One of the unfortunate side effects of the Iraq war will be the post traumatic stress disorders (PTSD) many of the returning men and women will experience. In earlier wars, this condition was referred to as shell shock or combat fatigue or battle fatigue. For Vietnam vets, it was referred to as post-Vietnam syndrome.

PTSD is defined by a number of very simple and illustrative symptoms. Many people suffer headaches, nausea, lapses in concentration but most of all they have flashbacks of the events that caused them the stress. The recurrence of these symptoms and conditions can be extremely debilitating.

One feature is constant video replays, that is, remembering and replaying the event for months after. This repeated and recurring stress means we have trouble sleeping. Some people have very dramatic and violent nightmares, and most wake feeling that their sleep did not refresh or re-energize them.

When we are stressed, one of the best solutions is to seek social support from our loved ones. The sad part about PTSD is that we often have personality changes that interfere dramatically with the quality of our relationships. Instead of being able to approach our loved ones, our irritability and bad temper causes people to move away from us.

Most of these victims have attentional problems and find it hard to stay on task and be productive at work. There is a constant theme of remembering and agonizing. Even the notion of having these recurrences and being unable to concentrate can cause people to worry even more.

If you knew how many people experienced PTSD, you would be amazed. Something in the order of 8% of people in the US experience stress at a level and for a length of time that can be extremely dysfunctional. And stress and PTSD do not respect gender or race.

Despite the high figures of stress and PTSD, many people are able to cope with their daily lives and manage stress effectively. They have learned effective strategies to reduce stress by identifying the stressors and finding ways to understand and alleviate the tension and anxiety. The problem is, of course, if people cannot manage stress effectively it will impact negatively many areas of their life.

We have to accept in our fast society that being tense and anxious is a normal part of life. We all have complex lives that present us with daily challenges to our emotional equilibrium. The real issue is to be able to manage stress and tension so that we do not become tense and irritable and lose the social support from our loved ones that are so central in having a stable and happy life.

The issue is not whether we experience stress - the real issue is how we manage stress. Stress management is not a complex science. It is a matter of knowing ourselves (self-awareness), understanding our impact on others (social perspective) and being able to communicate effectively with our colleagues and loved ones so that we reduce the threats, challenges, tension, and stress.

The best way to start to manage and reduce stress is to gain as much information as possible about this syndrome. Knowing the stressors and how to deal with them is an essential first step - whether it is a serious psychological condition like PTSD - or a less debilitating but still worrisome disorder - elevated stress. Once you know you enemy - then you know how to manage stress and overcome the worry and anxiety.