Combat stress reactions are natural responses of the body and brain to the extreme stress of combat. Sometimes a threat is so prolonged or intense that it causes a "stress injury." In these cases, the body and brain continue to maintain that state of high alert long after the danger has passed. Combat stress is not a sign of weakness — it affects many exceptionally strong service members and here's how you can learn the signs and manage it in a healthy way.

RECOGNIZE THE SIGNS AND SYMPTOMS OF COMBAT STRESS

Although there are many signs and causes of combat stress, there are certain key symptoms common in most cases: • Problems sleeping • Feeling anxious • Uncharacteristic irritability or angry outbursts • Withdrawal from others • Other changes in behavior, personality or thinking.

Combat stress sometimes leads to stress injuries, which cause physical changes to the brain that alter the way it processes information and handles stress. Be aware of the following when dealing with a stress injury:

• Stress injuries can change the way a person functions mentally, emotionally, behaviorally and physically.

• The likelihood of having a combat stress injury rises as combat exposure increases.

• The earlier you identify the signs of a stress injury, the faster a full recovery can occur.

• If left untreated, a stress injury may develop into more chronic and hard-totreat problems such as post-traumatic stress disorder, or PTSD.

DEAL WITH COMBAT STRESS FOR A HEALTHY RECOVERY

There is no guaranteed way to protect yourself from a stress injury, but there are things you can do to help yourself and others recover:

• Return to a routine as soon as possible with regular meals, sleep and exercise.

• Maintain your health. Drink plenty of water, eat nutritious meals, exercise and get enough sleep. Rest and recuperate after stressful events and practice relaxation techniques before, during and after stressful events.

• Reach out to others with similar experiences. They are probably having many of the same feelings, so you'll see you are not alone. Participate in your unit's after-action reviews and work to build trust with your unit.

• Use your sense of humor. Sometimes humor can help you look at stressful situations from a different perspective. Laugh often – it is a great stress reliever.

• Address your spiritual needs. Some people find strength in some form of prayer or by discussing their concerns with a chaplain.

• Ask for help in managing problems at home while you are away. It is hard to keep your head in the game if you're worried about issues back home.

FIND HELP FOR COMBAT STRESS INJURY

If you or someone you know is suffering from a combat stress injury, it is important to get professional help as soon as possible. The earlier you identify the signs of a stress injury, the faster a full recovery can be. The following resources can help:

• Combat stress control teams: Combat stress control teams include mental health professionals who support service members on-site during deployment.

• Your unit's chaplain: Military chaplains provide counseling, guidance and referral on many issues affecting deployed or returning service members and their families.

• Department of Veterans Affairs: These counselors who are also veterans provide readjustment counseling at no cost to combat veterans and their families, including those still on active duty. About 300 community-based Vet Centers ( vetcenter.va.gov) provide these services.

• TRICARE: Therapy services may be available at your nearest military treatment facility or a local network provider. Your primary care manager can refer you to appropriate counseling, or you may contact your regional TRICARE office ( tricare.mil).

• Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Outreach Center: This Department of Defense call center is available 24/7 to provide information and local resources to service members with questions or concerns about psychological health issues and traumatic brain injury. Call 866-966-1020.

• Outside military support channels: In some cases, service members choose to find help outside military support channels. If you do, be sure you understand the costs before you begin a treatment program. If you need immediate help or are experiencing a crisis, contact the Military Crisis Line at 1-800-273-8255 and press 1, or visit veteranscrisisline.net/ActiveDuty.aspx