Tag Archives: trauma

Alternative PTSD treatments, self-healing, and self-empowerment

16 Oct

self-empowermentMore than a mental health issue, more than a first responder issue, post-traumatic stress disorder is a human issue. Post-traumatic stress disorder is a serious anxiety disorder often associated with the military, first responders, and sexual assault victims, but anyone who experiences trauma can be affected by it. As a one-time or accumulative anxiety disorder, PTSD can be a terribly haunting, unrelenting reality for many people.

People who are most prone to the illness are first responders because they see more trauma more often. Though there is effort on the part of first responder organizations to deal with trauma-stricken employees with early psychological support, peer support, medical attention, and hot lines, first responders continue to take their own lives. It seems that every week, we hear of another first responder suicide. Why is this happening? PTSD is a disorder in which therapies fall into a political game of what is acceptable and what is taboo, complicated by a negative social regard for mental illness, and a society that expects traumatized men to “suck it up” and get on with the job ( this topic to be further discussed in the next and final installment of this PTSD series).

PTSD is as complex as it is terrible.

Treatment of PTSD should be thought of as an investment. Until quite recently, the outlook for PTSD sufferers didn’t look so good unless years of therapy and pill-popping seemed appealing. New alternative therapies have emerged for PTSD, and the options give promise of better things to come, provided that we’re open to acknowledging that we have a problem that affects our normal function, and that we’re willing to reach out and ask for help.

The physical origins of PTSDbrain neurons

University of Toronto psychology PhD candidate, Lauren Drvaric, says “good mental health means good physical health and well-being. Poor mental health influences physical health, and we should be investing in the entire self, mind and body.”

Many professionals in psychiatric fields keep the mind and the body separate; their focus is on the mind, behaviour, and cognitive operations, with no attention paid to the body. This is curious, since the brain commands the body and the body responds to the brain; they cannot be separated.

Toronto psychotherapist, Matt Cahill, says when his clients do not verbally discuss their trauma, he picks up on the non-verbal cues. “Tears, blushing, or tremors, to name just a few,” he explains. “Sometimes a client will comment on how a part of their body feels numb or, alternately, feels constricted during a session where we are covering traumatic experience, rather than openly discuss their feelings. The body tells its own story, so I try to pay attention to everything.”

Dr. Bessel van der Kolk, has been involved with PTSD research for over 30 years and believes that trauma lies in our bodies; PTSD has a physical-basis that prompts “a cascade of physiological catastrophes that affects almost every major system in the body”.

Van der Kolk believes that trauma victims are alienated from their bodies by a response from a brain structure called the amygdala, the brain’s emotional processing and feeling centre. The amygdala responds to threats and traumas with a flood of hormones that set off the “fight-or-flight” response. The physical response subsides when the threat does, but when it doesn’t, as is the case with people with PTSD, the traumatic memories play out in the patient’s mind, and the amygdala continues to produce stress hormones that sustains a heightened state of anxiety.

Dr. Frank Ochberg, MD, psychiatrist, and founder of trauma science, believes that there are possibly two types of PTSD. One type makes PTSD-affected people more prone to flashbacks, and the other causes a numb, dream-like state that cushions people from feeling the anxiety associated with PTSD. Some people experience both types. Ochberg notes a measurable change in the electrical discharge of brain cells in the grey matter of the right temporal lobe in PTSD patients, and believes that this part of the brain is responsible for traumatic flashbacks.

Traumatic brain damage causes other problems in the brain. Dr. Ochberg notes a reduction in the number of pathway cells between the limbic system (of which the amygdala is a part of) and the grey matter (the thinking part of the brain). The hippocampus, another part of the limbic system, is part of the mid-brain that looks like a long wishbone; it organizes and saves memories and associates them with feelings and actions. Studies on combat soldiers exposed to trauma show a correlation between a smaller their hippocampal volume and the tendency to develop PTSD.

Trauma is literally “all in our mind” and also of our brain; it manifests physically as damage to our brains, and brain damage, as Dr. Ochberg sees PTSD, should be considered an injury, an injury that can be healed.

PTSD therapy: the body and mind connectionyoga

In her article, A Revolutionary Approach to Treating PTSD, Jeneen Interlandi says “If there’s one thing van der Kolk is certain about, it’s that standard treatments are not working. Patients are still suffering, and so are their families. We need to do better.”

Van der Kolk says psychological trauma should be treated through the body, not the mind. He says trauma has nothing to do with cognition, but the body interpreting the world as a dangerous place. In many cases, the PTSD patient’s body was violated, and they need to find a sense of security in their own bodies. “Unfortunately,” van der Kolk says, “most psychiatrists pay no attention whatsoever to sensate experiences. They simply do not agree that it matters.”

There are no cures in the world of psychiatry; there are no physical tests for mental health disorders, and there are no drugs that can cure brain injuries. However, it turns out that there are a number of promising, albeit unconventional therapies that eclipse traditional psychotherapy, and questionable, side effect-laden psychomeds for treatment of PTSD. Some of these therapies will sound odd, even outrageous, but there are no side effects, no secret ingredients, and best of all, many of them are free that people can do themselves.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR, or Eye Movement Desensitization and Reprocessing looks bizarre but it has an excellent track record for relieving mental and emotional anguish. During the treatment, the patient holds their trauma in their mind while their eyes follow the therapist’s fingers that move back and forth before them. It sounds crazy, but according to EMDR.com, the therapy works “for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.”

Over 10,000 therapists worldwide use EMDR therapy and millions of people have been successfully treated since its inception in 1989. In fact, EMDR is now recognized as an effective treatment for trauma by the American Psychiatric Association, the World Health Organization, and the U.S. Department of Defence. This unusual therapy may still have its controversies, but van der Kolk, who uses this technique himself, knows what he sees in his own patients and places his faith in the treatment. EMDR is especially useful to people with acute PTSD from isolated traumatic memories like single episode assaults and car accidents.

Yoga and massage

Yoga and massage are complimentary therapies for people with PTSD. A U.S. yoga group specifically for PTSD-affected combat veterans, Yoga Warriors,  says that yoga helps veterans “retrain” their fight-or-flight response.

“When vets confront a situation that triggers their memories,” the Yoga Warriors site says, “instead of resorting to aggression or drowning in fear, they have other options: deep breathing, for example, as a means to self-calm.”

Yoga, like dance, focuses on breath and movement and helps with body and emotional awareness, relaxation, and mental clarity. Yoga Warriors says it “allows one to safely express stored emotions such as guilt, shame, anger, sadness and grief so those feelings can be understood and integrated.”

Massage, the laying on of the hands, can help people with PTSD relax and feel safe in their bodies; massage can release toxins, and reduce scar tissue and muscle pain. According to the Canadian College of Massage, the practice may make the PTSD-affected feel more mentally balanced, and can “help to reduce mental anguish, anxiety and trauma by regulating stress hormones. Regular massage therapy reduces cortisol [the stress hormone produced by the amygdala] and stimulates the release of endorphins like serotonin and dopamine”, the hormones that make us feel good.

Acupuncture

Acupuncture, the ancient Chinese treatment, is finally being taken seriously. Through the use of small needles, heat, or pressure on points of the body’s energy meridians, pathways that carry blood, body fluids, and Qi, or life force energy, this very effective therapy provides relief of many physical ailments, improves sleep, relieves stress, and balances the emotions. The theory is that when the body’s flow of energy is disrupted due to an injury, trauma, or an emotional disturbance, acupuncture can help to free the energy blockage and release the patient back into health. There is evidence that acupuncture can regulate brain function and modify the activity in the limbic system, where PTSD is thought to originate.

Energy psychology and Emotional Freedom Techniqueenergy

The energy meridians acupuncture is based on is the root of energy psychology, or energy medicine for the emotions, a method that helps change the way the brain processes thoughts, feelings, and behaviours. Clinical psychologist and pioneer in energy medicine, David Feinstein, says tapping on accupressure points changes the neuropathways to bring about changes in the energies that underlie psychological problems, including PTSD.

Multidisciplinary doctor and healer, Dr. Adonis Makris, says that modern medicine focuses on chemistry, but energy healing has to do with the body’s electricity. Energy work is based on the body’s undeniable electrical nature. Most of us don’t often consider the body electric, but if you’ve ever been to a hospital for tests, you may have experience with the EEG, or electroencephalograph, the system that monitors your brain’s electrical activity, or the EKG, or electrocardiograph that reads the heart’s electricity.

Both energy psychology and Emotional Freedom Technique (EFT) use the energy meridian system to initiate healing. Carol Look, EFT master, explains energy work affecting the entire body: “Our feelings, states, moods, and levels of stress are formed by emotional responses and subsequent chemical reactions to specific events in our lives. These events and chemical reactions are stored in our cellular, physical, and emotional memories.” Her explanation explains how memories, thoughts, sights, smells, and sounds can trigger a PTSD-related flashback or sustain the anxiety related to it.

By tapping on various energy points on the skin and focusing the mind on specific problems (i.e. trauma), the brain’s electrochemistry can be shifted and the body’s energy system brought into balance, which allows the mind and body to resume their natural healing abilities. Studies show that accupoint stimulation (tapping) can reduce production of cortisol, the stress hormone, normalize brain wave patterns, and like massage, increases hormones associated with pleasure.

Gary Craig, EFT founder, says that trauma is a result of a disruption in the body’s energy system, and tapping works to neutralize the emotional charge. “I have helped hundreds of people with traumatic memories,” he says. “After using EFT, not one person – ever – has shown any interest in exploring the issue further or “getting to the bottom of it”. For them, it is completely resolved and they are gratefully relieved of its burden. People’s attitudes about the memory change almost instantly. They talk about it differently. Their words shift from fear to understanding. Their demeanour and posture evidence a dramatic shift.”

“It’s difficult for us to compute EFT because it’s so foreign to us, so unconventional,” Craig explains, “but at the same time, we’ve been conditioned to believe that medicine is the answer and doctors should not be questioned, but second opinions are always a good option.”

This energy work sounds so simple, so amazing, but this seems too easy, I hear you say. Even the pioneers of the treatment and experts in Traumatology agree.

Dr. Charles Figley is a psychologist and expert in Traumatology at the Tulane University in Florida. He says that sometimes the simplest things bring on the strongest results: taking deep breaths can calm anyone down, getting into a warm bath to relieve stress seems to be “a miracle” he says, and EFT is just as miraculous. “We don’t understand it, and it doesn’t make sense, but it works.”

Dr. Figley believes in EFT and the tapping method for trauma. He sees tapping as an alternative to the hierarchy of fear method that many PTSD treatments employ — therapies that begin at the lower level and build up to the terror, like exposure therapy which forces the client to relive their trauma over and over again in an effort to desensitize the patient. “These simple treatments reverse 50 years of psychological research and are turning the scientific community on its head in many ways.”

Gary Craig explains that there is no long, drawn out, tell-me-your-life-story feature to EFT. “There are no pills. There is no painful reliving of past traumatic events. It takes a fraction of the time typically required in conventional psychotherapy, it is often done in minutes. People simply get beyond their emotional luggage, usually permanently, and go about their lives more effectively.”

Compared to EFT, Craig says, “in general, conventional psychotherapy is among the slowest, most ineffective sciences on Earth.”

Positive Psychotherapy

When we think of psychotherapy, we may envision people who languish on couches, discussing nighttime dreams with cold, our-of-touch Freudians  who write prescriptions for mostly useless drugs for years on end. But a new and progressive psychotherapy that you’ve probably not heard of is making headway.

Positive Psychotherapy, born in the late 1960s, focuses on a client’s perception to realize the positive influences in their life instead of focusing on the negative – an all-too-common modern psychological state. This type of therapy directs a client’s attention to such things as positive character strengths, optimistic emotions, and their happiness in the present moment. Positive psychotherapy is much happier and more dynamic than conventional psychotherapies and the treatment typically lasts for weeks, not years.

Tayyab Rashid, licensed psychologist at the University of Toronto and a practitioner of Positive Psychotherapy, explains that the treatment acknowledges the client’s negative emotions, but instead of picking them apart and dwelling on them, the therapy “aims to validate these experiences, whilst gently encouraging clients to explore their effects and seek out potential positives from their difficult and traumatic experiences.”

Positive Psychotherapy has made significant gains in trauma prevention, to the point that it has made its way into a U.S. army program, Comprehensive Solider Fitness. The therapy is used in resilience training to “build mental toughness and identify signature strengths, meaning, purpose, and positive relationships, in addition to preventing pathology.”

Alternative drug therapy: MDMApills

“There’s not a single pharmacological treatment out there that has been developed specifically for PTSD,” says Dr. Alexander Neumeister, MD and psychiatrist at the New York University. “There’s a consensus among clinicians that existing pharmaceutical treatments such as an antidepressant simply do not work.”

Long-term medication places a band-aid on the wound at the core of the problem: trauma; its emotions, its energy, and its connection to mind and body. An alternative to pharmaceuticals is psychedelics. These drugs are pure and powerful, and administered under controlled conditions. MDMA, methylenedioxymethamphetamine, also known as ecstasy, is one of these drugs and it has long-term potential for PTSD.

MDMA increases feelings of trust, affection, and compassion for others, could make an excellent combination with psychotherapy for PTSD. Unlike most mental illness medications that are taken daily for years, pure MDMA only needs to be used a few times or less, and there is no threat of addiction to the drug.

Early studies are promising. Dr. Michael Mithoefer is the investigator in MDMA studies through MAPS, the Multidisciplinary Association of Psychedelic Studies. Dr. Mithoefer has seen 90 percent of rape victim’s symptoms vanish after just one intense 8-hour session with MDMA. In another study, combat veterans, fire fighters, and police officers took MDMA and 14 out of 19 patients reported dramatic improvements to PTSD-related issues.

MAPS is the only organization in the world that funds clinical trials for MDMA-based psychotherapy, according to its website. The goal is to make MDMA into an FDA-approved prescription medicine by 2021.

Medical marijuanamarijuana

The drugs that they were giving them … they couldn’t get up in the mornings,” said Army first sergeant Gregory Westbrook. “Most of the guys weren’t the type of soldiers who had issues before Iraq or even in Iraq, but they bring them back and put them on these drugs, and they’re falling asleep in the chair. There was no way they could function, especially in a civilian job. So maybe marijuana is an alternative. (Source)

THC, tetrohydrocannibanol, the active chemical in marijuana, binds with cannabinoid receptors in the brain that affect appetite, memory, and pain. Marijuana is associated with forgetting and this is the link to PTSD that researchers are most interested in. “Forgetting well is almost as important as remembering,” says Michael Pollen, American author, journalist, activist, and professor of journalism, and author of Botany of Desire, an investigation of the nature of plants. “Forgetting is about editing, it’s about taking the flood of sense information coming at you, and forgetting everything but what is important.”

Pollen says that life is not about accumulating memory because memory can cripple us, and uses combat experiences in his argument. “Soldiers return from war zones traumatized by experiences that they can’t unlearn. So if you could help them unlearn that, essentially a productive kind of forgetting, with a drug or another kind of regime, it would be incredibly useful.”

Marijuana calms the mind, relieves anxiety, and promotes new thought patterns and behavioural responses. A recent Globe and Mail article reports that marijuana users may be more likely to survive a serious head injury. For people affected by PTSD, cannabis brings users into the present instead of watching the reel of never-ending traumatic scenes that keep them in their mental prison.

Medical marijuana for PTSD looks promising, but unfortunately, marijuana carries a stigma with it, even though it is legal for medical use. Sadly, the social stigma around cannabis is associated with the suicide of another first responder’s life. Just last week, RCMP Corporal Ron Francis, a PTSD sufferer and medical marijuana user, committed suicide.

Cpl. Francis was videotaped smoking pot while wearing his formal red serge, to protest the RCMP’s PTSD policy last year. “I’m trying to draw attention to the fact that the RCMP fails to have a program in place for proper [PTSD] screening for their members and proper information for their families,” he said. The National Post reported Justice Minister Peter MacKay’s condemnation of the stunt, saying it “sets a poor example for Canadians.” Francis was forced to hand over his RCMP uniform, and a year later, was dead.

If we as a society are serious in our support of people who suffer from PTSD, we must let go of old rules and laws that keep relief from those who need it most. Drug stigma is politically based and we have been conditioned to believe that illegal drugs – natural and synthetic substances associated with counter-culture — are harmful and should not be a therapy alternative. What is legal are dodgy, psychotropic medications with sometimes horrendous side-effects that may not do much to help people in dire need of effective therapies.

Through brain scan technologies, early neurological markers have emerged for PTSD. This is exciting because now that PTSD can be “seen”, it gives validation; a visual change in the brain makes it more factual, and this will move us toward a social acceptance of mental illness as something real.

Relief for PTSD sufferers may lie in unconventional therapies that don’t line the pockets of the pharmaceutical companies and are rooted in self-empowerment. We are more powerful than we think. As Dr. Makris says, “We have an incredible capacity to heal themselves in so many ways.”  

PTSD and first responders

2 Oct

“I think I’m too broken to ever be fixed.”
Text from Ken Barker, retired RCMP officer to his sister during a traumatic flashback

Barker was one of the first responders to arrive at the scene of the ambulancehorrific Manitoba Greyhound bus beheading in 2008. This summer, he ended his life. Since April 2014, Barker was one of an unprecedented number of first responders in Canada whose suicides have been linked to PTSD.

Post-traumatic stress disorder, considered an treatable anxiety disorder is a mental illness that can result from a traumatic one-time experience or accumulative trauma and stress on a personal or large scale. PTSD can bring the horrors of past traumas to life and wreak havoc in the minds and the lives of all it touches. PTSD can happen to anyone; the most vulnerable  people are rape victims.

PTSD has its roots and associations in modern warfare, and its incidence rate is highest among people who experience trauma every day – military and emergency services personnel. Symptoms include flashbacks to the traumatic event, nightmares, sleep disorders, and uncontrollable thoughts; anger, fear, distrust, personality changes, and extreme anxiety. PTSD can manifest physically as chronic pain and hypertension, and can induce self-destructive behaviour like drug and alcohol abuse, long-term addiction, and suicide. The collateral damage of PTSD is its effect on relationships, families, finances, and work and social status. It can be devastating on many levels.

PTSD in emergency services

The men and women of Canada’s public safety, military and correctional organizations witness human suffering up close and it sometimes becomes very difficult to cope with the aftermath. There is light at the end of that dark tunnel. There is help available, and we want to make sure these men and women – and their families — know where to find it.
Heroes Are Human

Vince Savoia is the founder of Heroes Are Human and a former paramedic. His organization focuses on PTSD research, education, and training, and acts as a peer and psychological support resource for Canada’s public safety organizations personnel.

Savoia says 16 – 24 percent of emergency personnel suffer from PTSD, but he believes this is a modest number. Paramedics are faced with more trauma more often, and run a risk of PTSD two to three times higher than in any other emergency service. Kim McKinnon, Superintendent at Toronto Emergency Medical Services (EMS), says PTSD predictors for paramedics include their “involvement in a critical incident like a mass casualty event, or an organizational or environmental event such as the death of a service member in the line of duty.”

EMS personnel tend to victims of horrific scenes large and small, they resuscitate the sick, and witness death. At the same time, they form a bond with sick and injured people as they spend time talking and giving hands-on treatment. This one of the reasons why Mr. Savoia believes paramedics are the hardest hit of any emergency service.

PTSD does not discriminate. While it affects paramedics more often, PTSD afflicts 10 – 12 percent of police officers and 6 – 8 percent of fire fighters. According to a recent StatsCan report quoted in the Globe & Mail, PTSD rates among members of the Canadian Forces have nearly doubled since 2002; 1 in 6 Canadian soldiers have mental health problems after ten years in Afghanistan. And the numbers keep growing.

First responder organizations must create programs and supports for their employees, but this takes funding and resources that may or may not be available. Some emergency services have excellent support systems in place for their employees like Toronto EMS’ comprehensive suite of services for employees to proactively manage their health. With a focus on prevention, their resources include early psychological support with a staff psychologist, a peer support team, employee assistance plans, and other community resources.

Canada’s RCMP has nation-wide systems in place that utilize peer support, RCMP doctors, and chaplains. A Regina RCMP sergeant explained that the RCMP wants to make sure it’s there to listen to their officers who respond to major incidents like car crashes, deaths of children, multiple fatality incidents, shootings, and violence.

We’re fortunate that we’re finally acknowledging PTSD as a real illness with real consequences, but despite the good intentions of emergency services to their employees, the question is, are the support systems being utilized, and if not, why not?

Stigma, discrimination, penalization, and the John Wayne Syndromesuffering in silence

In the emergency services culture, there is stigma and perhaps a shame attached to being affected by trauma and asking for help. It is considered a “weakness” and it is the largest problem that first responders face because it is a deterrent to getting help.

Though more women are joining military and emergency services, men still form the majority of employees, and because they’re men, they are expected to adhere to the traditional masculine code that demands they use the “suck it up” method of dealing with harrowing trauma and stress.

Vince Savoia says that first reponders work with respect for the public who needs them, but the same respect is not offered to colleagues. “First responders who look for support are bullied by their peers and colleagues,” he says, “they are ridiculed and harassed. Mental health is viewed as a weakness, not an illness, and the expectation is that we should be able to stop it and move on.”

The mental illness stigma exists in all branches of emergency services and the armed forces. David Whitley, a paramedic who suffered his own PTSD from a terrible ambulance accident, now volunteers for a local emergency services support group that checks in with first responders who experience potentially traumatic events like shootings, suicides, crashes, and situations that involve children.

“We give [members of the group] an opportunity to talk because there is a stigma,” he told the Toronto Star. “First responders need to lower the trauma mask, and that’s scary because there are feelings of vulnerability and anxiety. But if you don’t do that it’s a precursor to mental illness, including PTSD.”

Kent Laidlaw, a retired police veteran in Burlington, Ontario, and principal of Canuckcare, a consulting service for people who deal with workplace stress and trauma, says that the systemic corruption that exists in police ranks ensures that officers who ask for help are considered “less than” and therefore a weak link in the chain. They are penalized rather than punished, a subtle difference that speaks just as loud.

New York State police veteran and police trauma and suicide researcher, Dr. John Violanti, observed in the Ontario Ombudsman’s 2012 report that the nature of the policing environment often goes against the goal of improving health: “The police culture doesn’t look favorably on people who have problems… Not only are you supposed to be superhuman if you’re an officer, but you fear asking for help… you may not be considered for promotions and you may be shamed by your peers and superiors. In some cases, your gun can be taken away, so there is a real fear of going for help.”

 ***

Emergency service workers are very well trained but cannot be prepared for every possible situation, so perhaps masking the emotional response to what they experience is the way to cope, but unfortunately, first responders are human, and part of being human is to be emotional. To expect that anyone could not be affected by horrific and traumatic events is ridiculous, and then to believe that there is no emotional aftermath is absurd, even abusive.

The code of masculinity that demands men to be stoic, brave, and in control, subscribing to what Vince Savoia calls the “John Wayne Syndrome”: the tall, rugged, macho cowboy who can deal with any situation and stand up for justice. Savoia believes that first responders have to be this way in order to do their job, but what happens after the mission is accomplished and reality sets in?

On his very first call, a house fire, Vince Savoia lost his first patient, a two-year old child. He wanted to talk to his paramedic crew about it, but when he tried to, “the crew was very stoic –just walls.” If this code prevents men from being able to get support from the experiences of trauma in their jobs, what purpose does it serve? A culture of hyper masculinity is a hindrance more than a help; it creates broken men who can’t do the job as well as healthy men.

Saskatchewan counsellor, Peter Griffith, says that men don’t like to admit, or even recognize when they need help, to the degree that they will ignore their own health problems sometimes until it’s too late. Hospital wards, he says, “are full of men who refuse to go to the doctor when they have physical symptoms and who seem to prefer to pay the price rather than to go for help.”

Anna Baranowsky, a clinical psychologist who works with police officers in private practice, explained to the Toronto Star in 2012 that “people can recover[from PTSD], but if we see ourselves as being strong and we won’t tolerate any kind of weakness, then what we might end up doing is pushing (ourselves) until we are past the point of recovery, and that is really dangerous.”

Experts say that the stigma attached to mental health needs to change for us to get anywhere. It could be as simple as changing our perception of what it is to ask for help and equate it with responsible prevention, with the power to keep oneself healthy, capable, and strong. Putting a positive spin on the consequences of responding to a traumatic situation is much more agreeable than demeaning someone who can’t control their mental health response.

The PTSD misunderstandingshattered glass

There is a very interesting argument happening right now around PTSD. Some, like Vince Savoia, believe that PTSD is responsible for taking the lives of more than 20 first responders since the spring, but some mental health professionals like psychologist, Dr. Paulette Laidlaw, believes that PTSD has become something of a blanket diagnosis for many other problems.

While it’s true that in some cases, PTSD symptoms can worsen after an emergency service employee retires, Dr. Laidlaw wonders why is it when we hear “police suicide”, we make the automatic assumption that it is related to PTSD.

Dr. Paulette and Kent Laidlaw do not believe that first responder suicides are exclusively job-related, but are more likely a combination of many stresses including work, finances, and relationships. They say the individual’s long-term mental health should be examined and more questions asked about a first responder’s life before we slap the PTSD label on them, just because that individual happened to work in the armed forces or emergency services.

Dr. Laidlaw explains that PTSD is not as commonplace as we are led to believe. “PTSD affects only 8 percent of the population,” she says, “whereas depression affects 30 percent and anxiety touches 20 percent. We’re in murky water trying to distinguish PTSD from burnout, acute stress, trauma, grief, or clinical depression”.

We see PTSD in the news a lot and it has become something of a “trendy” disorder. Media reminders of the illness can cause people to self-diagnose via the Internet, and all hell can break loose. Dr. Laidlaw suggests that PTSD is the “sexy” disorder of the day, and with any popular disorder, like we saw with childhood ADHD, suddenly there are specialized medications and “PTSD therapists” come out of the woodwork. PTSD can only be diagnosed by registered psychologists and medical doctors.

How will change happen?fireman

“I wish I had cancer because then people would understand.”
-Veteran paramedic Ken Barker communicated to his sister shortly before taking his life

Mental illness is not something tangible, something that hurts, something that can be fixed with a cast or a bandage. It affects the brain and though it may not show on the outside, it can torment the mind from the inside.

Regard for mental health is changing, albeit slowly, but Vince Savoia believes that cultural change in PTSD acknowledgement has to come from the top down, and says that “we must respect mental wellness as an issue and stop the harassment and bullying from the bottom up. It has to be a grass-roots movement to encourage people to take responsibility about how they treat themselves and their colleagues.”

Dr. Violanti agrees:  “If I tell you that the first time you see a dead body or an abused child that it is normal to have feelings of stress, you will be better able to deal with them; exposure to this type of training inoculates you so that when it does happen, you will be better prepared. At the same time, middle and upper management in police departments need to be trained in how to accept officers who ask for help and how to make sure that officers are not afraid to ask for that help.”

This means changing the culture from one that ridicules people who need support to one that supports and embraces human vulnerability.

Dr. Jeff Morley, former RCMP officer and psychologist for Canadian Forces and Veterans Affairs says “Canada needs a national mental health strategy for first responders, but the political will does not exist right now.”  He says that to change the system, we need a high-profile person to promote the cause, like Romeo Dallaire who played a big role in the beginning but retired from senate this year.

“That, or if the government clues in that the high financial cost of not doing anything (i.e. disability costs, sick time, leaves of medical absence) exceeds the cost of early intervention, education, and prevention.” He says that the RCMP spends tens of millions of dollars per year on PTSD disability claims, but asks how much they’re willing to come up with to prevent it.

The Globe & Mail reports that global estimates for antiviral drugs have run close to $10-billion since the SARS outbreak of 2002.  The authors of the original report in the British Medical Journal acknowledged that the “important benefits have been overestimated and harms under-reported”. Imagine if the Canadian government spent the same amount on long-term mental health as it spends on stockpiling useless drugs for unlikely flu epidemics. Imagine if people shrugged off the toxic masculine codes that keep men from flourishing and actually paid attention to what they need. And can you imagine the tremendous benefits of supporting the mental health of the people we depend on to take care of us?