CFB PETAWAWA — The stress of multiple tours in Afghanistan is showing, as military families on this sprawling base and across Canada seek help in growing numbers.

At the Phoenix Centre for Children and Families in nearby Pembroke, Ont., the military caseload has soared to 71 families -- up from 12 before the deadly Kandahar mission began more than three years ago. Another 26 are on a waiting list.

They're grappling with issues ranging from anxiety-driven child behaviours like bed wetting and aggression, to domestic violence, depression and marital breakdown.

Petawawa is an epicentre of reverberating effects from repeated exposure to an always tense and sometimes horrific war zone. Thirty-eight soldiers of the 117 Canadian troops killed in Afghanistan since 2002 were based here.

Soldiers are trained for up to a year for tours they voluntarily accept. Many are heavily decorated veterans of missions in Somalia, Bosnia, Kosovo and the Golan Heights.

But Afghanistan -- particularly the volatile South where Canadians have been punching over their NATO weight since 2006 -- is different. It involves dodging massive roadside bombs while taking fire from an enemy that is as ghost-like as it is resilient.

"There has always been a risk attached to deployments," said Pam Sampson, whose husband Warrant Officer Brian Sampson has six tours under his belt in hot zones around the world. He heads to Kandahar in September.

"This one is different because I am scared," she said. "Before, I was worried about how I was going to manage on my own, and it was difficult not seeing him for six months. Whereas this time, I'm scared. You know, I'm scared that he's not going to come home alive."

For Sampson's two daughters, aged 15 and 18, news of their Dad's next assignment hit hard.

"Just upon notification, my kids started having nightmares. My oldest daughter . . . she had nightmares about a padre coming to the office at her school to tell her that her Dad was killed."

Sampson has thought in cruel detail not just about the risk of losing her cherished husband, but that he'll come home hurt or forever changed.

"There's also the mental injuries," she said. "And I have heard other women say: 'That's not the same man that I used to know. He's come back different.'

"I've had other soldiers say to me it's hard to go to a place like Afghanistan and not have it change who you are."

Yellow ribbons flutter from a bridge leading to the Petawawa base to welcome the latest rotation of soldiers home. About 1,800 local troops and 400 reservists -- many of them completing their second or even third tours in Afghanistan -- will arrive over the next several weeks.

Therapist Greg Lubimiv, executive director of the Phoenix Centre in nearby Pembroke, says most soldiers will gradually blend back into usual routines.

For a small but growing minority, however, problems will range from sleeplessness and irritability to heavy drinking or drug use, erratic behaviour, panic, anger and hopelessness.

A post-deployment questionnaire was filled out last November by 8,222 Canadian Forces members. It showed that, three to six months after coming back from Kandahar, about six per cent -- almost 500 respondents -- had symptoms of post-traumatic stress disorder (PTSD) and/or major depression.

"Issues of family violence have increased," Lubimiv said. "It is much, much higher pressure, stress, worry and anxiety going on for family members now than I think ever before.

"I don't think we understand . . . how much what they're exposed to there can impact them," he said of soldiers who return to Kandahar with brief breaks at home between training and field exercises.

"They're seeing a buddy who's blown up, who's torn apart. They're seeing children and women and men who are . . .. dying of impoverishment."

An admittedly overstretched military has taken several steps to ease the burden on soldiers who often feel it would be career-limiting to turn down an overseas tour.

Parliament agreed last year to extend Canada's military mission in Afghanistan to 2011 from the previous 2009 pull-out date.

"I think the sacrifices are enormous and commendable," said Defence Minister Peter MacKay. "We've attempted to double the number of counsellors that are available to deal specifically with the effects of post-traumatic stress disorder. We've come a long way and there's a long way to go."

Ottawa committed $98 million to hire another 218 military mental health specialists, for a total of 447, by last month. That time frame was extended to 2010 as bases including Petawawa, like smaller communities across the country, struggle to attract social workers, psychologists and psychiatrists.

The former military ombudsman concluded, based on interviews in 2007, that soldiers "and their families were not getting the care that they needed in the Petawawa area to deal with operational stress injuries, the consequences of which could be tragic."

In response, the military now spends more time screening and training troops to ensure they're mentally and physically fit before heading to Kandahar, says Lt.-Col. Jim Kile, a physician and commanding officer overseeing health care on the base.

He calls it "First aid for the mind."

Mental-health staff "introduce our soldiers to the idea that they could be exposed to horrific things, horrible things, while in places like Afghanistan," he said. Troops are trained to frame such ordeals as "a normal person in an abnormal situation."

There are also efforts to mentally and physically assess soldiers when they come home, although issues can go undetected for months unless self-reported.

For families, there are 24-hour deployment centres for information updates, military family resource centres and a toll-free crisis line. Plans are underway for eight new support centres for injured soldiers and their families on bases across Canada, including Petawawa.

Such changes are welcome, said Bernadette Wren, director of mental health services at the Pembroke Regional Hospital. But she still expects a surge of referrals two to three months after soldiers return and start to process their latest tour.

Wren paused when asked about the lingering impact of such stress.

"I would think, given what we've experienced locally -- with the losses, the trauma, with this being the third tour for some people -- there's definitely going to be long-term effects.

"And we won't even have the full understanding of all that for probably the next 10 to 15 years."