Maxwell reaches out to those in need Published Nov. 30, 2012 By Rebecca Burylo Air University Public Affairs MAXWELL AIR FORCE BASE, Ala. -- -- Everyone deals with stress differently, and how people respond to that stress can be the difference in living or taking one's life. Saving lives is the goal of Maxwell, not just for others, but for its own. Mental health professionals and programs at Maxwell are aimed to keep Airmen from becoming suicidal statistics. Suicide is more complex than simply causing one's own death. There are dozens of contributing factors that lead up to the point of being overwhelmed, where some feel they cannot go on living and they see suicide as the only way. There are also many adverse consequences such an action can leave on friends, family and the workforce, according to Col. Trent Edwards, 42nd Air Base Wing commander. "Suicide has a negative impact on the morale of an organization and thus the ability for the organization to effectively achieve its mission. Every Airman is important not only to the mission but more broadly to our Air Force and our nation," he said. "However, the impact of the suicide on the mission is secondary to the impact on the immediate family members and friends." This is the reason so much research and resources are put toward suicide prevention and awareness, which are supported strongly throughout the different military services. The military has an average of one suicide completed daily, with 56 suicides this year in the Air Force, according to the Department of Defense. However, Maxwell is not following the national average and has had two completed suicides within the last five years, according to mental health clinical psychologist Capt. Neysa Etienne. Each one is troubling, she said. "Suicide is not a major problem here, but even one suicide is devastating," she said, contributing the low number to base programs and demographics. "Maxwell is unique in that it's an educational environment," she said. "They (students) are here to climb in their careers through leadership training and promote to a higher rank. These tend to be healthier individuals, in-tune with themselves and others." One's physical health and mental outlook and their relationships within the workforce and at home all seem to play a vital role in whether or not someone is contemplating suicide. Professionals from the mental health clinic, family advocacy office, the Airman and Family Readiness Center and the chaplaincy all agree that those attempting suicide are impacted by a variety of stressors affecting the "whole body" - physically, emotionally, socially and spiritually. Each department plays a part in educating the base about suicide prevention and awareness through lectures, briefings, online training and pre- and post-deployment seminars. Physical Marie Hixon, personal work-life consultant for the Maxwell Airman and Family Readiness Center, has helped people cope with life's stressors for more than 10 years. Counseling potential suicide victims, Hixon first eliminates any physical factors that may be contributing to their stress. "If someone comes into my office with stress, anger or depression concerns, the first thing I'm going to do is ask them questions relating to their physical health. 'How are you sleeping?' 'Are you exercising?' 'How are you handling the stress?' 'How are you eating?' 'Are you drinking enough water?'" she said. "If someone has a physical need, and unless that gets met, you're not going to help them address the other areas." Hixon said a lack of sleep, exercise and proper hydration, eating foods packed with sugar and caffeine, and substance abuse can contribute to stress and depression, which, when compounded with the effects of adrenaline, may lead to suicide. "When you are stressed, your body produces adrenaline, which affects your body in a lot of different ways," said Hixon. One hormone that can help counteract the effects of adrenaline, she said, is endorphins, also known as "happy hormones." Endorphins are produced through muscle motion and exercise, and they help maintain healthy mood levels, regulate sleep and create a sense of well-being. Social Feeling cared for is one of the best combatants against thoughts of suicide. The core desire of humanity is to be loved, according to Chap. (Lt. Col.) Gary Ziccardi, the wing chaplain, whose services include visitations, ministry, counseling, intervention and deployment cycle support. That core desire, when not met from relationships, work or family, has the power to "poison people's minds." "We all need to be known and cared about in some form of community," said Ziccardi. "That's how we're created and wired. The world can be a cold and uncaring place. Genuine caring and listening is like a refreshing cup of cold water on a hot summer day. It enhances life." Hixon said listening can be one way to help someone who may be considering suicide. "The majority of them just want to know that somebody cares enough to give them a moment to validate that they're worth something," she said. "Listening can make a difference. Even eye contact and a smile really can make a difference in someone's day." Some of the social indicators that someone may be struggling with depression and suicidal thoughts are isolation and withdrawing from social circles. That is why all community members on base have a part to play in keeping each other safe, whether as a neighbor, a co-worker or a student, Hixon said. Maxwell and Gunter are a family, said Edwards. "We are an Air Force family, and on a smaller scale, a Maxwell-Gunter family," he said. "Families care about each other and take care of each other. Our profession is 24 hours a day, 365 days a year, and we don't stop caring about our Airmen and their families at five o'clock." Emotional Boosting someone's self-worth can also make the difference in someone's life. Many times, according to Etienne and Capt. John Noah, a mental health physician, those coming to the mental health clinic with thoughts of suicide are struggling with feelings of low self-worth. They tend to use absolutes such as "I can never do anything right," or "I'm always a failure," they said. "First we help them to identify and verbalize the thoughts going on in their head, then we can start working with those thoughts of how realistic they are or are not," said Etienne. "I would notice their rank and mention that they have been promoted, so they must have done something right to be successful. Then I start pulling out evidence that conflicts with that thought that they are having." Staff at the mental health clinic, family advocacy and the Airman and Family Readiness Center all agree that relationships are the No. 1 stressor leading to suicide and can greatly affect one's emotional state and confidence level, according to Hixon. "A divorce, a loss of a friendship, a loss of a pet, financial loss, foreclosure or bankruptcy, rejection, feeling like a failure, not passing a test or being turned down for something can all take a toll on your confidence," said Hixon. "And so what you're looking at in someone considering suicide is someone focusing on the negative and can't see past that." Spiritual Connecting with a church and building relationships and support systems can greatly decrease the chances of suicide. Ziccardi said the spiritual counseling within such a community can give a person a reason to live. "It opens their outlook to see the wonderful gift of life and the opportunities waiting to be explored and experienced in the years to come," he said. "My goal is to help people to see the light and find joy in living." Clinical help Most times, those dealing with suicidal thoughts are experiencing a multiple of stressors coming from relationship, lack of affirmation at work, feeling worthless, financial troubles or legal disputes. The mental health clinic has a process to evaluate stressors and to treat potential suicidal victims who are seeking help or displaying depressive symptoms. Etienne said they look at the two mental states of those contemplating suicide: passive, those wishing harm on themselves, and active, those formulating a plan to inflict harm on themselves. "There are ideations, which are thoughts of suicide, and there are morbid ideations, which are more to do with thoughts about being dead. That person is not suicidal, they're not happy to be alive, but they're not suicidal in the same sense that they're going to go do something about it," said Etienne. Through asking direct questions such as, "Are you having thoughts of harming yourself," and "Do you have a plan or how often do you think about it," Etienne can determine whether or not a patient is passive or more actively suicidal. "We're looking for frequency, we're looking for intensity, we're looking for whether or not they have formulated a plan or is this just a vague notion," she said. Once a mindset is established, Etienne said they will determine how often such suicidal thoughts occur and how long those thoughts are dwelt on. By refining the questions and honing in on the catalyst for such thoughts, she can evaluate the severity of their condition and the appropriate treatment will be prescribed. A crisis response plan is created for each individual based on personal interests to help them cope when thoughts of suicide come. Etienne explained the plan as a tangible list of activities that equate meaning in a person's life and preoccupy their minds from suicidal thoughts, such as talking to grandchildren or going for a walk. "We want people to be empowered to be able to manage the stressors of their life, because life is stressful and people manage stress differently," she said. "So by helping people reconnect with something meaningful, we are giving other options to manage their stress." Noah said that most suicide attempts occur within the first hour after the initial thought, and that if friends, family or base resources can keep them safe during that time, they can save upwards of 95 percent of attempted suicides. In cases where thoughts continue, someone should call 911. Those diagnosed with an imminent risk of self-harm are hospitalized immediately and placed on a high-interest list. Once discharged, mental health clinic staff meets with patients weekly for the next 30 day, for continued care and stabilization. Edwards encourages those struggling with thoughts of suicide to ask for help and that they are not alone in their fight. "For those struggling with suicidal thoughts, you are not alone, and we care about you," said Edwards. "We want to see you do well and succeed. I encourage you to have the strength and courage to talk to your friends, family or co-workers about it. Asking for help is not a sign of weakness; it is a sign of strength."