An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

Part III: Ways to recognize and treat combat stress

  • Published
  • By Master Sgt. Orville F. Desjarlais Jr.
  • 455th AEW public affairs
BAGRAM AIRFIELD, Afghanistan --  EDITOR'S NOTE: This is the last in a series of three articles about Air Force combat stress control teams in Afghanistan treating troops on the front lines.

Psychologists say all deployed service members will encounter stress during their deployments.

In fact, 50 percent of all troops who visit a combat stress control team at Afghanistan forward-operating bases are diagnosed with combat-related stress.

The trick is to learn how to deal with it, according to Lt. Col. Rhonda Ozanian, Combat Stress Control team leader, Task Force Med.

Combat stress control teams are scattered throughout Afghanistan because of an Army request, called a request for forces. The Airmen augment the Army with psychologists, psychiatrists, social workers and mental health technicians.

"There are two types of deployment stress, combat and operational," Colonel Ozanian said. "Combat-related stress is the culprit blamed for post traumatic stress disorder, a steady state psycho-physiological condition that develops as a reaction to severe traumatic events or prolonged trauma. PTSD is widely noted among Vietnam veterans."

Combat operations, roadside bomb explosions and suicide bombers create incredible stress on troops. Service members may also endure mortar and rocket attacks.

The second type of stress is operational stress -- the type that most service members are susceptible to. This type of stress occurs at a main operating base, such as here, where service members live with little privacy, sleep in jammed quarters for months on end and don't get to see first hand the progress U.S. forces have made in fighting extremists or helping Afghanis re-build their villages and towns.

"People get bored, lonely, and have too much time to think and get into trouble," Colonel Ozanian said. "Here, personnel don't get to forward deploy. The intensity of the stress is lower but just as problematic for commanders."

Colonel Ozanian said her team has diagnosed 9 percent of Bagram patients with combat-related stress.

"We accept a lot of things as normal, when they are not," said Maj. Jocelyn Kilgore, a combat stress control team chief at Kandahar Airfield, Afghanistan. She's a psychiatrist from Andrews Air Force Base, M.D.

"We're at war. People need to have the resources to they can take care of themselves and their buddy," she said. "People need to find someone they can confide in - a wing man"

The combat stress control teams practice what they preach. When they return from weeks of FOB hopping, they get what they call "re-fitted" to recharge. They put a priority on setting aside a day of R and R, rest and relaxation.

She said for the combat stress control team to be successful, they stress prevention and teach service members coping skills.

The following symptoms are signs of stress. Professionals say a person may experience some or none of the stress symptoms because people react differently. Professionals say the reactions may last for weeks or months, but that they usually gradually decrease over time. They say the responses are normal and don't need treatment unless the symptoms continue for extended periods of time.

Physical signs: Upset stomach, vomiting, muscular contractions, sweating, shakiness, tension, disorientation, vision problems, hyperventilation, exhaustion, urinary frequency and diarrhea.

Emotional signs: Anxious or agitated, guilt, fear, anger, grief, general loss of emotional control, depression, emotional numbing, feeling abandoned or lost, helplessness, resentment, shock and feeling overwhelmed, loss of confidence or faith or hope, fear of repetition of the event and avoidance behavior.

Cognitive signs: inattention, impaired thinking, poor concentration, confusion, difficulty performing calculations, low attention span, flashbacks, time distortion, memory lapse, distressing dreams, intrusive memories and a decreased alertness to your surroundings.

Behavioral signs: Carelessness, panic running, withdrawal from others, eat habits change, lower sex drive, lower interest in loved ones, startle response, avoidance behavior, trouble staying awake or falling asleep, nightmares, night sweats, excessive angry outbursts and crying spells.

The following suggestions may help people cope with stress.
How to develop resilience to traumatic events: Recognize it as a traumatic event, remain calm, get enough rest, focus on day to day tasks, exercise, maintain close social ties, talk about your experience with others, think positively, accept support from others, eat right, don't label yourself crazy, give yourself permission to feel rotten, re-establish routine activities, do things that make you feel good and don't make any major life changes.

Other known helpful stress relievers: keep a journal, appropriate humor, deep breathing, mediation, music, reading, prayer, seek spiritual help and counsel.

Unhealthy signs and when to seek help: Poor self care, prolonged isolation from friends, anger, irritability, depression that doesn't decrease with time, frequent suicidal thoughts and alcohol or drug abuse.