The following letter
is from an officer who wrote it in the Guestbook
and kindly gave me permission to use it in an article
in the hope that his experience will help others.
He describes many of the classic symptoms of police
PTSD, or post traumatic stress disorder. In fact,
every distressing thought, feeling and behavior
he relates below is a symptom of PTSD.
I am a (10 plus)-- year police veteran and (30
plus)-- years of age. I have become seriously
concerned with some of the events that have been
taking place in my life for the past two years.
I have started having nightmares frequently and
have great difficulty going to sleep at night.
There is always a feeling of uneasiness at night
and I have started to develop some unnatural habits
associated with these uneasy feelings. At the
slightest sound, I have to get out of the bed
and check every room in the house.
I have two children who live with me and my wife
and I have gotten to the point that I almost always
make them come into my room at night because of
the feelings I have. If I am the first one in
the house to go to sleep, I am ok, but otherwise,
the feelings surface about 0:00 pm. I usually
end up passing out somewhere between 3 and 5 AM.
I get up for work at 7 am and this has started
causing me a great deal of problems in my job.
I often find myself in a trance thinking about
traumatic events that have taken place in my career
and always find myself in a very disheartened
state afterwards. During the recollection of these
events, I often experience a shortness of breath
and fear. I feel sad often and one specific event
makes me feel very guilty. I know that I could
have stopped a murder if I had taken other steps
at the time of this incident. I often think about
things while driving and end up going in the wrong
direction before I realize where I am at.
Certain events that I have experienced cause
me a great deal of emotion l distress when I think
or communicate about them. My hands are shaking
here at 1:06 AM as I write this letter. I have
recently found myself to be very irritable, and
my wife and I often argue because I don't want
to go to social gatherings with her. I am not
being anti-social, I just don't like to be around
people. I just like being with my kids and taking
care of them. I feel bad about some things that
are happening to me. My daughter came into my
room four nights ago and kissed me on the cheek
while I was sleeping. I jumped and scared her
to death. My wife came to bed one night and when
she walked up to the bed, I drew my fist back
to hit her. I get up all hours of the night and
check the house over and over. I don't even know
what I am looking for. I was asleep about a month
ago, and I just knew that someone had fired a
gun in my living room. I hear people pound on
my door in the middle of the night, when in fact
there was never anyone there to my knowledge.
One night I got up out of the bed and got my gun.
I was about half-asleep. I don't know what I was
looking for, but on my way through the house,
I cocked my weapon. On the way through the house,
the .357 discharged and shot a hole through my
floor. Some of the incidents that I remember the
most seem vague. I remember every aspect of a
shooting where I held the victim as he died. I
can't remember what he looked like. We do not
have counselors to speak to about these things
and I feel that the average doctor would not be
able to understand what I am talking about. I
Know I need help, but I have dealt with it for
the past two years. It is getting harder to deal
An officer may develop PTSD after experiencing
an critical incident, or being exposed over a period
of time to stress that he was unable to alleviate.
These are two basic causes of PTSD with police officers:
The first is what the public envisions when police
PTSD is brought up, especially after 9-11. These
are the single event traumas. Perhaps someone shot
him (or, throughout him = and/or her), or maybe
he had to kill someone himself. Or perhaps both.
The critical incident stress management team might
have made every effort possible to debrief the officer.
They could have been skilled, they could have been
novices. Everyone paid attention at the time, but
their lives are like everyone else's lives, and
after a while they go about their business and while
they still cared, the officer and his family are
their own. Hopefully everything worked out and there
were no lingering effects. Post traumatic stress
disorder can sometimes be avoided even when an individual
has the most traumatic, life threatening and life
changing experience. Sometimes officers don't get
any treatment at all and never develop it. Other
times they get what seems like the best treatment
and they do.
But sometimes intervention isn't as good as it
should be. And other times even the best intervention
doesn't work. As far as CISM and CISD*, look at
it like a vaccine that is effective a certain percentage
of the time. You don't not want to be inoculated,
but you have to realize the preventative measure
isn't 100%. So it is with critical incident stress
management and debriefing. It doesn't always prevent
PTSD. Nobody really knows why, except that knowing
this there's no excuse for law enforcement administrators
not to making sure officers are followed closely
for at least two years after an incident. I would
recommend at least a monthly half hour session with
a good therapist and every other month a meeting
which includes the spouse if there is one. Sometimes
the individual doesn't see his own symptoms. Either
he is denying them or really doesn't recognize how
he's changed. Or maybe he kind of sees how he's
different but it's too painful to think about it
for very long.
The second kind of trauma is addressed, in part,
in some of the article list in the "Politics"
section of Police Stressline, where the stress is
caused by an aspect of the job over a long period
of time that undermines the officers self-esteem,
confidence and trust in his superiors and/or coworkers.
This may occur where there is racial or sexual discrimination.
It may occur with an honest officer in a less than
honest department. It may occur in an officer that
believes in proactive policing in a caretaker reactive
department. It can occur in a department where decisions
are made on the basis of favoritism, politics and
ego. The term "hostile work environment"
is generally used to describe this kind of internal
police department atmosphere. Of course prolonged
trauma that builds up and leads to PTSD can be caused
by having to work day after day with an unappreciative
or hostile public and being exposed to the worst
aspects of the human condition.
Mild PTSD can disrupt a life, but moderate to severe
PTSD is a nasty condition. For one thing, it involves
a combination of psychological and physiological
changes in a person. On the psychological side,
it can shake a person's very belief system to the
core. It can produce overwhelming, if illogical,
guilt feelings. It can lead to an "I don't
give a crap" attitude. It can make a police
officer question whether the job has any meaning
or value. It can make someone so vigilant he becomes
paranoid, unable to trust or let his guard down
even when he's completely safe. It can lead to suicidal
thoughts and in rare instance actual suicides. On
the physiological side, as noted in other articles
here, it can produce anxiety, irritability, depression,
insomnia and a host of physical problems from headaches
to digestive problems.
But in the interpersonal realm, there's where the
family is really effected. PTSD can cause the sufferer
to become emotionally withdrawn and distant from
family members. The sex drive can go out the window.
He can become overly needy and dependent, or on
the other hand outrageously demanding and impatient.
He can revert back to old habits like smoking or
drinking, or become a newly hatched adolescent and
engage in reckless, sometimes life threatening,
hobbies. Sometimes hobbies like motorcycling can
border on suicidal when officers test the limits
of speed and good sense. I hate to say it, but PTSD
can contribute to an officer thinking, "what
the hell, I might as well have an affair."
He may not do it, but thinking it can be very distressing,
and the spouse may pick up signs her mate is thinking
Needless to say, if an officer has turned into
a devil-may-care adolescent or become sullen and
melancholy, and his personality is different, he
might as well be a different person than he was
before the critical incident and the onset of PTSD.
The family becomes the secondary victim. Loyalty
is tested in the extreme. So spouses and kids ask
themselves, "if husband or Dad isn't the person
he used to be, if sometimes it seems I hardly know
him, what am I doing sticking with him?" Of
course the families know when the changes occurred
and why, and Dad was probably a hero, made the newspaper,
got a distinguished officer award. So they stand
by him, but the unhappiness is incredible.
What can the family do? First of all, make sure
that nothing was missed as far as treatment goes.
Especially whether or not there ever was or still
is a need for medication. Sometimes law enforcement
officers, especially men, are loathe to take meds.
But they need to understand that PTSD may actually
irrevocably alter the way their brain functions.
Research into this is fairly new, but this is what
the evidence suggests. Most people reluctantly accept
when they've had a serious injury, say to their
back, that they may never quite be the same again.
But to think that the stress of a critical incident
can essentially injure the brain so it will never
return to optimal functioning is a horrendous thought.
And it may be true.
We know that the efficacy of serotonin in the brain
is drastically effected by stress, and by PTSD,
which alters the receptor nerve cells. Medications
like Prozac, Zoloft, Paxil, Wellbutrin, Celexa,
and more recently Lexapro are often recommended
and used very effectively to help people through
rough times. They help the brain return to normal
by making the neurotransmitters work the way they're
supposed to. If the officer was on them after the
incident and they seemed to help, but he stopped
using them in the hopes he wouldn't need them anymore,
and the symptoms returned, he should probably start
using them again. And if he never was on them, family
members should urge him to see his doctor to discuss
a trial of at least two months.
The treatment of choice for PTSD is generally a
combination of psychotherapy and medication. Officers
should be advised that PTSD does not mean post traumatic
stress distress. The "D" stands for disorder,
and this indicates that one is having a serious
reaction to a single incident or to a prolonged
In addition to finding a sympathetic and knowledgeable
physician or psychiatrist, the officer will need
to seek out a therapist who works well with police
(or correction) officers. Any law enforcement therapist
has seen officers who have developed PTSD after
a critical incident or after exposure to prolonged
I wouldn't recommend any drastic life or career
changes for an officer until he (and again, it could
be a female officer too) has had some therapy, and
when appropriate some couple sessions with the spouse.
Some officers do quite well when they move out of
law enforcement into something completely different
following a critical incident that resulted in PTSD,
but because law enforcement is as much of a "calling"
as medicine or the clergy (or therapy), it is not
a decision to be taken lightly. And it is never
too late to start.
In closing, the good news for those who suffer
directly from it, and those family members who suffer
indirectly, is that PTSD is very treatable like
most police stress.