PTSD in First Responders and Combat Veterans

FIRST RESPONDERS PTSD THERAPIST

Are you are First Responder with PTSD and looking for help? Our First Responder PTSD therapy can help. PTSD, or posttraumatic stress disorder, is a serious concern facing many first responders. Our first responders are those who are typically the first on the scene when disaster strikes. They face highly charged and stressful situations dealing with critical incidents on a daily basis. These essential workers are key players in our communities; we often take for granted that they will be the ones facing danger when others will not and risking life and limb so the rest of us do not have to. We have extensive experience providing First Responder PTSD counseling services and are here for you.

What many of us do not realize is the extreme physical, emotional, and psychological stress that such occupations place on those who regularly face such challenging circumstances on a regular basis. Research clearly shows that such exposure to severe stress puts this population at much greater risk to mental health disorders like posttraumatic stress disorder compared to the general population when it comes to suffering from problems related to their occupations, including depression, anxiety, and PTSD.

FIRST RESPONDERS SUFFERING FROM PTSD

According to the National Alliance on Mental Illness (NAMI), PTSD is having a severe impact on first responders all across the United States. Our law enforcement officers, fire fighters, emergency medical technicians (EMTs), and even their dispatchers, are experiencing record cases of PTSD, particular with the additional stress of covid, riots in the streets, and turmoil everywhere we have all witnessed over the past year.

In early 2021 there were already more than 140 police officers who had died by suicide in the current year alone. In fact, both police officers and firefighters are more likely to die this way than in the line of duty, and far too many increase the other risk factors of being on the jobs when they self-medicate with alcohol and other substances in order to cope with the stress they are dealing with on a daily basis.

Many of these individuals regularly experience exposure to death and destruction; no wonder PTSD and depression rates among them are nearly five times higher than the civilian population. Not only can helping people through personal tragedy take a toll on the mental and physical health of our first responders, but because many on the “front lines” seldom have time to recover between calls before being exposed to the next traumatic event, the problem only compounds itself over time.

Unfortunately, too many will not seek help because the stigma of struggling with mental health issues within fire and police departments still hinders people from doing so. Instead, many report turning to alcohol or other substances in efforts to cope with the constant pressure from the public, their department, the long shifts, and the other challenging aspects of their jobs.

First responders (police officers, firefighters, public safety and security personnel, EMTs, paramedics, and disaster relief workers are not the only ones vulnerable to this type of trauma. E.R. physicians, nurses, and other medical services personnel who treat traumatized patients are also vulnerable to acute stress, psychological stress, behavioral health, mental health, and traumatic stress disorders.

How PTSD Counseling Can Help

Counseling plays a pivotal role in treating trauma and PTSD. Therapeutic approaches often include a combination of trauma-focused psychotherapy along with medication where indicated. If you are looking for help alleviating your symptoms, PTSD counseling and therapy can certainly help you reach that goal. This area of counseling does, however, require the expertise of someone who has the necessary skills. Lifepaths Counseling can help.

Counseling aims to help individuals understand the traumatic events and change how they think about them. This helps in reducing the emotional burden of the trauma, teaching coping skills, and assisting in navigating triggers. Moreover, therapy can help the individual reconnect with themselves and their loved ones, aiding in the process of social reintegration, which is often challenging for combat veterans.

PTSD: A brief history

Humans have always suffered as a result of their very traumatic experiences. Overwhelming fear and terror are bound to leave their marks on our minds and hearts, whatever the circumstances. When it comes to veterans of war, it is said that even when the battles were over, soldiers who took part in them still continued to fight – many did so privately, in their sleep or in the internal worlds of their minds, while others became fearful, haunted, reactive to unseen ghosts of war. Some called it shell shock or soldier’s heart, while others said it was combat stress, battle fatigue, or war neurosis. Eventually, the condition became recognized as posttraumatic stress disorder.

Whether it was service members of the Vietnam war or later battles, the bottom line is that too many veterans were suffering and not getting the relief they so desperately needed.

Post-Traumatic Stress Disorder, or PTSD, is an acquired (reactive) disorder that results from exposure to extreme trauma, “an event outside normal human experience,” that leaves the person experiencing it feeling powerless, helpless, paralyzed, and yet forced to focus consciousness on some aspect of the trauma (to the point of later needing to avoid any reminders of it) in attempts to cope.

PTSD diagnosis of trauma-related psychological injury

PTSD was officially recognized as a psychological disorder in 1980 when a great number of war veterans were displaying the after-effects of their wartime military service experiences. Some of the psychological effects included heightened startle response, emotional numbing, difficulty sleeping, and a host of other stress symptoms due to their combat exposure experiences.

It was once thought that when the traumas of war were over and danger was in the past that the symptoms of having been involved in an extreme or life-threatening event would naturally abate with the passing of time. For that reason (and of course others) many never sought professional treatment for their symptoms if they recognized them, while others thought they were simply normal and would pass with time. We now know that nothing could be further from the truth. We also know that there are a variety of ways someone can acquire PTSD.

The resulting flashbacks, avoidance, hypervigilance, sleep disturbances (nightmares, insomnia) can often become so disabling that help and support from a professional with expertise in dealing with them is needed. This is not an issue of weakness in the person dealing with such symptoms, but of necessity. Finding a mental health professional who understands how combat stress affects your physical and central nervous system can teach you how to deal with these issues and can help you find relief, especially from the many misunderstandings surrounding this condition.

How PTSD affects work and family life

For the veteran, combat trauma can certainly leave you feeling like you are still living in a war zone; it can hamper your civilian life and hurt your relationships with friends, family members, and others you care about. Many vets report feeling alone and isolated from those around them; they lack emotional and social support, and many struggle with depression, loneliness and isolation, suicidal thoughts, and feeling trapped and alone with the memories of their traumatic experiences bottled up inside them.

What surprises many is that their symptoms seemed to come up “out of the blue” and unexpectedly. This is not at all uncommon. It isn’t always easy to identify the triggers to what brings up symptoms initially. In other words, delayed onset of symptoms is not at all uncommon. In fact, one study found that men who reported combat as their worst trauma were more likely to have lifetime PTSD, delayed symptom onset, have unresolved PTSD symptoms, and experience work and relational distress compared to those reporting other traumas as their worst experience (Prigerson et al., 2001). What that means is that this does not go away on its own, so please seek help.

Military sexual trauma (MST)

Once PTSD began to be better understood, service members who had violent combat experiences were not the only ones exhibiting the signs of PTSD when it finally began to be understood. Many survivors of other types of traumas or terrifying ordeals, such as victims of rape, violent assaults, childhood abuse, and/or those who had witnessed an event where an experience of terror or threat (or perceived threat) to “life or limb” also displayed similar PTSD symptoms. Where this is relevant to service members is when sexual trauma occurs in service.

MST is an experience, not a diagnosis, and those who have experienced it do so in a wide variety of ways. Sometimes, symptoms of this type of trauma may not surface until after leaving military service. Both males and females can experience military sexual trauma.

MST is any type of sexual assault or sexual harassment experienced during military service. Any sexual activity that you are involved against your will is considered MST, including the following:

Unwanted comments about your body or any kind of sexual activities that you felt were threatening
Unwanted or threatening sexual advances
Sexual contact or sexually related activities that happened without your consent, including those that occurred when you were asleep or intoxicated
Threats of negative treatment or negative consequences for refusing to participate in sexual activities
Feeling pressured or coerced into sexual activities by promises of better treatment in exchange for sex
Being overpowered or physically forced to have sex
Being touched or grabbed in a sexual way, including during “hazing” experiences, in a manner that made you feel uncomfortable

This type of trauma can certainly affect an individual’s mental, physical, and/or emotional health. It can impact work and other relationships, including those with your loved ones, long after the event has passed. These might include the following emotional, physical, and psychological consequences:

Nightmares or flashbacks
Depression or numbness
Isolation from family and friends or other people
Alcohol or other substance use/substance abuse
Sleep disturbances
Physical health-related conditions
Anger, irritability, anxiety, panic attacks

DSM-5 PTSD Diagnostic Criteria

The criteria for diagnosing post-traumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are somewhat different than the criteria in the fourth edition. Here are the symptom criteria in the DSM-5.

Symptoms of PTSD.

The following are the formal diagnostic criteria that need to be met in order to be diagnosed with PTSD.

Criterion A

You were exposed to one or more event(s) that involved death or threatened death, actual or threatened serious injury, or threatened sexual violation. In addition, these events were experienced in one or more of the following ways:

Directly experiencing the event
Witnessing the event as it occurred to someone else
You learned about an event where a close relative or friend experienced an actual or threatened violent or accidental death
Experiencing repeated exposure to distressing details of an event, such as a police officer repeatedly hearing details about child sexual abuse

Criterion B

You experience at least one of the following intrusive symptoms associated with the traumatic event:

Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic event
Repeated upsetting dreams where the content of the dreams is related to the traumatic event
The experience of some type of dissociation (for example, flashbacks) where you feel as though the traumatic event is happening again
Strong and persistent distress upon exposure to cues that are either inside or outside of your body that is connected to your traumatic event
Strong bodily reactions (for example, increased heart rate) upon exposure to a reminder of the traumatic event

Criterion C

Frequent avoidance of reminders associated with the traumatic event, as demonstrated by one of the following:

Avoidance of thoughts, feelings, or physical sensations that bring up memories of the traumatic event
Avoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event

Criterion D

At least two of the following negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event:

Inability to remember an important aspect of the traumatic event
Persistent and elevated negative evaluations about yourself, others, or the world (for example, “I am unlovable,” or “The world is an evil place”)
Elevated self-blame or blame of others about the cause or consequence of a traumatic event
A negative emotional state (for example, shame, anger, or fear) that is pervasive
Loss of interest in activities that you used to enjoy
Feeling detached from others
Persistent inability to experience positive emotions (for example, happiness, love, joy)