is combat stress?
overlooked are the many adaptive or "good" combat
stress reactions. These might include increased alertness,
exceptional strength, heightened endurance or tolerance
to pain and hardship.
stress" is a term used to describe normal physiological, behavioral,
and psychosocial reactions experienced before, during or after combat.
In the past, it was thought that service members experiencing combat
stress reactions were mentally ill.
has shown this is not the case. Most conditions related to stress
during combat are normal reactions to the abnormal circumstances
of war. Typical (maladaptive and adaptive) combat stress reactions
include difficulty concentrating, extreme anxiety or "fright,"
diarrhea, regression, and marked sadness, and are often not mental
illness at all.
combat stress that big a deal?
Yes! Failing to
prevent or effectively manage combat stress reactions has resulted
in significant preventable combat losses. During World War II an average
of one combat stress casualty for every four wounded typically occurred.
However, in battles such as Okinawa, involving particularly heavy
fighting, a ratio as high as one stress casualty for every two wounded
management of battle fatigued military members has reduced
the rate of chronic mental illness following combat.
has proven that dedicated combat stress control efforts have prevented
unnecessary evacuation of battle fatigued service members and has
led to greatly increased return to duty rates for affected members.
is "battle fatigue"?
fatigue is the term used by the Army to describe combat stress casualtiesthat
is, service members experiencing combat stress reactions to the point
where they are no longer combat effective. Battle fatigue is not a
disease. It is a transient state and a normal response to the abnormal
circumstances of war.
are battle fatigued service members managed?
fatigued service members are most often managed using the four R's.
Rest, Replenishment, Reassurance, and Restoration.
Minimum of rest (4-6 hours) and respite (or shelter from heat,
cold, rain, snow).
Provide plenty to drink, a hot meal, a wash, as possible to restore
the service member's energy level and hygiene.
Reassure the military member that he/she is OK and allow him/her
to verbalize what happened. Members (75-95 percent) experiencing
battle fatigue are experiencing a normal response brought about
by a combat situation and not necessarily suffering from a mental
illness or a "weakness." The fact is most of these military
members can return to duty, with no ill-effects, within 24-72
hours. In the past, when a member has been labeled as sick or
disturbed, he/she was more likely to develop a real psychological
problem and less likely to return to duty.
Engage the military member in tasks which restore his/her identity
as an active duty member (rather than a patient) and that restores
his/her sense of competency as a capable, combat effective member
of the team.
are the basics used in managing battle fatigue casualties, there
of course will be service members who also require a brief medical
or neuropsychiatric evaluation to rule out serious physical/mental
illness or injury.
I experience combat stress, does that mean I have a mental problem?
As mentioned above, most service members who experience combat stress
reactions are not mentally ill and make a full recovery within 24-72
hours. This is because the majority of combat stress reactions are
simply related to fatigue or are normal reactions to abnormally stressful
or traumatic situations.
Detachment, Fort Bragg, U.S. Army