Combating the stigma against help-seeking Published Feb. 1, 2022 By Rebecca Ward Pentagon -- Col. Heather Fox, the 9th Reconnaissance Wing commander at Beale Air Force Base, California, doesn’t mince words when it comes to encouraging supervisors at the wing to support Airmen and Guardians who may need help. During all-calls, and whenever else she gets the opportunity, Fox lets her Airmen know that help-seeking should be viewed in a positive light. “You will create an environment where members understand that it’s okay to come forward and say they are having a problem,” said Fox. Combatting the stigma against help-seeking behaviors for the individual as well as leadership is personal to Fox. As a U-2 Dragon Lady pilot, she suffered a brain injury while on a mission over Afghanistan in 2009. The high altitude and intense tempo of the operation caused nitrogen bubbles to come out of her blood and into her brain tissue in a neurological event called decompression sickness (DCS). The four hour flight to safety while experiencing DCS led to long term anxiety in situations where she felt trapped, as well as occasional panic attacks. Fox ultimately found her way to the right therapy with the support of most her leadership. There was one leader, though, with whom she didn’t feel comfortable talking, and they had already used a derogatory slur toward her when she was not able to fly because of the brain injury. “Everybody else has always been incredibly supportive so there was just that one kind of specific personality, and that was 12 years ago now. So I think that as time progressed, there’s less of those personalities. But I have to think in some of our communities, there’s still some supervisors like that out there,” said Fox. Fox and her team at Beale AFB are dedicated to creating a culture that moves from toughing it out and suffering in silence toward viewing help-seeking behavior as a model of courage and strength. To encourage others to seek help when needed, Fox began telling her own story to demonstrate it can happen to anyone. “I had what we now know is a neurological DCS case. It’s essentially like having a stroke and it just depends on where those bubbles are as to what your symptoms are going to be – as far as what part of your brain is going to be impacted,” Fox explained. The brain injury resulted in severe vertigo while flying and she also had trouble remembering words and experienced weakness on the left side of her body. “But it was mostly extreme dizziness and fighting to stay conscious which is not super great in a single-seater aircraft,” said Fox. Then-Capt. Fox did what she was trained to do, including guiding her plane to a lower altitude as she headed back to base. Nevertheless, she said it was a pretty terrible four-hour flight home as she considered ejecting from the plane over the Persian Gulf or Oman. Once back on the ground, the ordeal wasn’t over. She spent the next year recovering from what she describes as a minor brain trauma. “Every time I was flying, I would start to feel the same way and of course you start worrying about feeling that way, which is kind of panicky and it was like the same symptoms that I had felt during DCS – nauseous, feeling light-headed, and that same sort of thing.” said Fox. Finally after two years, Fox said she admitted to her commander that she was having a problem. She said, “I thought at that point perhaps I would never fly again and this is the point we really try to stress. Of course, in my mind, I had made the repercussions to be far more terrible than they ended up being. I figured when I walked into my squadron commander’s office that would be it—I’d never fly again and might not be able to stay in the Air Force.” Instead, Fox said she was flying the next week. She went through counseling and her anxiety seemed to improve. However in 2011, Fox went to school and did a staff exchange in the United Kingdom where she started having panic attacks. This time it was outside of the cockpit. “Whenever I felt trapped, because in the jet, when it was happening, that’s how it felt. It was four hours of this terrible experience and there was just nothing I could do to get out of that cockpit. And so the anxiety was starting to rear its head just sitting in meetings,” said Fox. Fox jokingly says the British have a lot of meetings and don’t believe in bathroom breaks, but her demeanor takes on a more serious tone as she describes one particular meeting with the Royal Air Force where she was in a planning cell for a real-world issue happening at the time. She had been up for close to 72 hours straight, staying awake with the help of a lot of caffeine and sugar, when she told her colleagues she wasn’t feeling great and needed to sit down. She started having symptoms just as she had in in the cockpit, including weakness in the left side of her body. Fox’s colleagues took a look at her and called the ambulance. She describes the experience now as a full-on panic attack and so she sought the help of a therapist for the third time in the past three years. Although the previous sessions were helpful, this time her counselor focused on Cognitive Behavior Therapy, (CBT) which had a much more dramatic impact. Fox admits she was taken off of flying status for eight months. “This may have been the third therapy, but it was the first time I’d done CBT. It was kind of the golden ticket that really worked,” said Fox. When speaking with members of Beale AFB, Fox likes to emphasize that it was not until her third counselor that she found life changing healing. “It can be really hard and frustrating at times, but individuals need to stick with it and keep trying until they find something that works. It is not always an immediate ‘fix’,” said Fox. Fox is back on flying status now and a wing commander. That’s one of the most important messages Fox wants to stress with Airmen and Guardians, it did not hurt her career long term even though she was off of flying status for close to a year. She said the first time she went to her squadron commander and ‘fessed up,’ it wasn’t the dramatic event she had envisioned, and she only wishes she had done it sooner. Fox says struggling with depression and anxiety is part of being a normal human being. There may be temporary setbacks but a six- or eight-month setback has very little impact in the grand scheme of things. What matters is the resolution and how much better of a person you are at the other end of working though a challenge. Interestingly, when she had her first reinvestigation interview for security clearance, she was a little worried about the reaction to her CBT therapy for anxiety. Just like everything else, Fox says, it was an incredible non-issue. “The interviewer was like ‘oh yeah, that’s great. In fact, we prefer that people with clearances seek counseling to make them more resilient,’” said Fox. Fox’s message to frontline supervisors is similar, “this is a normal thing and we’re changing the culture.” She says if supervisors worry about production because they are one person down, they need to realize that, first of all, they need to take care of the person. Even from a production standpoint, taking the time to get this person better is ultimately only going to help with the long-term production. “Asking for help doesn’t make you weak,” Fox said. “It makes you brave. It makes you strong. It makes you smart.” ___________________________________________________________________________________________________________________________________ To locate the right providers or get a referral for treatment, contact your installation’s mental health clinic, behavioral health, or Military OneSource at 1-800-342-9647. In an emergency, call 911 or the Military Crisis Line at 1-800-273-8255.