Psych Services: Personal trauma: If you see something, say something

Lisa Garmezy

Maybe it’s anxiety, maybe it’s depression, or maybe it’s both. Maybe yours is a unique brand of misery that defies categorization. If you need mental health help but have hesitated, please reconsider.

Nationally, the fear of rejection, discrimination or failure keeps people out of mental health treatment and causes those who do go to drop out early. Emergency responders, in particular, feel they have to be superheroes who walk through fire (real or metaphorical) without flinching.

Get real. Your courage is admirable, but everyone has a limit.

The military, law enforcement and firefighting professions share many concerns. Any of these professions, except perhaps a peacetime enlistment, brings exposure to trauma. The average police officer sees a dozen gruesome, potentially traumatic scenes in the first year. Exposure to trauma among firefighters rose when medical response calls began to outnumber fire-related call-outs.

People in these jobs have a remarkable camaraderie with coworkers. The dark flip side is an “us-versus-them” mentality. That mindset thinks no one outside a small circle of trust can understand or help.

Trauma exacerbates that sense of separation from others. Survivors can feel stained or permanently damaged. First responders feel even more separate from “normal” people.

Recognizing the Risk

Men and women in these jobs have trouble acknowledging vulnerability. Endurance and fearlessness are prized. Even the women pick up the macho attitude, “I’ll be fine.”

Although the danger is great, concern about stigma and its impact on a career is an obstacle to getting care. (Kudos to HPD supervisors who show leadership by unashamedly taking a seat in our waiting room.) Our office constantly reminds employees that HIPAA laws work: your privacy is protected. We divulge information only as required by Texas law to prevent homicide, suicide, or abuse.

Admitting a mental health problem feels like joining the other side. You fear developing the qualities you associate with the mentally ill—violence, instability, and victimhood. Taking medication seems to suggest a more serious problem, so it’s often out of the question.

But you’re not always fine. The ugly truth is that there are three police suicides for every two line-of-duty deaths. Among firefighters, there are three suicides for each line-of-duty death.

As war theater casualties go down, the proportion of military suicides goes up. In 2015, the armed forces saw 21 deaths in Afghanistan, seven in Iraq, a minimum of 18 aviation deaths, a minimum of five training deaths . . . it’s too soon for final numbers. The total won’t be anywhere close to 265, the number of U.S. military men and women who died by their own hands.

Oddly, folks who dedicate themselves to protecting others sometimes think suicide keeps them from burdening loved ones. The guilt and horror felt in the wake of these deaths never eased anyone’s burden.

Other risk factors for suicide in first responders can be PTSD, sleep disturbance, being male, a break-up, immediate access to weapons, and heavy alcohol use. Also, seeing death over and over may make it less frightening.

Overlooking the Obvious

Writer David Foster Wallace said in an often quoted 2005 graduation speech, “Important realities are the ones that are hardest to see.” We get confused about what matters in life. He did, apparently, choosing suicide three years later.

In the speech, Wallace described a wise old fish greeting two young fish. The older fish says, “Morning boys, how’s the water?” They all swim on and later one of the young fish asks the other, “What the hell is water?”

Sometimes there’s something around you that everyone else can see plainly that you don’t want to or can’t recognize. Having emotional problems is like that.

Wallace told the graduates that adult life “involves boredom, routine, and petty frustration.” People put up walls in response. The seniors were urged to maintain “attention and awareness and discipline, and being able to care about other people and to sacrifice for them over and over in myriad petty, unsexy ways every day.”

So here are basic truths that are easily overlooked. Real men get hurt. Cops aren’t perfect. Your wives and girlfriends, your husbands and boyfriends and parents, even your buddies, all know you’re not perfect. Admitting it won’t shock anyone.

Holding Back Versus Reaching Out

I buried my father in 2016. He was a research analyst, not a cop, but like most men of his generation, he hid his emotional pain. Now that he’s gone, I pore over his journals and wish desperately that he had shared more of his heart.

Distancing yourself from the people who care about you is a common response to trauma or burnout, but it only creates more problems. A bias against treatment can cause unnecessary suffering or be fatal. Wallace died after getting off the antidepressants he thought were limiting his creativity.

The little fish of the story needed a dose of situational awareness. So do police officers, and not just on the streets. If past trauma on or off the job keeps you from finding joy in life, don’t remain silent.

Let’s give new meaning to the old slogan, “If you see something, say something.”