Should troubled officers take antidepressant medication?

From Force Science News published by The Force Science Research Center

Are antidepressants dangerous medications for cops?

That question was raised recently on the listserv for the IACP's Psychological Services Section. A psych professional from south Florida reported noticing of late "a marked increase in police officers being prescribed" antidepressants, known pharmacologically as SSRIs (selective serotonin reuptake inhibitors). These include common brand-name drugs such as Prozac, Paxil, Zoloft, Luvoc and Lexapro.

The staffer was curious about the possible negative effects of SSRIs on an officer's reaction time.

Other respondents, in effect, told him to rest easy. "Little evidence supports a SSRI problem," wrote a PhD from Louisiana, who cited studies in the journal Psychopharmacology for Apr. 2001 and Jan. 2002. "Also recall," this correspondent suggested, "that untreated, emotionally impaired officers may also have a reaction-time risk."

A police psychologist from Colorado noted that he used to treat airline pilots who were depressed but could not take antidepressants because they would not be allowed to fly if they did. "I always thought this was odd," he wrote, "since I would rather have a depressed pilot on an SSRI who was feeling good than have a depressed pilot not taking anything and feeling lousy. I feel the same about police."

Dr. Bill Lewinski, executive director of the Force Science Research Center at Minnesota State University-Mankato, emphatically agrees. A specialist in law enforcement psychology for more than 30 years, Lewinski is an internationally recognized expert in police reaction times in lethal force encounters.

"Most of the time that's required for you to react to a threat is taken up with perceiving the danger, processing that information, deciding what to do and then sending commands from your brain to your body to react," Lewinski explains. "The actual mechanical action of pulling a trigger to defend yourself requires only 6/100 of a second, a very minute portion of overall reaction time.

"The 'front end' of reacting, so to speak, depends on your ability to pay attention to what's going on around you so you pick up danger cues. If you're not or can't be attentive because of your emotional state, the rest is irrelevant.

"If you're depressed you are preoccupied with your own suffering, your own bleak view of the world. You're focused inward, not focused on what's important 'out there' in the environment around you.

"Any effect on reaction time by antidepressant medication is miniscule compared to the profound impairment of cognition, information processing and survival-oriented decision-making caused by untreated depression."

The case of a Midwestern officer who shot and killed an assailant and who was himself slightly injured in a gunfight serves as a dramatic illustration. This officer's reactions were so blunted by untreated post-traumatic depression that he had difficulty even tracking radio calls. "By the time he tuned in to a dispatch, the message was almost over," says a therapist who knew him. "He'd ask the dispatcher to repeat, fully determined to pay close attention to what was said, but he couldn't remember long enough after hearing the words to write them down. You can imagine how unprepared he was for any tactical challenges."

"You shouldn't even be working if you have a seriously depressed frame of mind," Lewinski declares. "Yet many officers won't seek help for depression, either with medication or through counseling, because they're afraid they'll be stigmatized for getting psychological aid. Instead, they compromise their safety and effectiveness by trying to tough it out."

Depression can arise from a number of causes, including your life experiences, your body chemistry, mental illness and post-traumatic stress disorder. Lewinski advises that if you have any lasting symptoms from the following list, it would be wise to seek professional investigation and help:

--Persistent sad, anxious, or "empty" mood
--Feelings of hopelessness, pessimism
--Feelings of guilt, worthlessness, helplessness
--Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
--Decreased energy, fatigue, being "slowed down"
--Difficulty concentrating, remembering, making decisions
--Insomnia, early-morning awakening, or oversleeping
--Appetite and/or weight loss or overeating and weight gain
--Thoughts of death or suicide; suicide attempts
--Restlessness, irritability
--Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

"Ironically," Lewinski says, "when a depressed officer knows he is responding to a high-risk call, the adrenalin surge will tend to counteract the effect of his depression and his judgment, alertness and reaction time may well be appropriately sharp for the situation.

"But on seemingly 'routine' calls, such as 'ordinary' traffic stops, the depression will dominate his mental state and significantly affect his sixth sense and tactical awareness, making it more difficult for him to perceive an evolving threat. He'll be way behind the reactionary curve and detect any danger cues too late. And we know that most officers die not on known high-risk calls but in common patrol situations that appear benign at the outset."

Lewinski strongly advocates combining antidepressant medication with psychological therapy and a self-administered program of positive self-talk, such as described in the popular police text "The Tactical Edge". "The combination of medication, therapy and your own positive belief system can have a powerful impact on your survival," he says.

The effects of antidepressant medication vary from individual to individual, and in a small minority of cases SSRI drugs may not work at all, Lewinski told Force Science News. It may take some experimentation for a physician to find the right drug and dosage for you. "Once you find a helpful medication with minimal personal side effects, the better you'll operate on the street and in life," Lewinski says. "If you feel better, you're going to be more attentive…and much safer."

[Thanks to Force Science News member Wayne Schmidt, executive director of Americans for Effective Law Enforcement, for bringing this subject to our attention.]

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