An officer develops police PTSD* after experiencing an critical incident. Perhaps
someone shot him (or as always, her), or maybe he had to kill
someone himself. Or perhaps both. Every critical incident has similarities, and every one is different.
And every officer's reaction is individual to them as well.
Some officers go through the process of
integrating the experience into their psyche without difficulty. Usually
this is with the help of others. It is difficult, perhaps not impossible, but difficult to do it
But even if the critical incident stress management
team made every effort to debrief the officer, individual differences may mean
that issues weren't entirely resolved. Or, it often happens that
everyone paid attention
at the time, but their lives are like everyone else, and after a while they
go about their business and while they still cared, the officer and his
family are 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
But sometimes intervention isn't as good or as timely as it should have been
And other times
even the best intervention doesn't work.
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 debriefing. It doesn't always
prevent police PTSD. Nobody really knows why, except that knowing this there's
no excuse for law enforcement not to make 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 see how he's different but it's too
painful to think about it for very long.
Police PTSD can be a nasty condition. Aside from dying of a police
stress related heart attack, police
PTSD is the worst result of police stress sometimes leading to suicide
assault (or even
homicide) or divorce. PTSD 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. On the physiological side, as noted in other articles here, it can
produce anxiety, irritability, depression, insomnia and a host of physical
But interpersonally, there's where the family is effected. Because police 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.
Needless to say, if an officer has turned into a devil-may-care adolescent
or become sullen and melancholy, he is 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: "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 knows 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
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. We know that
the serotonin in the brain receptor system is drastically effected by stress,
hence medications like Prozac, Zoloft, Paxil and the botanical St. John's
Wort**, are often recommended and used very effectively
to help people through
rough times. But sometimes a person needs to stay on these medication indefinitely.
So if the officer was on them after the incident and they seemed to help,
but he stopped using them, 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 police PTSD is generally a combination of psychotherapy
and medication. So 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 and correction officers. Any law enforcement
therapist has seen officers who have developed PTSD after a critical incident
since this is a common occurrence. I wouldn't recommend any drastic life
or career changes to an officer until he (and again, it could be a female
officer too) has had some therapy, and probably some family meetings with
the therapist too. 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
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.
And it is never too late to start.
* The term "Police PTSD" is used to differentiate
from PTSD percipitated by other causes like rape PTSD or combat PTSD;
and also so search engines can more accurately index this page.
PTSD, no matter what the cause, is essentially the same condition.
** Many police officers who object to taking psychotropic medications
are willing to take St. John's Wort because it isn't pereived as medicine, even though it has
the same effect as Prozac in increasing
the availability of serotonin in the brain. See my
article Nature's Prozac