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Thursday, April 23, 2009

PTSD and a NY Cop, a life told for a lesson to be learned

I've read a lot of articles on PTSD attempting to lay it all out, but this one is one of the best. Cop Shock was a great book, so I'd expect nothing but a fine job from Kates, but this lays it all out and especially focuses on what I've been calling "secondary stressor" because that's what the experts in the 70's and 80's were calling it. While "delayed onset PTSD" is the term used in this article, I can only imagine it's what's been used for a while but there has been very little written about it even though many are suffering from it. When it hits, it's PTSD on steroids!

A Vietnam vet, oblivious that he had PTSD, got on with his life, masked the pain with smoking pot and felt he "adjusted" but PTSD was simply slumbering within him waiting for the next traumatic event. Several came to his life but it was something as simple as taking a trip to Washington to see the Vietnam Veterans Memorial Wall to awaken the beast. He fell to his knees wondering what just hit him.

A combat veteran, assigned as part of the DEA, had horrific experiences in the drug wars. He too thought he had readjusted well and "got over it" until one of his younger brothers was killed in Operation Iraqi Freedom. He couldn't figure out what the hell happened to him after all he'd been thru already.

Their stories go on and on, just like my husband. He came home from Vietnam with mild PTSD. It was there and he was fully aware there was something wrong with him, but no one could talk him into doing anything about it. After all, he could work, drank a bit, smoked some pot now and then, but problems were not enough to get him to seek help. He had a job and could work so the nightmares and flashbacks were overlooked. He couldn't just bury it because it was too strong but he still managed to avoid facing it. It was not until I miscarried twins that the secondary stressor hit him so hard by that night I had to beg him to come back to the hospital to be with me. He changed that fast.

Now read this article about a cop from NY and understand what the police officers, firefighters and emergency responders face but more, translate it into being deployed into Iraq and Afghanistan over and over again, then maybe you'll know what far too many will be facing when they come home and the "next one" hits them.



PTSD can attack years later
Even with no previous symptoms

by Allen R. Kates, BCECR, MFAW
Author of CopShock, Second Edition: Surviving Posttraumatic Stress Disorder (PTSD)

Editor’s note: Be sure to also read the new PoliceOne Series, “Tips for keeping it together after a bad call”

“I can’t eat, I can’t sleep, I can’t think, I feel sick. I can’t do this anymore.”

Can you develop Posttraumatic Stress Disorder (PTSD) months or even years after a traumatic event like 9/11? Without showing any previous symptoms?

There are studies of Word War II veterans and victims of motor vehicle accidents that say Yes.

This phenomenon is called “delayed onset PTSD,” according to the therapist’s diagnostic bible known as the DSM-IV-TR. It states that symptoms first appear at least six months after the traumatic event. That could mean months or even years later.

Yet some mental health professionals argue that the individual must have had symptoms early on, but didn’t recognize them. They also suggest that the PTSD sufferer delayed getting help for months or years, not that the PTSD itself was delayed.

Nevertheless, many law enforcement officers with no obvious previous symptoms do develop PTSD months or even years after a traumatic event.

As an example of delayed onset PTSD, here is the story of a police officer that developed the disorder five years after 9/11…

On the morning of September 11th, 2001, thirty-one-year old K9 officer Jonathan Figueroa was told to head down to the burning World Trade Center. As his team was crossing the Brooklyn Bridge, his cell phone rang. His wife said that his sister had called, and his brother-in-law, Mario Santoro, an EMT, was already there. She wanted Jonathan to find him and make sure he was okay.

They reached city hall, which was about three blocks from the World Trade Center, and “it was just a cloud of dust. You couldn’t see anything. It looked like a major snow storm, a blizzard,” said Jonathan. They didn’t know that the south tower had already crumbled to the ground.

“Then we heard this large boom. It was earthshaking and metal twisting.” He was listening to the north tower in the process of collapsing.

Jonathan went to the Woolworth Building where triage was underway and asked about his brother-in-law, Mario, but nobody knew anything.

A few days later, he was ordered to work on the pile of rubble that was once a thriving financial district. “My whole motivation for going down there was to see if I could find my brother-in-law.” Though he knew it was unlikely he was still alive.

“I did the bucket brigade for awhile. You get a line of guys digging down, throwing stuff in a bucket, trying to clear debris. We didn’t have enough shovels, and we dug by hand, trying to recover something, somebody.

“On the first day, I found a skull. No flesh, no skin, like right out of a biology science class. I brought it over to a supervisor, and he said, ‘We’re looking for living people right now, put that down.’ And I did.”

A month after 9/11, he still had no word about what had happened to his brother-in-law, and his family assumed that Mario had died in one of the towers. It was difficult to grieve without a body, without knowing, and this weighed heavily on Jonathan’s mind.

Then, two months almost to the day after 9/11, on November 12, 2001, another unthinkable event occurred. At 9:17 AM, a jetliner with 260 people aboard exploded just after takeoff, and bodies and pieces of the plane fell into the Queens neighborhoods of Belle Harbor and Rockaway Beach, part of Long Island, fifteen miles from Manhattan and the pile.

Jonathan was among the first responders to the disaster. “We were recovering the bodies… mothers holding their babies, charred, stuffed in the airplane seats,” he said. “You can’t block that out.”

A few days after the plane crash a friend of his on a midnight phoned him at home and told him they had found his brother-in-law in the wreckage. At least his family had a body, unlike so many other families. Now they could bury him and mourn.

Jonathan continued to work on the pile and didn’t think about what it was doing to him emotionally and psychologically. “You don’t stop to think because if you stop to think, you won’t be able to do it.”

Jonathan knows now that he was suppressing his emotions. “People at work, we’d sit around, we didn’t talk about it. No way. That’s icky. Talking about our feelings, our emotions? You’re a wuss if you do because we’re macho men, we’re police officers, we can handle anything, nothing affects us. You stuff your emotions.”

While Jonathan was at the pile, his frustration built. “We weren’t recovering anything, we felt like we weren’t doing anything. I worked twelve, thirteen, fourteen hours a day. I had to get back to a regular life, you know, pay the bills, have dinner.”

During this time, his sister was staying at his home. “She had lost her husband. I was trying to comfort her, trying to maintain the family. I’m on the pile, I had the plane crash. There’s a lot going on but I was doing it.

“Then we were allowed to adopt a baby boy, but he wasn’t sleeping through the night yet. Here I’m up all these hours working and worrying and he’s not sleeping either. So even if I wanted to get some sleep, I couldn’t. Everything converged at the same time.”

Jonathan worked on the pile from September 11th to December 17th, 2001, 98 hellish days. Then he left the pile and returned to his normal routine at work. He did not attend counseling or peer support.

Five years after 9/11, on January 16th, 2007, he went into work and his sergeant told him that his friend Ronnie, another K9 officer, was hit by a car during his midnight shift and they were going to see him at the hospital.

“You know, I’ve seen many cops bandaged, bruised, beat up, in the hospital. So it was just another day to go see how Ronnie’s doing. We get to the hospital, and he’s on a stretcher. I saw the emotion with his mother and father and wife and I got anxious, and that’s when it bubbled over.”

Jonathan’s wife called and he suddenly worried that maybe one of his babies was sick. She told him that her cousin’s wife was killed in a car accident.

“I started feeling shaky and nervous, and right on that day, I spiraled down, and everything from the past came out: 9/11, the plane crash, my brother-in-law, the first homicide I ever saw as a rookie.”

That began his night sweats, night terrors, anxiety, panic attacks, dry mouth, aches and pains, heart palpitations, nightmares and flashbacks of horrific images—except he became the victim.

“I was that first homicide on the street. I was my brother-in-law underneath the rubble. I was in the plane crash, strapped to a seat holding a charred baby.”

For the next three months, Jonathan couldn’t sleep, had difficulty eating, and lost weight. “And I became obsessive-compulsive about death because it seemed like that’s all I ever saw. Death on TV, death in my job, death in the newspaper.”

Jonathan began taking days off work. He didn’t tell anybody about the turmoil inside him. “Because I didn’t know what the heck was wrong with me. I didn’t think depression or anxiety, no way. I figured it would pass. You know, let me get a good night’s sleep. I was trying to rationalize it all. I didn’t know anything about PTSD.”
go here for the rest of this great article
PTSD can attack years later

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