The Global War on Terror, commonly referred to as GWOT, became one of the longest periods of sustained military conflict in United States history. Spanning more than two decades, the war fundamentally shaped an entire generation of veterans who experienced repeated deployments, urban warfare, counterinsurgency operations, terrorism related combat, and prolonged psychological stress.
Unlike many previous conflicts, GWOT involved multiple overlapping military operations across Afghanistan, Iraq, Syria, and surrounding regions. Many service members deployed multiple times over the course of their military careers, often returning to combat environments repeatedly with little time for emotional recovery between deployments.
At Montare Behavioral Health, trauma informed mental health care recognizes the unique emotional and psychological challenges faced by GWOT veterans, including PTSD, depression, anxiety, moral injury, traumatic brain injuries, survivor’s guilt, chronic hypervigilance, and dependence related coping behaviors that developed while attempting to manage the realities of prolonged war.
Table 1. What Was the Global War on Terror?
The Global War on Terror began following the terrorist attacks on September 11, 2001.
After coordinated attacks carried out by al Qaeda killed nearly 3,000 people in the United States, the U.S. military launched military operations targeting terrorist organizations and associated groups across multiple regions.
The GWOT era included several major operations:
| Military Operation | Location | Years Active |
|---|---|---|
| Operation Enduring Freedom (OEF) | Afghanistan | 2001–2014 |
| Operation Iraqi Freedom (OIF) | Iraq | 2003–2010 |
| Operation New Dawn (OND) | Iraq | 2010–2011 |
| Operation Inherent Resolve (OIR) | Iraq and Syria | 2014–Present |
| Operation Freedom’s Sentinel (OFS) | Afghanistan | 2015–2021 |
These operations involved:
- Counterterrorism missions
- Urban combat
- Improvised explosive device (IED) threats
- Counterinsurgency warfare
- Drone warfare
- Special operations missions
- Extended deployments
- Multiple combat rotations
Many veterans spent years cycling between deployment and reintegration into civilian life.
Operation Enduring Freedom (OEF): Afghanistan
Operation Enduring Freedom began in October 2001 shortly after the September 11 attacks.
The mission initially focused on dismantling al Qaeda and removing Taliban leadership from power in Afghanistan.
Combat conditions in Afghanistan were often unpredictable and physically demanding.
Table 2. Common Stressors During OEF
| Combat Stressor | Potential Psychological Impact |
|---|---|
| Mountain warfare | Chronic stress and exhaustion |
| IED threats | Hypervigilance and anxiety |
| Ambushes | PTSD and survivor’s guilt |
| Long deployments | Emotional fatigue |
| Harsh environmental conditions | Burnout and sleep disruption |
| Civilian uncertainty | Moral injury and emotional conflict |
Many OEF veterans experienced repeated deployments over multiple years.
Operation Iraqi Freedom (OIF)
Operation Iraqi Freedom began in 2003 following the U.S. invasion of Iraq.
The conflict quickly evolved from conventional warfare into prolonged urban combat and counterinsurgency operations.
Veterans serving during OIF frequently encountered:
- Roadside bombs
- Urban firefights
- Suicide bombings
- Civilian casualty exposure
- Constant threat environments
Table 3. Psychological Effects Commonly Seen in OIF Veterans
| Mental Health Concern | Common Symptoms |
|---|---|
| PTSD | Flashbacks, nightmares, hypervigilance |
| Depression | Emotional withdrawal and hopelessness |
| Anxiety disorders | Chronic fear and panic symptoms |
| Moral injury | Guilt and emotional conflict |
| Sleep disorders | Insomnia and fragmented sleep |
| Traumatic brain injury | Memory and concentration problems |
The unpredictability of urban warfare often left veterans feeling mentally exhausted even after returning home.
Operation New Dawn (OND)
Operation New Dawn marked the transition toward reduced U.S. military involvement in Iraq from 2010 through 2011.
Although troop levels decreased, many service members still experienced:
- Ongoing insurgent threats
- Combat stress
- Anxiety related to instability
- Emotional exhaustion from repeated deployments
For many veterans, OND represented the continuation of nearly a decade of sustained war related stress.
Operation Inherent Resolve (OIR)
Operation Inherent Resolve began in 2014 as a coalition campaign against ISIS and ISIL forces throughout Iraq and Syria.
OIR introduced many veterans to a different form of warfare involving:
- Drone surveillance
- Urban counterterrorism missions
- High intensity special operations
- Exposure to graphic violence
- Constant operational readiness
Many veterans serving during OIR had already completed previous deployments during OEF or OIF, increasing cumulative psychological stress.
Operation Freedom’s Sentinel (OFS)
Operation Freedom’s Sentinel followed Operation Enduring Freedom in Afghanistan beginning in 2015.
The mission focused on:
- Counterterrorism operations
- Supporting Afghan security forces
- Ongoing combat operations against extremist groups
Many OFS veterans experienced prolonged uncertainty surrounding the war’s future, especially during the final withdrawal period from Afghanistan.
For some veterans, the 2021 withdrawal from Afghanistan triggered renewed grief, anger, guilt, or emotional distress connected to years of deployment and sacrifice.
PTSD Among GWOT Veterans
PTSD remains one of the most common mental health conditions affecting GWOT veterans.
Repeated deployments, IED exposure, urban warfare, and constant threat environments significantly increased trauma exposure.
Table 4. Common PTSD Symptoms in GWOT Veterans
| PTSD Symptom | How It May Present |
|---|---|
| Flashbacks | Reliving combat situations mentally |
| Nightmares | Recurrent deployment related dreams |
| Hypervigilance | Constant scanning for threats |
| Emotional numbness | Difficulty connecting emotionally |
| Irritability | Anger and frustration |
| Avoidance | Avoiding crowds or reminders of service |
| Sleep disturbances | Difficulty sleeping or staying asleep |
| Anxiety | Persistent fear or tension |
The VA continues reporting elevated PTSD rates among post 9/11 veterans. (ptsd.va.gov)
Traumatic Brain Injuries and Blast Exposure
One defining characteristic of GWOT combat was widespread exposure to blast injuries from IEDs and explosive devices.
Many veterans experienced traumatic brain injuries (TBIs), including mild concussions that sometimes went untreated during deployment.
Table 5. Common Symptoms of TBI
| Symptom | Possible Effect |
|---|---|
| Memory problems | Difficulty concentrating or recalling information |
| Headaches | Chronic pain and sensory sensitivity |
| Mood changes | Irritability and emotional instability |
| Sleep issues | Fatigue and insomnia |
| Cognitive difficulties | Slower processing and mental exhaustion |
TBI symptoms often overlap with PTSD and depression, complicating recovery for many veterans.
Moral Injury and Survivor’s Guilt
Many GWOT veterans experienced moral injury related to the realities of modern warfare.
Table 6. Common Sources of Moral Injury
| Experience | Emotional Effect |
|---|---|
| Civilian casualties | Guilt and shame |
| Loss of fellow service members | Survivor’s guilt |
| Rules of engagement conflicts | Emotional confusion |
| Repeated combat exposure | Emotional exhaustion |
| Afghanistan withdrawal aftermath | Anger, grief, betrayal |
Moral injury can intensify depression, PTSD symptoms, suicidal thoughts, and emotional withdrawal.
Suicide Risk Among GWOT Veterans
Veteran suicide remains a major national mental health concern.
The Department of Veterans Affairs continues reporting elevated suicide rates among post 9/11 veterans compared to civilians.
Table 7. Veteran Suicide Statistics
| Statistic | Data |
|---|---|
| Veteran suicides in 2022 | 6,407 |
| Average veteran suicides per day | 17.6 |
| Veterans as percentage of U.S. population | About 7.6% |
| Veterans as percentage of national suicides | Nearly 14% |
Table 8. Mental Health Factors Associated With Veteran Suicide
| Mental Health Concern | Association |
|---|---|
| PTSD | Elevated suicide risk |
| Depression | Strong correlation with suicidal thinking |
| Anxiety disorders | Increased emotional distress |
| Alcohol dependence | Higher suicide attempt risk |
| Traumatic brain injury | Increased long term suicide risk |
| Isolation | Reduced emotional support systems |
Dependence Patterns and Emotional Coping
Some GWOT veterans developed dependence related coping behaviors while attempting to manage combat stress, insomnia, anxiety, or emotional pain.
These patterns may involve:
- Alcohol
- Prescription sedatives
- Emotional avoidance
- Social withdrawal
- Risk taking behaviors
Many veterans struggled privately for years before seeking treatment.
Why Many GWOT Veterans Delay Mental Health Treatment
Table 9. Common Barriers to Treatment
| Barrier | Explanation |
|---|---|
| Stigma | Fear of appearing weak |
| Military culture | Emotional suppression normalized |
| Career concerns | Fear of professional consequences |
| Isolation | Difficulty opening up emotionally |
| Hyper independence | Belief they should handle symptoms alone |
Many veterans normalize trauma symptoms because they become deeply ingrained during deployment cycles.
Trauma Informed Mental Health Treatment for GWOT Veterans
Modern veteran treatment programs recognize the complex psychological effects of prolonged war exposure.
At Montare Behavioral Health, individualized trauma informed care helps veterans process combat related experiences while rebuilding emotional stability, connection, and long term mental wellness.
The Lasting Mental Health Impact of GWOT
The Global War on Terror shaped an entire generation of veterans through repeated deployments, prolonged operational stress, and exposure to modern combat environments.
Many veterans returned home carrying invisible wounds tied to PTSD, depression, traumatic brain injuries, anxiety, moral injury, survivor’s guilt, and emotional isolation.
As awareness surrounding veteran mental health continues growing, more GWOT veterans are seeking support and discovering that trauma informed treatment can help reduce emotional suffering, improve relationships, and restore stability even years after military service.
Frequently Asked Questions
What does GWOT stand for?
GWOT stands for the Global War on Terror, a series of military operations launched after the September 11, 2001 terrorist attacks.
What was Operation Enduring Freedom?
Operation Enduring Freedom was the military operation in Afghanistan from 2001 through 2014 targeting al Qaeda and Taliban forces.
What was Operation Iraqi Freedom?
Operation Iraqi Freedom was the U.S. led invasion and military operation in Iraq from 2003 through 2010.
Why do GWOT veterans experience PTSD?
Repeated deployments, combat exposure, IED threats, urban warfare, and prolonged stress environments significantly increased trauma exposure among GWOT veterans.
Sources
- U.S. Department of Veterans Affairs. (2021). PTSD in Iraq and Afghanistan Veterans. https://www.publichealth.va.gov/epidemiology/studies/new-generation/ptsd.asp
- U.S. Department of Veterans Affairs. (n.d.). Afghanistan/Iraq Veterans. https://www.research.va.gov/topics/oef-oif.cfm
- National Center for PTSD. (n.d.). Combat Exposure. U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/understand/types/combat_exposure.asp
- U.S. Department of Veterans Affairs, Health Services Research & Development. (2009). Mental health diagnoses among OEF/OIF Veterans increased rapidly following invasion of Iraq. https://www.hsrd.research.va.gov/research/citations/pubbriefs/articles.cfm?RecordID=140
- U.S. Department of Veterans Affairs, Health Services Research & Development. (2012). Majority of OEF/OIF Veterans with traumatic brain injury also diagnosed with mental illness and head, neck or back pain. https://www.hsrd.research.va.gov/research/citations/pubbriefs/articles.cfm?RecordID=435
- U.S. Department of Veterans Affairs, Health Services Research & Development. (2011). Suicide risk factors for OIF Veterans. https://www.hsrd.research.va.gov/research/citations/PubBriefs/articles.cfm?RecordID=330
- U.S. Department of Veterans Affairs, Health Services Research & Development. (2013). Traumatic brain injury and post-concussive symptoms among OEF/OIF/OND Veterans. https://www.hsrd.research.va.gov/publications/management_briefs/eBrief-no62.cfm
- U.S. Department of Veterans Affairs. (2018). Study: Veterans with multiple brain injuries twice as likely to consider suicide, compared with those with one or none. https://www.research.va.gov/currents/1118-Veterans-with-multiple-brain-injuries-twice-as-likely-to-consider-suicide.cfm
- Combined Joint Task Force Operation Inherent Resolve. (n.d.). CJTF-OIR History. https://www.inherentresolve.mil/WHO-WE-ARE/History/
- U.S. Department of Defense Office of Inspector General. (2022). Lead Inspector General for Operation Freedom’s Sentinel and Operation Enduring Sentinel, October 1, 2021 to December 31, 2021. https://www.dodig.mil/Reports/Lead-Inspector-General-Reports/Article/2934979/lead-inspector-general-for-operation-freedoms-sentinel-and-operation-enduring-s/