Are You the One in Two?

Neither your bulletproof vest nor your duty weapon can protect you from mental illness. Mental illness knows no age, gender, ethnicity, age, or profession. As a cop, you are as susceptible to mental illness as anyone else. The lifetime prevalence rate for mental illness is nearly 50%. Over one in four has a mental illness in any given year.

May is recognized as "National Mental Health Month." Put down your fitness magazines, turn off "American Idol," clean your gun later, and read this.

Reality Statement

Your chances of having a mental illness, this year and within your lifetime are significantly higher than of having a heart attack. Yet, you get a physical, chest x-ray and EKG annually. You take your prescribed medication for your cholesterol and high blood pressure daily. You change your diet; you exercise more and do whatever else your doctor tells you to decrease your odds of myocardial infarction. What are you doing to prevent and/or treat mental illness? It is time to get rid of the stigma of mental illness in your own head and within your department.

A landmark study (NCS-R) reviewed four diagnostic mental health disorders based on Diagnostic and Statistical Manual of Mental Disorders (DSM) criterion for mood, anxiety, impulse control and substance abuse disorders. The results may surprise you.

The lifetime prevalence for any of these disorders is 46.4%; the annual rate is 26.2%. For the one in four who have a mental illness this year, 40% will have mild symptoms; 37% will have moderate symptoms (including suicidal thoughts or gestures and substance dependence without serious role impairment). The remaining 22% will have serious symptoms (suicide attempt with serious lethality intent, work disability or substantial limitation, substance dependence with serious role impairment, or an impulse control disorder with serious repeated violence).

Mood, Anxiety, Impulse Control and Substance Abuse Disorders
Prevalence and Symptoms

Mood Disorders: Your chances of suffering from a mood disorder sometime in your lifetime are one in five. Annually about 10% of the population has a depressive disorder. A depressed individual often reports a persistent feeling of sadness, hopelessness, and a diminished ability to experience pleasure. Depression can lead to thoughts of suicide. It can affect all aspects of an individual's life: relationships, health, and careers.

Women experience depression about twice as often as men. Hormonal factors may contribute to this increased rate, particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause.

Men are much less likely to admit to depression, and doctors are less likely to suspect it. The suicide rate in men is four times that of women (more women attempt suicide). Men's depression is frequently masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up as irritability, anger, and discouragement. Men are much less likely then women to seek treatment.

Anxiety Disorders: The anxiety disorders included in the NCS-R study were panic, post-traumatic stress, and obsessive-compulsive disorder. Your chance of suffering from one of these disorders sometime in your lifetime is around 30%. Annually, approximately 18% of the population has an anxiety disorder. Additional anxiety disorders include generalized anxiety disorder (GAD), additional anxiety disorders, social phobia, and specific phobias. Although each anxiety disorder has different symptoms, all the symptoms cluster around excessive, irrational fear and dread.

Impulse Control Disorders: Impulse control disorders include oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and intermittent explosive disorder. One in four Americans will suffer from an impulse control disorder within their lifetime. ODD and ADHD are generally classified as childhood and adolescent disorders.

Intermittent explosive disorder is characterized by failure to resist aggressive impulses which result in serious assaults or property destruction. The degree of aggression during an episode is grossly out of proportion to any provocation or situational stress. Symptoms include irritability or rage, increased energy, and racing thoughts during the episode. These episodes are followed by a depressed mood, fatigue, remorse, and embarrassment.

Substance Abuse Disorders: Substance abuse disorders include drug and alcohol abuse and dependence. Yes, LEOs are at risk for alcohol abuse and dependence. So are their family members, friends and partners. If you believe that you or someone you care about has a problem with alcohol, you can take a self-test.

Most cops avoid all illegal drugs, but they may fall victim to prescription drug abuse. After all, it was "prescribed by a doctor." Hurt your back apprehending a suspect, slipped on ice plant, rotator cuff problems, kidney stones? The doc and some good meds will help. However, the medications used are frequently very addictive. According to the National Institute of Drug Abuse (NIDA) over nine million people use prescription medication for non-medical uses.

Mental Illness and Substance Abuse Treatment

The average individual delays seeking mental health treatment for years (six to either years for a mood disorder and nine to 23 years for an anxiety disorder). So you decide to weather it out; "things will get better when [something happens]." Why wait, what are you most afraid of? Early identification and treatment of mental health disorders is paramount. Mental illness and substance abuse are treatable disorders, and with the appropriate treatment the success rate is quite high. Medications, individual/group/family therapy, and support groups (especially in combination) are the treatments of choice. Psychotropic medications can actually help rather than hinder your on-the-job performance in law enforcement. "Any effect on reaction time by antidepressant medication is miniscule compared to the profound impairment of cognition, information processing and survival-oriented decision-making caused by untreated depression" (Force Science News--see link below). If you do not respond to a medication, inform your doctor. It may be the med and he/she can adjust the dosage or change you to a new medication.

Keep in mind; you do have the right to strictly confidential mental health treatment, with a provider of your choice. Consider this before your department mandates a fitness-for-duty psychiatric assessment. You also have the right to receive treatment in the least restrictive environment available.

This is what you can do today. Make an appointment with your primary care physician, ask for a referral to psychiatric specialist through your insurance plan, contact your EAP, call a hotline, find a chat online, go to a forum, or reach out to someone you trust. If you are concerned about someone else, convey your concerns and provide them with some options.

Hotlines

  • Anxiety Hotline: 1-888-826-9438
  • Mental Health Info Source: 1-800-447-4474
  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Depression Hotline: 1-800-248-4344
  • Alcohol and Substance Abuse Referral Hotline: 1-800-662-4357

If you have no symptoms, or your symptoms are mild, you still can benefit from a mental health plan. You probably already have a routine to promote physical health and avoid that heart attack. Mental health month is the perfect time to start.

25 Tips to Improve and Maintain Your Mental Health

  1. Treat yourself well; you deserve it. Value yourself. Work on building your self confidence.
  2. Maintain a healthy work/life balance.
  3. Eat a balanced diet and drink sensibly.
  4. Incorporate exercise into your daily routine.
  5. Learn to deal with stress: develop coping skills.
  6. Learn ways to cope with negative thoughts. Positive thoughts can change the negative.
  7. Identify and deal with moods. Find safe and constructive ways to express your feelings of anger, sadness, joy and fear.
  8. Set priorities. Do what you can as you can.
  9. Set realistic goals, professional and personal.
  10. Plan your day in advance. Don't put off until tomorrow what you can do today.
  11. If you feel overwhelmed, break large tasks into small ones.
  12. Break up the monotony. Alter your routine, try something spontaneous.
  13. Postpone important decisions until you feel mentally healthy.
  14. Make time for family and friends. Surround yourself with good people and stay connected to others. Close relationships are important for good mental health and overall well-being.
  15. Enjoy hobbies. Plan ahead and develop interests that can truly be lifelong.
  16. Daydream. Close your eyes and imagine yourself in a dream location.
  17. Share and enjoy humor.
  18. Keep your brain alive. Learn something new.
  19. Collect and reminisce positive emotional moments.
  20. Quiet your mind. Meditate, pray.
  21. Do something for others: volunteer.
  22. Use your voice. Challenge discrimination and stigma whenever and wherever it happens.
  23. Confide in someone. Reach out to someone you trust.
  24. Allow yourself to give and accept support. Relationships thrive when they are "put to the test."
  25. Get professional help when you need it.

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