stress and suicide management

1. STRESS AND
SUICIDE
MANAGEMENT
OF ARMY
SOLDIERS

2. MANAGING COMBAT and
OPERATIONAL
STRESS

3. STRESS AND SUICIDE OF
SOLDIERS
INTRODUCTION
No human being is exempted from
stress. The army are no exception.
Infact they are comparatively in an
ideal stress breeding environment
due to frequent and large number of
uncertainties/ changes as
compared to civilian counterparts

4. WHAT IS STRESS?
In general terms, stress
refers to experiencing
events that are perceived as
endangering one’s physical
or psychological well-being.
S = P > R Stress occurs
when the pressure is greater
than the resource 3

5. Statistics -There were as many as 635
cases of suicide including attempted
suicides in the three services of Armed
Forces during the years 2003 to 2007.
These statistics also indicate that Army
was worst affected. According to Ministry
of Defense, every third day a soldier is
killing himself, at a rate higher than the
toll taken by the militants. From 2007 to
May 2010, 208 soldiers lost their lives in
actions against militants while 368
soldiers killed themselves during this
period. 4

6. Factors causing stress in soldiers
- The stress can be triggered among
soldiers due to any change or event
that happens. These factors do not
cause stress in a mathematical
measure. It could be a single factor or
it could be a number of factors
depending upon the personality traits
of an individual that make him react to
a stressor. The effort here is to bring
out all the factors that may initiate
stress reaction in soldiers.

7. Responsiveness of Civil Administration -
Often it is the problem back at home that
makes a soldier feel helpless and drives him/
her to suicide than work related stress. The
inability of the soldiers to solve their family
problems due to operational requirements
leads to behavioral problems. According to the
battalion commanders, the biggest problem is
the soldier's helplessness in resolving
property disputes back at home that makes a
soldier feel tense and helpless. There are
several instances of neighbors or even own
brothers making use of soldier's long absence
from home to encroach on his property.

8. Inter-Personal Relationship - Armed
forces community has a culture of its
own, where sense of belonging and
responsibility are cultivated in an
individual to display brotherhood. A
better interaction should be there
between armed forces personnel at
various levels. The soldiers have to be
encouraged to share their problems
with their seniors and emphasis has to
be laid to redress their genuine
grievances.

9. Shortage of Manpower - As on March 4,
2010, there was a shortage of
approximately 12,000 officers in the Army
and this shortage adversely affects the 17
functioning at the unit level. This shortage
of officers is leading to greater stress
among junior and middle level officers
owing to the need to perform multiple
functions in inadequate time. Situation is
worsened particularly in counter-
insurgency operational areas, impinge
upon performance of both officers and
soldiers.

10. Absence of Mental Health
Professionals in Units While the
strength of mental health
professionals in army hospitals is
lower than the required, the units
in army have no mental health
professionals authorized to them.
This leaves a void in the system
despite increasing instances of
stress among soldiers 9

11. Unpredictable Factors Several
unpredictable factors such as:
battle fatigue unseen threats
extended field tenures absence of
adequate recreational avenues
domestic feuds inability to ensure
quality education to children and
inability to meet aspirations of
spouse and children increase the
level of frustration, leading to
stress

12. Social Apathy A soldier believes that
he is facing all sorts of difficulties to
serve his nation and countrymen.
The soldier has this sense of honor
and duty that motivates him to face
any challenges. It is unfortunate that
the society does not acknowledges
their contribution most of the times.
When incidence happen it starts
questioning his commitment towards
his profession and the nation.

13. Remarks from seniors Most cases of
fragging (killing of superiors) result from
humiliating taunts by seniors on small
matters. Due to shortages of officers, the
commanding officer is unable to devote
necessarily required time to his troops for
counselling. The commanding officer's
inability to spare time for his troops
demoralizes a soldier. Junior leaders tend
pass humiliating comments to their
aggrieved subordinates at critical moments.
This triggers emotions of revenge in the
already aggressive soldier and generally
results into fratricidal killings.

14. Retiring Blues The soldiers retire at
a comparatively much younger age.
This is the time when they are
expected to share major domestic
responsibilities like higher
education of children, construction
of a house, marriages of children,
attending to obligations towards
aged parents. Starting a fresh
career at this age is not an easy
proposition.

15. Memories of Unfortunate incidents The
combination of combat exposure and
ready access to guns can be lethal to
anyone mulling suicide. Combat
exposure can at times lead to trauma-
such as seeing flashbacks of combat,
killings or face of a fallen comrade who
might have told you about his wife or
children just before quitting this world.
Memories of unintentional slayings or
killing of innocent humans by mistake
can also haunt them for long. 14

16. Reluctance in Seeking
Psychiatrists Help .The personnel
in the armed forces are prompted
to hide their mental problems as
the referral to a psychiatrist for
treatment is considered a 'stigma'
which may adversely affect the
career of service personnel. Since
such cases have been identified to
be causative

17. Denial of Leave at the Required Time The
existing leave policy is being constantly
monitored to ensure that everyone gets his
due without compromising operational
requirements. The ministry of defense
mentioned that the operational and
functional requirements have to be kept in
view while granting leave and this aspect
cannot be compromised. Here lies the
catch. Under this clause, a soldier fails to
get leave when he actually needs. This is a
major cause of stress in army. 16

18. THE INDIVIDUAL - Everyone is different,
with unique perceptions of, and reactions
to, events. There is no single level of
stress that is optimal for all people. Some
are more sensitive owing to experiences
in childhood, the influence of teachers,
parents and life experience etc. Most of
the stress we experience is self-
generated. How we perceive life - whether
an event makes us feel threatened or
stimulated, encouraged or discouraged,
happy or sad - depends to a large extent
on how we perceive ourselves

19. SYMPTOMS OF
STRESS
-Physical symptoms
-Mental symptoms
-Behavioral symptoms
-Emotional symptoms

20. PHYSICAL SYMPTOMS
1. Dizziness
2. Fainting
3. Sweating &
trembling
4.Tingling hands &
feet
5. Breathlessness
Palpitations
6. Missed heartbeats
7. Sleep pattern
changes
8. Fatigue
9.Digestion changes
10. Loss of sexual
drive
11. Headaches
12. Aches and pains
13. Infections
14. Indigestion

21. MENTAL SYMPTOMS
1. Lack of concentration
2. Memory lapses
3. Difficulty in making
decisions
4. Confusion
5. Disorientation
6. Panic attacks

22. BEHAVIOURAL SYMPTOMS
1. Appetite changes - too much or too
little
2. Eating disorders - anorexia, bulimia
3. Increased intake of alcohol & other
drugs
4. Increased smoking
5. Restlessness
6. Fidgeting
7. Nail biting
8. Hypochondria

23. EMOTIONAL SYMPTOMS
1. Bouts of depression
2. Impatience
5. Fits of rage
6.Tearfulness
7. Deterioration of
personal hygiene and
appearance

24. STRESS RELATED ILLNESSES
Stress is not the
same as ill-health,
but has been
related to such
illnesses as;
1. Cardiovascular
disease
2. Immune system
disease
3. Asthma
4. Diabetes
5. Digestive
disorders
6. Ulcers
7. Skin complaints
- psoriasis
8. Headaches and
migraines
9. Pre-menstrual
syndrome
10. Depression

25. SUICIDE SYMPTOMS
A person contemplating
suicide:
1. Appears depressed, sad, and tearful and/
or may display changes in patterns of sleep
and/ or appetite.
2. Believes he/ she is in a hopeless situation.
3. May talk about or actually threaten
suicide, or may talk about death and dying
in a way that strikes the listener as odd.
4. May display changes in behavior,
appearance or mood.
5. May increase or start drug or alcohol use

26. SHORTAGE OF MANPOWER
As on March 4, 2010, there was a
shortage of approximately 12,000 officers
in the Army and this shortage adversely
affects the 17 functioning at the unit level.
This shortage of officers is leading to
greater stress among junior and middle
level officers owing to the need to perform
multiple functions in inadequate time.
Situation is worsened particularly in
counter-insurgency operational areas,
impinge upon performance of both
officers and soldiers.

27. Absence of Mental Health
Professionals in Units. While the
strength of mental health
professionals in army hospitals is
lower than the required, the units
in army have no mental health
professionals authorized to them.
This leaves a void in the system
despite increasing instances of
stress among soldiers.

28. UNPREDICTABLE FACTORS
Several unpredictable factors such as:
1. battle fatigue
2. unseen threats
3. extended field tenures
4. absence of adequate recreational
avenues
5. domestic feuds
6. inability to ensure quality education to
children and inability to meet aspirations
of spouse and children increase the level
of frustration, leading to stress

29. SOCIAL APATHY
A soldier believes that he is facing all
sorts of difficulties to serve his
nation and countrymen. The soldier
has this sense of honor and duty that
motivates him to face any challenges.
It is unfortunate that the society does
not acknowledges their contribution
most of the times. When incidence
like this happen starts questioning
his commitment towards his
profession and the nation.

30. MAY INJURE SELF OR
ENGAGE IN RISKY BEHAVIOR
1. Abandons planning for
future.
2. May start withdrawing from
others, including family and
close friends.
3. May give away possessions.
4. May appear apathetic,
unmotivated and /or
indifferent.

31. STRESS CONTROL
AWARENESS What causes you
stress? How do you react?
1. B = BALANCE There is a fine
line between positive / negative
stress How much can you cope
with before it becomes negative ?
2. C = CONTROL What can you
do to help yourself combat the
negative effects of stress

32. STRESS MANAGEMENT
TECHNIQUES
1. Change In Thinking
2. Change In
Behavior
3. Change In Life
Style

33. CHANGE IN THINKING
1. Reframing
2. Re-framing is a technique to change
the way you look at things in order to
feel better about them.
3. There are many ways to interpret
the same situation so pick the one you
like.
4. Re-framing does not change the
external reality, but helps you view
things in a different light and less
stressfully.

34. POSITIVE THINKING
1. Forget powerlessness, dejection,
despair, failure
2. Stress leaves us vulnerable to
negative suggestion so focus on
positives;
3. Focus on your strengths
3. Learn from the stress you are
under
4. Look for opportunities
5. Seek out the positive - make a

35. CHANGE YOUR
BEHAVIOUR
1. Be assertive
2. Get organized
3. Ventilation
4. Humor
5. Diversion and

36. Be Assertive Being assertive involves
standing up for your personal rights
and expressing your thoughts, feelings
and beliefs directly, honestly and
spontaneously in ways that don’t
infringe the rights of others.
Assertiveness helps to manage
stressful situations, and will , in time,
help to reduce their frequency. Lack of
assertiveness often shows low self -
esteem and low self - confidence. The
key to assertiveness is verbal and non
- verbal communication. Extending our
range of communication skills will

37. ASSERTIVE SKILLS
1. Establish good eye contact /
don’t stare
2. Stand or sit comfortably -
don’t fidget
3. Talk in a firm, steady voice
4. Use body language
5. ‘I think’ / ‘I feel’ ‘What do you
think?’ ‘How do you feel ?’
6. Concise and to the point

38. EQUALITY AND BASIC RIGHTS
1) The right to express my feelings
2) The right to express opinions / beliefs
3) The right to say ‘Yes/No’ for yourself
4) Right to change your mind
5) Right to say ‘I don’t understand’
6) Right to be yourself, not acting for the benefit of
others
7) The right to decline responsibility for other
people’s problems
8) The right to make reasonable requests of others
9) The right to set my own priorities
10) The right to be listened to, and taken seriously

39. ASSERTIVE PEOPLE
1. Respect themselves and
others
2. Take responsibility for actions
and choices
3. Ask openly for what they want
4. Self - confidence remains
intact
5. Not reliant on the approval of
others

40. GET ORGANISED
1. Poor organization is one of the
most common causes of stress.
Structured approaches offer
security against ‘out of the blue’
problems. Prioritizing objectives,
duties and activities makes them
manageable and achievable.
2. Don’t overload your mind.
Organization will help avoid
personal and professional chaos

41. TIME MANAGEMENT
1. Make a list what MUST
be done what SHOULD be
done what would you LIKE
to do
2. Cut out time wasting
3. Learn to drop
unimportant activities
4. Say no or delegate

42. PLAN YOUR DAY
1. Set achievable
goals
2. Don’t waste
time making
excuses for not
doing something

43. Ventilation ‘A problem shared
is a problem halved’ Develop
a support network through
friends or colleagues to talk
with. It’s not always events
that are stressful but how we
perceive them. Writing a diary
or notes may help release
feelings but do not re-read
what has been written

44. HUMOR
1. Good stress - reducer
2. Applies at home and work
3. Relieves muscular
tension
4. Improves breathing
5. Pumps endorphins into
the bloodstream - the body’s
natural painkillers

45. DIVERSION AND
DISTRACTION
1. Take time out
2. Get away from things that
bother you doesn’t solve the
problem
3. Reduce stress level
4. Calm down
5. Think logically

46. CHANGE YOUR
LIFESTYLE
1. Diet
2. Smoking & Alcohol
3. Exercise
4. Sleep
5. Leisure
6. Relaxation

47. DIET
In general, we should include a range of
nutritious foods and eat: plenty of
breads and cereals (particularly
wholegrain), fruit, vegetables and
legumes (such as chickpeas, lentils and
red kidney beans) low-salt foods, and
use salt sparingly small amounts of
foods that contain added sugars
reduced-fat milk and other dairy
products. It is also important to drink an

48. SMOKING AND ALCOHOL
1. Alcohol is high in energy
(kilojoules) and should be
consumed in moderation.
2. Stop or at-least your
consumption to bare minimum
3. Men should drink less than two
standard drinks per day and women
less than one standard drink per
day. One standard drink is 375 ml
mid- strength beer, 100 ml wine or
30 ml spirits

49. BENEFITS OF EXERCISE
1. Uses up excess energy released
by the ‘Fight or Flight’ reaction.
Improves blood circulation
2. Lowers blood pressure
3. Clears the mind of worrying
thoughts
4. Improves self image
5. Makes you feel better about
yourself
6. Increases social contact

50. SLEEP
1. The longer a soldier or a military
officer goes without rest and sleep,
the more his thinking slows down.
2. Continuous work declines speed
and accuracy more rapidly than
intermittent Work.
3. Good stress reducer
4. Difficult to cope when tired.
5. Wake refreshed after night’s sleep
6. Plenty of daytime energy

51. BENEFITS OF RELAXATION
1. Lowers blood pressure
2. Combats fatigue
3. Promotes sleep
4. Reduces pain
5. Eases muscle tension
6. Decreases mental worries
7. Increases concentration
8. Increases productivity
9. Increases clear thinking

52. LEISURE
1. Interest/hobbies
2. Online Games/sainik
samelans/roll outs
3. Movies
4. Gives you a ‘break’ from
stresses
5. Provides outlet for relief
6. Provides social contact

53. SUICIDE PREVENTION KEYS
The junior/ sub-unit leaders are the first
ones to identify the signs of potential
suicide- risk soldier.
1.The following prevention keys will provide
aid to persons at anticipated risk: Ask: “Are
you thinking about hurting yourself?”
Intervene immediately.
2. Do not keep a secret concerning a
person at risk. Locate help (JCO/ NCO/
doctor/ nursing assistant/ MI Room/ friend/
family/ help line).

54. 3. Inform your chain of
command.
4. Find someone to stay with
the person. Do not leave the
person alone.
5. Expedite, get help
immediately. A suicidal
person needs the immediate
attention of helpers.

55. CONCLUSION
It has to be realized that every soldier
and officer has to be treated as a
human being with self respect and
dignity. Before expecting the society
and civil administration to display
care for service personnel, the
services themselves have to carry out
introspection. The human resource of
armed forces should not be allowed to
feel neglected or unwanted after
vacating certain appointments. If this
aspect is sincerely addressed by the
services themselves, a sharp decline
in the stress and suicide levels.

56. THE END