Beyond the Uniform: Supporting Military Members and Veterans Through Mental Health and Addiction

When Alex, a Staff Sargent in the Army, stepped off the plane after his final deployment to Afghanistan, his wife, Elena, and their two children ran to greet him. From the outside, it looked like a perfect homecoming: hugs, tears, and the relief of a family reunited. But as the weeks went by, the celebration faded into a quieter, more complicated reality.

At night, Alex struggled to sleep. The sound of a car backfiring or a door slamming could send his body into instant alert, as though he were still on patrol. Elena noticed how he paced the house at 2 a.m., restless and tense, whispering that he “just couldn’t shut it off.” Their children, ages six and nine, began to sense the difference. They stopped asking him to play as often because his temper was shorter than before.

Alex’s story reflects a broader reality facing many military members and veterans. While their courage on the frontlines is honored, the invisible wounds—mental health struggles and addiction—often follow them home, reshaping family life in ways few outsiders can see.

A Foundation of Trauma: Adverse Childhood Experiences (ACEs) 💔

For some, the challenges of service begin long before enlistment. Research shows that individuals who join the military, particularly during the all-volunteer era, are more likely to have a history of Adverse Childhood Experiences (ACEs)—traumatic events such as abuse, neglect, or growing up in homes with substance abuse or domestic violence.

Some enlist out of passion or family tradition. Others, however, see the military as an escape from instability—a place promising structure, belonging, and purpose. But this history of early trauma creates a pre-existing vulnerability. When those with ACEs encounter the stress and trauma of combat or military service, it doesn’t just add another layer of pain; it can compound what was already there. Studies even suggest that a history of ACEs can be more predictive of suicidal thoughts than combat exposure itself.

For families, this means a loved one’s struggles after service may not be rooted only in what happened overseas—but also in the unresolved wounds of childhood, carried silently for years.

What the Research Tells Us About Recent Veterans

A major national study of U.S. combat veterans (2019–2020) compared mental health across service eras—from World War II through Iraq and Afghanistan National health and Resilience in veterans study - PMC. The findings are sobering for families today:

• Heavier Trauma Burden: Gulf War and Iraq/Afghanistan veterans reported significantly more trauma and combat exposure than earlier generations.

• Higher Risk of Mental Health Conditions: Iraq and Afghanistan veterans were more likely to screen positive for both lifetime and current PTSD and depression.

• Addiction Concerns: Among Iraq/Afghanistan veterans:

• Nearly 1 in 3 (29%) screened positive for lifetime PTSD.

• About 1 in 6 (17%) currently had an alcohol use disorder.

• Roughly 1 in 8 (12%) currently had a drug use disorder.

• Over 1 in 4 (26%) currently have suicidal ideation.

Why Recent Veterans Face Greater Challenges

The fact that Iraq and Afghanistan veterans experience higher rates of PTSD, depression, and substance use than veterans of earlier wars is significant. These conflicts were marked by multiple, extended deployments, exposure to improvised explosive devices, and the strain of fighting in unpredictable environments. Advances in battlefield medicine also meant more service members survived severe injuries, but many returned home with lasting physical and psychological scars. Combined with pre-existing ACEs, these stressors create a generation of veterans carrying heavier invisible burdens than those who came before—making early awareness and family support more critical than ever.

The Dopamine Drive of Active Combat

For Alex, the struggles weren’t just about memories of war—they were also about what was missing when he came home. In combat, his brain and body had adapted to constant life-or-death stress, fueled by adrenaline and dopamine. That neurochemical surge created a powerful rush, sometimes described as combat addiction.

Back home, civilian life felt flat and meaningless in comparison. He found himself restless and irritable, seeking stimulation through alcohol and risky behavior. This “itch” to recreate the intensity of the battlefield is common. Some veterans turn to thrill-seeking, binge drinking, or high-stakes jobs as an unconscious way to regain that sense of purpose and intensity.

For families, understanding this biology is crucial: their loved one may not just miss the mission—they may be neurochemically wired to crave it. Recognizing this helps shift the perspective from frustration (“Why can’t you just settle down?”) to compassion (“Your brain is still in survival mode”).

The Hidden Struggles Families Often See

For Elena, the hardest part was the loneliness. Friends asked about Alex’s return, expecting happy stories, but she didn’t know how to explain that he was home physically but seemed far away emotionally. Family dinners grew quieter. She often felt like she was walking on eggshells, unsure what might trigger his anger or silence.

Families and friends are often the first to notice these subtle changes. Common signs include:

• Withdrawal from family activities or social circles

• Restless sleep or recurring nightmares

• Heightened anger, irritability, or mood swings

• Heavy reliance on alcohol, medications, or drugs

• Reluctance to talk about work or deployment experiences

• A sense of numbness or disconnection

These behaviors aren’t about weakness—they’re wounds that are harder to see.

The Impact on Families and Friends

When a veteran or first responder struggles, the ripple effect is real. Families may experience:

• Emotional strain: Feelings of helplessness, sadness, or guilt

• Relationship tension: Distance in marriages, strained parent–child bonds

• Caregiver fatigue: Burnout from constantly “being on alert”

• Isolation: Fear of judgment leading to silence

• Secondary trauma: Stress symptoms from hearing or witnessing their loved one’s struggles

For Elena, it meant carrying her fear and exhaustion in silence, worried that sharing her struggles would sound like complaining about a man who had already sacrificed so much.

How Families Can Support Their Loved One — and Themselves

Eventually, after one particularly tense evening when Alex snapped at their son for spilling milk, Elena reached out to a local veterans’ family support group. There, she met other spouses who understood the invisible wounds of war and the toll they take on families. Encouraged by their stories, she gently suggested Alex attend a peer support meeting.

Families can play a powerful role in opening the door to recovery. Here are practical steps to support both loved ones and themselves:

Supporting Your Loved One

• Listen without judgment. Even small conversations help.

• Encourage professional help. Suggest resources like the VA, peer support, or counseling.

• Watch for warning signs. Suicidal thoughts, increased substance use, or sudden withdrawal should be taken seriously.

• Respect their pace. Change takes time—gentle encouragement works better than pressure.

• Celebrate progress. Small steps forward matter.

Supporting Yourself

• Seek your own support. Groups like Al-Anon, NAMI Family Support, or veteran family networks can help.

• Set boundaries. Protect your mental health while supporting your loved one.

• Educate yourself. Understanding PTSD, addiction, and trauma fosters empathy.

• Practice self-care. Rest, exercise, and connection are essential.

• Remember: you’re not alone. Many families face this. Asking for help is strength.

Over time, Alex began meeting with a counselor and connecting with other veterans. It wasn’t an instant fix—he still had tough nights, and Elena still leaned on her support group—but slowly, the family found balance again.

A Shared Mission

Their story is not about a quick recovery but about resilience—the kind that doesn’t just belong to those in uniform, but also to the families who stand beside them.

Awareness is the first step. By noticing the signs, approaching with compassion, and connecting loved ones to care, families and friends can make a life-changing difference.

Resources for Families

If you’re supporting a veteran or active military member facing mental health or addiction challenges, you don’t have to do it alone. These resources can help both your loved one and your family:

• 988 Suicide & Crisis Lifeline – Dial 988 and press 1 for the Veterans Crisis Line, or text 838255. Free, confidential support is available 24/7.

• Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline – Call 1-800-662-HELP (4357) for treatment referrals and information.

• VA Mental Health Services – VA Mental Health provides resources, treatment options, and family support information. Mental Health Home

• National Alliance on Mental Illness (NAMI) Family Support – NAMI Family Programs offer free peer-led groups and education. Family Members and Caregivers | National Alliance on Mental Illness (NAMI)

• Military OneSource – Military OneSource provides confidential counseling, financial, and family support resources for service members and families. Free 24/7 Support for Military Life | Military OneSource

• Al-Anon & Alateen – Al-Anon Family Groups offer support for families impacted by a loved one’s drinking. Al-Anon Family Groups

• Code of Support Foundation – Code of Support connects veterans and families to critical services through case management. Home - Code of Support