All “Stressed Up” with No Place to Go

Next, let’s talk about the cumulative effects of chronic stress – the day-to-day tasks and responsibilities of doing the job that can eventually take a heavy toll on our personnel.  In our research, we’ve utilized a couple of tools to help us find out what police officers believe is causing them the most stress in their job.

The Operational Stress Questionnaire asks respondents to score 20 items relating to the tasks associated with police work according to the amount of stress they perceive as caused by each item.  Here are the top five most stressful tasks based on results we have received:

  • 5: Paperwork
  • 4: Feeling like you are always on the job
  • 3: Upholding a “higher image” in public
  • 2: Shift work
  • 1: Fatigue

The Organizational Stress Questionnaire asks respondents to score 20 items relating to the administrative and bureaucratic aspects of police work according to the amount of stress they perceive as caused by each item.  Here are the most stressful aspects based on the results we have received:

  • 5: Feeling like you always have to prove yourself to the organization
  • 4: Dealing with co-workers
  • 3: Inconsistent leadership style
  • 2: The feeling that different rules apply to different people
  • 1: Staff shortages

Then, of course, police officers also have to deal with critical incident stress.  It is said that between 50% and 60% of adults in the U.S. will suffer one traumatic event during their lifetime.  Truth be told, 100% of police officers will experience multiple traumatic events over the course of a career, including:

  • Line of duty death
  • Suicide of a colleague
  • Serious work-related injury
  • Multi-casualty / disaster / terrorism
  • Events with a high degree of threat to personnel
  • Significant events involving children
  • Events in which the victim is known to personnel
  • Events with excessive media interest
  • Events that are prolonged with a negative outcome
  • Any significantly powerful, overwhelming distressing event

            We also need to talk a little bit about trauma and stressor-related disorders.  There are a number of stress-related conditions that can show up, either because of the cumulative effects of chronic stress or in the aftermath of an especially traumatic event such as a critical incident on the job.  These include post-traumatic (critical incident) stress, Acute Stress Disorder, Post-Traumatic Stress Disorder, and Adjustment Disorder.

            Let’s start by talking about post-traumatic stress, otherwise known as critical incident stress.  Here are the basics that you need to know:

  • Notice here that I did not say “post-traumatic stress disorder.”  It is important to understand the difference between post-traumatic stress and post-traumatic stress disorder.
  • About 95% of people experiencing a traumatic event will experience symptoms of post-traumatic stress, and those symptoms will show up with changes in their mental status, their emotions, their physical condition, their behavior, or even in how they view the world in the aftermath of the traumatic incident.
  • Evidence does show, though, that the majority of those people, through their own natural resiliency, will recover without any type of formal psychological intervention if they receive some form of early psychological intervention.  This is one of the reasons, of course, that we advocate so strongly for a peer support program in every public safety agency with a team of people that can provide that kind of intervention either for their own personnel, or to help personnel from other agencies around them.
  • Symptoms in the aftermath of a traumatic event will typically show up within the first 3 days and will typically be gone within 1-2 weeks.  Recovery may be gradual, but with the right kind of supports in place, recovery does happen.

Next, let’s take a look at Acute Stress Disorder (ASD).  If recovery in the aftermath of a critical incident has not happened within the 1-2 week time frame, if new symptoms come up, or if existing symptoms become more intense, then the individual should be evaluated by a mental health professional for Acute Stress Disorder (ASD).  About 30% of individuals experiencing post-traumatic stress will go on to develop this disorder.

  • Acute stress disorder has a specific set of symptoms that are listed in the DSM-5.  We’re not going to go into detail about those symptoms here, but again, duration of symptoms after a critical incident is the key to deciding whether someone should be evaluated by a clinician.
  • The good thing about acute stress disorder – if it’s possible to believe that anything is good about having a disorder – is that it is acute, meaning that the symptoms will go away, usually within about a month.

Next, we come to a discussion about the condition most believe is the worst stress-related disorder of all, Post-Traumatic Stress Disorder (PTSD).  According to the American Psychiatric Association, about half of the people who develop Acute Stress Disorder will go on to develop Post-Traumatic Stress Disorder (PTSD).  This can include family members who have been indirectly exposed to trauma, although in those cases that individual would likely be diagnosed with what is known as Secondary Traumatic Stress Disorder versus receiving a diagnosis of PTSD. 

  • In addition to being caused by direct exposure to a specific traumatic event, PTSD may also develop in some cases due to repeated exposure to critical incidents on the job as a first responder
  • A key factor in the diagnosis of PTSD is that a legitimate diagnosis of PTSD cannot be made until at least 30 days have passed since the traumatic event that triggered the stress-related symptoms.
  • The symptoms may only include those from the specific list of symptoms in the DSM-5 and occur with the required frequency and intensity, otherwise a diagnosis of PTSD is not appropriate.  And the precipitating event MUST involve death, the threat of death, sexual assault, or the threat of sexual assault, otherwise a diagnosis of PTSD is not appropriate

Finally, we come to a condition known as Adjustment Disorder (AD).  This is another stress-related disorder that is sometimes diagnosed when a diagnosis of PTSD is not appropriate.  We may refer to this sometimes as “stress response syndrome.”  With this condition:

  • Stress related symptoms may not appear for a few weeks up to about 3 months in some people after some type of trigger event, and after a long period of time dealing with the same type of stressor.
  • The only 2 conditions under which the symptoms of adjustment disorder will go away are 1) if the underlying stressor is removed, or 2) if the sufferer learns more effective coping skills for managing the underlying stressor.
  • One of the reasons we believe this is such a serious condition is that research indicates that a person with a diagnosis of adjustment disorder is 19 times more likely to die by suicide than a person without that diagnosis.  For more information on our suicide awareness and prevention efforts, I would encourage you to visit our website at callforbackup.org.

There we have an overview of these common trauma and stressor-related disorders and the impact they can have on those who suffer from them. 

This is Part 3 of a series of articles on Confronting the Issue of Suicide and we encourage you to visit again for more installments in this series. Meanwhile, if you are struggling with the stresses of the job or of life in general and are looking for some resources for help, please reach out to us at m.me/callforbackup.org and one of our peer support specialists will be happy to help. If you are in crisis now and need immediate help, please text the keyword BADGE to 741741 to be connected to a trained crisis counselor 24/7/365 – always free, always confidential.

Published by Chaplain David Edwards

David is a police chaplain, author, and educator, and is affectionately known as "Pa" to his grandkids. David is board certified in crisis response and pastoral counseling, and is an approved instructor for the International Critical Incident Stress Foundation and member of the International Law Enforcement Educators and Trainers Association.

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