It is OK to not be OK With Your PTSD

This article is the first in a series to outline an issue that is rapidly growing into an epidemic across our country. It is an issue that we ourselves can mitigate and most certainly eliminate given a desire and opportunity. I am talking about suicide in our first responder population and the Post Traumatic Stress that causes those actions.

All will agree that this is not a fun topic, yet it is one that needs to be addressed. Without attention, there is nothing to prevent it from perpetuating its growth as the number one killer among all response disciplines.

First of all, let me reinforce the fact that I am not singling out anyone and would like to thank those out there who have taken the time to implement fine programs within their system. I am simply bringing out the truth that spans across each of our public safety families. It is an issue that is prevalent, we acknowledge that it is there, now we have the responsibility to address it.

With that being said, the fact that we as public safety workers are our own worst enemy is causing many hardships within our family. We provide meticulous care to our patient’s physical wounds and needs, yet we ignore the blatant signs of trouble in our partners, members of our work family and members of agencies that we work with. We aggressively treat physical wounds that we can see with the utmost care. Yet when there is a change in behavior that we don’t understand, we address it with sarcasm and by chastising that person for their behavior. We fail them. Many just simply don’t understand how Psychological Trauma impacts every aspect of a person’s life. Unknowingly, we have all had co-workers that were going through a very difficult time with past and present traumatic events. Although many co-workers recognized the change in their behaviors and offer understanding, others don’t grasp what is going on and attributed the behavior to the fact that “They are just crazy” or labeling them as being weak. They then become a target of secret conversations and are blackballed from social networks and normal work related activities.

We often view psychological trauma a weakness when it is not. We view the term mental health as a derogatory term and PTSD as an affliction instead of the injury that it truly is. PTSD is not a disorder, it is an injury that needs care just like a multisystem trauma that we send helicopters to. It needs to be addressed before it gets out of control. And care needs to be given to the person before we address the needed suicide intervention. Yet we treat it like a white elephant at the party. No one wants to talk about it or face it. Unfortunately, this denial is genuinely a defense mechanism against something that we do not understand and will cause us grief or bring out our own demons if we address it. Some people are impacted worse and quicker than others and suffer from the impact of their bad calls early in their careers. This doesn’t make them any less of a person, it just means that they are human too. We all do the job we do because we care. Looking at our careers with an honest eye, we must admit that we have all had a call that has bothered us. If you haven’t then we are kidding ourselves, in denial, or haven’t been on the job for more than a week. It is the nature of the profession but it is because we care that we are impacted so deeply.

There are some that have a difficult time grasping the true magnitude that post-traumatic stress has on a person. It is a foreign concept for those who have a greater capacity to manage the bad and ugly aspects that our profession throws at us. With that being said, I would venture to say that if one asked the people close to those warriors if their personalities had changed since venturing into this profession, the answer would be yes. It changes all who take on the responsibility of managing an event that puts someone else’s very existence in their hands. The outcome of that change varies and depends upon how we as individuals and as a response system manage the impact. To do this correctly takes education and an understanding of the problem.

For those who have never experienced the aftermath of what PTSD brings to the table, allow me to pose an example.

A person has a bad call or a series of bad calls with no chance to process or work through the grieving process of each traumatic impact. Now imagine reliving that call in your mind over and over every minute of every day. You can’t push it to the back of your mind, it doesn’t work that way. You have nightmares that get more vivid and real as time goes on to the point that you can’t sleep at night. You try to manage it by denying that it is a problem, but you can’t. Your doctor says “Here take this pill, it will relax you.” Now you are drugged and find it even more difficult to function which causes added stress. That stress, anxiety, sleep deprivation, and medication all impact your family life, your relationships, your self-confidence, your work proficiency and your interaction with co-workers just to name a few. Your co-workers, supervisors, loved ones don’t understand how psychological trauma impacts every aspect of ones’ life.

Eventually it threatens your overall ability to do your job. You can’t admit anything is wrong because it will mean that you will risk being classified as weak by your co-workers, not fit for duty by your boss and less of a human being by your family for whom you can no longer provide for. So you struggle along until you can’t anymore. People start to talk about your performance behind your back. You can’t help but hear about it. The rumor mill is not as top secret as it may wish to be. This causes additional stress and friction. You end up quitting your job before you are fired due to disciplinary action. You just can’t hold it together due to all the stress, sleep deprivation, anxiety and the endless day mares about the bad calls. In turn you also lose your ability to get another job in your chosen profession. You have now lost everything that you have worked for and in turn feel that you have lost your Identity and your sense of self. This whirl wind won’t stop. You need help but can’t ask for it. Eventually you have no option but to find another job that doesn’t “Trigger” those memories.

This is not an exaggeration. This happens every day. By denying that post traumatic injury is valid and refusing to provide the same compassion to our peers as we provide when managing patients, we are contributing to the failure of very talented, experienced individual.

Before we can expect anyone to change how they view psychological trauma in our industry and affect a change, we must change the way we see it, lead by example and care for our own.

How do we do that? First we need to learn what to look for. This may be difficult in that psychological trauma impacts everyone differently. But the first and most obvious is noticing a change in their behavior. You know your co-workers sometimes better than their own family does. Be cognizant of their “normal” and recognize that change. Don’t be afraid to sincerely reach out and just say. “Are you OK?” Now if you do this, you better be ready for the answer.

Secondly, take the time to respect that person by not gossiping about their behavior. Before we go off the deep end and draw a conclusion that is disastrously wrong, understand that they may be going through something that you don’t know about.

We offer compassion to our patients so why don’t we show that same compassion to each other and to ourselves. We may have to ask ourselves, “am I alright” and be OK with the answer. It is Ok to not be OK as long as we take the initiative to manage it properly. That is the rumor that we need to start spreading and truly believing.

Next edition we will discuss how the job impacts the family dynamic.

Jim Starlin is a career responder having been part of many organizations in his 40 years. He has taken his experience to a new level to form the Tuscarora Conference and Training Institute that offers tools to “manage the unimaginable.” The goal of TCTI is to build a mountain retreat for our Fire Fighters, Law Enforcement, EMS and 911 dispatch to access that will allow for the job to be forgotten at least for a little while. Please reach out to Mr Starlin for information on how you may be able to help make this happen. He can be reached at or at

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