FIRST RESPONDERS AND MENTAL HEALTH CARE; THE DILEMMA AND THE SOLUTION

“Until you put your life up as collateral for another life, you don’t know what life saving is about”

by KATHRYN GALLOUPE MSW, LICSW, SUDPC

It can be daunting to find a therapist who is competent to understand civilian issues and is agood personal fit, but for First Responders and those on the front lines, there is much more to consider when seeking out mental health care than competence and a good fit.

It is these additional issues that often keep First Responders from seeking out mental health treatment. While civilians have a lot to consider when pursuing mental health care, First Responders have many additional fears and questions when it comes to asking for help.

Additional considerations to seeking mental health care for those on the front lines include, but are not limited to:

• Will they be judged as unfit for duty by their Commanders, co-workers, and family?

• Will there be reprisal if they have turned to alternative coping outlets like alcohol, drugs, or other illegal or against policy channels to relieve their pain?

• Are the perceived and/or real repercussions to their reputation too high to admit that they need help?

Not to mention, asking for help can be difficult when everyone looks up to you. Asking for help can carry a perceived stigma of weakness and/or failure to those who everyone admires.

“A number of first responders I know start to find their careers difficult to cope with around the 10-year mark. That’s when the invincibility they felt as new first responders begins to waver, and it becomes apparent that holding on for another 30 years until retirement could be damaging. Traumatic calls add up, and we rarely discuss them with our work or life partners, let alone process them with a trained psychologist. Instead, the stigma of mental illness can make first responders feel like they have no choice but to “pull it together” and move on to the next call.” (Processing Trauma Can’t Wait Until Retirement For First Responders | HuffPost Canada Life (huffingtonpost.ca))

“For a very long time, I felt like asking for help was a sign of weakness.”

The heavy mental and physical toll extracted upon First Responders due to the nature of their service, often alienates them from their family and friends. They often feel that nobody in their lives understand the world in which they survive, and they are right. First Responders protect and serve 24 hours a day. Once their shift ends, they continue to protect their friends and family from the atrocities that they endure daily. First Responders are taught to be courageous, but their courage is unfortunately suffered in silence.

ACUTE AND CHRONIC STRESS OFTEN LEADS TO DEPRESSION, ANXIETY, AND PTSD.

First Responders are trained to respond to emergencies. To endure the witnessing of daily trauma, interact with populations that are dangerous and unpredictable, and to bring the most frightening and shocking scenes to a state of control and safety for all involved. Their bodies are in a constant state of stress or fight or flight response. When under perceived and/or real threat or witness to trauma, the brain’s alarm center is alerted, and the body releases a vast amount of hormones to cope with these environmental changes. “The release of all these chemicals causes important changes in the body’s ability to respond to threats such as increased energy, heart rate and blood sugar; increased arousal and pain relief.” (Charney, 2004)

Living in a constant state of stress can quickly lead to Post Traumatic Stress Disorder or PTSD, and/or several other mental health and medical diagnosis. Untreated mental health or medical diagnosis can lead to decreased quality of life, illness and/or an early death. The statistics for First Responders living with PTSD are alarming. “PTSD isn’t just an inconvenience – it can be debilitating and even deadly:

• 20-30 per cent of paramedics have PTSD symptoms.

• 39 first responders committed suicide in Canada in 2015. Approximately 60 per cent of those deaths are related to PTSD, according to the Tema Conter Memorial Trust.”

(ptsdfirstresponderfactsheet.pdf (opseu.org))

“Unknowingly, first responders may wait until they are forced to quit, often after PTSD has scarred their minds and bodies forever.”

First Responders are essential to the lives of everyone.

WHAT IS PTSD?

Posttraumatic Stress Disorder (PTSD) is a mental illness. It involves exposure to trauma involving death or the threat of death, serious injury or violence. Traumatic events may include crimes, natural disasters, accidents, or other threats to life. It could be an event or situation that you experience yourself or something that happens to others in the course of your employment. Sometimes it may take several traumatic events before PTSD is diagnosed. This is often referred to as Cumulative PTSD. (ptsd-fact-sheet-final.pdf (opseu.org))

Common Symptoms of PTSD include:

• Recurring flashbacks (memories) of a traumatic or difficult session

• Suicidal Thoughts

• Being on Alert / Looking Out for Danger (Hypervigilance)

• Panic Attacks

• Racing Thoughts / Spiraling

• Feelings of Guilt or Shame

• Feelings of Anxiety

• Feelings of Depression

• Feelings of Anger and Rage

• Nightmares

• Trouble Sleeping

• Insomnia

• Negative Self-Image / Self-Esteem

• Lack of Feeling / Being Emotionally Numb

• Dissociation / Out-of-body Experiences

(Common Symptoms of PTSD Checklist - DVEN)

WHO IS TAKING CARE OF THOSE WHO TAKE CARE OF EVERYBODY?

The good news is that PTSD and all other mental health conditions related to First Responders and those on the front lines are treatable. With the right therapist and therapeutic modality, you can not only get well, but you can also live a life free of PTSD, anxiety, depression, and thought’s of ending your career or worse, suicide.

First Responders are essential to the lives of everyone, and it is the responsibility of the mental health community to have experienced therapists who are skilled in the diagnosis and treatment of First Responders, Veteran’s and front-line workers so that they can live full lives free of the psychological burdens that steal their vitality if left untreated.

As a 25-year veteran provider of psychotherapy and community mental health, I have had tremendous success working with First Responders, Veterans, and those on the front lines of emergencies and the COVID-19 Pandemic. I have served in our emergency departments as a crisis counselor, worked as a mental health professional in corrections and owned a thriving practice for those needing a high level of confidentiality in their mental health treatment.

Currently at Thrive Counseling Kirkland, I specialize in First Responders, Veteran’s, and front-line workers. I concurrently specialize in men’s issues. I would be honored to provide a free consultation and/or work with you in my practice. My goal is to prevent, intervene on, and treat all stages of mental health diagnosis that are common to our First Responders, Veteran’s, and front-line workers. If I am not a good fit for you personally, I am committed to helping you find another therapist to work with.

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RESOURCES:

Emergency help for Police and First Responders

Emergency Responder Resources - King County

Self-care Toolkit for King County First Responders and Essential Personnel

Police resources — Connecting the DOTS (dotsproject.org)

First Responders and Disaster Responders Resource Portal | SAMHSA

Mental health crisis lines | Washington State Health Care Authority

The mental health crisis lines listed below are available for all people in Washington regardless of your income or whether you have insurance or not.

• For immediate help: call 911 for a life-threatening emergency.

• For immediate help with a mental health crisis or thoughts of suicide: contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TRS: 1-800-799-4889)

How your body holds your story

How your body tells the story of you.

By Lindsay Deiley MA, LMHCA

We’ve all been there right? Driving down the highway, listening to music, when a song pops on that—bam!—takes you back to a specific moment in time. The present seems to fade, and your body responds to a specific memory associated with the song. If it’s a happy memory, maybe your body grows warmer and lighter. If it’s a sad memory, your eyes may begin to glisten. If it’s a scary memory, your chest may tighten. Perhaps the song evokes such an overwhelming response from your body that you need to skip to the next song or turn off the music altogether.

Here’s another example…perhaps one that too many of us are familiar with. Have you ever experienced a difficult, or even traumatic, event? Maybe you got into a car accident at that intersection where you pick up coffee on your way to work every day. Although you were not injured, your body remembers this scary experience every time you drive by that intersection. What does that “remembering” look like? Maybe it’s a heightened state of alert—paying extra attention to other cars, riding the break a little more closely. Maybe you realize you are holding your breath. Or maybe, just driving through that intersection evokes so much emotion that you begin to drive a new route to work.

How does your body remember?

Do you hold your breath? Avoid certain places? Does your heart speed up?

Our bodies remember. They are living time capsules, embodied memories of the past, sojourners through the present, and expeditioners toward the future. Not only do our bodies hold memories, but they are also speaking to us, every moment of every day. The stories of our lives are carried in our bodies, waiting to be told and longing to be heard. Can we hear what stories our bodies are telling about our lives, about our greatest hurts and greatest hopes? Do we care to listen?

Important parts of our stories often can be found by paying greater attention to the signals our body is giving us in the present. Some bodies talk louder than others; some have more to say than others. But every single body has a voice, has a story to tell. What does your body have to say?

Your body is a living time capsule.

Our stories can be carried in permanent, visible marks, as well as transient, seemingly invisible ones. Many of us have experiences that physically change us and leave scars. Maybe that scar on your lower abdomen tells something of your joy in conceiving a child, as well as your suffering and disappointment in enduring a caesarian birth. Or maybe the scar below your kneecap reveals something of your perseverance in competitive athletics, as well as the immense cost of a new ACL and months of rehabilitation. Aside from visible scars, our bodies also tell stories in ways that may be invisible to others. Maybe, after a disappointing blind date, an empty pit in your stomach drives you to the bottom of a potato chip bag. Maybe you discover yourself trembling inside after a difficult conversation with your partner. Perhaps you find yourself slamming doors harder than usual after a phone call with an invalidating parent. These bodily responses are “scars” from earlier memories that have been triggered to resurface by something similar in the present.

Unfortunately, many people are conditioned to ignore their bodies’ signals or to have contempt for them. But what if we adopted a disposition of curiosity towards these signals our bodies are trying to give us, instead of contempt? What if we thanked our bodies for trying to tell their stories and invited them to share more, instead of scolding them for speaking up? What parts of our bodies, and therefore, parts of our stories, are we dismissing?

Often, visible and invisible scars are remnants of difficult chapters in our stories that have not been cared for well. Inviting someone to come alongside us, hear our stories, and carry our burdens leads to greater integration, healing, and growth. It fosters increased compassion, attunement, and greater appreciation for our bodies. The counselors at Thrive Counseling Kirkland are dedicated to holding your embodied story with gentle compassion and walking with you on your journey of self-discovery. If you want to learn more about the story your body is trying to tell, reach out today!

Overcoming Anxiety

By Ashley Bryan MS, LMHCA

Shallow breathing, racing heart, chest tightening, thoughts going one million miles per minute. Sometimes it stops there while for others it can lead to physically debilitating symptoms making life seem nearly impossible. You may think this is a physical medical condition being discussed, or maybe you understand too well that we are talking about anxiety.

Anxiety creates mental and physical exhaustion

Everyone faces a degree of anxiousness in their life. It might be that you are feeling anxious about finishing a task you started, or maybe going to work when you know you were late yesterday, and the boss is not going to be happy. It could be that you hate large crowds, and you have to be at your best friend’s wedding this weekend, or possibly that you just don’t like making phone calls and it’s time to schedule an appointment. Whatever the cause, anxiety is uncomfortable. It is important to understand that although there is a spectrum of anxiety, all anxiety can cause significant distress and despair in people’s lives. At times we may begin to even lose sight of what a life would be like without this constant level of worry. This is why it is important to understand what anxiety is, how it affects you, and what we can do about it.

All anxiety can cause significant distress and despair

So, what is anxiety? Anxiety is a thought process in which excess worry and tension fill your mind and body creating both mental and physical exhaustion. Anxiety can present as intrusive thoughts that create levels of paranoia-like worry and lead us to avoid situations we might not otherwise.

How does anxiety affect me? Anxiety can affect people in many ways. It is common to have physical side effects – including but not limited to – heart palpitations, shallow or short breathing, increased blood pressure, visual impairment, or sweating. These are often short-term effects but can become more substantial if anxiety begins to take over your life. Anxiety can also affect your day-to-day living. Many people who suffer from intense anxiety avoid things because they are easily worried or overwhelmed by them. This can make it difficult to build strong social and familial relationships, a happy work environment, and activities of self-care such as going to the doctor, getting a haircut, and eating at a restaurant. Active anxiousness often causes us to lose sleep and become increasingly concerned and stressed out about something bad happening. We lose a lot of time being consumed by this feeling.

Anxiety can be overcome

What to do about anxiety? Anxiety is individual to each person and there is not a one size fits all approach in how to deal with it. There are many things that can alleviate anxious symptoms and allow you to take back control of your life. Start first with giving yourself grace and understanding that you are not alone. There are many ways to find reprieve and it is likely that with some guidance you can overcome your anxiety.

If you feel like you’re not in the driver’s seat of your own life – reach out today.

Reach out today

There has to be a better way to do this…

By Ashley Bryan MS, LMHCA

If there was ever a time that we could all agree life is overwhelming, its likely been this last year. For some of us, just merely getting up and going can feel like a task and for others it is the buildup throughout the day. To do list: get presentable, take the kids to school (or zoom), go to work (or zoom), clean the house, cook the food, pay the bills, bathe the dogs, and for the love of all things holy DO NOT FORGET YOUR MASK - as if we needed one more thing to add. It is nearly impossible to complete the day’s list, so by tomorrow we add the new tasks on top of the things we were unable to get done today -slowly burying ourselves in unrealistic and oftentimes unnecessary expectations. Then you end the day trying to get some sleep, while consistently playing over in your head how you might have managed your time better today and what you will now have to do tomorrow. We can survive this for a day, maybe two, but eventually it compiles into this feeling of impending doom.

This transformation shifts from feeling stressed to feeling completely overwhelmed. You are not alone in this. You are not alone in having this happen and feeling like you cannot escape sinking into the quicksand that feels like your life. And you are not alone in looking for help in how to overcome this.

Remind your body what rest feels like.

We too often mistake our priorities for society’s expectation of us. It is in these moments of feeling overwhelmed that we need to take a step back and evaluate our real priorities. These priorities should align with our internal values, desires, and needs. Will the dog not survive without a bath today? Is the laundry going to cause an actual explosion of the house (not just the couch) if not folded today? Are the dishes going to grow legs and attack us because we left them in the sink, for just one night? Is it more important that you get the to-do list done than being able to take a moment to sit with your partner, friend, or child in a moment of embrace and calm before the day’s end?

Did you find connection today?

To yourself and/or others?

It is easy to interpret our feelings of being overwhelmed as something that happens because of all the things we do or need to do but sit with me for a moment and think of how it might be a result of what you do not find time to do. Did you find happiness and connection today? Did you do something you love today? Did you find time to relax today? Being overwhelmed is a sign from your body. It is an indicator that is time to find balance. Take something off the list, say no, find help, listen to your heart, and allow yourself to stop worrying for a little while. There is tomorrow to get things done, but it starts with finding happiness today.

If you are feeling overwhelmed and stuck, we would love to help you recover your joy and happiness. You do not have to figure this out on your own. Reach out today.

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