Combat Stress vs. PTSD: How to Tell the Difference

Post Traumatic Growth 160227

I have wanted to write about my thoughts on the differences between combat stress and PTSD. Lately, I am hearing the term Combat PTSD. Anyway, when I began my research I found this gem written by a Navy Doctor named Commander Carrie Kennedy. It is a good read:

FEBRUARY 18, 2015


This blog post is from Navy Medicine Live, written by Cmdr. Carrie Kennedy, a neuropsychologist and aerospace experimental psychologist with Marine Corps Embassy Security Group. Kennedy describes the similarities and differences of combat stress and post traumatic stress disorder (PTSD) to help you prevent or effectively manage both.

It seems like the terms combat stress and PTSD are everywhere these days; it’s hard to go a few days without seeing a news story about veterans and these issues. But what are these concepts? Do they mean the same thing? And, perhaps most importantly, what can be done?

Combat stress and PTSD are very different. However, because they share certain symptoms, you may not easily recognize that they’re different. It requires some understanding to separate the two. Unfortunately, sometimes they look similar, which can make understanding them somewhat complicated.

By definition, combat stress is an expected and predictable reaction to combat experiences. After being in a combat zone where you’re under constant physiological stress (poor diet, extreme temperatures, little opportunity for good personal hygiene, etc.) and psychological stress (concerns about improvised explosive devices, snipers or the death of fellow service members), a number of responses is expected.

These responses often show up as hyperstartle (exaggerated response when something surprises you — often a loud noise), hypervigilance (always being on guard or super-alert), nightmares, irritability, sleep problems, etc. While they sound negative, some combat reactions are actually considered adaptive, notably hyper startle and hyper vigilance. PTSD, on the other hand, refers to a psychological disorder which impairs functioning. It’s considered very serious whereas combat stress is considered to be a normal reaction to traumatic circumstances.

To receive a PTSD diagnosis, specific symptoms have to be present following a traumatic event in which death, serious injury or sexual violation occurred or was a real possibility.

These include re-experiencing symptoms (recurrent dreams, flashbacks or intrusive images), avoidance symptoms (avoiding conversations about the event or people associated with the event, memory loss, etc.) as well as sleep disturbance, irritability/anger problems, concentration difficulties and hypervigilance.

Although there’s some overlap between combat stress responses and PTSD symptoms, they’re not addressed in the same way. Keep in mind that combat stress isn’t considered a medical problem or something that requires treatment. For many war veterans, combat stress wears off after being back in the states for a few weeks to months. However, if service members don’t do certain things, combat stress can persist or morph into something else, like PTSD, depression or alcohol abuse. Knowing what to expect may prevent that from happening.

Because of destigmatization programs and policies, service members are more likely to question whether or not their combat stress reactions should worry them. Military mental health providers and psychiatric technicians can provide one or two sessions of psychoeducation discussing what combat stress is and what the usual reactions are, assist in processing difficult experiences, and teach how to proactively address combat stress (maintain contact with other veterans, have a plan for anniversaries of friends’ deaths, keep alcohol use low, etc.).

For those with normal reactions, this is often all it takes to make a smooth transition from the combat zone.

However, the real key to effective management of combat stress and long term adjustment is something that veterans have known through the ages — namely — veterans have to be in regular contact with other veterans. Talking about difficult experiences with members of the same unit is the best way to process combat experiences, stay grounded, get rid of lingering doubts and concerns and prevent the development of abnormal problems.

This is done frequently while in the combat zone and should continue when you return home. Other good people to talk to are veterans of the same war even though they may have served in a different unit or branch of service as well as veterans of any other war. While warfare changes somewhat over time, the basic stressors are enduring. American Legions, Veterans of Foreign Wars and other veteran-centric groups are significant assets in effectively dealing with combat stress.

What about PTSD? While treatment for PTSD will involve some of the same concepts as those necessary to effectively manage combat stress, the primary interventions need to be done with a mental health provider. The good news is that there’s very effective treatment available — Cognitive Processing Therapy and Exposure Therapy are provided by just about every mental health department in military and Department of Veterans Affairs hospitals and clinics. These treatments help with symptom resolution and lifelong strategies for the effective management of disturbing wartime experiences, decreasing the likelihood of symptom recurrence.

In short, combat stress is a reaction which through some basic self-implemented strategies, in addition to the passage of time, wears off. Terrible experiences and memories will always be troubling to think about. — the goal is not to make these kinds of experiences easy. However, through observation of anniversaries, life-long interactions with members of the unit and other veterans, you can move into different phases of your life without too much difficulty.
PTSD is a higher hurdle, but not one you can’t overcome. If you’re experiencing PTSD symptoms, seek help. New, evidence-based treatments effectively address PTSD, even for veterans of prior wars.

By the Defense Centers of Excellence For Psychological Health & Traumatic Brain Injury

Combat Stress vs. PTSD: How to Tell the Difference




Brought to you by the dudes at Spotter Up! 

Originally posted Feb 27, 2016 @ 13:16



About The Author

David K. Devaney SgtMaj USMC Retired 2009 City of Hit Iraq with PTTDavid was born in Geneva New York and graduated from Geneva High School in 1980. He joined the Marine Corps on a guaranteed Infantry contract in April of 1983. After graduating boot camp he was stationed in Hawaii with 3rdBattalion 3rd Marines (3/3). While assigned to 3/3 he held billets as a rifleman, fire team leader, and squad leader. During 1986 Corporal (Cpl) Devaney was selected as a member of Surveillance and Target Acquisition (STA) Platoon, 3rd Battalion 3rd Marine. Upon graduation of Scout Sniper School he was assigned to the Scout Sniper Section of 3/3 STA Platoon. During his second deployment as a Scout Sniper with 3/3 he was promoted to Sergeant (Sgt). After a tour on the drill field from 1989-1991 Sgt Devaney returned to STA 3/3 were he deployed two more times. During 1994 Sgt Devaney was selected to the rank of Staff Sergeant (SSgt) and ordered to III Marine Expeditionary Force (III MEF), Special Operation Training Group (SOTG); while at SOTG SSgt Devaney was assigned as a Reconnaissance and Surveillance (R&S) and Urban Sniper Instructor and Chief Instructor. At the time III MEF SOTG Instructors were members of Joint Task Force 510 (JTF 510 CT); a Counter Terrorism Task Force. In 1998 he deployed to Operation Desert Fox with Battalion Landing Team (BLT) 2/4 and was attached to Operational Detachment Alpha (ODA) 572/594 as a sniper. SSgt Devaney deployed again, during 2000, with ODA 135/136/132 to Malaysia as member of JTF 510, working with the Malaysian National Police. After leaving SOTG Gunnery Sergeant (GySgt) Devaney was assigned to Company A 1st Battalion 7th Marine, and spent much of his time training the Scout Snipers of 1/7. Just before the invasion of Iraq, in 2003, he was selected to the rank of First Sergeant (1stSgt) and led 270 Marines, sailors, and soldiers during combat – receiving a Bronze Star Medal for destroying the enemy and their will to fight. During 2004 1st Sgt Devaney was ordered to duty as the Inspector Instructor Staff 1st Sgt for 2nd Beach and Terminal Operations Company, Savannah, Georgia. During 2007 he was selected to the rank of Sergeant Major (SgtMaj) and received orders to Electronic Warfare Squadron 4 (VMAQ-4) stationed at Cherry Point, NC. There he trained a CADRE which in turn trained a massive Quick Reaction Force in combat operations. After two more deployments to Iraq SgtMaj Devaney received orders to Weapons Training Battalion, Quantico, VA. SgtMaj Devaney retired from the Marine Corps on 31 December 20013. He now works as an adjunct combat instructor at the “Crucible’’ in Fredericksburg, VA. David is also on the Board of Directors of the Marine Corps Scout Sniper Association. David’s published work: Books Devaney, D.K. (2007). Surviving combat: Mentally and physically (3rd edition). 29 Palms, CA: USMC. Devaney, D.K. (2015). They Were Heroes: A Sergeant Major’s Tribute to Combat Marines of Iraq and Afghanistan. Annapolis, Maryland: Naval Institute Press. Articles Devaney, D.K. (2011) Enough Talk of Suicide, Already! Proceedings Magazine. Devaney, D.K. (2011) Can PTSD Be Prevented Through Education? Proceedings Magazine. Devaney, D.K. (2012) PTSD Is Not Cancer. The Marine Corps Gazette. Devaney, D.K. (2012) Women in Combat Arms Units. The Marine Corps Gazette.

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