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Stress injuries, stigma and early warning signs

This is the first part of a two-part series on stress injuries and their warning signs. Part one focuses on the stigma surrounding stress injuries for law enforcement officers as well as the warning signs and possible indicators of a stress injury or PTSD. Part two will focus on defining what is and is not PTSD, as well as evidence-based treatment for stress injuries.

Law enforcement officers are often exposed to traumatic incidents through their work. In simple terms, an incident is traumatic if it was distressing, especially when the individual had no choice in the experience; if it was unexpected, overwhelming and/or if they felt powerless over the situation and were unable to stop or prevent it from occurring. So, does the very fact that your work requires you to put your life on the line and repeatedly expose yourself to traumatic incidents mean that you will be impacted? Yes and no. You will have some level of post traumatic stress but, this will not necessarily develop into a post traumatic stress injury like PTSD.

Terminology

Terminology is important. When discussing stress injuries, professionals often try avoid the word ‘disorder’. An injury originates outside of you (it happens to you), while a disorder is too often thought of as originating from within you. It is far too easy to take the next step in your thinking and blame yourself for being “weak” or “not strong enough” to handle the repeated exposures to traumatic incidents. This is not correct.

It’s not about character. Post traumatic stress injuries happen to all sorts of people, including those who are strong, capable, driven, motivated and fierce.

Put very simply, a stress injury is a cluster of symptoms that point to a stress response system stuck in overdrive, unable to relax. For example, when a car’s RPMs are too high, the engine will start to break down. In the same way, people with a stress injury are “revving too high”, which often impacts every aspect of their life. Just as you would want to take your car to the mechanic if the engine were revving too high, you need to seek treatment quickly for stress injuries.

“It’s not about character. Post traumatic stress injuries happen to all sorts of people, including those who are strong, capable, driven, motivated and fierce.”

Stress injuries are treatable. Together with a mental health professional who specializes in PTSD, you can figure out where you are “stuck”, take steps to bring stress levels down and allow natural recovery to occur. This is not to suggest that it is simple or that it is not a profoundly painful struggle because neither of those is true. Post traumatic stress injuries can wreak absolute havoc on your life. The point is that the symptoms are treatable and there are also tools you can use to protect yourself.

What to do

The first step is to educate yourself about post traumatic stress and become familiar with some of the early indicators. Pay attention to your body, thinking patterns, emotions and social life. Here are some examples of indicators and what they may look like:

Physical indicators

• You carry a lot of muscle tension, back pain or start grinding your teeth;
• Your sleep patterns are changing significantly—waking frequently, struggling to fall or stay asleep, having disturbing or consistent nightmares, not feeling rested upon waking;
• Your sex drive changes—low libido, hypersexuality or erectile dysfunction;
• Your menstrual cycle changes for no obvious reason;
• You experience significant changes in digestion;
• You experience a marked change in your appetite (overeating or skipping meals).

Mental indicators

• Lose focus on your goals (and get down on yourself for your lack of motivation);
• Imagining things you have been exposed to at work happening to the people you love (i.e. children or spouse);
• Zoning out for hours on end;
• Difficulty with focus, concentration or retention of information;
• Struggling to let things go, endless rumination;
• Begin taking more and more risks (e.g. reckless driving, instigating arguments, abusing substances, unprotected sex with strangers).

Emotional indicators

• Loss of enjoyment in things that used to be fun or pleasurable;
• Easily overwhelmed by routine tasks;
• Begin questioning people’s intentions/words, even those closest to you;
• Feeling separate from your loved ones, like you are on the outside looking in;
• Loss of interest in your appearance, fitness health or wellness;
• More irritable, angry or impatient than you used to be;
• Feeling nervous in new settings and will actively scan for exits, threatening faces or suspicious behaviours;
• Startling easily.

Social indicators

• Withdrawing from social circles—not returning messages, backing out of plans, missing family functions;
• Find yourself increasingly saying “F*@? it – I’m out!!” when friends or potential friends disappoint you (when you would have cut them slack previously);
• Wanting more and more time alone, which can often mean staying up late and compromising on sleep;
• Seeking distractions (e.g. overworking, shopping, pornography, drugs or alcohol).

Drop the idea that self-care is a negotiable. It isn’t. If you want to do this work, you have to be mindful, actively and consistently, and make a concerted effort to take care of your body, mind and spirit. Learn to rest when you need to. Cut yourself slack on at least one of your days off. Follow your body’s lead. Nap if you feel you need it, stretch if you feel stiff, go for a run if you feel want to move, eat peanut butter out of jar with a spoon if you don’t want to cook… just drop the push!

Work to build pressure releases into your life. How you release pressure is up to you and everyone will be different, but here are some ideas to start you thinking:

• Cardio workouts;
• Laughter—a really good, long belly laugh;
• Physical affection with your partner, your children, your pets;
• Saunas;
• Cold water swims or showers, year round;
• Mountain biking;
• Motorcycling.

Find a focus outside of your job where you can work toward mastery. Mastery is about goals, improvement and feeling a sense of accomplishment. It’s not about competition with others. It doesn’t have to be anything profound or time consuming and it certainly doesn’t have to make sense to anyone else. Hit that archery target, rebuild the engine on a collector’s car, bake a cheesecake, bench press 200lbs, learn to tango, play the electric bass, grow the best cherry tomatoes…master something, anything that you love. Then, once you’ve mastered that, try something new and do it all over again.

Lastly—and most importantly—build your social life. Research suggests that this is the most critical protective factor. Focus on your relationships from the most intimate to the most casual. Forget the immaculate house and yard and, instead, spend time with the people in your life. Take your partner on dates. Call your family. Visit a friend you haven’t seen in years. Take the time to chat with neighbours or clerks at your local shops. Bit by bit, all of these interactions weave you into a safety net of social affiliation. Humans need this. We are social animals, not solitary animals. Once you have that safety net of social affiliation, if/when things do go sideways, you’ll feel comforted knowing that people have your back in both small and significant ways.

What you do for a living is honourable and difficult work. You will inevitably be exposed to horrible events and that will take a toll on you, but you can take steps to seek help early and manage the impacts. When things get challenging, always remember: it’s not about character.

Colleen Stevenson is a clinical counsellor based in Victoria, B.C., specializing in the treatment of PTSD. Prior to counselling, she worked as an educator and graphic facilitator and worked in Ghana, Mexico and with Indigenous communities across North America. She was also the trauma counsellor at a maximum-security jail.