Military nightmares

When entering the supermarket, the soldier immediately scans all available exits. It's a mechanism that happens without thinking, to ensure that there's no danger coming from any side. The soldier feels tense, even though he is no longer on a mission in Afghanistan, but visiting the shop around the corner. Naval squadron physician Dirk Preusse from the German Armed Forces Hospital in Koblenz knows of a lot of cases where returning soldiers can't lead a normal life.

"I have been in a life-threatening situation, I need to make sure that I never experience this again," said Preusse. "Everything that slightly reminds me of this situation takes me back to the traumatic experience. For soldiers, even triggers like narrow streets can do the job. Small triggers can bring up the memories and the soldiers are reliving the situation again in that moment."

Experiences they can't put aside

What exactly triggers those memories differs from soldier to soldier. For some, it's a certain smell, for others it's certain images. Flashbacks force the soldiers to re-live many experiences which they can't put aside, said Preusse.

"It’s different to a normal memory, you are in the situation, you are reliving it. That's caused by an extremely stressful situation where the emotional experience is separated from reality. Soldiers learn to push feelings aside in stress situations – otherwise they would be paralyzed in combat – so they can't process the two of them together."

On deployment, soldiers don't have much time to deal with what they experience. It's when they're back home that images and memories return. The soldiers are haunted by nightmares, they break out in sweat and get depressed.

Life-threatening situations have lasting impact

"There is often the accusation: 'Well, he's simply not stable enough for the job,'" said Preusse. "That's definitely not the case. Everyone can suffer from post-traumatic stress disorder; you just need to experience a certain amount of traumatic moments. Of course there are people who might react to it a little quicker, everyone has their Achilles heel, and then a few or even just a single dramatic situation is enough. But in general – especially for our soldiers – it's several situations where their lives were in danger."

According to Preusse, one third of the affected soldiers recover after a mission. Another third develop post-traumatic stress disorder, and the last third cope with the situation quite well, but it doesn't take much to throw them off balance.

Many soldiers remain silent because they think their family and friends cannot understand them anyway. "They are right on that count," said Preusse. "You can't tell your wife how your fellow soldier stepped on a mine and was blown to pieces. She might be traumatized as well if you tell her that, because she might have known the soldier, too. You can't tell her that, and that's the first thing we advise our soldiers. Yes, something happened, but don't narrate details. Otherwise you put a lot of burden on your loved ones."

Spare the family too much detail

Lieutenant-Colonel Ralph Adametz from the medical service section of the German Armed Forces has participated in five foreign deployments so far. In his last mission he commanded a tank battalion in Kosovo. At home, he didn't talk about certain details – for instance that he and his team found body parts after a mine exploded.

For him, the most difficult question to answer is: "How was it?" He usually needed a couple days or even weeks before he was able to talk. "Things are difficult to explain, especially at the beginning, because you know the other person can't really imagine what has happened", said Adametz.

He started talking later on when something random, like a product in a supermarket, reminded him of Kosovo. Adametz says he got lucky on his missions. He wasn't exposed to traumatic situations. It's quite different in today's Afghanistan mission where soldiers regularly come under fire.

Returning soldiers need assistance

Military chaplain Stefan Werdelis knows how the soldiers on mission in Afghanistan feel. For four months he held church services in northern Afghanistan. Ten soldiers died during that period, five of them were German. Werdelis said that the returning soldiers shouldn't have to feel ashamed upon return.

"They need to feel appreciated by society. They shouldn't feel that they have to hide or that they even have to be ashamed of their actions", Werdelis said. "And they need a military environment that is attentive and says: 'Someone needs assistance. And you don't have to be ashamed of needing assistance.' And we are on the way to stop treating mental illnesses as a taboo."

Author: Sarah Steffen

Editor: Susan Houlton