Combat stress is not new. It was called "shell shock" in World War I, "battle fatigue" in World War II, and "traumatic stress" in the Vietnam War. Combat stress should not cause shame or embarrassment. Today's term, "combat stress," encompasses the typical and normal responses to working in a war zone. Combat stress can be managed, but special steps must be taken.

Step One: Recognizing Combat Stress

It is very common, normal, and expected for service members exposed to traumatic events to display combat stress reactions. These reactions are not signs of weakness, lack of discipline, or insanity. They are normal reactions to abnormally stressful situations. They can appear a few hours, days, or even months after the traumatic event. According to the "Combat Stress Reactions: Normal Responses to Abnormal Conditions" video, symptoms may include but are not limited to:

• physical reactions, including rapid heart rate, trembling hands, headaches, and chest pain
• cognitive reactions, including nightmares, heightened alertness, intrusive images, and difficulty concentrating
• behavioral reactions, including withdrawal, isolation, appetite change, and increased alcohol consumption
• emotional reactions, including anxiety, fear, guilt, grief, denial, anger, outbursts, irritability, and depression

Step Two: Coping With Combat Stress

Service members should not try to block stress reactions (especially recurring thoughts, dreams, or flashbacks) or numb the pain with alcohol. These are normal responses and will decrease over time. Talking is recommended, according to Leslie H. Slosky, MSW, LCSW, Treatment and Intervention Unit Program Manager at MCAS New River. She explains, "One of the proven mediation factors for combat stress is the ability to process the experience with others who have been through the same experiences."

Other recommendations include reading about trauma, engaging in physical activity, and practicing relaxation methods. Often these methods will reduce the severity of the stress reactions, which will fade over time. Sometimes though, these normal stress reactions persist and require professional assistance.

Step Three: Finding Professional Help

Professional help is needed when combat stress reactions interfere with service members' personal relationships, everyday lives, or job performance. According to Slosky, "The sooner the service member seeks assistance, the easier it can be to resolve the issues, and the less likely he or she is to experience disciplinary problems."

Help is available through area chaplains and licensed counselors at Navy Fleet and Family Support Centers and Marine Corps Community Services.

Some service members fear that seeking professional help will harm their careers. "Absolutely not," says LtCol Mayer in the "Combat Stress Reactions: Normal Responses to Abnormal Conditions" video. "He wouldn’t think twice about going [to the doctor] if he had broken an ankle. … His buddies are counting on him. … He must come forward in order to get better. If he lets combat stress continue to fester inside of him, it will only get worse."

Traumatic memories cannot be erased, but with knowledge, patience, and professional assistance, the stress they cause can be managed.