This page is no longer being maintained. Please visit our new site at

Ya no se mantiene esta página. Por favor visite nuestro nuevo sitio en

Overview of Clinical Challenges

The Stress of War:  Many men and women who have served in Iraq and Afghanistan have spent a long time in a very hard part of the world, surrounded by:

  • Constant stress
  • Blinding heat
  • Sudden and violent attacks
  • The loss of people they love and respect
  • The sights and sounds of injury and death
  • The need to make split-second decisions that might have lifelong consequences

The physical and neurological stress and survival systems that have kept them alert and alive were never meant to stay in high gear for days, weeks, or months at a time.  Our species was designed for short-term exposure to stress and threat, followed by periods of rest that would let our stress systems return to balance.

Post-deployment stress effects live on a long continuum:

  • From acute stress symptoms to chronic posttraumatic stress disorder (PTSD)
  • From a mild loss of energy to major depression
  • From trouble at work to unemployment
  • From a few problems at home to divorce or domestic violence
  • From blowing off steam to serious problems with the law
  • From a few drinking binges to a fifth-a-day habit

Even strong, brave, intelligent Service Members can bring home significant burdens.  For many, their post-deployment stress injuries are triggered or compounded by the traumatic brain injuries (TBI) that have been declared the “signature” wounds of these wars (Emmons, 2006).

As if these complexities were not enough, there is also the fact that these physical changes are taking place in human beings who have belief systems, thoughts, feelings, spirits, and relationships.  While their bodies are responding to threat in powerful, primitive ways, people are also coping on many higher level—and their physiological stress responses are adding intensity to the impact throughout the whole human being. 

This new “generation” of veterans also returns home to a nation in which many veterans of the last large conflict, the Vietnam War, still need help for the stress-related wounds of that conflict, including significant levels of substance use disorders (Kulka et al., 1990;  Schnurr et al., 2003). 

Our ways of welcoming the new veterans home are infinitely better than the devastating homecoming that many Vietnam veterans received.  But our collective understanding of the military culture, the experience of war, and the true and full nature of post-deployment stress effects still does not do justice to the extreme sacrifice that so many have made, and so many are still making.

Next: Stigma & Reluctance to Seek Help


The material on all of the Clinical Pages is taken directly from the clinicians' manual Finding Balance:  Considerations in the Treatment of Post-deployment Stress Effects, published by the Great Lakes Addiction Technology Transfer Center and Human Priorities.  This manual is copyright © 2008, Pamela Woll.  Reprint permission is universally granted, but attribution is requested. Click here for References and Other Resources.
Click the following links for PDFs of materials in the Finding Balance series:   Clinicians' Guide <> Workbook for Service Members and Veterans <> Quick Guide for Service Members and Veterans <> Workbook for Military Families <> Suggestions for Facilitators (Counselors, Trainers, Mentors) using the workbooks

ATTC Network Home      Treatment & Help      The ATTC Hub        Contact Us      Site Map      Copyright Information      Join Our Email List
Site Developed by KC Web Programmers