Life After Combat: Coping with an Anxiety
In combat, you were under a lot of
stress. You were in a strange place. You were away from your home and family. You
with the constant threat of danger, violence, and harm. You may have been asked to
things that challenged you in unexpected ways.
Military culture can be demanding. It
involves long days, short nights, and little room for emotion. Being brave is standard
practice. Anxiety is a healthy response to stress like this.
But too much anxiety can be a problem.
It may start kicking in at the wrong time. Or it may never go away. This causes physical
and emotional distress.
For some people, anxiety can become so
severe that it causes problems in daily life. It can cause problems at work or school,
in relationships. When anxiety gets to this point, it’s an anxiety disorder.
How anxiety helps keep you safe
Anxiety is a more intense form of
worry and stress. When you’re threatened, there’s rarely time to decide how to react.
Instead, the body’s automatic defenses kick in. Your body is flooded with anxiety
This causes physical and emotional
responses. Your heart pumps harder. Your muscles tense. You tremble or sweat. You
intense worry, fear, or dread. These feelings alert you to danger. They are meant
help you react quickly. In response to a threat, anxiety prompts you to do what's
to protect yourself.
When anxiety becomes a problem
In a war zone, you’re on high
alert. Even if there is no urgent threat, danger can present itself at any time. You
worry for your own safety and the safety of others. It’s natural to have anxiety in
But the anxious feeling may
continue after you leave the war zone. Even back at home, you may be on constant alert.
Or extreme anxiety may pop up over minor issues. This makes it hard to live and enjoy
your daily life. If this sounds like what’s happening to you, you may have an anxiety
disorder. Someone with an anxiety disorder may:
Have panic attacks. A
panic attack is a sudden, intense anxiety response. It includes extreme anxiety,
severe physical symptoms (like a pounding heart or difficulty breathing), and a
strong desire to escape. You may feel closed in or all alone, even if you’re in an
open, public place. Most panic attacks start suddenly, for no clear reason. The
attack can last around 5 to 20 minutes. During an attack, you may think that
you’re having a heart attack, going crazy, or dying.
Feel anxious all the
You might worry about money, your family and friends, work, war,
or the world in general. You might not even be sure what you’re anxious about. But
you have a strong fear that the worst will happen. This is called generalized
anxiety. It affects your quality of life and makes it hard to function.
Have intense anxiety in
For example, you may fear spending time in the
dark, in new social settings, or in enclosed spaces. These fears (sometimes called
phobias) may relate to something that happened in combat. Or they may not. To
escape the anxiety, you may try to avoid the situation that prompts it. This can
have a serious impact on your life.
Feel a strong need to act on
An anxiety disorder can make unwanted
thoughts invade your mind. You know the thoughts don't make sense. But you still
feel a strong need to act on them. For example, you may constantly check your
doors to make sure they’re locked. Or you might walk a perimeter around your house
to make sure no one is watching. Doing so helps ease the anxiety for a short time.
But it can disrupt daily life.
Symptoms of anxiety disorders
Anxiety makes you feel worried and
fearful. It can also cause physical symptoms. Many people with anxiety disorders first
go to the healthcare provider to get checked for a physical problem. Symptoms can
A pounding or racing
Shortness of breath
Restlessness or problems
Muscle tension, especially in
the neck and shoulders
Nausea or stomach
Very fast speech
Feeling irritable or on edge
all the time
- Unplanned weight gain or loss
Talk with your healthcare provider. They can rule out any physical
problems that may cause the anxiety symptoms.
Treatment will help you get your life
If an anxiety disorder is diagnosed, the next step is to get mental
healthcare. It is an illness, and it can respond to treatment. Most types of anxiety
disorders will get better with talk therapy and medicine.
You may think that asking for help
is a sign of weakness. In fact, taking action to make your life better takes a lot
courage. With the right treatment, most people learn to manage anxiety.
Your treatment may include talk
therapy (counseling). This is a process in which you talk about your anxiety and related
problems with a healthcare provider. You may be prescribed medicines. For many people
with anxiety disorders, treatment includes both medicine and counseling.
Counseling means you work with a healthcare provider to better
understand your anxiety and learn skills to manage it. Many types of counseling have
been shown to work well for anxiety disorders.
You’ll likely learn new ways of responding to thoughts, feelings, and
memories that make you anxious. This can improve your symptoms. It helps change how
react to situations that make you anxious. Counseling could be done one-on-one. Or
may have group therapy with other Vets who have been in combat.
You may be prescribed medicine. Some medicines are used only for a
short time. This is done to treat immediate symptoms. Others are taken long-term.
is to help improve your mood over time.
At first, medicines and doses may need to be adjusted. Tell your
healthcare provider how a medicine affects you. This way, you can work together to
what works best for you. It may take a few weeks before you feel a medicine’s full
impact on your mood. If you don’t notice a change at first, you may just need more
But if you don’t feel results after the first few weeks, tell your healthcare
Other steps to take
- Learn more about anxiety disorders. Keep track of helpful
online resources and books you can use in stressful times.
- Try stress management methods such as meditation.
- Think about joining online or in-person support groups.
An anxiety disorder affects your
emotions, health, and life. But treatment
you get better. Taking the first step can be hard. But once you start treatment and
how much better life can be, you’ll be glad you did.
To learn more, talk with your
healthcare provider or your Veterans Administration (VA) mental health coordinator.
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