How much stress returning military personnel experience may be affected in part by:

• The extent to which their duty was dangerous (even if they were only awaiting this danger)

• Death or serious injury in their military unit

• Possibility of exposure to chemical warfare or other weapons of mass destruction

• Length of time they spent overseas

• Exposure to dead and wounded (including enemy combatants and civilians)

• Past trauma that can be heightened by the stress of war

• Degree to which family dynamics have changed during their absence, such as a child's or spouse's increased dependency or independence

Families have been stressed, too. The families of deployed personnel have had their own set of problems during the conflict, such as:

• Fear for the deployed family member's safety

• Disruption of established patterns and routines

• Decreased income and financial worry

• Negative reactions from children to sudden changes in the family environment

• Need to develop new resilience skills, renew family relationships, make new friends and join support groups

• Being overburdened by new roles and responsibilities

Many families will continue to have pressures during the homecoming period, including:

• Being second-guessed for decisions made during a member's absence during war

• Having conflict over new relationships — such as a new baby and new friends

• Experiencing shifts in decision making

• The fact that family dynamics can never return to what they were before deployment

The number and intensity of stressful experiences notwithstanding, most returning personnel and their families should be able to bounce back successfully.

Even those who have learned resilience skills, however, should not expect homecoming to be effortless or free of emotion. It is quite normal to experience days or several weeks of mild to moderate symptoms of depression, anxiety and anger, even if the initial homecoming was full of joy.

Children, for example, reassured with the safe return of a parent or sibling, may now feel they can express some of their negative feelings of fear or anger over what they may have experienced as abandonment.

Normal Is What Works for You

There are no standard or normal stages for homecoming. The process varies from person to person. Understanding that homecoming has its own brand of stress is a first step in the process of a long-term successful reentry for military personnel, their families and the community.

1. Early in the process, identify people who can help — a friend, clergy, mental health professional, financial advisor — and seek help if needed. Some of these sources can supply emotional support, while others can provide direct help with day-to-day problem solving. Resolve to be open about problems and work on resolving them together, either with family members or those professionals who can help.

2. Dismantle big problems into manageable small parts. Then, attack and solve these parts as a means of rebuilding confidence. A step-by-step approach can eventually resolve the larger problem.

3. Be an active player, not a passive victim. Social involvement through religious organizations, hobby groups, exercise clubs, social groups, etc., helps individuals rejoin the community.

4. Don't put off solving problems. Begin to work on problems immediately; inaction can reinforce the feeling that a problem is out of your control.

5. Don't seek solace in drugs or alcohol. This not only fails to resolve the problems at hand, but creates new ones.

6. Recognize that family readjustment problems are normal. Don't blame others for your distress, and don't blame yourself excessively.

7. Keep things in perspective. Cynicism or excessive pessimism about life and the future can become self-fulfilling and have a negative impact on you and others. Keep things in perspective — not every problem is a catastrophe. Although it sounds simplistic, a positive outlook helps raise morale and increase resilience.

8. Recall how you met past challenges and use the same strategies to meet the stresses of homecoming. By facing current problems with an eye to solutions, you are more likely to achieve a sense of progress, of "getting ahead" with life.

9. Realize that the stress of homecoming can magnify other daily stresses, so make allowances for yourself and your family.

10. Accept as inevitable some setbacks in the return to "life as normal"— whether they are emotional, financial, physical or job-related. At the same time, be aware that the skills of resilience can help you bounce back.

Children will experience a wide range of stressful emotions and experiences around the war and homecoming, but they are less likely than adults to speak directly about what bothers them. They may, instead, exhibit their emotions through poor school performance; inability to get along with siblings, peers or parents; withdrawal; or by becoming accident-prone.

For children whose parent(s) went to war, the trauma of separation may have been severe. These children are more likely than adults to act out their feelings, in part because they have less experience in coping with life stress.

To help children deal with war-related stress, parents and teachers should:

• Listen to children's thoughts and concerns about the war in a nonjudgmental fashion.

• Provide warmth and reassurance, without minimizing the child's concerns.

• Avoid imposing their own fears on children. Adult difficulties should be worked out without burdening the child or expecting a child to support the adult for any prolonged period. Children can provide important love and comfort, but they need strong adult support to do so.

• Recognize that children, like most adults, will bounce back successfully. Relate this positive expectation to them, so that the children's past experience will not lead them to a pessimistic view of the future.

• Remember that a child often will mirror a parent's reaction. If parents demonstrate resilience, children will have positive role models.

• Seek help from a mental health professional for the family if the family is unable to function on a daily basis.

It is important to recognize the symptoms of stress that has not been effectively managed. Following is a checklist of warning symptoms for those who have come home.

• Guilt about actions or shame over some failure

• Excessive drinking or drug use

• Uncontrolled or frequent crying and other extreme reactions to events that normally would be handled more calmly

• Sleep problems (too little, too much)

• Depression, anxiety or anger

• Too much dependence on others

• Verbal or physical family violence

• Stress-related physical illness (headache, backache, gastrointestinal problems, poor stamina)

• Inability to escape from horror scenes remembered from the war

• Difficulty concentrating

• Suicidal thoughts or plans

Families, too, may exhibit symptoms of stress that has not been dealt with effectively. Following is a checklist of warning symptoms for families.

• Inability to resolve family conflict

• Isolation of members from one another

• Overdependency and clinging of members

• Use of one or two family members (often children) as scapegoats

• Disciplinary or academic problems of children

If you (or a family member) continue to feel stress, anxiety or frustration or experience any of the negative signs of coping discussed here, asking for help can be one of the quickest ways to recover a sense of control and balance. For many people, using the skills of resilience will help with the homecoming. But for families and individuals who are unable to perform the functions of daily life because of stress or trauma, seeking the help of a licensed mental health professional, such as a psychologist, can help with progressing beyond the difficulties of homecoming.

Click here to take the Post Traumatic Growth Inventory.

Information contained in this brochure should not be used as a substitute for professional health and mental health care or consultation. Individuals who believe they may need or benefit from care should consult a psychologist or other licensed health/mental health professional.

APA gratefully acknowledges the following contributors to this publication:

Nancy Molitor, PhD, assistant professor of Psychiatry and Behavioral Science, Northwestern University Medical School; Independent Practice, Evanston, Ill.

Ronald S. Palomares, PhD, assistant executive director, Practice Directorate, American Psychological Association

Cmdr. Morgan Sammons, PhD, Navy Mental Health Department, Annapolis, Md.

APA,located in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. Its membership includes more than 134,000 researchers, educators, clinicians, consultants and students. APA works to advance psychology as a science and profession and as a means of promoting health and human welfare.