No human being is exempted from stress.
The army soldiers are no exception
This presentation highlights various risk factors leading to stress, depression and suicide, the clinical features of stress and various preventive strategies for prevention of stress for army soldiers.
STRESS AND SUICIDE IN
DR. ROBIN VICTOR
DEPTT. OF PSYCHIATRY
No human being is exempted from stress.
The army jawans are no exception.
Infact that they are comparatively in an ideal stress breeding
environment due to frequent and large number of
uncertainties/ changes as compared to civilian counterparts
with similar service conditions.
What is stress??
In general terms, stress refers to
experiencing events that are perceived as
endangering one’s physical or
S = P > R
Stress occurs when the pressure is greater than the resource
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 Defence, 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.
Factors causing stress in soldiers
The stress can be triggered among soldiers due to any change or event
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.
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 behavioural 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 neighbours or even own brothers making
use of soldier's long absence from home to encroach on his property.
Armed forces community has a culture of its own, where sense of
belonging and responsibility are cultivated in an individual to display
A better interaction should be there between armed forces personnel at
The soldiers have to be encouraged to share their problems with their
seniors and emphasis has to be laid to redress their genuine grievances
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
Situation is worsened particularly in counter-insurgency operational areas,
impinge upon performance of both officers and soldiers.
Absence of Mental Health Professionals in
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
Several unpredictable factors such as:
extended field tenures
absence of adequate recreational avenues
inability to ensure quality education to children and inability to meet
aspirations of spouse and children increase the level of frustration, leading to
A soldier believes that he is facing all sorts of difficulties to serve his nation
and countrymen. The soldier has this sense of honour 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 jawan starts questioning his commitment
towards his profession and the nation.
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 demoralises 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.
The soldiers retire at a comparatively much younger age.
This is the time when they are expected to share major domestic
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.
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.
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 factors for stress, the system
of referring a soldier for psychiatrist's evaluation by the commanding officer needs
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 defence 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.
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
Lack of concentration
Difficulty in making decisions
Appetite changes - too much or too little
Eating disorders - anorexia, bulimia
Increased intake of alcohol & other drugs
Bouts of depression
Fits of rage
Deterioration of personal hygiene and appearance
STRESS RELATED ILLNESSES
Stress is not the same as ill-health, but has been related to such illnesses as;
Immune system disease
Skin complaints - psoriasis
Headaches and migraines
A person contemplating suicide:-
Appears depressed, sad, and tearful and/ or may display changes in
patterns of sleep and/ or appetite.
Believes he/ she is in a hopeless situation.
May talk about or actually threaten suicide, or may talk about death and
dying in a way that strikes the listener as odd.
May display changes in behaviour, appearance or mood.
May increase or start drug or alcohol use.
May injure self or engage in risky behaviour.
Abandons planning for future.
May start withdrawing from others, including family and close friends.
May give away possessions.
May appear apathetic, unmotivated and /or indifferent.
A = AWARENESS
What causes you stress?
How do you react?
B = BALANCE
There is a fine line between positive / negative stress
How much can you cope with before it becomes negative ?
C = CONTROL
What can you do to help yourself combat the negative effects of stress ?
Stress Management Techniques
CHANGE IN THINKING
CHANGE IN BEHAVIOUR
CHANGE IN LIFE STYLE
CHANGE IN THINKING
Re-framing is a technique to change the way you look at things in order
to feel better about them.
There are many ways to interpret the same situation so pick the one you
Re-framing does not change the external reality, but helps you view things
in a different light and less stressfully.
Forget powerlessness, dejection, despair, failure
Stress leaves us vulnerable to negative suggestion so focus on positives;
Focus on your strengths
Learn from the stress you are under
Look for opportunities
Seek out the positive - make a change
CHANGE YOUR BEHAVIOUR
Diversion and distraction
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 improve our assertiveness.
Establish good eye contact / don’t stare
Stand or sit comfortably - don’t fidget
Talk in a firm, steady voice
Use body language
‘I think’ / ‘I feel’
‘What do you think?’ ‘How do you feel ?’
Concise and to the point
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
Respect themselves and others
Take responsibility for actions and choices
Ask openly for what they want
Self - confidence remains intact
Not reliant on the approval of others
Poor organisation is one of the most common causes of
Structured approaches offer security against ‘out of the
blue’ problems. Prioritising objectives, duties and
activities makes them manageable and achievable.
Don’t overload your mind. Organisation will help avoid
personal and professional chaos.
Make a list
What MUST be done
What SHOULD be done
What would you LIKE to do
Cut out time wasting
Learn to drop unimportant activities
Say no or delegate
Plan your day
Set achievable goals
Don’t waste time making excuses for not doing something
‘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.
Good stress - reducer
Applies at home and work
Relieves muscular tension
Pumps endorphins into the bloodstream - the body’s natural
Diversion and Distraction
Take time out
Get away from things that bother you doesn’t solve the problem
Reduce stress level
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 adequate amount of water.
Smoking and Alcohol
Alcohol is high in energy (kilojoules) and should be consumed in
Stop or at-least your consumption to bare minimum
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.
Benefits of Exercise
Uses up excess energy released by the ‘Fight or Flight’ reaction.
Improves blood circulation
Lowers blood pressure
Clears the mind of worrying thoughts
Improves self image
Makes you feel better about yourself
Increases social contact
The longer a soldier or a military officer goes without rest and sleep, the
more his thinking slows down.
Continuous work declines speed and accuracy more rapidly than
Good stress reducer
Difficult to cope when tired.
Wake refreshed after night’s sleep
Plenty of daytime energy.
Games/sainik samelans/roll outs
Gives you a ‘break’ from stresses
Provides outlet for relief
Provides social contact
Suicide Prevention Keys
The junior/ sub-unit leaders are the first ones to identify the signs of apotential suicide-
risk soldier. The following prevention keys will provide aid to persons at anticipated
Ask: “Are you thinking about hurting yourself?”
Do not keep a secret concerning a person at risk.Locate help (JCO/ NCO/ doctor/
nursing assistant/ MI Room/ friend/ family/ help line).
Inform your chain of command.
Find someone to stay with the person. Do not leave the person alone.
Expedite, get help immediately. A suicidal person needs the immediate attention of
It has to be realised 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.