Combat Stress: A Call to Awareness and Action

By McEwen, Michael T. | Army, April 2008 | Go to article overview

Combat Stress: A Call to Awareness and Action


McEwen, Michael T., Army


"There is no better way to put it," A said SSgt. Mark M. "I was acting totally squirrelly. I was definitely not sleeping right. I was always shifting moods with my wife and kids, and I know I was drinking too much. I also developed a really weird feeling that I wanted to avoid going to my unit drills, even though I had always really enjoyed my National Guard unit and my buddies."

Mark is a high school teacher who is well respected in his hometown. He reports that his family and friends typically ignored his strange behavior, and he assumes they were thinking that it was just a phase of readjustment, which would pass. It did notin fact, it got worse as time went on.

Mark did get the help he needed with his problems, but it was not until he happened to attend a returning veterans social event where he met some other recently returned soldiers who were part of a veterans support group in town. That particular group of soldiers quickly picked up on Mark's situation because they knew the signs.

When veterans return from combat today, one of two primary scenarios will occur. One: They will remain on active duty with their military unit, in which case many "homecoming and reintegration" resources and programs will be provided by their military organizations. Two: They will return to the civilian world as newly discharged servicemembers or as Reserve or National Guard members released from their active duty tours. The second scenario is one in which hometown individuals and organizations, including active and retired military members, can perform a major service for returning servicemembers-much like the support group did for Mark.

People at home can be a source of vital assistance to veterans if they know what to look for and how to respond.

Emotional Trauma and Combat Stress

Adapting information from American Psychiatric Association diagnostic criteria provides the following description of the conditions leading to emotional trauma from combat: A person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others; and that person's response involved intense fear, helplessness or horror. When these two criteria occur, post-traumatic stress disorder (PTSD) or other stress disorders may result. Obviously, combat veterans are potential victims of stress disorders.

Since awareness of combat stress problems has recently been expanded, leading to improved intervention and treatment, the percentage of veterans who will experience full-blown PTSD is lower now than in the past. The key to maximum effectiveness in treating the disorder is early recognition and treatment.

The major signs and symptoms of PTSD and related disorders are:

* A generally depressed demeanor, perhaps with occasional unexplained anxiety.

* Nightmares that may or may not be related to actual past experiences.

* Other sleep disturbances-any sleep abnormality that interferes with normal, restful sleep.

* Decreased interest in pleasant activities, including loss of appetite but also a lack of interest in hobbies, family events, social life and the like.

* Flashbacks-intense "reliving the event" experiences which sometimes involve several or all of the senses.

* Intrusive memories-while not as intense as flashbacks, these unwanted remembering episodes intrude on the normal state of mind.

* Physiological reactions-increased heart rate or breathing, the shakes, sweating and so on that accompany an intrusive memory or occur unexpectedly.

* Cue-related reactions-for example, a victim may drop to the ground when hearing a loud gunshot-type sound.

* Sexual dysfunction-may be an unusual decrease or, more rarely, an increase in sexual desire or activity.

* Amnesia-inability to remember traumatic events.

* Hyperstartle-a "jump/jerk" reaction to an unexpected stimulus.

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