Recognizing EMT’s, firefighters or Police Officers:
with Post-traumatic Stress Disorder
PTSD is diagnosed by symptoms. As you read through this page, keep in mind that it takes a professional who knows PTSD to diagnose this disorder from other disorders. One supervisor recently asked me how anyone can separate those with PTSD from the variety of other mental disorders, or those faking it. My answer to this question: the same way you recognize a Volkswagen. There is no substitute for a trained experienced psychologist/psychiatrist that works specifically with PTSD, and especially one that knows the social environment in law enforcement. Part of the problem with this disorder is that there are far too few that have a lot of first hand experience with PTSD and cops.
Here is a new page for personnel dealing with events of Hurricane Katrina and Rita!
Spouses and family members should be taught to look for these symptoms as police officers will often exhibit the symptoms associated with PTSD at home and attempt to mask these symptoms at work.
If you are exhibiting these symptoms, or know of someone with these symptoms, my recommendation is you talk to a professional psychologist/psychiatrist about getting help. If you know of someone with these symptoms, you may want to talk to a professional before talking to the person. The officer may not admit to the problem, if he/she even knows there is one. Professional guidance is of major help.
PTSD is an emotional, sensual, psychological and physical disorder. Several or all of these may be displayed through symptoms.
A person with PTSD usually cannot tell you “I have PTSD”, unless they are already diagnosed and in therapy. It’s not like having a cold or the flu, or a broken leg. The person may or may not remember the traumatic event. They may, in fact, outright deny that they are having any problem, other than the day to day stresses of the job, when in fact they feel inside that they are going crazy. Another difficulty with PTSD is there is generally a period of time that elapses between the trauma and when the behaviors start to show. With acute PTSD this is a much shorter time than with chronic PTSD, which can conceivably be years between the trauma and the fallout.
What I’ve listed below are behaviors and symptoms I have seen others experience, and some I have experienced myself. This list is not all-inclusive, and, again, may be indications of something other than PTSD. If it is PTSD, they will exhibit more than one symptom from each of the three areas, though you may not see more than one or two.
A word of caution: a few of these behaviors are normal for police officers. It’s when they go from “normal” to the extremes that they become abnormal. If you know the person, you know what’s normal. Watch out for these changes.
- extreme nightmares
- extreme paranoia
- sense of shortened future, impending doom
- loss of interest in sex
- isolation-especially from loved ones
- avoiding work: increased absenteeism
- avoiding certain previously visited locations that were favorites
- diminished interest in previously interesting activities, sports, people
- lack of motivation, constantly fatigued
- loss of Faith in God
- sleeping too much
- addictions: alcohol, drugs, sex (repeated affairs, or found with a prostitute)
- previously active in their work, significant shift to doing little or nothing
- weak work performance, quality of work drops significantly
- just plain numbing out
- stops exercise and previous self-care (poor hygiene)
- memory loss or poor recall
- disappears for periods of time from home or work
- problems falling asleep, or problems staying asleep
- worse than usual problems with Police Management and/or the public
- more than usual contempt/exasperation with supervision, peers, public
- increasingly cynical, maybe at most everything
- sudden outbursts of anger or rage, especially overkill for the situation at hand
- hypervigilance (paranoia)
- exaggerated startle response
- obsessive behavior (what is repressed is obsessed and acted out)
- compulsive behavior (shame can power compulsion, which can become addiction)
- overeating: noticeable weight gain
- anorexia: noticeable weight loss
- they were previously balanced in their work, or maybe even one of the best, but now it’s insatiable, like a crusade
- more violence
- more hyperactive, and maybe now most all the time
- problems urinating
- frequent headaches
- chest pains
- intestinal pain
- diarrhea, constipation, irritable bowel syndrome, blood in stool
- frequent, meaning very frequent, belching
- very high use of antacids
Chances are you will see only a few of these things, not all of what is really going on. Some of these behaviors a person will outright hide, such as the addictions, for obvious reasons. These symptoms are a window to the soul. These symptoms are digressive, meaning over time they will probably get worse if not treated.
PTSD does not go away by itself.