Dealing With Combat and Operational Stress

Combat stress reactions are natural responses of the body and brain to the extreme stress of combat. Sometimes a threat is so prolonged or intense that it causes what is called a "stress injury." In these cases, the body and brain continue to maintain that state of high alert long after the danger has passed. This is not a matter of weakness. Many exceptionally strong service members are affected. The following information will help you understand combat stress and where to get help if you need it.

Recognizing the signs of combat or operational stress

The signs of combat stress are many, ranging from loss of motivation to hallucinations, and they may change over time. But certain key symptoms are common to most cases, including:

  • Problems sleeping
  • Uncharacteristic irritability or angry outbursts
  • Unusual anxiety or panic attacks
  • Signs of depression (such as apathy or loss of interest in things once enjoyed)
  • Other changes in behavior, personality or thinking

It is not clear why some people have more severe stress reactions than others. Even the strongest and most seasoned service member can have a severe reaction under certain conditions. One thing is clear: pre-existing stress, such as sleep deprivation, exhaustion, excessive heat or cold, or distractions by problems back home can reduce a person's ability to absorb the extreme stress of combat or other traumatic experiences.

Ways to protect yourself

Although there is no guaranteed way to protect yourself from a stress injury, there are things you can do to help yourself or others who may be at risk.

  • Maintain your health. Not only is this essential to your military performance, it also lowers your resting heart rate, which studies have shown reduces the risk of stress injury.
  • When possible, rest and recuperate after stressful events. Studies have shown that rest and recuperation can reduce the risk of developing a persistent stress injury. Staying under stress without a break increases the risk.
  • Stay hydrated. Drink plenty of nonalcoholic fluids and avoid excessive use of caffeinated or carbonated drinks, which may be dehydrating.
  • Get back to a routine as soon as possible with regular meals, sleep and exercise.
  • Practice relaxation techniques before, during and after stressful events. This can lower your resting heart rate and stress-hormone levels, which will greatly lower the risk of stress injury to your brain. For example, breathe in to a slow count of five, then breathe out to a slow count of five and repeat this for several minutes.
  • When you can, talk with others who have had similar experiences. They are probably having a lot of the same feelings that you are. You will see that you are not alone.
  • Work to build trust, communication and a reliable flow of information within your unit. Participate in unit after-action reviews.
  • Address your spiritual needs. Some people find strength in some form of prayer or through discussing their concerns with a chaplain.
  • Ask for help in managing problems at home while you are away. It is hard to keep your head in the game if you are worried about issues back home.
  • Have a sense of humor. Sometimes humor can help you look at stressful situations from a different perspective.

Where to find help

In many cases, symptoms of combat stress improve over time without any treatment. But if you or someone you know is suffering from a combat stress injury that's interfering with work or relationships, it is important to get professional help as soon as possible. The earlier you identify the signs of a stress injury, the faster a full recovery can be.
If you notice symptoms of combat stress in yourself or another service member, the following resources can help:

  • Combat stress control teams — Available to service members during deployments, combat stress control teams are made up of mental health professionals who support the emotional well-being of service members. They provide on-site support when service members may be experiencing combat or stress injuries.
  • Your unit's chaplain — Military chaplains can provide counseling, guidance and referral on many issues that affect deployed or returning service members and their families.
  • Military and family life counselors — As licensed professionals, military and family life counselors can provide short-term confidential counseling at no cost to military members and their families. To find a counselor, contact your installation's family support center.
  • Military OneSource — Professional counselors can also provide confidential non-medical counseling services to military members and their families. Services are available face-to-face in your local community (through a referral), by telephone with a trained counselor, online in real-time chat format or through video. For more information, visit Military OneSource or call (800) 342-9647.
  • Department of Veterans Affairs — The Department of Veterans Affairs provides readjustment counseling at no cost to combat veterans and their families, including those still on active duty. The services are provided at more than 200 community-based Vet Centers by counselors who, as veterans themselves, understand the issues service members and their families face.
  • TRICARE or your nearest military treatment facility — Therapy services may be available through TRICARE, either at a military treatment facility or through a network provider in your area. Your primary care manager can refer you to appropriate counseling, or you may contact your regional TRICARE office.
  • Outside military support channels — In some cases, service members choose to find help outside military support channels. If you do, be sure you understand the costs before you begin a treatment program.



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