are four kinds of deployment-related stress problems: Combat/Operational Stress Reactions (COSRs); Adjustment Disorders; Acute Stress Disorder (ASD); and Posttraumatic Stress Disorder (PTSD).

During the Civil War, PTSD was called “soldier’s heart.” In World War II, it was “battle fatigue.” Studies estimate that nearly 30 percent of Vietnam veterans (some 830,000) have experienced some level of PTSD. MORE ON PTSD.

10JUL2010: Today, more than 150,000 veterans of the Iraq and Afghanistan wars have been officially diagnosed with PTSD. The number likely is higher because of the stigma attached to the disorder and also because some service members have sought out private treatment rather than through the Defense Department or Department of Veterans Affairs (VA). As many as 300,000 war vets from Iraq and Afghanistan have experienced post-traumatic stress disorder. Now, the process for getting treatment and compensation for PTSD is being streamlined.

The government is taking what President Barack Obama calls "a long overdue step" to aid veterans with post-traumatic stress disorder, making it easier for them receive federal benefits. The changes that Veteran Affairs Secretary Eric Shinseki will announce Monday fulfill "a solemn responsibility to provide our veterans and wounded warriors with the care and benefits they've earned when they come home," Obama said in his weekly radio and online address Saturday.

As PTSD is better understood, what Secretary Shinseki calls “the hidden wounds of war” are being addressed in many ways by a growing number of communities, agencies, and organizations around the country. This streamlined system will apply to vets of earlier wars, including Vietnam.

“They’ve been required to produce evidence proving that a specific event caused their PTSD. And that practice has kept the vast majority of those with PTSD who served in non-combat roles, but who still waged war, from getting the care they need,” said Obama. No longer will veterans have to prove what caused their illness. Instead, they would have to show that the conditions surrounding the time and place of their service could have contributed to their illness. "I don't think our troops on the battlefield should have to take notes to keep for a claims application," the president said. "And I've met enough veterans to know that you don't have to engage in a firefight to endure the trauma of war."

Veterans advocates and some lawmakers have argued that it sometimes could be impossible for veterans to find records of a firefight or bomb blast. They also have contended that the old rules ignored other causes of PTSD, such as fearing a traumatic event even if it doesn't occur. That could discriminate against female troops prohibited from serving on front lines and against other service members who don't experience combat directly.

"This is a long overdue step," Obama said. "It's a step that proves America will always be here for our veterans, just as they've been there for us. We won't let them down. We take care of our own." A study last year by the RAND Corp. think tank estimated that nearly 20 percent of returning veterans, or 300,000, have symptoms of PTSD or major depression. A senior official at the Department of Veterans Affairs said the agency doesn't expect the number of veterans receiving benefits for PTSD to rise dramatically, as most veterans with legitimate applications for benefits do eventually get claims. The goal is simply to make the claims process less cumbersome and time-consuming, said the official, who would speak only on condition of anonymity ahead of the VA's announcement.

Department of Veterans Affairs: http://www.ptsd.va.gov/

An Anger Management Intervention Model For Veterans With PTSD

By April Gerlock, R.N., C.N.S. - NCP Clinical Quarterly 6(3): Summer 1996

Anger and rage are prevalent emotions in individuals experiencing posttraumatic stress disorder (PTSD; 1), as well as in male veterans with PTSD. Vietnam combat veterans experience more anger and hostility than their civilian counterparts (5-6), and Vietnam combat veterans with PTSD experience more anger than Vietnam combat veterans without PTSD. A greater capacity for violence also figures predominantly in veterans with PTSD. Vietnam theater veterans with PTSD report statistically higher rates of hostility and physical aggression towards their partners than their non-PTSD counterparts. This predilection for hostility and assaultive behaviors contribute greatly to readjustment difficulties in veterans with PTSD.

Attention to and treatment of the anger component of PTSD is considered an essential element in trauma recovery work. Despite highly variable approaches to anger management intervention, goals include a reduction in the level of anger experienced by the veteran as well as learning constructive ways to manage and express anger. The model presented here combines a cognitive and behavioral approach (developed in consultation with Anne Ganley, April, 1984). It is currently used in outpatient treatment with veterans (with and without PTSD), and has been adapted for inpatient PTSD treatment as well. However, the treatment model was designed for veterans with generic anger management problems, and not as treatment for those who are domestically violent. Anger management fails to account for the premeditated controlling behaviors associated with domestic violence.

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