Combat stress refers to a cluster of symptoms that can occur following exposure to significant stressors related to combat and operational events. Shell shock, battle fatigue, and traumatic stress are all terms that have been used in previous wars to describe similar symptoms. Combat stress is generally viewed as a normal reaction to abnormal conditions.  People respond to stressful events in unique ways.  When someone does experience combat stress, it may be of a limited intensity or duration and require no help from a professional.  Another individual might find that combat stress disrupts his or her daily life and work to the point that seeking assistance becomes necessary.

Combat stress refers to a cluster of symptoms that can occur following exposure to significant stressors related to combat and operational events. Shell shock, battle fatigue, and traumatic stress are all terms that have been used in previous wars to describe similar symptoms. Combat stress is generally viewed as a normal reaction to abnormal conditions.  People respond to stressful events in unique ways.  When someone does experience combat stress, it may be of a limited intensity or duration and require no help from a professional.  Another individual might find that combat stress disrupts his or her daily life and work to the point that seeking assistance becomes necessary.

Combat stress can cause problems with thinking and emotions, changes in behaviors, and worsening or development of physical issues.

Symptoms related to thinking include:

• lack of concentration
• confusion
• re-experiencing events or flashbacks
• dreams and nightmares
• problems concentrating
• heightened alertness
• loss of trust

Emotional symptoms include:

• anxiety and nervousness
• depression
• numbness
• agitation and intense anger
• guilt and shame
• feeling overwhelmed

Behavioral symptoms include:

• withdrawing and avoiding others
• angry outbursts
• crying
• changes in diet
• drug or alcohol usage

Physical symptoms include:

• problems falling asleep or staying asleep
• worsening health problems
• pounding heart and sweating
• digestion problems
• trembling hands
• headaches
• vision changes

Symptoms can occur immediately after the stressful event or may take several weeks to develop.  Symptoms might not be identified or recognized until the service member has returned home. Some of the key symptoms of combat stress are also symptoms of other health conditions which is why it is important to seek professional help if the symptoms continue or have an impact on an individual's day-to-day functioning. 

Combat stress can cause problems with thinking and emotions, changes in behaviors, and worsening or development of physical issues.

Symptoms related to thinking include:

• lack of concentration
• confusion
• re-experiencing events or flashbacks
• dreams and nightmares
• problems concentrating
• heightened alertness
• loss of trust

Emotional symptoms include:

• anxiety and nervousness
• depression
• numbness
• agitation and intense anger
• guilt and shame
• feeling overwhelmed

Behavioral symptoms include:

• withdrawing and avoiding others
• angry outbursts
• crying
• changes in diet
• drug or alcohol usage

Physical symptoms include:

• problems falling asleep or staying asleep
• worsening health problems
• pounding heart and sweating
• digestion problems
• trembling hands
• headaches
• vision changes

Symptoms can occur immediately after the stressful event or may take several weeks to develop.  Symptoms might not be identified or recognized until the service member has returned home. Some of the key symptoms of combat stress are also symptoms of other health conditions which is why it is important to seek professional help if the symptoms continue or have an impact on an individual's day-to-day functioning. 

Each person going into a stressful event will have a different reaction to it. Service members come from varied backgrounds with unique experiences that are factors in determining the way in which they may respond to combat or operational events. In fact, most service members do not experience any symptoms related to combat stress following exposure to a stressful event. Research does suggest, however, that the risk of combat stress injury increases as the number and duration of combat and operational stress events increase.

Each person going into a stressful event will have a different reaction to it. Service members come from varied backgrounds with unique experiences that are factors in determining the way in which they may respond to combat or operational events. In fact, most service members do not experience any symptoms related to combat stress following exposure to a stressful event. Research does suggest, however, that the risk of combat stress injury increases as the number and duration of combat and operational stress events increase.

Intense feelings of fear and sadness, emotional numbing, and feelings of agitation are common experiences when returning home from combat and operational events. They are normal, understandable reactions given the conditions faced during deployment. These symptoms often resolve with time if given some care at home. If these and any other symptoms become apparent, do not get better within a few weeks, and/or worsen to the point of causing changes in daily functioning, relationships, or work, a service member should talk to a trusted spouse, other family member, friend, medical professional, or chaplain.  If a service member notices symptoms of combat stress while deployed, he or she can talk to a member of the Combat Stress Control (CSC) Team, a medical professional, or a chaplain. 

Intense feelings of fear and sadness, emotional numbing, and feelings of agitation are common experiences when returning home from combat and operational events. They are normal, understandable reactions given the conditions faced during deployment. These symptoms often resolve with time if given some care at home. If these and any other symptoms become apparent, do not get better within a few weeks, and/or worsen to the point of causing changes in daily functioning, relationships, or work, a service member should talk to a trusted spouse, other family member, friend, medical professional, or chaplain.  If a service member notices symptoms of combat stress while deployed, he or she can talk to a member of the Combat Stress Control (CSC) Team, a medical professional, or a chaplain. 

CSC Teams are available as an added field resource to support the mental and emotional well-being of service members during deployments.  These teams of mental health professionals have been used in many wars to provide immediate, on-site support when service members have experienced a combat or operational event that has the possibility of causing a stress injury. 

CSC Teams are available as an added field resource to support the mental and emotional well-being of service members during deployments.  These teams of mental health professionals have been used in many wars to provide immediate, on-site support when service members have experienced a combat or operational event that has the possibility of causing a stress injury. 

Family readiness programs help family members learn more about what they can expect when their loved one returns from deployment. Families are encouraged to know the symptoms of combat stress and to know where to get assistance if it is needed.

When someone appears to be struggling with symptoms of combat stress, friends or family members can express concern and talk to the service member about what they have been noticing. Symptoms often improve over time without any treatment and family members and friends can work together with the service member to help during recovery. If family members and friends believe professional assistance may be required, they can offer to help the service member identify appropriate resources and services. If there is ever a concern that the service member may be suicidal, friends and family members should seek help immediately from a medical professional through the installation Military Treatment Facility or through a local civilian mental health clinic.

Family readiness programs help family members learn more about what they can expect when their loved one returns from deployment. Families are encouraged to know the symptoms of combat stress and to know where to get assistance if it is needed.

When someone appears to be struggling with symptoms of combat stress, friends or family members can express concern and talk to the service member about what they have been noticing. Symptoms often improve over time without any treatment and family members and friends can work together with the service member to help during recovery. If family members and friends believe professional assistance may be required, they can offer to help the service member identify appropriate resources and services. If there is ever a concern that the service member may be suicidal, friends and family members should seek help immediately from a medical professional through the installation Military Treatment Facility or through a local civilian mental health clinic.

Military mental health professionals are specifically trained to understand the conditions experienced during combat and operational events.  Treatment typically involves regular conversations with the professional focused on reducing and resolving the current symptoms as well as becoming more educated about combat stress in general.

During treatment for combat stress, the service member may be:

• assessed to accurately identify the condition
• provided with information about the condition
• taught stress reduction techniques to reduce mind and body tension
• taught coping skills to improve functioning with daily life routines
• encouraged to talk about the stressful event to process experiences in the field
• encouraged to take advantage of Cognitive Behavioral Therapy (CBT) to address thoughts as they relate to emotions and behavior
• provided with medication to assist in symptom reduction if needed

Military mental health professionals are specifically trained to understand the conditions experienced during combat and operational events.  Treatment typically involves regular conversations with the professional focused on reducing and resolving the current symptoms as well as becoming more educated about combat stress in general.

During treatment for combat stress, the service member may be:

• assessed to accurately identify the condition
• provided with information about the condition
• taught stress reduction techniques to reduce mind and body tension
• taught coping skills to improve functioning with daily life routines
• encouraged to talk about the stressful event to process experiences in the field
• encouraged to take advantage of Cognitive Behavioral Therapy (CBT) to address thoughts as they relate to emotions and behavior
• provided with medication to assist in symptom reduction if needed

Having a combat stress reaction is not a sign of weakness. No one is immune to experiencing a stress reaction. This response can happen to anyone who has experienced a significantly stressful combat or operational event.  It can be difficult to accept that the brain has had a response that seems to express a limitation of any kind.  Service members who are able to recognize when symptoms are having a negative impact on their daily lives and are willing and able to seek out necessary support are demonstrating adaptability, resilience, and strength of character. 

Having a combat stress reaction is not a sign of weakness. No one is immune to experiencing a stress reaction. This response can happen to anyone who has experienced a significantly stressful combat or operational event.  It can be difficult to accept that the brain has had a response that seems to express a limitation of any kind.  Service members who are able to recognize when symptoms are having a negative impact on their daily lives and are willing and able to seek out necessary support are demonstrating adaptability, resilience, and strength of character. 

Most people experiencing combat stress can proceed with normal daily activities while recovering.  Some people with more extreme combat stress symptoms may have difficulty working and will need time to recover more fully before returning to duties. Some service members and their families fear that seeking assistance for combat stress may count against them in their careers.  Military leaders are well-informed about stress injuries and, in fact, encourage getting care when needed, just as they would when physical injuries occur.

Most people experiencing combat stress can proceed with normal daily activities while recovering.  Some people with more extreme combat stress symptoms may have difficulty working and will need time to recover more fully before returning to duties. Some service members and their families fear that seeking assistance for combat stress may count against them in their careers.  Military leaders are well-informed about stress injuries and, in fact, encourage getting care when needed, just as they would when physical injuries occur.

Levels of stress tolerance and resilience vary for each person.  Increasing tolerance and resilience requires an awareness of the likelihood of stressful events, a plan for managing them as best as possible, and supportive, healthy lifestyle habits.

The following are some tips for increasing stress tolerance and resilience:

• be aware of stressful events
• rest and eat well
• maintain focus and routines
• talk with friends
• accept support
• use relaxation techniques
• keep a journal
• pursue spiritual activities

Levels of stress tolerance and resilience vary for each person.  Increasing tolerance and resilience requires an awareness of the likelihood of stressful events, a plan for managing them as best as possible, and supportive, healthy lifestyle habits.

The following are some tips for increasing stress tolerance and resilience:

• be aware of stressful events
• rest and eat well
• maintain focus and routines
• talk with friends
• accept support
• use relaxation techniques
• keep a journal
• pursue spiritual activities