Army takes proactive strides to manage combat stress
November 27, 2006
SCHOFIELD BARRACKS, Hawaii (Army News Service, Nov. 27, 2006) - When Sgt. Dartagnan Baker returned to Oahu in 2005 from his first deployment to Iraq, he remembered the unforgiving traffic on H-1, but he now finds it to be overwhelming and startling.
"Nobody likes traffic. But now I hate it," said Baker, who was deployed with 2nd Battalion, 11th Field Artillery Regiment. "Once, when my wife was driving on H-1, I had to roll the windows down because the congestion was making me nervous."
Baker's response, like that of many Soldiers who have experienced long, perhaps violent tours of duty, is a symptom of combat stress.
Combat stress is any type of mental stress or mental strain from being in combat, according to Dr. (Capt.) Aika Gumboc, officer in charge of Schofield's Soldier Assistance Center.
"There may be depression, anxiety or exhaustion from the high-tempo environment, yet such strain does not meet the parameters of a full-blown diagnosis of post-traumatic stress disorder, which is a clinical diagnosis."
Stress is a natural, universal human experience. Combat stress, once known as battle fatigue or shell shock, is also natural. It is the result of the heavy mental and emotional work required to face danger in combat conditions.
Combat situations may be so severe or so prolonged that a person may continue to be on "high-alert" long after the event, creating a wide range of reactions that vary by Soldier.
"In combat, Soldiers must think and act quickly," Gumboc said. "Family or fellow Soldiers might notice extreme reactions to small stressors that, prior to deployment, would not have bothered them in the least."
The stress reactions may be physical (difficulty sleeping), mental (inability to concentrate, nightmares or flashbacks) or emotional (irritability, anger, depression).
Most Soldiers returning home grapple briefly with readjustment or experience mild stress symptoms, then move on. Some are plagued by subliminal reminders - sights, smells, sounds - that may trigger stress reactions for months, even years, after.
"Sometimes at night, the sounds of heavy trucks passing by my house would give me a sort of flashback," admitted Baker. "After being back home for a while, things don't bother me as much anymore."
"In combat, Soldiers are highly accountable for equipment and their fellow Soldiers," Gumboc said. "When they get home, family members might find that their Soldier has become hyper-protective of their things."
Every Soldier has a limit and is at risk of experiencing combat stress.
"Combat stress affects all Soldiers and in no way should be viewed as a negative or weakness," explained Chaplain (Lt. Col.) Kenneth W. Stice, 25th Infantry Division chaplain. "It is not weakness; it's human nature and that's okay. There is no shame in being human and having to sort through the emotions that we all share.
"We are not weak. U.S. Army Soldiers are very capable and resilient," Stice asserted, continuing, "We are also human and should expect to have normal emotional reactions to abnormal events."
Stice said he would be more concerned about the Soldier who claims to have not been
affected at all.
"That's a sure sign that you were, and just don't recognize it," he said.
Though a Soldier may not serve on the front line, he or she is just as likely to have stress reactions.
The Army Medical Department (AMEDD) cautions family members that combat stress reactions can be caused by non-violent pressures like loneliness, boredom and discomfort during extended service in isolated, unpleasant places.
AMEDD also acknowledges that combat stress is better prevented than cured. Leaders are encouraged to correct controllable stressors "in the unit or on the home front," so the Soldier can "face the unavoidable pressures of battle without other issues on their minds."
"Soldiers need to have the comfort of knowing that their family is being taken care of, and they (need to) know whom they can turn to in times of need," Stice said.
Soldiers may be reluctant to seek help with stress reactions for fear of shame or loss of credibility. However, attitudes within the Army about getting help have changed dramatically.
One of the Army's more proactive approaches to managing combat stress reactions downrange are critical-event debriefings.
Stice said certain events occur that require leadership to seek out affected Soldiers.
"A traumatic event, for instance - loss of a servicemember, a serious injury, friendly-fire accidents or mass casualties - will trigger a critical-event debriefing within 36 hours," Stice added. "This debriefing keeps the unit healthy."
Further, each unit, down to the battalion level, is assigned a chaplain and an assistant.
"As a chaplain, one of our tasks is to be a calming presence and deal with the Soldiers who are 'stunned,'" Stice said. "A Soldier may have to retrieve bodies from the fields, retrieve only body parts, or retrieve the bodies of children and women. We help guide them through the normal chain of emotions."
Gumboc affirmed that now more than any other time in the Army's history, Soldiers and leaders are more in tune with the importance of mental health.
"We have more resources available at home and in the theater of operations than ever before," she said. "I am very proud of what we provide our Soldiers.
"The emphasis is on getting Soldiers the health care they need and deserve, and eroding the stigma associated with getting help," she said. "The Soldier's chain of command is only notified if the safety of the Soldier or others is in jeopardy, or laws have been violated. It's on a need-to-know basis," she stressed.