Authors' note: This is our third and final installment of our series on Another Cop Killer. If you have not yet read them, please refer to Parts 1 and 2 (linked below)
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The first three weeks were like living life in a fuzzy tube, rolling through it under a power he had no control over toward a distant light he could neither focus on nor trust was really even there. The walls of his tube were snapshots from the lives of everyone else around him - his wife, his daughter, the neighbors who waved with uneasy concern when he shuffled out to grab the mail each day - going about the business of living, except with the gauzy, Dali-esque quality of a fever-dream from which he was both frustratingly disconnected and unable to escape.
Thank God for seventeen years of accrued sick time!
As fuzzy as the walls of his tube were, the memories of what he lived and felt and experienced were in sharp relief. His (was it his?) snap decision to pick up the phone and dial 911. Dale shooing off the paramedics and telling them he would give Kurt a ride to the ER tonight and we won't be needing you here and Thank You Very Much Now Beat It! Dale's non-stop chatter as they rode to the hospital, alternating between work gossip and the never-before-revealed story of his own nearly fatal bout of depression six years before. Telling the assessment counselor about The Black and how he had scared himself tonight and how he DID NOT want to die - that IS why he called, after all - and how he loved being a cop and just knew he had lost that forever...
He remembered the assessment counselor telling him her cousin was a cop, and she knew how much The Job meant, and to just trust her. The psychiatrist he chose told him same thing - Just trust me - and his therapist did too. So he started to trust them a little; and the therapy; and the little chemistry experiments the Doc insisted doing on him.
As days turned to weeks, and the shrink seemed more and more satisfied his tinkering had landed on the right mix of chemicals, and the talks with the therapist became less guarded and more open; the tube became less fuzzy and surreal until finally it was no more. The Black dissipated to ever-lighter shades of gray on its way to gone when Dale, in the middle of one of his many visits, asked the question,
- So Kurt, you about done with being crazy for awhile? Cuz we are seriously thinking of fragging your fill-in, man!
- Yeah, Dale, I'm all cleared. Monday it is then...
Months had passed with no return visits from The Black and Kurt was reviewing reports at his desk mid-tour when a young patrol officer, just a few weeks on the shift, tentatively approached.
- Uh, Sarge. Hey, uhhh, is it okay if...? Can I ask you something important?
Kurt looked up, shocked at the thin, quavering voice coming from this usually confident kid. He was alarmed to look into teary, red-rimmed eyes.
- Todd? What is it?
- Um, Sarge. A couple of the other guys said I should probably talk to you. They said you could probably understand and know what to do. Sarge, things just are not going so well for me right now. I really think I need some help...
Fear is one of the primary reasons law enforcement officers fail to seek help when they find themselves in the midst of a clinical depression. Being depressed already takes a person's sense of control and autonomy. Add to it the fear of losing personal and professional face at work, the sense of self and purpose LEOs derive from work, and possibly even their very employment, and it is understandable so many are hesitant to seek help. Fear and uncertainly are byproducts of depression that serve only to deepen it.
We wish we could dismiss the concerns a depressed cop has, to tell the officer No need to worry at all. That fear you have? Completely unfounded! We cannot do that. The simple fact is that seeking help for a mental illness may have significant personal and professional consequences. Each agency has its own unique culture. Each state its own mental health code. Depending on the agency and where it is located, an officer seeking or requiring treatment may face official or unofficial sanctions if the treatment or illness become known. In the worst case scenario, if the depression is so severe it requires locked psychiatric hospitalization for the patient's own safety, it is likely the right to possess or carry a firearm, an essential component of being a cop, will probably be revoked at least temporarily.
Of all the fears, losing the very privilege to be a cop and earn a livelihood in law enforcement is probably the greatest. It is perhaps the one that causes so many cops to try and tough it out, hoping the depression will lift on its own. It is perhaps the one that leads to hundreds of cops taking their own lives each year. Ask yourself what is worse; a most likely temporary disruption of life and career, or death? And remember, locked hospitalization is a worst case treatment scenario and far from the norm for most patients.
Early Intervention vs. Crisis Management
Crisis management of a depressive disorder is obviously not the preferred method of treatment but is often the one people find themselves forced into. By the time depression has become a crisis, personal functioning is often notably diminished, the sufferer is less likely to make good decisions, and the number of viable treatment options are reduced. A very personal issue is likely far more public than anyone realizes or is comfortable with, and the likelihood of long-term consequences increases. Realistically, at this stage the depression and resulting crisis may well be a medical emergency and should be treated as such.
Far better is the option of early intervention by a mental health professional. The patient can be more involved in and better informed about treatment decisions, maintain control of life and work, and choose to let just as many, or as few, people know about what is going on as he or she chooses. The earlier someone with depression chooses intervention, the greater the chance of successful treatment and recovery and getting back to normal life. And early intervention ensures privacy is protected, whereas a crisis may well put someone's personal problems on public display.
When should I find help?
In order to choose early intervention, it is important to recognize some of the common symptoms of depression. Although there are several different types of depressive disorders, and the variety of symptoms are great and experienced differently by different people, below are some of the most commonly used by mental health practitioners When you are experiencing any of the following, and they are affecting your quality of life and functioning, it is time to look for help:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
- Marked irritability and easily frustrated
- Feeling overwhelmed and increased anxiety
- Crying more often
How do I find help?
Finding help is easy! Look on your health insurance list of providers for a psychiatrist or licensed counselor, or ask your primary care physician for a referral. Talk to your pastor or department chaplain. Ask the department social worker or psychologist for a referral, or call your EAP. Maybe just start flipping through the Yellow Pages for a doctor or therapist. Going straight to a professional in the field is the most direct path to help, and each are bound by strict legal and ethical rules of confidentiality as stated in HIPPA laws! As long as you are not actively a danger to yourself or anyone else they and their staff will not - cannot! - tell anyone you have come to them for help, advice, guidance, or treatment. Not your Chief. Not your coworkers. Not their spouse, or even yours if you do not want them to. No one.
But what if they want me to go on pills?
Consider it. Remember, while depression is a mental illness caused by impaired functioning within the brain - typically a chemical disorder - that means it is also a medical problem. If your psychiatrist, a physician, suggests medicine, or your licensed therapist wants you to see a psychiatrist to be evaluated for medication, it is because they think it will help. The medication will not change you it will just help you not to experience extreme lows or extreme highs. When the medication begins to take effect, most begin to report they feel like their old selves. Studies find depression is 90% treatable with talk therapy in conjunction with medication.
There is no shame in being depressed. If you are in a room of 10 people, most likely 4 will be on antidepressants or are in a midst of a depression whether minor or severe. If you are experiencing symptoms as stated above, the earlier you seek treatment, the better. Types of treatment can be as simple as 3 EAP sessions all the way to the most severe of hospitalization, but that is only necessary when someone is an imminent threat of life threatening harm to themselves or someone else. So if this article describes you, please seek the help you need. It is better than suffering through something that can be easily treated.