![]() Short-term memory frequently may be affected during postdeployment transition. ![]() Learning styles developed during predeployment phases may be altered so that more conscious effort is required to comprehend and retain new information. A more intense effort to master new concepts may be required. 9– 11, 13 Manifestations are variable, but problems with focusing on minor tasks are commonly reported. Transient difficulty with concentration and attention is often prominent within the postdeployment transition period. Difficulty falling asleep or difficulty staying asleep also commonly occurs. Inadequate, non-restful sleep is frequently reported on return to the civilian world. 9– 12 Sleep-wake cycles often are altered, reflecting residual effects of the rigid schedules required by military duties and poor sleep hygiene in the combat theater. Sleep difficulties are intrinsic to the postdeployment period. For example, a veteran might feel no strong emotion when notified of the death of a close relative and yet cry uncontrollably while watching a sad scene in a fictional movie. This emotional dysregulation creates confusing paradoxes for veterans. The former is largely overlooked in medical literature to date except in relation to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) categories, and the latter is often described in limited terms as increased irritability, restlessness, and low frustration tolerance. 1, 9– 11 These difficulties usually fall into 2 broad categories: (1) relative emotional neutrality to major life events that cause nonmilitary civilians great joy or sadness and (2) overreaction to trivial events, causing significant irritation, anger, or sadness that normally would not produce such emotional reactions in nonmilitary civilians. Although individual experiences vary widely in intensity and frequency, during postdeployment transition veterans often note difficulty in adjusting emotional expression to match that of nonmilitary counterparts. This article reflects the author’s experience as a medical director working in a VA postdeployment clinic combined with data available in the medical literature and lay press.ĭysregulation of emotional expression in returning combat veterans potentially can be present throughout the postdeployment period of adjustment. Such knowledge will enable HCPs to evaluate transition symptoms among these combat veterans reentering the civilian world, normalize common transition reactions, and recognize when further intervention is needed. The purpose of this article is to promote HCP awareness of common, nonpathologic postdeployment transition symptoms in combat veterans who are National Guard members or reservists. 5– 8 Without a balanced understanding of normal postdeployment transitions, a health care provider (HCP) inappropriately may equate transition symptoms with the presence of mental health disorders or cognitive injury and medicalize the coping strategies needed to promote healthy adjustment. Frequently, when postdeployment transition symptoms are discussed, the medical literature tends to explain these in the context of a mental health disorder, such posttraumatic stress disorder (PTSD) or a cognitive injury, such as traumatic brain injury. If transition symptoms are prolonged, veterans are at risk for developing chronic adjustment difficulty or mental health issues.Īlthough there is significant attention paid to postdeployment adjustment by military family advocacy groups, there is little information in the medical literature on what constitutes common, nonpathologic postdeployment reactions among combat veterans. 1, 3, 4 Veterans will have difficulty reintegrating into the family unit and society without successful coping strategies to address these symptoms. 1, 2 Frequently encountered symptoms of this period include impaired sleep, low frustration tolerance, decreased attention, poor concentration, short-term memory deficits, and difficulty with emotional regulation. More than half of post-9/11 combat veterans report at least some difficulty with postdeployment transition. The process of this reintegration into the civilian world is known as postdeployment transition. Reacclimating to the postdeployment world is not a quick process for these veterans because of the time required to adjust from a deeply ingrained military combat mentality to civilian life. ![]() The rigid dichotomy between combat deployment and postdeployment environments necessitates a multitude of cognitive, behavioral, and emotional adjustments for National Guard members and reservists to resume postdeployment civilian lifestyles successfully.
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