Combat stress – what is it?

Combat stress – a response to permanent life-threatening experience

“Stress is a normal response of the body to a situation. It is when the situation is getting on top of an individual that stress becomes a problem. Every individual has a unique adaptability, with different vulnerability to stimuli that can cause mental breakdown," says Lieutenant Colonel and Doctor Radosław Tworus, head of the Psychiatry and Military Combat Stress Clinic of the Military Institute of Medicine in Warsaw.

He further explains that “combat stress" refers to stress elicited by the involvement in military activities. “It is more of a literary name that you won’t find in any medical classification," he adds.

The identifying characteristic of combat stress is permanent life-threatening experience; soldiers within the combat zone are exposed to the constant risk of being attacked in the base or during a patrol, or stepping into a mine. Being away from the family is also a distressing experience, which might be augmented by worrying news from home about, for instance, a sick child or a power outage in the apartment.

“Such stress may lead to the disorganisation of one’s psyche," Mr Tworus adds. On the one hand, its after-effects might be mild and include increased irritability. On the other hand, it causes permanent damage in the form of anxiety disorders, depressive symptoms and sleep disorders.

The PTSD is not preventable

Combat stress might cause the PTSD (post-traumatic stress disorder). “Under certain circumstances, patients experience sudden mental flashbacks of past events, which are so vivid they feel as if they are actually reliving them. These things creep into their minds against their will," explains Doctor Tworus.

Post-traumatic stress disorder can also cause the suffering individual to have dreams about the traumatic events. The individual might become irritable or hyperactive, or, on the contrary, become withdrawn and reluctant to leave home. Moreover, they are often seen to have problems with reintegrating into normal life in their home countries.

As the psychiatrist points out, the PTSD is not preventable, as there is no way of fully predicting what extreme experiences a soldier might face on a mission and to which of these experiences he or she will prove vulnerable. This makes it impossible to prevent this condition.

The PTSD does not, however, afflict only soldiers. Victims of car accidents, for example, suffer of this disorder as well.

Treatment: psychotherapy plus medication

The Military Institute of Medicine estimates that approximately 10 percent of soldiers who have served in a mission struggle with mental health problems. Since 2005, the Clinic at the Szaserów Street provided over 500 hospitalisations, with some of the patients being re-hospitalised several times. For over a year now, half the patients of the Institute are military people.

The PTSD has been found in over 30 percent of veterans, with others suffering from other disorders including, in extreme cases, psychosis.

Doctor Tworus claims that treating the PTSD is a complicated process. It combines medication and psychotherapy in a proportion that depends on which symptoms are more severe. Medication is, however, indispensible to stabilise sleep, reduce irritability and alleviate anxiety.

The Institute treats its patients in stages. The first one involves a diagnostic cycle, which, in the case of classic PTSD, is followed by two or three psychotherapeutic cycles, which are six weeks long each.

“The longest hospitalisation we have provided to a patient lasted almost one year. Before receiving treatment, the patient, severely disturbed, was preliminarily deemed unfit for military service. After hospitalisation, however, he went back to the military and started a family. Recently, he has made it to an officer’s school," Doctor Tworus concludes.