The Purple Heart is more than just a medal—it’s a powerful symbol of courage, sacrifice, and service. Given to members of the armed forces who are injured in combat, it honors the physical wounds they carry. But behind each medal is a story that goes much deeper than the surface. For many veterans, the real struggle begins long after the battlefield has gone quiet.

While physical injuries may heal over time, the emotional and mental scars of war often last for years, sometimes even for the rest of a person’s life. These invisible wounds can include anxiety, depression, nightmares, and a deep feeling of stress that never seems to go away. This kind of long-lasting psychological stress can affect a veteran’s overall health, relationships, and ability to adjust to life after service.

In this blog, we’ll explore how combat affects a veteran’s mental health long after they’ve returned home. We’ll also highlight the ongoing need for support, not just for the veterans themselves, but also for their families and caregivers. Programs like the Wounded Warrior Project and other support services are doing important work, but there’s still much more to be done. Healing takes time, care, and most of all—understanding.

What are the psychological effects of combat?

For many veterans, the battle doesn’t end when they leave the war zone. The effects of combat can stay with them for years, even decades, and often show up in the form of serious mental health struggles. These are not just feelings of sadness or worry—they can be real medical conditions called mental disorders that affect how a person thinks, feels, and acts every day.

One of the most common mental health conditions in combat veterans is Post-Traumatic Stress Disorder (PTSD). It happens after someone experiences something terrifying, like fighting in a war. Veterans with PTSD may have nightmares, flashbacks, or feel constantly on edge. Other common disorders include major depressive disorder, anxiety disorders, and sometimes more serious illnesses like schizophrenia or bipolar disorder.

What makes these conditions even harder is that they don’t always show up right away. A veteran might feel okay for months or even years, and then suddenly start to struggle. This delayed onset can make it difficult for veterans and their families to understand what’s happening or where to turn for help.

Combat experiences can actually rewire the brain. When someone is in danger, often—like in a war zone—the brain learns to always stay alert. Areas like the amygdala (which handles fear), the prefrontal cortex (which helps us make decisions), and the hypothalamus (which controls stress hormones) all change how they work. The autonomic nervous system, which controls things like heart rate and breathing, can also become overactive. This leads to long-term psychological stress, even when the veteran is safe.

These changes are the brain’s way of trying to protect someone during combat. But once they return home, those same changes can cause problems in daily life. That’s why it’s so important to understand what veterans go through—and to make sure they have the support they need to heal.

What are the long-term effects of psychological stress on the body?

Stress doesn’t just affect your mood—it can change how your entire body works. For combat veterans, the intense stress they experience during war can stick with them for years. Even after the battle is over, their bodies may still react as if they’re in danger. This ongoing stress response can lead to serious long-term health problems.

During combat, the body releases stress hormones like cortisol and adrenaline to help deal with danger. These hormones speed up your heart rate, raise your blood pressure, and make your breathing faster. That helps in the moment, but if these reactions continue for months or years, they can cause damage. This is one of the biggest dangers of long-term stress.

Too much cortisol over time can weaken the immune system, which makes it harder to stay healthy. It also causes inflammation, which increases the risk of cardiovascular disease, hypertension, and type 2 diabetes. Veterans may also struggle with obesity, asthma, psoriasis, and even stomach problems like diarrhea. Ongoing stress can also lead to headaches that come and go or never seem to fully go away.

The nervous system, which controls things like your heartbeat and digestion, can become overloaded. When this system stays in high-alert mode for too long, the body has trouble calming down—even when there’s no real danger. This can lead to chronic sleep problems, stomach issues, and constant fatigue.

These are just some of the effects of long-term stress on the body. Veterans often carry these hidden symptoms for years without realizing they’re connected to their past experiences. Understanding how stress affects both the mind and body helps us better support veterans as they work toward healing and better health.

What are the mental health issues after war?

Coming home from war doesn’t always mean the fight is over. For many veterans, the real struggle begins after they return to everyday life. The mental and emotional weight of what they’ve seen and been through can lead to a wide range of challenges, many of which are hard to talk about.

One of the most common problems is substance abuse. Some veterans turn to alcohol or drugs to numb emotional pain, quiet their thoughts, or help them sleep. But this can lead to something called a dual diagnosis—when someone has both a mental health issue and a substance use disorder at the same time. This makes treatment more complicated and recovery more difficult.

Other common issues include insomnia (trouble sleeping), constant panic or fear, and acute stress reactions—sudden waves of fear or anger triggered by sounds, smells, or memories. Veterans may also suffer from mood disorders like depression, which can cause deep sadness or a lack of interest in things they once enjoyed. Some develop personality disorders or even more serious problems like psychosis, where they lose touch with reality.

Physical symptoms can happen too. Headaches, stomach issues like diarrhea, and body pain are often linked to mental stress. These issues don’t always go away with time—they can last for years without the right care.

All of this can deeply affect a veteran’s confidence, self-worth, and sense of identity. They may feel like they’re no longer the same person. That’s why it’s so important to understand the full picture of what veterans go through—and to offer support, not judgment, as they work toward healing.

How does PTSD affect veterans and their families?

Post-Traumatic Stress Disorder (PTSD) doesn’t just affect the person who went through the trauma—it often affects the whole family. When a veteran struggles with PTSD, the people closest to them—spouses, children, and other caregivers—can feel the effects every day.

Veterans with PTSD may deal with anger, mood swings, or emotional numbness. They might pull away from loved ones, avoid certain situations, or have trouble sleeping. These changes can put a lot of pressure on a marriage, create tension at home, and lead to social isolation. Kids may not understand what’s going on and feel confused or even scared by the changes in their parents.

Spouses and caregivers often face what’s called secondary trauma—stress from watching someone they love go through pain. Over time, this can lead to caregiver burden, which includes feelings of worry, guilt, sadness, or even physical exhaustion. Some may cope in unhealthy ways, like turning to emotional eating or ignoring their own health.

That’s why it’s so important to include caregivers in the treatment process. With proper stress management tools and support, families can learn how to handle tough situations, communicate better, and stay connected. Education helps them understand that PTSD is not a personal failure—it’s an injury from trauma, and it can be treated.

When we help both veterans and their families, healing becomes a team effort. No one should have to go through this alone. Supporting the caregiver is just as important as supporting the veteran. Together, they can rebuild trust, find balance, and create a path forward.

What are some barriers to mental health treatment for veterans?

Many veterans who need help with their mental health face roadblocks when trying to get care. Some live far from a mental health facility or don’t have access to a trained mental health professional, especially in rural areas. Even when a clinic or treatment center is nearby, there may be long wait times or not enough staff.

There’s also a strong stigma in the military around asking for help. Some veterans worry that admitting they need care makes them look weak. This stops many from speaking up.

Trying to figure out health insurance, veteran services, and mental health programs can be confusing and stressful. It’s often hard to find a physician or psychiatry expert who truly understands what veterans go through.

All of these challenges leave many patients without the health care and medicine they need—at a time when support matters most.

How to improve veteran mental health

Improving mental health for veterans takes more than a one-time visit to a doctor—it requires ongoing, long-term support. Many veterans benefit from structured mental health treatment programs designed to help them understand their emotions, manage stress, and rebuild their lives.

Some of the most effective treatments include Cognitive Behavioral Therapy (CBT), which teaches emotional control and coping skills, and exposure therapy, which helps veterans face and process traumatic memories in a safe way. More intensive options like Partial Hospitalization Programs (PHPs) and residential programs provide full-time care for those who need extra support.

Lifestyle interventions

In addition to therapy, lifestyle changes play a big role in healing. Exercise, yoga, meditation, and tai chi help calm the mind and improve mood. They also reduce stress and boost physical health.

Eating a balanced diet and getting proper nutrition can improve brain function and mood. Following a healthy diet, managing weight, and working toward weight loss (if needed) also lower the risk of other health problems that can make mental illness worse.

Addressing physical symptoms

Mental health struggles often come with physical symptoms. Poor sleep, changes in appetite, low energy, and loss of libido (interest in intimacy) are common. Treating these symptoms is just as important as treating the emotional side. With the right care, many veterans can start feeling more balanced and in control of their lives again.

Community support

Healing is easier with support. Peer support groups and community connections help veterans feel less alone. Talking with others who understand their experience makes a big difference. Nonprofit organizations like the Wounded Warrior Project and the American Red Cross offer free services, events, and programs to help veterans and their families.

Backed by research from places like the National Institutes of Health, Mayo Clinic, and Centers for Disease Control and Prevention, we now know more than ever about what works. National resources like the 988 suicide and crisis lifeline and groups like the American Psychological Association continue to push for better care.

Signs that you should see a mental health professional

If you’re a veteran and life feels harder than it should, you’re not alone—and there’s no shame in asking for help. Many veterans deal with stress, emotional pain, or invisible injuries that don’t just go away on their own. Seeing a mental health professional can help you feel more in control, supported, and hopeful.

Here are some signs that it might be time to reach out for support:

• You feel angry, sad, or numb most of the time 
• You’re having trouble sleeping or experiencing frequent nightmares 
• You avoid people or places because they remind you of painful memories 
• You use alcohol or drugs to cope with your feelings 
• You feel hopeless or like life doesn’t have meaning 
• You have a hard time focusing or making decisions 
• You’ve lost interest in activities you used to enjoy 
• You experience panic attacks or constant anxiety 
• You have physical symptoms like headaches, stomach problems, or fatigue with no clear cause 
• You’ve thought about hurting yourself or others 

Pacific Health Group can help

At Pacific Health Group, we understand the unique challenges veterans face. Whether you’re dealing with past trauma, relationship struggles, or daily stress, our team is here to help. We offer individual therapy, family therapy, and couples counseling, all with the goal of helping you feel seen, heard, and understood.

We also provide telehealth options, so you can get care from the comfort of your home. Our programs are designed specifically with veterans in mind.

Don’t wait to get the mental health benefits you deserve. Reach out today at 1-877-811-1217 or visit www.mypacifichealth.com to learn more.