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 at www.realwarriors.net 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: 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:

Visit your primary care provider Check out Military OneSource’s list of helpful combat stress resources Browse the Army’s combat stress webpage at https://phc.amedd.army.mil/topics/healthyliving/bh/Pages/CombatOperationalStressControl.aspx.   If you are experiencing combat stress while in the field or a deployed environment, you can contact the Combat Operational Stress Control 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.
Reaching out is a sign of strength. If you or a loved one needs additional support, contact the Defense Centers of Excellence for Psychological Health Outreach Center 24/7 to confidentially speak with trained health resource consultants by calling 866-966-1020 or use the Real Warriors Live Chat at www.realwarriors.net/livechat.