“Operator syndrome”: A unique constellation of medical and behavioral health-care needs of military special operation forces

B. Christopher Frueh, Alok Madan, J. Christopher Fowler, Sasha Stomberg, Major Bradshaw, Karen Kelly, Benjamin Weinstein, Morgan Luttrell, Summer G. Danner, Deborah C. Beidel

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: U.S. military special operation forces represent the most elite units of the U.S. Armed Forces. Their selection is highly competitive, and over the course of their service careers, they experience intensive operational training and combat deployment cycles. Yet, little is known about the health-care needs of this unique population. Method: Professional consultations with over 50 special operation forces operators (and many spouses or girlfriends) over the past 6 years created a naturalistic, observational base of knowledge that allowed our team to identify a unique pattern of interrelated medical and behavioral health-care needs. Results: We identified a consistent pattern of health-care difficulties within the special operation forces community that we and other special operation forces health-care providers have termed “Operator Syndrome.” This includes interrelated health and functional impairments including traumatic brain injury effects; endocrine dysfunction; sleep disturbance; obstructive sleep apnea; chronic joint/back pain, orthopedic problems, and headaches; substance abuse; depression and suicide; anger; worry, rumination, and stress reactivity; marital, family, and community dysfunction; problems with sexual health and intimacy; being “on guard” or hypervigilant; memory, concentration, and cognitive impairments; vestibular and vision impairments; challenges of the transition from military to civilian life; and common existential issues. Conclusions: “Operator Syndrome” may be understood as the natural consequences of an extraordinarily high allostatic load; the accumulation of physiological, neural, and neuroendocrine responses resulting from the prolonged chronic stress; and physical demands of a career with the military special forces. Clinical research and comprehensive, intensive immersion programs are needed to meet the unique needs of this community.

Original languageEnglish (US)
Pages (from-to)281-295
Number of pages15
JournalInternational Journal of Psychiatry in Medicine
Issue number4
Early online dateFeb 13 2020
StatePublished - Jul 2020


  • endocrine
  • military
  • pain
  • posttraumatic stress disorder
  • sleep
  • special forces
  • suicide
  • traumatic brain injury
  • veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health


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