Combat Stress Center.com

Coping with Combat Stress

LtC John P. Allen, PhD, USAR

785^th Med. Co. (CSC)

 

“Battle Fatigue,” “War Neurosis”, “Shell Shock,” colorful names from earlier wars, that all refer to the condition that today we call “Combat Stress.”  Combat stress refers to the emotional, mental, and behavioral effects that come as a result of intense armed conflict and from the many horrors that surround it – being terrified by the risk of losing one’s own life or being permanently injured, seeing friends hurt or killed, viewing disfigured and dead bodies of the enemy and innocent civilians, ear-shattering noises from many sources, glaring lights, sickening smells, and so on and so on…. As in all wars, these experiences are part of the very fiber of the current conflicts in Iraq and Afghanistan.

 

The terrifying aspects of war impose a heavy burden on the performance capability and well-being of service members.   If left untreated, combat stress reactions can devastate a unit’s performance for future engagements, shatter morale and the quality of life in camp, create excessive numbers of psychiatric evacuations of service members out of theater,  and haunt the soldier, sailor, airman or marine with the agony of “post traumatic stress disorder for a lifetime of years after the return home.”

 

Those most likely to suffer combat stress are less combat-experienced personnel or new to a unit as well as those who have participated in an unusually large number of or high intensity combat situations, nevertheless, any combatant can suffer it.  While a critical problem requiring immediate and effective treatment, combat stress is not a true psychiatric diagnosis.  Instead, combat stress to a generally temporary state in normal people dealing with an abnormal situation.

 

What does combat stress look like?  Combat stress can assume dramatically different forms depending on the background and personality of the victim, the number and nature of stressful events, and other factors that remain only poorly understood.  Often the person will be “hyper vigilant,” overreacting to any sound and being easily upset and scared.  He or she may display a variety of physical symptoms associated with stress such as rapid heartbeat and breathing rate, excessive sweating, shaking, diarrhea, frequent urination, problems sleeping, and nightmares.  Victims of combat stress may be very irritable and depressed.  In more affected cases their speech may be confused and incoherent, their fear may be nearly overwhelming, they may have problems following even simple conversations, and they may emotionally “freeze up” and “blank out” the memories of details related to the traumatic experience.  They may even attempt suicide or refuse or be unable to follow military orders.

 

How can combat stress be managed?  The first line of defense against combat stress is with the service member.  Maintaining proper rest, nutrition, and physical conditioning can decrease the risk of a combat stress reaction occurring and may reduce its intensity and duration if it does occur.  Learning specific stress coping strategies also helps. Combat skill proficiency, confidence in one’s abilities, trust in unit leadership, and having close friends to talk about concerns with life in general and combat in particular can make a huge difference.

 

The second line of defense against combat stress is with the military unit itself.  Rigorous and realistic training, preview discussions on the nature of the likely combat stressors to be confronted, unit cohesiveness/team spirit/camaraderie/morale and a buddy-system are powerful antidotes against stress in all of us.  Supervisors and fellow unit members need to look for early signs of stress and offer assistance in dealing with them.  They need to assure that the fundamental needs of their peers and subordinates are being met and that they can freely bring up personal worries and issues.  It is also important that leaders actively encourage service members to seek professional assistance outside of the unit when needed and support the efforts of service members in making positive changes.

 

Mental health providers, medical personnel, chaplains, and specially-trained combat stress management teams can all play important roles in helping the service member manage and resolve combat stress.   Depending on their orientation and expertise, these professionals can provide the individual with  tools needed to learn to manage and understand the stress reaction, can help him or her to talk thru the painful experience and, thus, keep it from coming back later to haunt the service member.  If necessary, short term medication can be given to aid sleep and reduce anxiety.

 

Combat stress teams have been assigned throughout Iraq and Afghanistan and are in other theaters of operation such as Bosnia and Kosovo.  These teams consist of a variety of specialists to include clinical psychologists, psychiatrists, social workers, occupational therapists, other medical specialists, and mental health technicians.  Combat stress control units are “force multipliers” since they help to maintain the fighting strength of military units.  They offer a range of practical services going from assessment, out-outpatient treatment, classes on various aspects of stress management (such as coping skills therapy, anger management, techniques to aid sleeping, and suicide prevention strategies), and consultation with the unit commander, to intensive treatment in a short-term, military-focused  restoration facility in theater.  To offset their fears of possible stigma and since stress is a fully normal response to combat situations; service members who seek care thru a combat stress control unit do not usually have their military records so-annotated.    Combat stress control teams have proven quite effective and 70 to 90 per cent of the service members they see are returned quickly to duty.

 

Combat stress teams and other service professional also aid personnel in dealing with stresses not specifically related to combat situations but, rather, associated with long term overseas deployments.  They train service members on behavioral strategies to manage anger and unhappiness, deal with boredom, sleep better, handle unit- or job- related stress, and manage relationship problems with significant people back home.

 

Stress in combat is a given and happens, at least to some degree, to almost everyone.  With well directed efforts from service members, their leaders, and mental health professions the effect of combat stress, however, can be managed, thus making units more effective in combat and helping their members to cope with the very real rigors and horrors of war.