All forces personnel suffer some form of stress as a result of combat. This happens to people even if they are not on the front line, although front-line troops tend to suffer most. Stress of this kind can have many causes. Among the most common are: coming under fire, seeing friends die, handling dead bodies, and killing people.

Some people can manage their stress and others find it difficult and haunting. Some suffer from severe stress (Post-Traumatic Stress Disorder [PTSD], sometimes called shell-shock) as a result of warfare.  About 1 in 25 of British troops between 2003 and 2009 show signs of this, or 1 in 15 for those in direct combat roles. Post-traumatic stress disorder can affect anyone, however 'tough' they may seem. It means nightmares and flashbacks, feeling restless and afraid, and can also mean flying into rages over small issues. It might not surface for several years and it can last for many years afterwards. Armed forces personnel are more likely than the general population to suffer stress; the rates of stress are similar to those experienced in the police, fire and ambulance services.

Perhaps a greater problem is the high level of harmful drinking in the armed forces.  Regular troops that have been on operations drink harmfully more than any other group in the armed forces: one in every seven people (i.e. 15.9%) in this group between 2003 and 2009 were found to drink harmfully, which is defined as having a high level of alcohol problems with effects such as blackouts and injury.  This rate is nearly three times as high as that in the civilian population.  The rates of harmful drinking among younger people are substantially higher than their civilian counterparts.  The graph below shows harmful drinking in the armed forces (in red) compared with the general population (in blue).

[Sources: 'War and Health', 2007; Lancet, 2007 and 2010; NHS, 2009; Journal of Occupational Health, 2002; New England Journal of Medicine, 2004; full references available on request]

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