Helping Families Understand Combat Stress
Welcoming home a loved one from a deployment is an emotional time for service members and their families. As a family member, you hope that your warrior quickly reintegrates to “normal” life, but the stresses associated with combat experience can linger. Traumatic events involving direct combat or non- combat, such as your loved one coping with the death of a fellow service member, can sometimes lead to behavior changes or even development of post-traumatic stress disorder (PTSD).
Combat stress-due to a single event, from a series of events, or from a continuous stressful situation-can result from working in tough, dangerous conditions.1 During a deployment, some factors contributing to the likelihood of a service member experiencing combat stress include:2
- Continuous operations
- Not knowing where or who the enemy is; this includes suicide bombings and improvised explosive devices (IEDs) which are often hidden
- Knowing that the conflicts are a subject of debate back home
- Having rules of engagement that restrict a service member’s ability to return fire in some circumstances leading to greater feelings of helplessness
As service members reintegrate following a deployment, they can experience symptoms of combat stress which appear in the form of physical, mental, emotional and behavioral changes. It is likely that your service member will experience at least some of these signs as a common reaction, which can last a few days to a few weeks:2
|Exhaustion||Difficulty concentrating, confusion||Fear, worry, extreme nervousness||Carelessness or recklessness|
|Inability to fall sleep or stay asleep||Inability to make decisions, to process information||Irritability, anger||Outbursts of anger or aggressiveness|
|Sweating, heart pounding||Nightmares||Mood swings||Staring into space|
|Nausea, frequent urination, diarrhea||Memory loss||Despair and sadness||Inability to perform on the job|
|Jitters, trembling or jumpiness||Flashbacks, reliving the trauma||Feelings of isolation||Increased use of alcohol or drugs|
|Numbness, tingling or total loss of function of limbs or other body parts||Loss of sense of what is real||Misconduct|
|Hallucinations or delusions (not taken care of by adequate sleep||Complete unresponsiveness to others|
The Real Warriors Campaign article, “Combat Stress: A Natural Result of Heavy Mental and Emotional Work”, provides an overview of combat stress – how to recognize its symptoms and when to reach out for support.
If your service member’s symptoms persist months after returning home or interfere with job performance or interaction with others, it is important to seek professional help.3 If you believe your service member is at risk of hurting himself/herself or others, seek medical attention immediately.
Back at home, several situations that your service member could experience may trigger stress reactions that are similar to combat stress reactions, such as: 4
The Real Warriors Campaign features videos of service members and veterans who have sought support and successfully managed their combat stress. One of the video profilees is retired Army Maj. Ed Pulido who was wounded by an improvised explosive device (IED) blast while serving in Iraq. He returned home facing tremendous physical and psychological challenges, including thoughts of suicide. Reaching out for and accepting support from others and focusing on helping service members and families in similar circumstances helped Pulido cope with his visible and invisible wounds.
- Large crowds
- Involvement in a car accident
- Seeing someone else involved in a traumatic experience, e.g. witnessing an assault
- High-stress events, e.g. arguments with loved ones
- Pressure from family or friends
- Differing priorities of the service member and family or friends
While there is no ideal way to protect someone from every situation that can cause a stress reaction, there are things that you can do to help protect your service member from stressful circumstances and deal with the stress reaction if it does occur, such as:5, 6
- Learning as much as you can about combat stress. Knowing how it can affect people may help you understand what your service member is going through. The more you know, the better you and your family can handle combat stress. The Real Warriors article, “Supporting Your Service Member with Psychological Health Concerns” also explores various reactions to traumatic experiences as well as additional resources and treatment options.
- Attending doctor visits with your family member. You can help keep track of medicine and therapy, and you can be there for support.
- Starting a conversation with your service member
- Let them know you are interested in hearing about their experiences and feelings, but also understand if he or she doesn't feel like talking.
- Help your service member put feelings into words. Ask, “Are you feeling angry? Sad? Worried?” Don’t argue or interrupt, repeat what you hear to make sure you understand, and ask questions if you need to know more.
- Tell your service member how you feel about them; they may not realize how much you care.
- Encourage them to share their experiences with a buddy or their chain of command.
- Suggest that they visit with a chaplain. Even if your service member is not religious, they might benefit from such a meeting. Religion will be discussed only if the service member requests it. Conversations are confidential and do not become part of your service member’s medical record.
- Planning family activities together, like having dinner or going to a movie.
- Taking a walk, going for a bike ride, or doing some other physical activity together. Exercise is important for everyone’s physical and psychological health.
- Encouraging contact with family and close friends. A support system will help your family member get through difficult changes and stressful times.
Trained health resource consultants are available through the DCoE Outreach Center around the clock to answer your questions through the Real Warriors Live Chat feature, by calling 866-966-1020 or by emailing firstname.lastname@example.org. (Note: All interactions are confidential unless there’s concern over expressions of self-harm or harm to others.)
Withdrawal can also be an initial symptom of combat stress. If your service member doesn’t feel like talking, taking part in group activities, or being around other people, give your loved one space, but tell him or her that you will always be ready to help. Afterdeployment.org’s “Overcoming Isolation” workshop provides a way to learn from other families sharing their stories of experiencing withdrawal by a loved one.
Remember throughout all of this that you also need to take care of yourself. Changes in family life are stressful, and taking care of yourself will make it easier to cope for you, your family and your service member. There are resources available that can answer your questions and provide the support you need to remain positive, stay healthy and help improve communication with your service member.
Visit the Real Warriors Campaign Message Boards and share your stories and advice in the Families forum to help others supporting loved ones with psychological health concerns.
- Guide to Coping with Deployment and Combat Stress [PDF 2.51 MB]
- Family Resiliency Training for Military Families
- Pre- and Post-Deployment Resilience Training for Spouses/Couples
1 "Combat and Operational Stress," Marine Corps Community Services. Last accessed Jan. 30, 2013.
2 "Combat and Operational Stress Control," [PDF 109.19 KB] Navy and Marine Corps Public Health Center. Last accessed March 15, 2013.
3 "Combat Stress Reactions," [PDF 477.2 KB] Operation READY, U.S. Army. Last accessed Jan. 24, 2013.
4 "Post-Traumatic Stress," [PDF 1.06MB] afterdeployment.org. Last accessed Jan. 30, 2013.
5 Combat and Operational Stress, Leaders Guide for Managing Marines in Distress, U.S. Marine Corps. Last accessed Jan. 24, 2013.
6 Helping a Family Member Who Has PTSD, National Center for PTSD, Department of Veterans Affairs. Last accessed Jan. 24, 2013.