Psychological Health Effects of Deployment

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Common Stressors During the Deployment Cycle

Throughout the deployment cycle (pre-deployment to reintegration), many stressors can contribute to symptoms of combat and operational stress. Combat and operational stress is defined as “the expected and predictable emotional, intellectual, physical, and/or behavioral reactions of an individual who has been exposed to stressful events in war or stability operations” Reference [1] . Common stressors across the deployment cycle may include Reference [2].

Pre-deployment (from notification to departure)

  • Family stressors may include marital disagreements or detachment; children may experience fear, abandonment, sadness, or anger
  • Stress of preparing home and family for extended absence (e.g., childcare, paperwork, missing holidays, paying bills)
  • Preparing family and self for potential of injury or death
  • Sleeping less than 6-8 hours a night

Deployment (from departure to return)

  • Combat stressors may include:
    • Personal injury
    • Killing of combatants
    • Witnessing death of an individual or unit member
    • Injury resulting in the loss of limb
  • Operational stressors may include:
    • Prolonged exposure to extreme geographical environments
    • Exposure to environmental stressors (such as chemicals, infectious diseases, radiation)
    • Reduced quality of life and communication with loved ones
    • Prolonged separation from support system
    • Exposure to significant injuries over multiple missions 
    • High-stress situations with feelings such as loneliness, anxiety, heightened agitation, sleep disturbances, health complaints
  • Apprehension about returning home
  • Expectations not met regarding communication from the service member or from family members

Post-deployment

  • May experience a honeymoon period
  • Resentment over loss of independence
  • Insecurity about place in family system
  • Difficulty disengaging from combat mission orientation

Common Stress Reactions

Combat and operational stress is a normal reaction to an abnormal event. Stress reactions can begin before deployment and last into the post-deployment phase, and they can be different for everyone. Combat and operational stress applies to all deployments, not just those involving a combat environment. Being away from the comforts of home and support systems can add stress that often is not recognized. Combat stress may elicit emotional, cognitive and physical stress reactions Reference [3]:

  • Emotional - Feeling overwhelmed; depressed; irritable; numb; frustrated; guilt; sadness; worthless; paranoia; anger
  • Cognitive - Difficulty with memory; loss of interest/motivation; concentration problems; difficulty talking about deployment experiences
  • Physical - Difficulty with sexual and non-sexual intimacy; fatigue; easily startled; trouble falling asleep, staying asleep or oversleeping; muscle tension; digestive issues; headache; heart palpitations or pains in chest; dizzy spells; appetite changes

Health care providers, leaders, service members and their families should take these common stress reactions seriously as prolonged levels of high stress can contribute to several mental health conditions, reduce the body’s immune response, and increase negative behaviors (e.g., acting out, inattention, and poor judgment). Stress can also impact productivity in the following ways:

  • Inability to concentrate
  • Increased incidence of errors
  • Lapses of memory
  • Increased absenteeism
  • Tendency to overwork