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Stressing out.


The prospect of having to leave her special-needs son when she deploys to Iraq was almost too much to deal with. The mother, an Air Force sergeant and single parent, worried. She didn't know what to do, or where to turn. The stress ate at her.

There were so many things going through her mind she couldn't focus. Plus, she had just moved to a new home and ended a long relationship. Friends and co-workers knew something was wrong--that she was stressing out.

"A friend of mine, who noticed I was going through a tough time, suggested I call and make an appointment with mental health," the cryptology linguist at Fort Meade, Md., said.

"I called my doctor for a referral and that was it," she said. "I definitely needed to talk to someone because I wasn't getting any better on my own."

The sergeant is one of thousands of American servicemembers facing similar problems with anxiety, stress and depression. The stress associated with deployments to fight the war on terrorism can compound existing problems, said Lt. Col. (Dr.) Steven Pflanz, the Air Force Surgeon General senior psychiatry policy analyst.

There are places for Airmen to turn when stress rears its menacing head. Secretary of the Air Force Michael W. Wynne addressed the issue in an August 2007 Letter to Airmen. He said stressful times sometimes push Airmen to the breaking point.

"It is vital that we all understand that we are not alone," the secretary said. "We are partnered in this war and bonded in the service. It is up to us to look out for one another."

Defense Department leaders are aware of the problem. In a 2005 department survey of health-related behaviors, 28 percent of Airmen reported "a lot of stress at work, and 16 percent reported a lot of stress in their personal lives," Colonel Pflanz said.

The most frequent stressors for Airmen include relationship issues, legal problems, mental health problems, work situations and financial difficulties. Airmen are more aware of the avenues for dealing with stress open to them.

Senior Airman Charles Colonna said doctors helped him through "my darkest times." For more than two years he fought stress and depression. But mental health specialists "have shown me the way," he said.

"I had a life of hopelessness, of misery. There was no light at the end of the tunnel," said Airman Colonna, a medical laboratory technician with the 79th Medical Wing at Andrews Air Force Base, Md. "That was when I knew I needed help."

Since seeking help, he said mental health providers "helped me be a better person, a better Airman and a better lab tech. (Air Force psychiatry) helped heal me."

In another case, a critical care nurse said the clear perspective mental health providers gave her allowed her to get over a stressful hump in her life.

During the last four years, the nurse, a captain who works in the Military District of Washington, had deployed three times as a member of critical care air transport teams. Her job was to transport the most critically injured troops from bases in Southwest Asia to medical facilities in Germany or the United States. She helped transport more than 150 patients.

But while deployed to Germany, she had to take emergency leave for a family death and another family member with a serious illness.

"It gets hard to focus when you're stressed," she said. "You forget to eat. Not everybody shows stress the same way. And if you don't tell someone you are stressed, then how can they know unless they see a change in your behavior?"

But she got the help she needed. Recognizing the signs of stress in the captain, a member in her chain of command suggested she seek help in adjusting. Family advocacy, financial and mental health counselors were there when she called.

"Even when the most catastrophic events happen in your life, it is easier to know leadership understands," the nurse said. "It helps to know if you have a problem you can go talk to someone who is not going to be judgmental and have answers to make your problem easier or less severe."

The captain said seeking mental health care might not resolve the problem, but "it can help you get over that hump so you can pick up the pace on the rest of the race. Sometimes you just need someone to give you a push up the rest of the hill."

Deployments are now part of the way the Air Force conducts business. Still, some Airmen may feel the stress of having to ship off to spots around the world to fight the war on terrorism.

"The Air Force is providing continuous integrated support to Airmen and their families throughout the deployment lifecycle," Colonel Pflanz said.

Support begins with predeployment briefings. Airmen also get help while deployed. Then there are post-deployment briefings and questionnaires Airmen fill out that tell health care providers of stress factors associated with deployments. Family members can take advantage of medical, spiritual and mental health care and direct unit support during the entire period.

At deployed locations, Airmen receive the same care as back home, Maj. (Dr.) Matthew Faubion said. The psychiatry department chair at Wilford Hall Medical Center, Lackland AFB, Texas, has deployed twice to Southwest Asia since 2003. He returned in July 2007 from six months in Iraq where he was available to thousands of American servicemembers.

"What I treated patients for most of the time was for combat and operational stress reactions, which is a normal reaction to an abnormal situation," Major Faubion said. "The common difficulties we see with those under stress are sleep problems, jumpiness, irritability, isolation, difficulty concentrating or paying attention and nightmares."


Of the 1,200 patients he dealt with in Iraq, only three needed additional care, the major said.

As stress continues to build, some people might opt for suicide as a way out. That's why knowing the signs a person is contemplating suicide is vital.

The major said, "A person who seems isolated, talks about dying, gives away prized possessions, has a change in work performance, or calls to say goodbye" is showing all the classic signs he or she is considering suicide.

The Air Force's suicide prevention program has helped reduce the service's suicide rate by 28 percent since the program began in 1996, the colonel said.

Over the last five years, the Air Force has had the lowest average suicide rate of any of the services.

A dozen years ago, the Air Force suicide rate was 13.8 per 100,000. Today, it is about 10 per 100,000, Colonel Pflanz said. The Air Force rate is lower than for a comparable population of American civilians, which is 18.6 per 100,000, when adjusted for age and gender.

The aim of the suicide prevention program is to teach Airmen the skills they need to recognize and intervene with those at risk for suicide or suffering from stress.

And help is just a phone call away. Mental health appointments at military clinics do not require referrals from a primary care manager. Tricare beneficiaries can even make appointments with civilian mental health providers without a referral.

Still, the stigma that seeking mental health help could affect a career persists.

"Those who need help should get help." Major Faubion said. "It is not a career ender to talk to mental health. It could be a career saver. It is not a black mark or a sign of weakness."

As a matter of fact, 97 percent of Airmen who seek mental health help experience no negative career impact, Colonel Pflanz said. In 90 percent of the cases, the person's unit never knows. Commanders are contacted only when a problem may impact safety or the mission.

Mental health clinics are not the only source of help. Some people seek out chaplains or the base health and wellness center. And the Airman and Family Readiness Center, legal office, services, morale, welfare and recreation, family member programs chiefs, family advocacy outreach manager, health promotion manager or the family support center director also help.

And the Air Force's new frontline supervisors training course is helping increase stress and suicide awareness.

The course helps supervisors "be better at connecting with their Airmen, recognizing when their Airmen are in trouble and knowing how to hook them up with whatever service they need," Colonel Pflanz said. "Good supervisors look out for all their people."

After three months of counseling the sergeant from Fort Meade said, "I learned that having someone to talk to is helpful." Health care providers "know what path to follow to help you realize your problem."

The sergeant said providers helped her find a better way to see things and not be so negative or stressed out about things.

Things are looking up.

"Since I began counseling, I'm more calm, focused and productive," she said.

Editor's note: Some names withheld by request.

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Title Annotation:coping with stress
Author:Gonzalez, Ben
Geographic Code:7IRAQ
Date:Jan 1, 2008
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