Early intervention crucial for officers in crisis
If caught and addressed early, emotional wounds are highly treatable and full recovery is likely
Law enforcement is an emotionally demanding profession, sometimes even dangerously so. What officers see and experience, the pressures they face both on the street and within their departments, and the profession’s strain on personal lives creates a type of psychological wear and tear that can beat down even the most well-adjusted among us. When the emotional corrosion becomes too much, its presence and impact inescapable, and life is spiraling out of control, “wear and tear” no longer suffices. These are signs of true psychological injury.
The idea of psychological wounds being on the same plane as a physical injury is difficult for a lot of people to accept, but the research bears it out. The effects of post-traumatic stress disorder (PTSD) on the brain’s amygdala, hippocampus, and prefrontal cortex – as well as their functions in information processing, learning, emotion regulation and executive function – are well known.
With a greater understanding and acceptance of the reality of PTSD, the police world has made great strides in caring for suffering officers. But PTSD isn’t the only disorder that can impact the brain, nor does psychological injury require profound trauma.
Depressive disorders and anxiety don’t necessarily need a catalyst event. Some of us may be biologically hardwired for major depression, anxiety, bipolar disorder, or other common mental illnesses, and it takes little or no triggering to set them off. If left untreated and over time, they can change the chemical and even physical structures of the brain in ways that mirror injury.
The good news is, if caught and addressed early, emotional wounds are highly treatable and full recovery is likely. But like with any injury or illness, the earlier intervention starts the better. Waiting and hoping things will simply get better on their own rarely works, and interrupting distorted thought patterns quickly can shorten treatment while maximizing its effectiveness.
Treating depression and anxiety
Depression is very common, with as many as one in four persons experiencing clinical depression at least once in their lifetime, and police officers are not immune. Given the stresses of the job, the pressure it puts on personal lives, and how shift work disrupts normal rhythms, it’s possible that cops are even more susceptible.
Anxiety disorders are even more common; it is estimated that about one in five persons in the U.S. experience diagnosable and clinically significant anxiety in any given year. Depression and anxiety are often co-occurring, hitting sufferers with a double whammy.
But both depression and anxiety are highly treatable. Medical research shows a 90% success rate for treating these common disorders when a licensed therapist and a psychiatrist, who can prescribe medication if needed, are working together. Once under their integrative care, people generally report feeling more like their old selves in just a few weeks. While the psychiatrist or a highly trained and experienced nurse practitioner manages medication therapies, the therapist focuses on talk therapy to help identify and challenge behavior and cognition patterns that lead to a greater vulnerability to depression, thought distortions, and impaired functioning.
The perils of waiting to seek help
Unfortunately, too many people wait to seek help, hoping their depression simply goes away, or that they can think themselves out of the anxiety swirling through their mind. The problem with this is that mild depression can worsen, and its mere existence can affect decision-making and the ability to cope with additional stressors. Anxiety is a monster that feeds on itself, growing and growing, until it overwhelms a person’s coping skills and disrupts normal functioning.
Additionally, waiting often leads to crisis, and by that time, a person’s ability to function is often notably diminished, it is harder for someone to make clear-minded decisions, and there are fewer viable treatment options. In these situations, an individual’s personal issues may become uncomfortably public and the likelihood of long-term consequences increases. Here, the resulting crisis is often a true medical emergency and needs to be treated as such.
With early intervention, the patient can be more involved with and better informed about treatment decisions. Disruptions to life and work are minimized or even eliminated, and there is greater control over how much information is shared and with whom. While waiting for a crisis may well put someone's personal problems on wide display, early intervention better ensures that an individual’s privacy will be protected.
Generally, police officers have ready access to several resources for finding help. Most departments offer fairly generous health benefits, including mental health options, so looking on your health insurance provider list for a psychiatrist, nurse practitioner, or licensed counselor is a good first step. Asking your primary care physician for a referral may help you target professionals your doctor is comfortable with and who are worthy of recommendation. You can also talk to your pastor or department chaplain, a department social worker or psychologist for a referral, or simply call your employee assistance program (EAP).
Going straight to a professional in the field is the most direct path to help, and – this is very important – all are bound by strict legal and ethical confidentiality rules as determined by Health Insurance Portability and Accountability Act (HIPAA) laws or, in some cases, even more protective state laws. Unless you are actively a danger to yourself or someone else, these professionals and their staff will not and cannot tell anyone you have come to them for help, advice, guidance or treatment.
Eliminating self-imposed roadblocks to early intervention
Understanding the reality and prevalence of highly treatable disorders, recognizing the symptoms in ourselves and others and a willingness to take early action to get back on track is great, but let’s be honest about the self-imposed roadblocks that endanger officers. While stigma has been lessened, it still exists, and the culture within many police agencies limits officers’ sense of safety when considering getting help.
The law enforcement field often gives lip service to the idea of “brotherhood” or “the fraternity” of law enforcement, pride is placed on “having each other’s six,” and administrators and officers are getting behind the idea of peer support and understanding PTSD and its effects. But if we are being completely honest, for many officers the catalysts behind their stress and depression lie within the walls of their agency rather than the streets they patrol. Isolation, bullying, and “talking the talk without truly walking the walk” about mental illness stands between officers in pain and the help they need. To tear down these roadblocks, we must:
- Recognize the importance of relationships: Humans are designed to be in relationship with others and to draw emotional support from them. Without these connections, most of us drift, and when hard times visit, we find it difficult to summon the motivation needed to confront challenges. Strong relationships are grounding and boost our emotional wellness. Be a support to those with whom you work and welcome friendship from them. When hard times come, lend or accept strength.
- Change the culture that creates crisis: While everyone in an agency has the power to help change a dysfunctional culture, administrators and supervisors carry a larger share of the burden. Is your agency supportive, focusing on officers’ strengths and their professional development, or punitive, seeing employees as latent liabilities to manage? Do senior leaders remember their days on the road or working investigations, and are those memories reflected in the decisions they make and the policy they write? Are line-level supervisors advocates for those they lead, with the courage to stand up to their own bosses when it is simply the right thing to do? Never forget that most cops are quite comfortable navigating the dangers of the street, but arbitrariness and uncertainty related to their standing inside the station can really freak them out!
- Promote a “culture of acceptance”: Simply put, at all levels, strive to eliminate any lingering stigma surrounding mental health issues. This is where you “walk the walk” by changing the language we use when talking about persons with mental illness or who are clearly going through difficult times. Be vulnerable about your own struggles, or those of people you know, in order to normalize the experience for others. Share your own tips for self-care, offer genuine support to those who might be struggling, or be vulnerable about your own journey if you can relate. And if you’ve benefitted from treatment now or in the past, consider sharing your experience.
- Understand the dangers of isolation: For the anxious, isolation allows the mind to run wild down rabbit trails of worry. For the depressed, it can literally be deadly. It is often easier to pull back from people whose anxiety fills the space around them, or whose depression pushes them to pull away from their normal social circles, but your ability to stay present even when it feels awkward can be a lifeline to someone else. A moment of regular connection here and there with people who care may be what it takes for someone with anxiety or depression to keep fighting. And administrators…
- Get rid of “Don’t talk about this to anyone but…” orders when someone is facing serious discipline: When an officer is facing discipline, administrators commonly tell them with whom they may or may not discuss the matter. Under the guise of “maintaining organizational order and discipline” or even (ridiculously) “looking out for the best interests of the officer” who is under investigation, it is routine for officers to be threatened with further punishment if they talk to others about their situation. Think about this for a second: Take an already stressed-out cop and then issue an order that will leave that person isolated from the very people who can offer understanding and solace. Often these orders are all-encompassing where, if read literally, talking to even family or friends is forbidden. The harm this causes outweighs any good in terms of organizational order.
Identifying the symptoms of depression, anxiety
Recognizing the signs and symptoms of depression in yourself (or someone close to you) is important when seeking early intervention. These are:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report such as feeling sad or empty or observation by others, such as appears tearful. In children and adolescents, this may be characterized as an irritable mood.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day.
- Psychomotor agitation (e.g., nervous energy, talking fast, engaging in movements for no purpose, such as pacing) or retardation (e.g., the slowing-down of physical and mental reactions, such as speech) nearly every day.
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a suicide plan.
- Marked irritability and easily frustrated.
- Feeling overwhelmed and increased anxiety.
- Crying more often.
Anxiety disorders can share some of these symptoms but typically can be identified by the following:
- Nervousness, restlessness or physical tension.
- Feelings of panic, dread or impending danger.
- Respiratory problems, such as hyperventilation or inability to catch a breath.
- Rapid heart rate (panic attacks are often mistaken for heart attacks or the sense “my heart is going to burst out of my chest!”).
- Obsessive rumination.
- Inability to “turn your mind off” (this is common to insomnia).
- Psychomotor agitation (twitching, trembling, the sense of being about to “jump out of your skin”).
- Gastrointestinal issues.
- Compulsive behaviors.
If any of these symptoms persistently fit your feelings or circumstances, or even if you generally are “having more bad days than good”, it is time to seek help. Contact your EAP, flip through your health insurance company’s provider manual, talk to your pastor, department chaplain, or social worker, or simply check online or in the yellow pages. Help awaits and, best of all, seeking it out is entirely confidential!
Cops face a great many stressors that challenge their emotional wellness. When things become too much and some of them find themselves in need of professional help, early intervention is always the best option. Knowing why, when, and how to seek help, and eliminating the roadblocks that get in the way is critical to getting them back on their feet as soon as possible.