1. Combat Stress and Redeployment Pope AFB Behavioral Health Flight

2. OBJECTIVES Why do we talk about Combat Stress? Define Combat Stress Describe signs and symptoms Post Traumatic Stress Remembering incidents/war stories What to expect when you return home What Helps People Cope What next?

3. Combat Stress Concept In battle opposing forces are attempting to inflict HELL LIKE conditions on one another until the opponent breaks down and can no longer endure the STRESS

4. Traumatic Events In The Deployed Environment Seeing co-workers who are injured –Work Related/Combat Related Death of Co-worker Seeing body parts or dead people Mortar/Rocket Attacks IED/RPG/VBIED Natural Disasters Rumors of danger Threats that elicit fear, worry and concern Can cause feelings of intense fear, helplessness, and horror

5. Signs of Combat Stress Re-experiencing event Nightmares Guilt about incident Nausea and vomiting Inability to sleep/rest Poor concentration Hyper-vigilance Feeling shocked/numb Feeling confused Irritable with others Intrusive thoughts Change in speech Reaction to sounds Withdrawal Poor decision-making Anxiety/Panic Fear Emotional Shock Depression Suspiciousness Headaches/stomach aches Feeling out of place

6. Post Traumatic Stress Disorder Persistent re-experiencing of the event Avoidance of similar situations associated with the event Numbing of general responsiveness Increased arousal Duration over 1 month Causes distress or impairment in daily functioning (social, occupational, personal)

7. Operational Stress Some units had more down time than expected –Stress occurs during down time while deployed –Members often worry about when the danger will occur –Members have down time to think about other personal, occupational stresses –Threats are more subtle, but they exist –Members often keep stressors within, since others do not expect them to feel stressed CUMULATIVE STRESS IS REAL!

8. Remembering Incidents Some have said: –“ I felt guilty about surviving when others died” –“ I couldn’t admit that I was afraid” –“ I react to loud noises –“ I don’t think people will understand” –“ I can still remember the sounds, the smell, the incident” –“ How do I get back to work (home station) after experiencing this?”

9. Remembering Incidents Some have said: –“ I was afraid after _ happened. I didn’t know what would happen next” –“ I feel angry about little things” –“ I sometimes wondered what would happen next and I realized that I could die” –“ I felt guilty about not having a lot to do. I thought I would be doing more” –“ I don’t think anyone understands me since I have been back.” –“ I saw some things that I never thought I would see” –“ Even though, I wasn’t in the direct line of fire, I was aware of threats to our safety”

10. What to expect when you return home Wealth of emotions –Homecoming let down –Exciting vs. uneventful –Anxiety/Depression –Happy vs. Sad (tearful) Physical/medical adjustments Readjustment to work and home environment –Marital issues –Children –Getting back into the work scene after being replaced

11. Readjustment Marital –Others may have difficulty understanding your experience…be patient –Intimacy is important, there may be temporary performance or communication issues –Household routines may have changed –If you had issues before you left, they will most likely be there when you return Children –Children may have difficulty expressing and understanding deployments-communicate age appropriately –Children may be distant or clingy –Children will need to gradually readjust to member’s return

12. Wingman Issues DUI / underage / binge drinking Anxiety/Depression Management Suicide Prevention Sexual Assault Prevention Child / Spouse Maltreatment Prevention Safe Driving

13. Things to remember NORMAL PEOPLE HAVING A NORMAL RESPONSE TO AN ABNORMAL SITUATION Individuals should understand: –You are NOT sick, you are just stressed and you WILL be all right –If symptoms persist, seek assistance from LSC, Chaplain, VA –Ignoring symptoms will only make things worse –Wingman take care of each other-Don’t delay seeking help for a friend

14. What helps people cope? Others have survived traumatic circumstances Sense that I’ll be okay; “I am not crazy” Identification with a group/get back into the “groove” Taking each issue one step at a time Strong beliefs (God, mission, values) Adequate preparation and flexibility Understanding that your environment has changed (just like you) Coping for family and/or others Talking about the incident with those that understand

15. Tips for Resilience Identify people/agencies that can help Dismantle problems into small parts Be an active player-not a passive victim Don’t put off solving problems Don’t seek relief with drugs or alcohol-problems will get worse Recognize that readjustment is normal and takes time Realize that stress of homecoming can magnify other issues Recall how you met challenges in the past Understanding that your environment has changed (just like you)

16. What next? Be aware of your stress Relax first then get involved in activities Enjoy your time off Gradually reintegrate into the family/work Talk with chaplain, Life Skills, Air Force One Source, Veterans Administration programs if necessary Take Care of yourself and your buddy –Know the signs of someone in distress –Know the signs of alcohol/drug addiction –Know the signs of family violence/maltreatment

17. Enjoy your return home!!! Take Care of yourself and your fellow wingman!!