Paramedics & PTSD: National Suicide Prevention Month

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Okay, so this title is a mouthful isn’t it? Well, suicide is too. One tiny word carries behind it so much; centuries of stigma, a legacy of pain, fear and panic. Prevention is an industry unto itself and yet, people are still dying by their own hand, you’d think we’d have cracked this particular nut by now.

In the past month three police officers in the province of Ontario, have taken their own lives, but they are not alone, each month over 700 people die by suicide in Canada.  It’s a pretty sobering statistic. Every single day, one family is touched by this tragedy and then must struggle to continue on.

I was going to stay silent this month because I have started this post a hundred times over the past few months and always ended up wondering what message it is that I’m trying to convey, now here it is, suicide prevention month and I’m no nearer to clarifying that than I was a month ago, so I think I’m just going to tell you my story.

My husband and I were paramedics. I was diagnosed with PTSD in 2008 after a particularly tragic call at work. I left the field for treatment under workers compensation in 2009. My benefits were terminated in 2012 because they could not force a return to the field and with that went any ability to secure proper ongoing treatment for my PTSD. When left untreated, things don’t get better, they just get ingrained.  Suicide was a common thought for me and I learned to talk about it, so it was not a forbidden topic in our home.  Despite threats by my employer and union, I was unable to return to work and was subsequently let go in 2014. My husband had to sit and watch, helpless, as I suffered and struggled on my own over those years to gain control of my life again. PTSD was the unwelcome guest in our home. My husband helped develop my safety plan. He encouraged me to challenge my limitations. He got trained in suicide intervention…He died by suicide in 2016, two years after I was let go. His biggest fear? That the same thing would happen to him if he got “sick”.  On January 30th, 2016, a physiotherapist told him his x-rays showed an enlarged heart, in his mind, he was “sick” and was going to lose his job. He died from a self inflicted gunshot wound in the early morning hours of January 31st, cold and alone in his car.

In terms of suicidal ideation, life has been particularly hard for me since then. He was the one who taught me to not let go, told me that things get better, while I struggled to convey to him the sheer strength of the compulsion that overtook me at times. That still strikes me even now – and I’m still here, holding on. I guess that’s the message that I want to convey. PTSD is not a life sentence, over time with practice and constant maintenance, you reach your level of New Normal and you begin to accept the changed way you now have to approach your life. If that means, for me, never going back into a certain city again so I have control over my symptoms, then my life is not lacking for it. If it means not attending large public gatherings or working up the courage to be there and leaving earlier than planned, then I’m okay with that. If it means adjusting my approach to life so my stress levels are at a bare minimum, I have to be okay with that because PTSD fundamentally changes who you thought you were.

I think with first responders this is the part that hits us the hardest. We are no longer the take charge people. We are no longer the enforcers, the brave ones, the see-it-all people. We can’t be anymore because seeing it all now wounds us even more and complicates our recovery. If we don’t scale back our duties, we leave the field entirely and for those of us more deeply impacted, we leave the workforce entirely. And these are very tough challenges to have to face to protect our own mental well-being.

But I think what I want to point out to everyone out there is that we don’t have to die. PTSD is going to be the toughest challenge you will ever have to face. It is going to drag you down to depths and whisper the sweetness of peace in your ear. It is going to try to take away from you every ounce of humanity you thought you had. It’ll take your friends, your families, your careers and it will tell you that you are worthless without any of it, but you’re not. The only person that stands between you and death is actually you and it’s your job to stay alive even if, in the moment, that life doesn’t look like it’s worth living.

There are times I live completely from breath to breath because anything further that that is just too much to deal with. On top of my PTSD, I now deal with complicated grief and with complicated grief also comes a severely depressive outlook and thoughts of suicide. I’m not sure if a day goes by where a thought of dying doesn’t come to mind now, fleeting mostly, but some days stronger and when I’m suddenly thrown into an emotional tailspin, even stronger. Heaven forbid I end up in a crisis situation, say I’ve lost some important paperwork or something around my house breaks, yes, on the surface of it, not such a big deal from a normal healthy mind’s perspective but from the perspective of  a PTSD/Complicated Grief mind? Crisis of epic proportions. In these moments the thoughts of suicide can grow in strength to near compulsion and it’s all I can do to keep myself still and not make a move for fear I’ll end up trying to die. In those moments a war is waging in my mind and there is no one to fight it but me.

And some days, I am soooooo tired of fighting.

My husband didn’t understand this on those days when I was glued to our bed, crying, gripping the sheets with white knuckles, screaming, “No more! Can’t do this anymore!” It wasn’t about him, it was about me, mentally and physically exhausted, lost in thoughts of worthlessness and hopelessness and not being able to see life as anything but painful and stacked against me. Some part of my brain knew it wasn’t true and it was fighting against other parts of my brain that wanted to die. And the compulsion was so strong it was all I could do to hold on.

You see, that’s what suicide comes down too, it’s a fight with your own mind and you are supposed to come out victorious, whether there’s snot on your face or dirt in your mouth, the Job you now have is to overcome those moments when your own brain defies you. Because when you have a mental health issue, be it depression, ptsd, ocd or any number of other labels, it can happen so fast and hit you so hard, you can be dead before you realize what’s happening.

This is why we need to be vigilant with our mental health as first responders (and former first responders). This is why we need to be internally aware, so we can catch when things are going south on us and work to correct it.  Be aware of your thinking patterns, stop and do an inventory every once in a while, if the things you write out are highly negative and bleak, then it’s time to start targeting those thoughts…and I don’t mean replace them with sunshine and rainbows or put on rose coloured glasses, I mean, change things just a bit to add a hint of hope. The words, “it is possible that” can bring about a lot of change in your internal wiring.

Get some sleep. A sleep deprived brain is not a healthy functioning brain. A sleep deprived brain will not have the same fortitude it would on a well rested day and so, you will experience more intrusion in your day. You will be more susceptible to emotional upheaval when your brain is not properly rested. Make sleep a priority.

Know that with PTSD and other mental health issues, your brain is now wired differently and is more susceptible to emotional reactivity and with emotional reactivity comes an inability to access reason. The one thing that truly defies reason is suicide and if we are unable to access our reasoning areas in the brain due to a pathway malfunction, in a crisis, it makes suicidal thoughts and compulsiveness more intense. If you need to, write it down on a paper and stick it to your fridge or your mirror to remind yourself every day that it is just your brain malfunctioning for the moment, you will eventually be able to think properly again and not want to die. It is just your brain trying to defeat you. With time and practice, you will eventually get the upper hand on those disturbances.

Oh and ask for help. I know, everyone says it and it’s the hardest thing to do when you’re not actually okay but when you’re in a place where you feel even just slightly okay, take that opportunity to reach out and say to someone, “You know, sometimes I’m not okay.” There are things like EAP, support groups, help lines and other organizations out there that can get you pointed in the right direction.

Last but not least, just breathe okay? If you feel like you’re in hell, well, I’m right there with you and I’m going to be cheering you on, reminding you to just take another breath, just stay still, cry it out, scream it out, beat the crap out of a punching bag until you fall to the ground crying but just don’t die, okay?

It doesn’t have to take us. I’m still here. I’m still breathing. I’ve been through absolute shit but I can still smile and laugh. And I can still get snuggles from my doggy. And it may not seem like much in the grander scope of life, but I’m grateful for that. My life doesn’t look like much from the outside looking in, and boy, people do like to judge, but it’s truly enough for me to handle and if I can do this, so can you.

In Solidarity.

*Post dedicated to the memories of Det-Insp. Paul Horne, Sgt. Sylvain Routhier and Cst. Joshua De Bock, of the Ontario Provincial Police*

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Remembering

It’s been a year now, buddy. For me, there are still those days where I think, “maybe, if we’d just had that visit; if you’d gotten to visit with him like you’d wanted too…” Guilt is so common after suicide. Everyone will find an ounce of guilt to torment themselves with, it is engraved along this path of grief that we walk.

This weekend was likely an emotionally difficult one for a certain family. I send them all hugs and strength, hoping they remember the joyful times – and that facetious look he’d get in his eye when he was scheming up another practical joke.

A friend recently gifted me a wonderful little book called The Wilderness Of Suicide Grief by Alan D. Wolfelt. I am going to outline his “Suicide Survivors Bill of Rights” for you:

1. I have the right to experience my own unique grief.”

Each of us has our own grief, there is no right way to grieve.

2. I have the right to talk about my grief.

Please don’t ever let people silence or shun you when you tell your grief story. Talk it out as much as you need to.

3. I have the right to feel a multitude of emotions.

A multitude is right, it is such a rollercoaster but it is your rollercoaster and you must feel your way along.

4. I have the right to work through any feelings of guilt and relinquish responsibility.”

Way easier said than done but your grief is a process that you must traverse.

5. I have the right to know what can be known about what happened.”

There will be endless and repeated questioning, but you have a right to the known facts.

6. I have a right to embrace the mystery.

Life and death are mysterious, death far more so and it’s okay to accept that which we cannot know.

7. I have the right to embrace my spirituality.

Death and spiritual beliefs go hand in hand, if you need to explore that in your own way, no one can say you’re wrong. It’s your journey.

8. I have the right to treasure my memories.”

It’s not uncommon for it to be hard to connect to happier memories at first but they do come back. Don’t let the death overshadow those joyful memories.

9. I have the right to hope.

Having hope for your own future and life without your loved one doesn’t mean you love them or miss them less. You are still alive and you can still live.

10. I have the right to move toward my grief and heal.

As we walk our grief path, we don’t suddenly one day come across a flashing sign that says, “Congratulations, you’ve reached the end.” That’s not how grief works. Eventually we hope to integrate the loss into our story and accept how it has changed us and continues to shape us. Don’t let people try to push you to “get over it”, find people who will allow and accept your ongoing grief and how it has changed you.

Because it does. Suicide changes us, fundamentally so.

I’ve been thinking a lot about you and your family lately, going through a lot of my own grief and pain once again. But you know what?

Sometimes I picture the two of you, sitting in that big truck in the sky, telling jokes and waiting for calls that never come. Forever Young.

PRPS 40839 & 36378

(Thanks to my friend Sam and I’m hoping Dr. Wolfelt won’t mind me sharing his insights.)

– Wolfelt, Alan D., 2010. “The Wilderness of Suicide Grief; Finding Your Way.” Companion Press. Fort Collins, Colorado.

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