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Combat and Operational Stress: A Natural Result of Heavy Mental and Emotional Work

soldiers in combat

Army photo by Staff Sgt. Chad Menegay

Combat stress reaction is a common response to the mental and emotional strain service members experience when facing tough or dangerous combat situations. It is often called combat and operational stress reaction because this type of stress can happen during peace and war time. It can be due to combat or stressful conditions during operational training or deployment. It can be triggered by a situation that reminds you of a difficult experience.

It’s important to remember that everybody responds differently to stress. You may not have the same symptoms as your buddy. To help determine if you’re experiencing combat and operational stress, talk to your primary care provider. You can also use a confidential, online self-assessment to jumpstart the conversation.

Recognizing Combat and Operational Stress

Unlike physical pain, the signs of combat and operational stress reaction may be tough to detect. Symptoms may involve thoughts and emotions that aren’t externally obvious. It can change the way you think, respond to emotions or behave. This can disrupt your work and home life.
Risk factors for combat and operational stress include:

  • Witnessing death
  • Fearing for your life
  • Losing a close friend or valued leader
  • Being physically injured
  • Deploying repeatedly or for a long period of time
  • Having a history of psychological health concerns
  • Experiencing relationship stress
  • Getting less than 6-8 hours of sleep daily, on average
  • Sustaining a traumatic brain injury

Common symptoms of combat and operational stress include:

  • Trouble with focus and/or memory
  • Flashbacks (re-experiencing stressful events)
  • Hallucinations (seeing, hearing or feeling things that aren’t real)
  • Nightmares and trouble sleeping
  • Depression
  • Guilt and shame
  • Withdrawing or avoiding others
  • Angry outbursts
  • Exhaustion
  • Extreme anxiety

Reach out for immediate medical evaluation and help if symptoms [PDF]:

  • Continue for longer than a month or severely impact your daily work and/or home life
  • Become increasingly worse
  • Include self-destructive behavior or thoughts of suicide

The Importance of Treatment

Because combat and operational stress reaction can affect your personal and professional lives, treatment is critical. The right treatment will help you maintain your readiness and support the strength of your family and military unit. Getting an assessment and care from your health care provider early can also prevent your stress from worsening or becoming long term.

During your assessment, your doctor will rule out other conditions. Many symptoms of combat and operational stress reaction closely mimic other psychological and physical conditions. For example, individuals with posttraumatic stress disorder can also have anxiety, guilt or trouble concentrating. A careful assessment ensures you and your provider can work together to create the best treatment plan for your needs.

Finding Care

There are many ways to get support for combat stress. If you aren’t deployed, you can:

If you are experiencing combat stress while in the field or a deployed environment, you can contact the Combat Operational Stress Control (COSC) team for your area of operations or embedded behavioral health care provider if there is one assigned to your unit. In many cases, these teams can help you return to your unit without a referral to higher level care. Every military service has a COSC program:

Reaching out is a sign of strength. If you or a loved one needs additional support, contact the Psychological Health Resource Center 24/7 to confidentially speak with trained health resource consultants, call 866-966-1020 or use the Real Warriors Live Chat. You can also visit our “Seek Help, Find Care” page to see a list of key psychological health resources.

Additional Resources

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