NOT ALL PTSD CASES ARE CREATED EQUAL
Addiction is not a symptom of PTSD, it CAN be a byproduct, or a reason to look deeper.
This is a critical distinction, one we have encountered in calls from Public Safety professionals needing help. Know the difference!
“My department said I can’t have PTSD because I am not an alcoholic.”
Public safety pros individually respond differently to traumatic experiences. For some, the incident is no problem. For others, various symptoms of PTSD can present themselves. LEFT UNTREATED addictions of various kinds may occur to mask the emotional turmoil experienced. For some, no symptoms develop. Know what to do and what to look for in yourself and others.
A Physical Wound
If a first responder responds to an event, let’s use a serious vehicle accident for example and on arrival the initial observation is smoke billowing from under the hood. The first responder will work to extricate the driver. Suppose the door is locked or jammed. The window is broken and the driver pulled to safety. Further imagine that first responder cut their hand deeply while making the rescue. Immediate attention to stopping bleeding and a temporary bandage will by the proper action – followed by a trip to the ER where proper evaluation and treatment will occur.
An Emotional Wound
Now suppose in that same scenario, the first on scene, after extricating the driver, observes a child in the back seat. If rescue is not possible, or if the impact caused death, that may well cause an emotional wound. Likely there will be a critical incident diffusion and/or debriefing. For some, the mental image of the dead child may well be a deep-seated traumatic memory. More than a debriefing may be needed. But, we are tough guys, and do not want to show emotional weakness.
Either a physical wound or an emotional wound, if left untreated, can cause serious repercussions. Physically, an infection,
gangrene, perhaps death if left untreated. No one would do that. However, significant emotional wounds left untreated can lead to symptoms of PTSD – signs first responders try hard to mask. Self-medication or other escape mechanisms may be employed. Such can spiral out of control. Suicide may be seen as the only way out.
Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normal reaction to an abnormal situation. (PTSD.com/uk)
Let me say it again, addiction is not a symptom of PTSD, rather, can be a byproduct. Those struggling with Post Traumatic Stress try to escape from the emotional toll whether from cumulative incidents, or for some, a primary event.
For some, the escape can be excessive exercise, while others find different attempts to cope – like a sex addiction, becoming a workaholic, isolation, or other such means. For some, the addiction is substance abuse, whether alcohol or narcotics. Each poor coping effort can become an addiction to divert thoughts from traumatic memories triggering the symptoms. In no way do I excuse addictions. Can an addiction precede PTSD symptoms? Of course. The addiction may have been an issue prior to joining a public safety profession. There could be prior personal issues driving the addiction.
The point is, if the emotional components of PTSD are properly treated, concurrent with treatment for the addiction, the first responder can recover well and be productive. However, if only treated for the addiction at an addiction treatment center, where the PTSD elements are either ignored or not adequately addressed through proven modalities, the addiction will most likely return, or another coping mechanism can become a problem, perhaps even more than before.
Specifically, if there is a diagnosis of PTSD with a co-occurring addiction, a true dual diagnosis treatment is paramount – moreover, treating the PTSD is the critical component, because it is possible the traumatic memories can drive the client to the addiction.
To say someone in public safety professions can stop an addiction if they choose is a misunderstanding of the likely motivators for the addiction, masking emotional turmoil, PTSD symptoms. Far too many do not ask for help because they fear the PTSD diagnosis out of concern for their job.
Sadly, some administrators with antiquated views on mental health and wellness reflect old school, uninformed understanding of PTSD and the emotional toll possible from trauma encountered on the job, whether traumatic incidents on the street or through administrative issues. Such management philosophies exacerbate the fear of asking for help.
How to Get Help
The first step is locating a properly trained trauma therapist for evaluation for PTSD and/or an addiction. If residential treatment is deemed necessary after assessment, the trauma therapist would recommend that step. By calling our Serve & Protect crisis line, trained professionals can connect the caller directly with a well trained intake professional to evaluate the immediate needs, or on the other hand, referral to a trauma therapist to begin the process of restoration.
Depending on the therapist, addiction therapists may not be as well trained in PTSD, and if treating it as an addiction do little if anything for the cauldron of emotion brewing in the mind. When the addiction does not subside, the addiction therapist will likely refer to psychiatrists – who too often prescribe pills. Pills likely ruin careers – unnecessarily. For some, medication may become necessary, but not until other means of treatment are attempted and exhausted.
The point is, not all addictions are created equal because we each have unique emotional makeup and backgrounds. If people could just choose to stop on their own, short of a miracle from God (which I have witnessed), there would be no need for all the addiction centers in America. Freedom from addiction can coincide with freedom from emotional bondage to traumatic memories.
To that end, Serve & Protect, and our partner Safe Call Now are committed to addressing PTSD and related addictions through dual diagnosis residential care facilities properly vetted with on-site visits and evaluation by our Safe Call Now partners. The quality of care, understanding of trauma and addictions, and understanding of the professions we serve is of paramount importance.
On the other hand, there are some addiction treatment centers that are focused on facility census, that is, filling beds for profit margins. Some initially recommend coming to their facility for assessment. Our care partners do a thorough initial assessment over the phone, and, if residential care is not warranted, we work together to locate adequate trauma therapist care locally. The focus is finding the best solution for each caller’s needs.
Certainly there are resources through employers, such as EAP, peer support, or Chaplains. Many in public safety are hesitant to utilize those for fear of breach of confidentiality and / or reprisal. Sadly, for some, that fear proved to be reality. For those afraid to ask in-house help. We provide a safety net, a confidential resource you can trust – absolutely. We are YOUR advocate.
The Process is Client Need Centered
Whereas Safe Call Now addresses the crisis line and facilitates residential care assessments, Serve & Protect facilitates trauma therapist care. We identify all therapists specializing in trauma in the client’s area – specifically, we go further and locate one who takes their insurance and has openings for care. We emphasize trauma therapists who have tools like EMDR and Rapid Resolution Therapy, among others in their toolbox. Both of those modalities of treatment have proven to be very effective for our clients.
We also can facilitate Equine therapy, service dogs, recreational therapy, and more through relationships we developed over the years. The bottom line – people can respond better to one therapy than another.
Rounding out what I call 360Care. We serve the caller from the first call, whether referring to a therapist or residential care, and following residential care treatment, we facilitate the same process of locating a therapist for aftercare at home.
The emphasis – real solutions for real problems.
Both Serve & Protect and our partner Safe Call Now charge callers nothing for our services, nor do we receive fees from those to whom we refer. We operate on the good graces of individuals and businesses that believe in the importance of the services we provide to our homeland heroes.
We provide confidential, collaborative, comprehensive, and compassionate care 24/7/365.
A Parting Thought
The impact of PTSD and/or addictions – and related behavioral issues directly impact relationships. High divorce rates and too often multiple marriages, estrangement from children, domestic violence, loss of friendships, not to mention the physical issues, are all potential ramifications of ignoring the elephant in the room. Too often, thoughts turn to suicide to end the problem, thinking all would be better of. Do not buy that lie. I personally have helped families pick up the pieces of shattered lives following the suicide of a public safety professional. The tragic impact is lifelong.
If you are reading this and feel at the end of your rope, or know someone who is, silence will kill. Say something, be engaged in reaching out. If it is you, please, call us. It truly breaks my heart to hear of yet another public safety suicide while knowing help is but a phone call away.
Lastly, as a Christian, I can absolutely assure you that if you call out to God for help, He will respond. He did for me. No matter where you are, how deep the well, I have found the teaching of Psalm 23 to be true and assuring. The Good Shepherd knows His flock, cares for their needs, and watches over them to help them through good times and hard times.
For help, please call us at 615-373-8000. One of our peer advocates – each of whom have experience in public safety – will help you identify the best solution for YOUR need.
Now. Be aware of these signs and symptoms of PTSD:
From Mayo Clinic www.mayoclinic.org
Symptoms of intrusive memories may include:
- Recurrent, unwanted distressing memories of the traumatic event
- Reliving the traumatic event as if it were happening again (flashbacks)
- Upsetting dreams about the traumatic event
- Severe emotional distress or physical reactions to something that reminds you of the event
Symptoms of avoidance may include:
- Trying to avoid thinking or talking about the traumatic event
- Avoiding places, activities or people that remind you of the traumatic event
Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:
- Negative feelings about yourself or other people
- Inability to experience positive emotions
- Feeling emotionally numb
- Lack of interest in activities you once enjoyed
- Hopelessness about the future
- Memory problems, including not remembering important aspects of the traumatic event
- Difficulty maintaining close relationships
Changes in emotional reactions
Symptoms of changes in emotional reactions (also called arousal symptoms) may include:
- Irritability, angry outbursts or aggressive behavior
- Always being on guard for danger
- Overwhelming guilt or shame
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble concentrating
- Trouble sleeping
- Being easily startled or frightened
Finally, if you or someone you know is presenting these symptoms please call our crisis line. 615-373-8000. We are on call 24/7/365. Visit www.serveprotect.org where we have several videos illustrating the issues of PTSD and suicide among public safety professionals as discussed here. There are several articles available too.
Serve & Protect, working with the Tennessee State Lodge and Williamson County TN Morris Heithcock Lodge 41 of the Fraternal Order of Police are working to impact our state with information to help understand PTSD and suicide in public safety. Several resources are available from the home page at Serve & Protect.
- Download our free mobile app from our Serve & Protect website. (Apple/Droid)
- Access multiple videos suitable for roll call or in-service training.
- Download our FREE PTSD Awareness Poster – RESOURCES
- Request business sized cards with crisis line information
- We have 50+ topical posts in archive on our site – feel free to use as you need.
- Consider a seminar / in-service with a Serve & Protect speaker to address these issues. Call 615-224-2424 for more information.
Most of all, remember – you are not alone. Many peers across the country experience the very same issues. Our mission is to serve families and save lives – yours and those just like you.
This article and related resources are part of an educational campaign from Serve & Protect and the Tennessee State Lodge and theWilliamson County TN Morris Heithcock Lodge of the Fraternal Order of Police. Our hope is to educate peers and provide insight into PTSD and suicide in public safety professions. Together we hope to serve families and save lives.
ABOUT THE AUTHOR
Robert Michaels is the CEO / Founder of Serve & Protect, an international organization dedicated serving public safety – police officers, firefighter/rescue/ems, dispatch, emergency management, and corrections professionals and their families through comprehensive, collaborative, compassionate, confidential care for emotional and spiritual needs.
In launching Serve & Protect, Michaels returns to his roots. He served in law enforcement first with the 229th Military Police Battalion of the Virginia Army National Guard, as well as with Norfolk (VA) Police Department, both on patrol and in the detective bureau.
Based in Brentwood Rob serves as the Chaplain for the FBI Memphis Division, Nashville R.A., State Chaplain for Tennessee Fraternal Order of Police, and is a Chaplain and Sergeant at Arms for FOP Morris Heithcock Lodge 41 in Williamson County TN, where he is an active member. He is a member of the American Academy of Experts in Traumatic Stress, National Center for Crisis Management, International Conference of Police Chaplains, Federation of Fire Chaplains, , and Luis Palau Association Next Generation Alliance. He holds a B.A. from Columbia International University and a M.A. from Wheaton College (IL).