Front Line Mental Health - The Hidden Pandemic of PTSD

     Back when I was 16 years old, I joined a volunteer rescue squad. I specifically remember a car accident that I responded to not far into my career. It was early one Sunday morning that took the lives of three people. The driver of the car that caused it was intoxicated, and the two sisters he hit, one died immediately and later the other from her injuries. 
     When I started out my mentors were tough, gritty, hardened men and women who have been working EMS for years already. They became family to me very quickly. They not only showed me the way, but during the really bad ones, they also checked in on everyone else to make sure they were okay. Who checked in on them? Good question. For the purpose of this entry, I will stay on point of mental health, but I will mention here that I went to many of these people's funerals throughout my career. None of which ever reached retirement.
     At this point in time there were very few ways of dealing with the things we saw. We were very good at our dark humor. I am pretty sure if an outsider were to hear some of the conversations had by frontline workers such as police, fire, EMS, nurses etc. they would think we were out of our minds, but really it was our way of trying to keep ours intact. You don't talk about the person whose leg was amputated.... you talk about that person meeting someone who has the other one amputated with the same shoe size and sharing the costs.
     Even if there were times that you were not okay, you had to be okay depending on the situation. I remember a different accident with a young child that didn't make it and being told to get my truck together because calls are pending. What did I do? I put my truck together. Calls were pending. This happened over, and over, and over throughout my career as an EMT. I only share these details with you for you to understand the gravity of what is witnessed on a daily basis by creatures that are no longer biologically intended to do so.

     Skipping ahead many years now, much more is known about Post Traumatic Stress Disorder (PTSD). Through wars of the past PTSD started off being known as "shell shock", "battle fatigue", and "gross stress reaction" among many other titles before becoming known as PTSD as it is now, and it is still evolving. Now it is understood that it is not a disorder only classified to our war heroes, but also our everyday heroes on the streets, in the hospitals, and even on the other end of the phone in dispatch centers. PTSD now even has subclassifications such as Complex Post-Traumatic Stress Disorder (CPTSD) which shares most of the same symptomology, but its cause is more deeply rooted in exposure to multiple distressing events over time.
     For the purpose of the rest of this entry I will simply refer to PTSD, but my intention is that both are equally as serious. Now if you think back to the beginning of this entry, I said that I started in this field when I was 16, and many still do start at this age. Mine you at this age in many states you are not allowed to drive yet, you cannot drink alcohol, you cannot buy a gun legally, you cannot join the military or vote... but you can witness a side of humanity that we as a society have done our best to keep hidden. Police officers dealing with not only being trashed by the same people they protect, but dealing with suicide by cop, accidents, daily danger etc. Corrections officers dealing with the people society says should not be allowed back into society stabbing each other as well as the officers. Nurses, doctors, 9-1-1 operators, the list goes on and on. 

     What does PTSD look like? If you're picturing someone in an active flashback reliving the moment as if they were still there, you're not wrong. There is much more too it though that doesn't look like that. Common signs and symptoms are (these are just brief descriptions)

• hypervigilance - having to sit facing the door in a restaurant or always looking around because you just have to know what is going on around you
• avoidance - taking the longer route to where you're going because you don't want to remember what happened in that playground
• nightmares - sure you're use to them, but it's not "normal"
• short temper - do you even know why such a little thing set you off?

     The point is that living this way is not "enjoying" life. Living this way is always feeling like survival. As always, there are people who still do not believe mental illness is real which is part of why the stigma exists. Science has proved that in PTSD the amygdala gets larger which is your center for your 'fight or flight' response and what tells the rest of your nervous system you're in danger before your visual cortex even has time to process what you are looking at. Science has also proven atrophy of the hippocampus, or the memory center of the brain. What was it I came in this room for? 
     The Stigma - This is something I am animate about. Society has created a stigma against those having issues with mental health. At this moment it is estimated that roughly 6.5 million people in the United States alone are dealing with symptoms of PTSD but are currently undiagnosed and untreated. The greater majority of these individuals are believed to be men because the added stigma that it makes the man less of one. There are therapies, medications, and options for treating this disorder, but regretfully because of the stigma against seeking help many of these cases end in suicide, additions, broken marriages, lost careers as well as many other negative results.
     We, as a society, need to band together against the stigma that has been reinforced throughout the years and get those that help everyone else the help they need. I do not pretend to believe I have all the answers, but I have some proposals such as routine yearly screenings for frontline workers. Keeping up with current information pertaining to how to best handle debriefing after major incidents, if at all as it has been found this can increase the rate of PTSD in some studies. For now, while trying to figure out the best ways to prevent some cases from happening, we can at least identify those who could benefit from treatment. If any of the things discussed here sound oddly descriptive of you, or someone you know, maybe it's something you should bring up to a medical professional. You can also use any of the hotlines I have listed on the important helplines page at Support & Resources - The Night Walkers LLC. 

MOST IMPORTANTLY - IF YOU OR ANYONE YOU KNOW ARE HAVING SUICIDAL THOUGHTS, PLEASE CALL 911 IMMEDIATELY OR GO TO YOUR LOCAL EMERGENCY ROOM.

     There is no need to feel shame or like you are weak for seeking help. In fact, it takes so much strength to do so. I have received my "official" diagnosis and have begun treatment. I can say that I sleep a little better, and the dreams are a little less frequent, but I still have a long way to go. Also, I know I am not alone, and neither are you. 

Thank you for stopping by. I'm glad you are here. - TNW