Filed under: Stress
Post-Traumatic Stress Disorder (PTSD) can tear apart your sense of what is safe and of what is good.
Part of the diagnosis of PTSD is exposure to a traumatic event: death, serious injury, sexual violence, or the threat of any of these. PTSD symptoms such as intrusive memories, avoidance of situations or feelings, problems in thinking or mood, and feeling overly amped up are common reactions to abnormal circumstances. Think of PTSD symptoms as self-preservation instincts gone haywire. One theory holds that, because you nearly died or experienced something awful or could picture it because it happened to someone close to you, your mind/body tries to sound the alarm bells to keep you safe. But the alarm bells sound at the wrong times and in the wrong ways.
However, PTSD symptoms can come from sources other than fear of bodily harm. They also can arise from inner conflict, when emotions trigger feelings such shame and guilt or when you question fundamental beliefs (such as “the world is basically good”). Witnessing or experiencing betrayal (especially by a leader in a high-stakes situation), within-ranks violence, extreme violence, and incidents involving civilians are some of what can disrupt your world view. It isn’t just an event but the interpretation of an event that causes Warfighters to experience “moral injury.”
If you suffer moral injury as part of PTSD, you start believing you live in an immoral world, or you view yourself as immoral, irredeemable, and defective. If you’re a Warfighter experiencing these feelings, you not only feel lousy, but you are more likely to isolate yourself just when you need others more than ever. Isolation can lead to self-handicapping or self-destructive behaviors.
So how do you save yourself from experiencing moral injury as a part of PTSD? Having a healthy sense of self-esteem can be one of your best protectors. There are no quick fixes. But forgiveness—of others and of yourself—can help you to let go of moral injury. With the help of a psychotherapist, you can begin to wrap your heart and mind around what happened. And pursuing positive interactions, such as getting involved with charitable groups, can give you opportunities to relearn that you are good and the other people in the world are generally good too. Last but not least, connecting with your spirituality—in whatever way is comfortable to you—can help you navigate this difficult journey.
Stress isn’t an isolated event. It can infiltrate your life in many ways. A survey of more than 12,000 military personnel across the services revealed the impact of stress levels on Warfighter performance. Compared with those with low stress, Warfighters with high stress were much more likely to be late for work, leave work early, get hurt on the job, or miss work altogether because of illness or injury. These trends were especially strong among a smaller subset of personnel who had recently needed a mental health evaluation. Other research suggests that stress can combine with a person’s (often unknown) predispositions, sometimes triggering mental health issues.
Depending on the severity of mental health concerns, focus on performance can take a back seat. So stress, mental health, and performance often go hand in hand. Stress-management techniques and proactive approaches to mental health can help stressed Warfighters perform their best.
Everyone experiences stress, but how you interpret stress determines how stressed you feel. This process is often referred to as the “ABCs of stress”:
Activating event + Beliefs = Consequences
When you experience an event, you interpret that “Activating event” according to your “Beliefs”—the lens through which you view the world. Generally, your interpretation is what causes your feelings of stress—that is, the “Consequences.” This is why two people can go through the same event and be affected in very different ways. If your interpretation of events leads to high levels of stress, you can manage your stress by finding ways to reframe your interpretation.
Afterdeployment.org suggests making a “Stress Toolkit” in which you identify helpful coping strategies. These could be strategies that ignite your relaxation response or reframe your thinking (see above) and/or behavioral methods such as deep breathing.
Another way to help you manage stress is to think through future stressful situations to be better prepared. Afterdeployment.org suggests: 1. Visualize potential stressful situations. 2. Determine how much of the situation you can control. 3. Problem-solve what you can control (using coping methods that work for you), and 4. Remember to lean on your friends and family for support.
For more information and ideas, visit HPRC’s Stress Management section.
- Stop what you are doing
- Take a few deep breaths and focus on the experience of breathing
- Observe your thoughts, feelings, and actions
- Proceed with new awareness
Like Warfighters, judges make very important decisions that affect peoples’ lives, but judges also are not immune to impacts of stress. Like everyone else under stress, they can thoughtlessly make quick decisions based on “rules of thumb,” but because we are human biases creep in, sometimes leading to bad decisions.
So, the STOP technique can be important too for Warfighters, spouses, parents, or anyone else looking to make good decisions when it matters. STOP-ping allows you to monitor and adjust your current stress in order to make good decisions.
Think of stress as a balance scale. All the situations you find stressful are heaped up on one side. How you deal with them is on the other side. The trick is learning to balance the two sides (or even better, having your coping resources outweigh the causes of your stress).
Everyone feels overloaded at times, when stress seems too much to handle. This can be compounded with multiple family demands—from finances, children’s needs, managing work and family demands, and fostering your relationships. Here are two suggestions to help you find balance:
- Find out what practical needs are causing your stress and come up with possible ways to address them using HPRC's problem-solving tips. For example, you know that you need seven to eight hours of sleep a night, but you and your partner seem to manage only five hours or so. So discuss possible solutions with your partner. For example, set a bedtime and stick to it no matter what chores aren’t done; put the kids to bed at an earlier time; create a wind-down routine 30 minutes before bedtime in order to get that eight hours—and stick to it! Then pick one of these possible solutions, try it out for a week, and then re-assess. If it doesn’t work, pick another; or if it does work, maybe tweak it a little to make it even better.
- Once you have plans to deal with the sources of your stress, then you can focus on managing your stressful feelings. There’s no need to continue feeling stressed out while you put your plan into action. Try some of the “behavioral strategies” in HPRC’s Managing Emotions that you can do anywhere with minimum fuss, such as deep breathing, progressive muscle relaxation, or other relaxation strategies. You can even teach them your children and do them together as a family. Learn how in “Calming & Grounding Activities” from the FOCUS Family Resiliency Training Manual, which describes several shared activities.
And check out HPRC’s Mind-Body Skills section for resources that are geared more for you as an individual.
The American Psychological Association (APA) wants to know how stressed out Americans are. Every year since 2007, they’ve conducted a yearly “Stress in America” survey in which they analyze trends about stress and its associated symptoms and behaviors across a range of people living in the U.S. In August 2013, they focused on 1,018 teens (ages 13-17).
A recent report of this information about teens and stress showed that the stats are staggering. Teens from the general population (civilian and military) exceed healthy levels of stress, mirroring the trends in the U.S. among adults. Stress affects sleep, exercise, and eating. Teens tend to get 7.4 hours of sleep on school nights, while the recommended amount is around nine or more hours according to the National Sleep Foundation, and between nine and 10 hours according to the National Institutes of Health. One in five teens exercises less than once a week or not at all. And 23% of teens report that they’ve skipped at least one meal in the past month due to stress.
Parents’ deployments are extremely challenging for children and teens, so military teens often have to deal with additional stressors. Consider this:
- When a parent deploys for 19 months or more, kids’ achievement scores are lower than peers’ scores.
- Teachers and counselors say that parental deployment can cause stress at home, often leading to more problems at school (such as incomplete homework, skipping school, or a less-engaged parent).
- Kids’ resiliency can be impacted when a parent is away, and parents/teachers/counselors sometimes feel that helpful resources can be hard to navigate.
What can you and your teens do to combat their stress?
- Watch for signs of stress, and actively use stress-management techniques. You can also find children-centered techniques in these HPRC resources. Recognize that stress-management skills are important to develop whether you are a Warfighter, family member, or civilian.
- Military parents can alert teachers and counselors when a parent is deployed and enlist whatever support is available.
- Parents’ well-being impacts their teens’ well-being. Be sure to take care of yourself by eating right (individually or with your family), exercising, and managing your own stress.
- Bolster resiliency skills, both in times of stress and in times of calm. You can learn how with practical tips in "Building Family Resilience."
The “relaxation response” is your body’s natural reaction against the negative effects of stress; it shuts off the “stress response” when the need for it is over. Recent research has shown that the relaxation response can decrease the harmful effects of chronic stress even at the gene level. Learn about your body’s natural stress and relaxation responses, when they are and aren’t helpful, and how to control them when their natural operations fail in HPRC’s “Influence Your Body’s Stress & Relaxation Responses.”
Some intense military training, such as in the Special Operations Forces, screens personnel by ultimately selecting those who can handle extreme adversity. In fact, how you view stress can have a big impact on whether the stress you experience is helpful or not. When you have a positive interpretation of your stress—that is, “eustress”—you may feel “amped up” enough to perform your best without experiencing any negative effects.
How do you experience stress in a positive manner? Try reframing it. Your situation doesn’t have to “suck”—it can just be a challenge that ultimately helps you grow more resilient. When you use this approach, it’s easier to take on whatever comes your way instead of engaging in unhelpful practices that may just increase your stress. Learn to find meaning in what’s difficult with your word choices. Here are some examples of statements you may find helpful:
- “Go beyond!”
- “I can!”
- “I am!”
- “Makes me stronger.”
- “For my buddies.”
- “For good.” (Or if you are spiritual, “For God.”)
- “Feel it!”
- “Dig deep.”
- “You got it!”
- “It’s all good.”
The list goes on. Figure out what words or phrases help you switch from seeing stress as a negative to feeling it’s just another challenge to tackle.
For more information on how to handle stress, check out HPRC’s Stress Management section.
The stress of deployment can linger when you return home and resume (or start new) work responsibilities and relationships. Sometimes it can be difficult to know how much to share about recent deployment experiences in the work environment, particularly if your coworkers are not or have not been in the military. Some may ask a lot of questions and others may steer clear of the subject entirely. This can create an interesting dynamic in your work relationships. Afterdeployment.org emphasizes that discussing your experience is a decision that’s completely up to you. So think ahead of time about how much (if any) you want to share, and be cautious about whom you choose to share with initially.
Afterdeployment.org also describes some common problems that can affect performance in the workplace. For example, combat experiences sometimes can impact your sleep quality, making it difficult to be at your peak at work. Other possible issues include inappropriate anger in response to people or situations and feeling uneasy and unable to let one’s guard down in a crowded office or worksite. This Work Adjustment factsheet provides more information and tips that can help with common issues, and another on Informal Relationships at work for more information.
Whether you’re falling asleep or too “amped up,” you probably aren’t performing your best. Depending on who you are and what the task is, some middle ground is generally going to be best.
With simple tasks that require little conscious thinking, your reaction time is probably at its best around 60-70% of maximum heart rate (see HPRC’s article on aerobic conditioning), but response times for bigger bursts of movement improve if you’re more amped up. For example, you may be able to pull the trigger of your weapon fastest when you’re at 60-70%, but reaching for your weapon in the first place may be quickest if you’re at 90%. Keep in mind that this may not apply to more complicated tasks that involve rapid thinking, such as distinguishing a “friendly” from a “non-friendly” when someone is disguised.
There are two basic ways to get yourself amped up: physical activity and anxiety. Physical activity can happen through an intentional warm-up or even on its own because of the demands you are facing. If anything, you might find yourself needing to calm your body down. The same goes for anxiety. There’s the “butterflies-in-your-stomach” kind of anxiety and the more panicky “Darn! What do I do now?” kind. A little bit of the butterflies kind can be helpful, but again, it’s good to learn how to calm down and find middle ground!
To learn more about being in the right “zone” for what you are doing, check out HPRC’s “Performance Strategies: Optimize Your Body’s Response.”