Ways to recognize, treat combat stress

Published Sept. 19, 2006
By Master Sgt. Orville F. Desjarlais Jr.
455th Air Expeditionary Wing Public Affairs

BAGRAM BASE, Afghanistan (AFPN) -- EDITOR'S NOTE: This is the third in a series of three articles about Air Force combat stress control teams in Afghanistan treating troops on the front lines.

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

In fact, 50 percent of all servicemembers 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. Servicemembers may also endure mortar and rocket attacks.

The second type of stress is operational stress -- the type most servicemembers are susceptible to. This type of stress occurs at a main operating base where servicemembers live with little privacy, sleep in jammed quarters for months on end and don't get to see firsthand the progress U.S. forces have made in fighting extremists or helping Afghanis rebuild 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, Md.

"We're at war. People need to have the resources so 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 rest and relaxation.

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

The following symptoms are signs of stress. Medical professionals say a person may experience some or none of the stress symptoms because people react differently. Reactions may last for weeks or months, but 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 may include upset stomach, vomiting, muscular contractions, sweating, shakiness, tension, disorientation, vision problems, hyperventilation, exhaustion, urinary frequency and diarrhea.

Emotional signs of stress are 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 include 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 surroundings.

Behavioral signs are 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: journal writing, appropriate humor, deep breathing, mediation, music, reading, prayer, 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.

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