Combat stress or post-traumatic stress disorder (PTSD), among military veterans and service personnel, is an anxiety disorder associated with severe traumatic conditions. It is characterized by such symptoms as survivor guilt and numbness, recurrent thoughts and images, re-living the trauma in dreams, and lack of involvement with reality. Current or previous combatants who were exposed to severe combat-related traumas show characteristic symptoms such as markedly dissociative behaviors and unreasonable complaint participating in events they previously enjoyed doing. They also show decreased interest, emotional estrangement and detachment, as well as, diminished affection, tenderness, intimacy, and sexuality. Because of the extreme traumatic stressors that such individuals had experienced, they have persistent re-suffering of self-induced threatening events, continuous avoidance of the associative traumatic stimuli, and other symptoms resulting from exaggerated arousal. Likewise, combat-PTSD sufferers manifest disarrayed behaviors, intense horrors, fears, agitations, and powerlessness due to related triggering traumas. Through military service members and veterans witnessing or reliving of combat-related recurrences, they continue to suffer debilitating psychological and social dysfunctions caused by combat stress or PTSD.
Not only does the severity of the traumatic experiences of military personnel vary, but the way they process their prior battlefield experiences may be dependent also with their prior mental health condition and other past traumatic experiences. Because PTSD recurs in various ways, military service members with intrusively recurring recollection of traumatic situations go through recurring nightmares. They experience dissociative conditionings in re-experiencing their psychologically painful life story, which could last for brief period up to many days, months or years. Any resemblance of traumatic scenarios could trigger extreme physiological distress. Related accompanying symptoms include excessive startles, immoderate wakefulness, and trouble falling asleep and sleeping. Other individuals with combat PTSD express anger outbursts, persistent irritability, and trouble finishing up an activity. Moreover, individuals with combat PTSD employ minimal responsiveness to their immediate surrounding should they have emotional anesthesia or psychic numbing as defensive reorientation tactics. They typically employ deliberate maneuvering effort by avoiding feelings, thoughts, conversations, feelings, or traumatic situations similar to the previous ones. By means of amnesia, they prefer avoiding an individual, activity, or events that only arouse recollection of previous scenarios.
II. History of Combat Stress / PTSD
Post-traumatic stress disorder (PTSD), combat over-fatigue, shell shock, or battle disorder is claimed to have been around far beyond past recorded history. It is simply a new label for an erstwhile mental disorder. The most common motivating defense for individuals with combat stress is to survive fear. In early 1800, there were initial discussions on traumatic events suffered by soldiers during battles. Military physicians diagnosed soldiers for being exhausted physically, hence, needing some rests. This disorder that was the result of extreme fatigue and helplessness was later on medicalized. Past combat-traumatic events induce in the soldiers too much sweating, startles, tremors, labored respiration, abnormal palpitation, and lost of consciousness.
During wartimes, such as the US Civil War, Vietnam War and World Wars, combatants with the stress disorder were relatively high. In those periods, combat stresses were serious problems for military physicians because they have difficulty diagnosing the disorder. PTSD in patients have crippling effects and enduring effect. PTSD was thus postulated as neurological and psychological, but still has not stood rigorous medical scrutiny (APA, 2013). During the Second World War, enlistment in the American army requires neuro-psychiatric screening to accept mostly people who can potentially endure war horrors. Military personnel were therefore expected to be more manly, thus, avoiding combat neurosis. To the contrary, still, some soldiers suffered from the war-related stress disorder.
These days, there are many biomedical researches on PTSD. It is increasingly being medicalized even though cultural expectation (for example, male strength) remains among soldiers. Many military personnel who suffered from the anxiety disorder showed intense emotions and promptings. Soldiers were typically amnesiac and show reduced responsiveness. They hide their feelings and shut their emotions to other people, events, and surroundings. Additionally, military service men with PTSD manifest dim vision; hence, they are not expected to have normal life, successful family life, and career. In the entire history of PTSD, the sufferers were, indeed severely injured.
III. Causes of Combat Stress / PTSD
Combat stress or PTSD among military staff has been attributed to life-threatening experiences as they suffered extreme helplessness, horrifying situation or intense fear. Medical doctors, researchers, and other health professionals cannot determine the precise cause why soldiers become prone in acquiring combat anxiety disorder than others. Thus, combat PTSD is considered a combination of inherited risk in mental condition, including the severity and extent of traumatic experiences, as well as, abnormal neural functioning.
In most cases, service members who are likely to be riskier acquiring PTSD includes people with Hispanic ethnic ancestry, individuals who encountered extensive traumas, persons with childhood trauma, and people lacking in emotional familial and social support systems (Schnurr et al., 2004). Moreover, individuals with high degree of anxiety and had traumatic brain injury, as well as, have relatives with history of mental illness are likely victims of this combat stress disorder.
Further, some medical professionals and researchers found out that specific neurotransmitters could give false alarms, but could be turned off using proper medication to avoid regular recurrence of the disorder. Other promising treatments are helpful for medical practitioners in detecting and preventing reliving this serious anxiety mental illness.
V. Prevention and Treatment Combat Stress
Since combat PTSD among military veterans and personnel has various potential causes, the use of different treatments require health professionals to practice proper care, not to mention patients’ consent, support system, and treatment options. Medical practitioners should be familiar with the utilization of clinical and research data in developing personalized rationale for intervention and treatment approach. The rationale serves as basis for treatment service.
Research shows that certain parts of people’s brain are responsible in regulating fear. Health professionals’ competence would be extremely helpful in the diagnosis of this condition. Because they have, not only healthcare but also legal capacity for doing diagnostic treatments specific to the client’s needs, they should do their best to give the needed attention and care for the patient to recuperate somehow from this mental condition. Additionally, professionals’ background in mental health can further assist soldiers and veterans to overcome some of its recurring symptoms before an intervention and treatment. Healthcare practitioners who are well-trained using neural feedbacking could be successful minimizing the depression and anxiety experienced by the victims. Because patients have abnormal level of hyper-vigilance and hormones, they have to inhibit conditions responsible for them to relive their trauma. Biofeedbacking, such as relaxation training techniques, can be another treatment option for patients with combat stress. Patients are taught to relax through positive intervention combined with techniques as guided imagery. A recreated reality will help PTSD victims cope with potentially incapacitating and disruptive scenarios.
Among veterans and service members, pharmacotherapy and chemoprophylaxis are also used to prevent the development of combat stress. Drugs (for example, propanolol, cortisol, and morphine) prevent this anxiety disorder. During the Gulf War, for example, soldiers were administered with high dosages of morphine so that PTSD is less likely to develop. Alternatively, war soldiers who were given cortisol minimize contacting severe stress. Likewise, the beta-blocker propanol demonstrates reduced sleep disturbance and hyperarousal symptoms (for examples, startling, numbing, re-living, and hypervigilance). Despite ongoing assessment and efforts to prevent combat PTSD, additional empirical research are needed to underscore the most efficacious modalities for the treatment of PTSD (Kim, 2013).
VI. Personal Insights
Combat stress or PTSD is mostly associated with seriously horrifying wartime experiences. Former soldiers like me have difficulty forgetting the traumatic experience (for example, gunned down). Even when the event was over, I still have a vivid recollections, flashbacks, and nightmares about my past war encounters. It have a hard time regulating my emotions. I easily get frustrated for no apparent reasons, have mood swings, and other deadening feelings. Some of my atypical mental reactions include my inability to concentrate on task, thinking about dying and death, making self-criticisms, and deciding impulsively. Additionally, I manifested behavioral reaction not limited to the following: compulsive behavior, substance abuse, and decreased sexuality. Despite of all that, I still manage to recover each day given the support that I receive from my former comrades, the government, my family, friends, and other support groups.
Research studies have revealed that combat PTSD is prevalent among veterans, soldier, and other military personnel. The history of PTSD is as far back as the desires of human beings for power, safety, and protection. Combat stress is caused by multiple factors during traumatic battlefield engagements. Soldiers with this anxiety disorder re-live war experiences such as violence, helplessness, fear, fatigue, and stress. In the event a veteran or military has past record of mental illness, high degree of depression and anxiety, and brain injury, he or she has greater risks of having the disorder. Some preventions and treatments for combat PTSD include social support, psychiatric counseling, chemoprophylaxis, and pharmacotherapy. Further empirical studies on combat PTSD are needed for the prevention of the long-term effects of this mental disorder.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders – DSM-5 (5th Ed.). Virginia: APA Publisher.
Kim, S. (2013). Meta-Analysis of Psychotherapy and Alternative Treatments for Combat-Related PTSD. Retrieved from Baylor University Waco, https://beardocs.baylor.edu:8443/xmlui/handle/2104/8662
Schnurr, P., Lunney, C., & Sengupta, A. (2004). Risk factors for the development versus maintenance of PTSD. Journal of Trauma Stress, 17(2), 85–95.