Battle Fatigue
*GTA 21-3-4
Normal Common Signs: What to do for Self and Buddy

Headquarters
Department of the Army,
Washington, D.C.,

War Is More Stressful Than Any Training Can Be
The enemy wants to break you -- to stress you until you can no longer do your combat job. To break the enemy's will, you may have to push to your limit. This is true for every soldier -- for Combat Service Support as well as for the Combat Arms. All of you may have to do or see things that make you feel badly.

Mental and physical fitness help you to endure that stress, but you will still have fear and other unpleasant feelings before, during and after combat. These symptoms are called "battle fatigue" because they are a natural result of the hard work of facing danger under tough conditions.

Recognize the signs of battle fatigue. Most of you will have some of these signs now and then. Some of you may have many of them often. All of you can still be effective soldiers, make the extra effort and win. Learn these practical ways to pace yourself and your buddies so that you can stand the strain.

Physical Signs

• Tension: aches, pains; tremble, fidget, fumble things.

• Jumpiness: startle at sudden sounds or movement.

• Cold sweat; dry mouth pale skin; eyes hard to focus.

• Pounding heart; may feel dizzy or light-headed.

• Feel out of breath; may breathe too much until fingers and toes start to tingle, cramp and go numb.

• Upset stomach; may throw up.

• Diarrhea or constipation; frequent urination.

• Emptying bowels and bladder at instant of danger.

• Fatigue: feel tired, drained; takes an effort to move

• Distant, haunted ("1000 yard") stare.

Mental and Emotional Signs

• Anxiety: keyed up, worrying, expecting the worst.

• Irritability: swearing, complaining, easily bothered.

• Difficulty paying attention, remembering details.

• Difficulty thinking, speaking, communicating.

• Trouble sleeping; awakened by bad dreams.

• Grief: tearful, crying for dead or wounded buddies.

• Feeling badly about mistakes or what had to be done.

• Anger: feeling let down by leaders or others in unit.

• Beginning to lose confidence in self and unit.

Many soldiers have these signs, yet still fight well and do all their essential duties.

What To Do For Battle Fatigue In Yourself Or Your Buddy

• Make yourself look calm and in control.

• Focus on the team's immediate mission.

• Expect to continue duties; focus on a well-learned task or drill; follow the SOP.

• Think of yourselves succeeding; talk about it.

• Take a deep breath; shrug shoulders to reduce tension.

• Remember that battle fatigue is normal and others have it, too; it helps to joke about 1t.

• Stay in touch with the rest of the team; keep talking.

• Get the facts; don't jump to conclusions or believe rumors .

• When the tactical mission and safety permit:

  • Drink plenty and share it (but save any alcohol for when it's really safe).

  • Prepare food and share it.

  • Dry off, cool off or warm up, if necessary.

  • Clean up (wash, shave, change; clean weapons).

  • Use quick relaxation techniques to "'unwind".

  • Arrange to sleep (4+ hrs 1f possible) or catnap.

  • Talk about what happened; put into perspective; clear up misunderstandings and lessons learned.

  • Share grief; talk out personal worries; consider talking with the Chaplain.

  • Keep busy when not resting (do recreational activities, equipment maintenance, etc.).

• If battle fatigue signs don't begin to get better with good rest, tell your leader or medic.

Protect Yourself And Your Buddy From Battle Fatigue

• Welcome new members into your team; get to know them quickly. If you are new, be active in making friends.

• Be physically fit (strength, endurance and agility).

• Know and practice life-saving self aid and buddy aid.

• Practice rapid relaxation techniques (see FH 26-2).

• Help each other out when things are tough at home or in the unit.

• Keep informed; ask your leader questions; ignore rumors.

• Work together to give everyone enough food, water, shelter, hygiene and sanitation.

• Sleep when the mission and safety permit; let everyone get time to sleep:

  • Sleep only in safe places and by SOP.

  • If possible, sleep 6 to 9 hours per day.

  • Try to get at least 4 hours sleep per day.

  • Get good sleep before going on sustained operations.

  • Catnap when you can, but allow time to wake up fully.

  • Catch up on sleep after going without.

Recovery From Battle Fatigue

• There are so many stresses in combat that even the most fit can get so battle fatigued that they temporarily become a problem to the team.

• Although this can take different forms, it is still only battle fatigue. It gets better quickly with rest. Sometimes your buddies or you may have to go to the rear or to a medical unit to get that rest.

• If this happens, let those buddies know that the team counts on them to come back quickly. Welcome them back and expect them to do their full share again.

• Don't be surprised or worried if some battle fatigue signs (like jumpiness and bad dreams) continue awhile after you come home from combat. That's normal, too.

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Operational Medicine 2001

Health Care in Military Settings

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