What’s in a label?

First responders are reluctant to see licensed mental health professionals for fear of being labeled as having a problem.  While this is certainly not always the case, the decision to fight the stigma and seek treatment for stress-related symptoms can often have unintended consequences.  Can the symptoms of chronic or critical incident stress lead to a wrong mental health diagnosis?

Under extreme stress, the kinds of responses consistent with an individual’s personality type will often mirror symptoms of other diagnosable mental disorders.  Humanizing the Badge published an article not long ago entitled Beneath the Surface in which the following the statement was made about professional diagnoses: “If the only tool you have is a hammer, every problem looks like a nail.”  That is to say that many licensed mental health professionals with little or no experience in treating individuals suffering from chronic or traumatic stress will often revert to some other diagnosis that can be much more harmful in the long run to the career of a first responder.  Information on the website for the National Center for PTSD, run by the U.S. Department of Veterans Affairs, confirms this to be true.

Diagnoses of other conditions might include:

  • Narcissistic Personality Disorder
  • Borderline Personality Disorder
  • Passive-Aggressive Personality Disorder
  • Obsessive-Compulsive Personality Disorder (NOT the same as OCD)

This is certainly a “catch-22” situation, because sometimes there is an underlying disorder that must be addressed in order for an individual’s condition to improve.  When in doubt, reach out to a qualified peer support specialist like those who provide support on this page who can help you understand what you are experiencing and help determine whether professional help is going to be necessary.

If you’re suffering, don’t suffer in silence.  Message us at m.me/callforbackup.org/ and let us help you begin a journey toward better mental health.  If you are having suicidal thoughts that won’t go away, please contact the National Suicide Prevention Lifeline at (800) 273-TALK (8255).

Regrets, I’ve had a few . . .

Do you see what I did there . . . a little double meaning?  The fact is that many people do have some regrets after they’ve had a few drinks, but they have begun to use alcohol to deal with stress, not thinking about the reality that it actually exacerbates their problems.  They may not be to the point of being alcoholic, but they certainly can be classified as what a pair of Harvard-trained professionals call “almost alcoholic” (Doyle & Nowinski, 2012, Almost Alcoholic).

Excessive alcohol consumption is a typical response to stress for those who have neglected to maintain more healthy coping mechanisms.  Sadly, this is especially true among police officers.  Two words every veteran police officer knows: “choir practice.” Stressful day on the job?  The shift gets together afterwards for choir practice.  Even so-called “tee-totalers” (total abstainers from alcohol) are likely to believe that consumption of alcohol in moderation has little, if any, ill effects on the consumer.  But that is not what we are talking about here.  The relationship between alcoholism and stress is not in dispute, and the relationship between police officers coping with extreme amounts of stress and attempting to find relief through alcohol consumption is not in dispute either.  It is no coincidence that in a study done regarding police suicide, data showed that the majority of the individuals completing a suicide had alcohol in their system at the time.

While a drink, sometimes two, can be okay, excessive drinking can cause a great deal of turmoil in other parts of the individual’s life and contributes to greater amounts of stress in the long run.  It is best to find other methods of coping with stress that do not actually exacerbate the problem.  With the right kind of help, you can:

  • identify and assess your patterns of alcohol use;
  • evaluate its impact on your relationships, work, and personal well-being;
  • develop strategies and goals for changing the amount and frequency of alcohol use;
  • measure the results of applying these strategies; and
  • make informed decisions about your next steps.

If you are struggling with stress, not coping well, and need a place to start learning about how to make it better, please reach out to us at m.me/callforbackup.org/.  I promise you, there will be no regrets.

The Realist Eats the Donut

An optimist, a pessimist, and a realist walk into a donut shop . . . Give me a few minutes, and I promise I will explain how this relates to being a police officer (besides just the fact that it mentions donuts!).

I would say that the majority of police officers enter the profession with a great deal of optimism about what the future holds.  After all, the main reason people become police officers is because they want to “help people.”  If you have a sincere desire to help people, and are willing to commit a significant amount of effort toward that goal, what could possibly go wrong?  Indeed, the law-abiding people in our communities, and especially children and other vulnerable members of our society, deserve to be helped.  Police officers begin their career by placing very high expectations on themselves about what it means to be in a position to help people, and how true they intend to be to that special commitment.

Your expectations on yourself may be legitimate.  Society’s expectations for you may be legitimate.  But soon the weight of those expectations begins to overwhelm you, and you begin to realize that you have placed yourself in a position in which you are not permitted to hurt, or to fail, or to simply be human.  Sure, there are days when you may be able to shake it off, regain a sense of hope, and push back against the negativity.  But eventually you find yourself becoming more pessimistic than optimistic about the difference that you are making as you perform your job in your community.  You become depersonalized, demoralized, and detached.  Soon you find yourself:

  • Developing a preoccupation with stress-producing people or situations
  • Overindulging in escape behaviors like alcohol, drugs, or overspending
  • Avoiding intimacy and seeking fantasy over reality
  • Seeking to control everything and everyone as a means to survive
  • Justifying your actions by blaming other things and other people
  • Choosing simply to leave the profession

Just as optimism is not the problem, pessimism is not the solution.  The answer is found in developing the ability to be realistic – about the profession, about your abilities, and about how to respond to the stresses that, if left unchecked, will result in a steady decline of interest in your job and ultimately in burnout.  This means that you should learn to find joy in your work without letting your work become your identity.  This means taking time for yourself, too, like making sure you get plenty of rest and watch your diet.  This means engaging in some productive activities that keep you fresh and positive.  And it also means identifying one or two people in your life to whom you can be accountable, who will listen and offer feedback and encouragement, to help keep you focused on what is important in your life and in your profession.

If you need help figuring out how to do any of these things, feel free to reach out to us by sending a message at m.me/callforbackup.org/.   We’re here for you.  Meanwhile, remember:

An optimist, a pessimist, and a realist walk into a donut shop.  The optimist sees the donut; the pessimist sees the hole; the realist eats the donut!  Be safe, be well, and enjoy your donut!

Is there such a thing as a “suicidal personality?”

Have you ever wondered whether there is such a thing as a “suicidal personality?”  Science has made some great strides, and quite a bit of research has been done on personality traits and their possible link to suicidal thoughts.  If we could only predict which individuals, based on personality, were more likely to consider suicide, wouldn’t we be able to do more to help them change their thinking and prevent that tragedy from happening?  If only it were that simple.

Let’s make a distinction here, because there are a number of diagnosable personality disorders or mood disorders that can be associated with suicidal thinking.  The good news is that if you are a first responder, or someone who cares about a first responder in your life, the pre-employment screening that is performed will catch those disorders and eliminate those candidates from the pool before they ever get the job!  So, if you think you have antisocial personality disorder or borderline personality disorder, the chances are you do not.  But . . . you can have a lot of different symptoms associated with the stresses of the job that can often mimic certain personality or mood disorders, and that’s where things begin to get tricky.

One of the most common mood disorders, of course, is depression.  The link between depression and suicidal thoughts and actions is irrefutable.  Data published by the Centers for Disease Control show that half of all people who complete suicide have at least one diagnosed mental health condition, and that the most common one of those – 85.2% – is depression.  Of course, the link between chronic stress and depression is also irrefutable, so much so that the American Psychiatric Association says that depression itself is a chronic stressor.  The significance of all this, of course, is that first responders often suffer from the effects of chronic stress, which in turn makes them more vulnerable to depression, which in turn may result in the increase of suicidal thoughts and behaviors.

Let’s add some additional behavioral traits to the mix that are not uncommon among first responders:

  • Internalizing – the tendency to adjust so that attitudes and behaviors that may be considered abnormal under most circumstances or for most people become normal.
  • Emotional dysregulation – the inability of a person to manage his or her emotional reactions to provocative stimuli, leading to the development of inappropriate coping mechanisms for stressful conditions. One example would be the tendency to self-medicate with alcohol or other drugs.
  • Somaticizing – a condition in which anxiety (also related to chronic stress) is converted into physical symptoms. Persons suffering from chronic stress are more prone to anxiety, making them more prone to physical illness.  Carry that a step forward, and people suffering from prolonged physical illnesses are more likely to experience suicidal thoughts.

Long story short, we all must certainly keep an eye out for ourselves and for our loved ones and notice any changes in behavior and thinking that may be warning signs of an underlying problem.

This article is not intended in any way to serve as a replacement for professional intervention in cases where that is needed.  Meanwhile, if you are struggling, whether you are a first responder, family member, or friend, please feel free to reach out to us at m.me/callforbackup.org/and we can help you understand what you are experiencing.  And as always, if you are having suicidal thoughts and are in crisis now, please call someone to be with you, then call the National Suicide Prevention Lifeline at (800) 273-TALK (8255).

Grief After Suicide – Part 3

The pain of grief can often cause you to want to withdraw from others and retreat into your shell.  But having the face-to-face support of other people is vital to healing from loss.  Even if you’re not comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving.  While sharing your loss can make the burden of grief easier to carry, that doesn’t mean that every time you interact with friends and family, you need to talk about your loss.  Comfort can also come from just being around others who care about you.  The key is not to isolate yourself.

 Finding support after a loss

 Turn to friends and family members – Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient.  Rather than avoiding them, draw friends and loved ones close, spend time together face to face, and accept the assistance that’s offered.  Often, people want to help but don’t know how, so tell them what you need—whether it’s a shoulder to cry on, help with funeral arrangements, or just someone to hang out with.  If you don’t feel you have anyone you can regularly connect with in person, it’s never too late to build new friendships.

Draw comfort from your faith – If you follow a religious tradition, embrace the comfort its mourning rituals can provide.  Spiritual activities that are meaningful to you—such as praying, meditating, or going to church—can offer solace.  If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.

Join a support group – Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help.  To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers.  You can also search on the website of the American Foundation for Suicide Prevention for a support group near you.

Talk to a therapist or grief counselor – If your grief feels like too much to bear, find a mental health professional with experience in grief counseling.  An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.

Using social media for grief support

Memorial pages on Facebook and other social media sites have become popular ways to inform a wide audience of a loved one’s passing and to reach out for support.  As well as allowing you to impart practical information, such as funeral plans, these pages allow friends and loved ones to post their own tributes or condolences.  Reading such messages can often provide some comfort for those grieving the loss.

Of course, posting sensitive content on social media has its risks as well.  Memorial pages are often open to anyone with a Facebook account.  This may encourage people who hardly knew the deceased to post well-meaning but inappropriate comments or advice.  Worse, memorial pages can also attract Internet trolls.  There have been many well-publicized cases of strangers posting cruel or abusive messages on memorial pages.

To gain some protection, you can opt to create a closed group on Facebook rather than a public page, which means people have to be approved by a group member before they can access the memorial.  It’s also important to remember that while social media can be a useful tool for reaching out to others, it can’t replace the face-to-face connection and support you need at this time.

When grief doesn’t go away

As time passes following a significant loss, such as the death of a loved one, it’s normal for feelings of sadness, numbness, or anger to gradually ease.  These and other difficult emotions become less intense as you begin to accept the loss and start to move forward with your life.  However, if you aren’t feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as complicated grief or major depression.

Complicated grief

The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage.  If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as complicated grief.  Complicated grief is like being stuck in an intense state of mourning.  You may have trouble accepting the death long after it has occurred or be so preoccupied with the person who died that it disrupts your daily routine and undermines your other relationships.

Symptoms of complicated grief include:

  • Intense longing and yearning for your deceased loved one
  • Intrusive thoughts or images of your loved one
  • Denial of the death or sense of disbelief
  • Imagining that your loved one is alive
  • Searching for your deceased loved one in familiar places
  • Avoiding things that remind you of your loved one
  • Extreme anger or bitterness over your loss
  • Feeling that life is empty or meaningless

When to seek professional help for grief

If you recognize any of the above symptoms of complicated grief, talk to a mental health professional right away.  Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide.  But treatment can help you get better.

Contact a grief counselor or professional therapist if you:

  1. Feel like life isn’t worth living
  2. Wish you had died with your loved one
  3. Blame yourself for the loss or for failing to prevent it
  4. Feel numb and disconnected from others for more than a few weeks
  5. Are having difficulty trusting others since your loss
  6. Are unable to perform your normal daily activities

The information in this article is not intended to replace professional help for those who need it.  If you’d like to chat with someone to help you understand what you’re experiencing and determine whether professional help is necessary, message us at m.me/callforbackup.org/ and one of our specialists will be happy to connect with you.  If you are struggling with suicidal thoughts and are in crisis now, please call someone to be with you, and then call the National Suicide Prevention Lifeline at 1(800) 273- TALK (8255).