Returning home from war may be a transitional period for many soldiers and their families -- from holding new babies to having to live with war injuries.

For many reasons, families must be prepared to help their loved ones re-adjust, whether it's by drawing them closer or giving them space, local psychologists agree.

"There's going to be a great variation about returning participants in the war, depending on their personality going in or depending on the action and experiences that have taken place over there," said Dr. Evie Adelman. "It's going to vary and you should take your cues from them in terms of what they need."

"In general from a health perspective a percentage of (soldiers) returning from war will experience post-traumatic stress disorder," said Brad Hedges, executive director of Mid-Ohio Psychological Services. "In World Wars I and II it was referred to as 'shell shock.' That was when we first saw it, with people who'd been on the front line or saw traumatic events, such as killing someone. It becomes a part of them."

PTSD is an anxiety disorder that can develop after being exposed to a terrifying event or being put in circumstances where extreme physical harm was done or a person was threatened.

According to the National Institute of Mental Health, about 30 percent of men and women who have spent time in war zones experience PTSD. One million veterans developed PTSD after serving in Vietnam and it has also been detected among veterans of the Persian Gulf War, with some estimates as high as 8 percent.

This reality of trials and war may in turn cause a series of things, including guilt, shame, nightmares -- haunting the individual.

"For a certain percentage of guys who experience (war) we can anticipate PTSD," Hedges said. "Not everyone who's had trauma will experience PTSD. (Many) will reevaluate the meaning of life -- not so much if they did the right thing, like in Vietnam, because the threat in this war was pretty clear -- but in general they will ask 'Is my life going along the way I want it to go, or is life too short for me to be doing this.'

"It will be a wake-up call."

"For the community, this is the first time many people have had their loved ones leave for a long period of time," Hedges said. "It's about reintegration.

"The phenomenon of modern war is that you go from the battlefield to your home in a matter of two or three days," Hedges added. With that, there's not really time for de-escalation. You have to have gradual reintegration."

This has been a problem since Vietnam.

"In World War II, it wasn't as easy to get home so you had a period for debriefing," Hedges said. "There's a lifestyle association with the military and you just can't jump from this vigilante (lifestyle) and then have to settle back down into everyday living. The military has taken some steps to make efforts with reintegration."

In this case, families have to be patient.

"Families need to give these people the opportunity to be de-escalated," Hedges said. "You can't expect them to step right back into life like it was when they left. They will have questions. Being in a life or death situation like war will raise these questions. They need time to bring resolution to those life questions."

Each family will deal with issues concerning war differently, Hedges said.

"In the process of doing life adjustments it may be a time period of three to six months before they can make the transition back in," he said.

Even employers have to be understanding and not expect employees to immediately jump right back into the swing of things, Hedges said.

"You should treat them with great respect and support, but not (anything) too unusual," Adelman said. "You shouldn't act strange or different as if they're a different person. They need to feel some continuity."

This includes lending your ear.

"A person who's interacting with them should listen with good contact skills, in a way that conveys 'I'm here, I understand and I care about how you feel' -- in a way that says you matter," Adelman said. "You can do that with the way you listen."

A significant part of this process includes letting your loved one feel whatever they feel, Hedges said.

"When we impose expectations that they should feel victorious, we may be discontinuing whatever feelings they may have been having like feelings of fear, shame or anger," Hedges said. "There needs to be time for them to validate whatever those experiences were."

Being alert and sensing signs of depression or anything dealing with acute trauma is critical.

"This may include insomnia, nightmares, being startled (often) or being very anxious," Adelman said. "Some people will probably need more help than merely friendly support."

For more information, see www.apa.org.

Originally published Saturday, May 3, 2003