Introduction 

If you are a Soldier returning from a combat or other intense or dangerous operational deployment, it is probably safe to say that you already know a few things about stress. You probably know that stress can be both a positive and a negative experience (e.g., it can keep you alive and/or it can put you or others in danger). You also probably know that it is common and totally normal to feel “stressed” both during and after a deployment. Finally, you probably have been told to expect some stress when you come home and go through the process of reuniting with your family and friends who were not with you during the deployment. Most of these stress reactions, although unpleasant in the short term, do not result in long-term problems. In some cases, however, the stress from an operational deployment can cause more serious problems that require additional help to overcome. This brochure is intended to help you understand some of the more serious deployment-related stress problems. It will also give you some general guidance on where you can go to get assistance if you think that you may be experiencing any of these problems. Remember, any Soldier CAN face serious deployment-related stress problems, but most Soldiers do not. Most Soldiers will only experience the mild to moderate forms of deployment-related stress. If you ever have any questions, ask a medical provider, behavioral health professional, or chaplain for more information or assistance.

An Overview of Deployment-Related Stress Our bodies and minds are built to deal with and handle stress. Sometimes, though, the amount of stress we face overwhelms our defenses. When this happens, we start to act, feel, and think in ways that are different from what is normal for us – we just do not feel “right,” or we feel like we cannot do the things we are used to doing. Whether these problems are mild or serious and whether they last for a short time or a long time depends on the nature of the stress and the strength of our defenses at the time the stress occurs. Keep in mind, though, that the strength of everyone’s defenses varies over time based on what else is going on in their lives and their overall health. For the most part, there are four kinds of deploymentrelated stress problems that you should know about. These are— 

• Combat/Operational Stress Reactions (COSRs). • Adjustment Disorders. • Acute Stress Disorder (ASD). • Posttraumatic Stress Disorder (PTSD). 

COSRs are the mildest and most common form of deployment-related stress problems, and PTSD is the most severe.  Soldiers experiencing COSRs are in the Green/Amber Zone, Soldiers with Adjustment Disorders are in the Amber Zone, and Soldiers with ASD or PTSD are in the Red Zone.

Any deployment-related stress problem can be serious, but most are resolved quickly with just a little bit of help.

Posttraumatic Posttraumatic Stafter a Soldier is combat or other oevent must have serious injury and involving intense following table lisPTSD with exam

Stress 

Performance Good Stress Bad Stress 

1. The trauma

• Unwanted 

nightmare

• Acting or 

(e.g., “flas

• Intense d

reminders 

2. Things that 

avoided an

• Trying to 

activities, event 

• Trouble r• Feeling e• Feeling d

3. The person 

• Having a • Feeling ir• Having a • Being “to• Feeling “j

In PTSD, symptocause significant function. Symptofollowing the evemonths later. 

• Combat/Operational 

Stress Reactions 

• Adjustment Disorders • Acute Stress Disorder • Posttraumatic Stress 

Disorder

Mild

Severe

Most Soldiers wido, it is importanof PTSD cases, gIt is also importaexperience some blown PTSD. Roreturning from OEnduring Freedosymptoms. We dactually have PT

PTSD is the mostress problem. suffering from Pa medical profe
Acute Stress Disorder (ASD) 

If PTSD is the most severe form of deployment-related stress problem, then the closely related Acute Stress Disorder, ASD, is the second most severe form. Both involve exposure to a significant traumatic event and a response of intense emotions. Overall, ASD looks and feels a lot like PTSD. There are, however, a few very important differences. First, ASD does not last as long as PTSD. In most cases, ASD lasts less than 1 month. If symptoms last longer than that, then the person may have PTSD rather than ASD. Second, in addition to the reexperiencing, avoiding, and being “keyed-up” that is associated with PTSD, people who develop ASD also experience “dissociation.” Basically, dissociation occurs when the mind and the body part company for a while. Examples of dissociation are listed in the following table.

Dissociative Symptoms 

• Being unaware of your surroundings • Feeling like you are “outside your body” • Feeling like things are happening to “you” • Not being able to remember important things about 

the traumatic event 

• Feeling like you “cannot feel” • Feeling detached 

ASD is more common than PTSD. Studies estimate that between 14 and 33 percent of people who have been in serious motor vehicle accidents develop ASD. It also seems that having ASD makes it more likely that a person will have stress-related problems later on. In some cases, ASD develops into PTSD. One study suggests that this may happen in as many as 80 percent of ASD cases. Adjustment Disorders Adjustment Disorders are much more common than either PTSD or ASD and, on the whole, are usually much less serious. An Adjustment Disorder occurs when an individual is exposed to stress, causing a reaction that results in significant distress or impairment. That reaction can involve depression, anxiety, disturbance of conduct, or any combination of these.

Principle Types of Adjustment Disorders 

• Adjustment Disorder with Depressed Mood • Adjustment Disorder with Anxiety • Adjustment Disorder with Mixed Anxiety and 

Depressed Mood 

• Adjustment Disorder with Disturbance of Conduct • Adjustment Disorder with Mixed Disturbance of 

Emotions and Conduct 

In general, Adjustment Disorders do not last for extended periods of time. Symptoms may start to appear as late as 3 months following the stressor, but are usually resolved within 6 months. Combat/Operational Stress Reactions Combat/Operational Stress Reactions, or COSRs, are normal reactions to abnormally stressful events—like combat or other dangerous operations. COSRs are NOT a medical illness, and people who experience COSRs are NOT sick or weak. COSRs are our bodies’ way of protesting or slowing us down when we have to push ourselves past the regular limits of endurance. The “symptoms” of COSRs can look a lot like the symptoms of PTSD, ASD, or Adjustment Disorders. The difference, though, is that the typical COSR has only a few symptoms, and they tend to occur immediately after stressful action and get better quickly without significant “treatment.”

Where to Get Help and More Information 

If you think you might be experiencing any of the deployment-related stress problems discussed in this brochure, talk with your medical provider, behavioral health professional, or chaplain. They can help answer your questions and help you make decisions about your health. Active Duty personnel can visit their local military treatment facility or go on sick-call. Reserve and National Guard personnel should consult with their family physicians or seek assistance at the nearest Veterans’ Administration Health Center.

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