By Lieutenant Robert Hiller, Contributor to In Public Safety
A few years ago, Dr. Tania Glenn visited our Cobb County (Georgia) Fire Department to discuss firefighter resiliency and post-traumatic stress disorder (PTSD). Her class was so inspiring that it motivated me to share my own battle with depression with my fellow firefighters to help end the stigma around mental health.
Up to that point in my career—as is likely typical of many firefighters—I closely guarded my major depressive disorder. I was afraid that my need to take medication to function “normally” might result in command staff prohibiting me from riding on an engine. However, following Dr. Glenn’s presentation, I realized that sharing my story might help other firefighters to seek the treatment they need to deal with their own mental health issues.
In an effort to open the dialogue in the firehouse, I participated in a panel discussion along with a therapist and a peer-support member from our department; I used myself as a case study.
In many ways, the experience was extremely liberating for me. I also realized what an important topic mental health is and how there needs to be much more discussion about it within the fire service. Participating in that panel led me to become a champion for mental resiliency and compelled me to start the conversation about PTSD and mental health issues with other firefighters.
This has been my new passion in the fire service for the past year. However, it hasn’t been an easy journey and it’s required me to come to terms with my mental health challenges and the many red flags I ignored for so long.
Addressing My Own Mental Health Issues
A major contributing factor to addressing my mental health came after an unexpected injury. Everyone who works in the fire service knows (or should know) that their career can take a sideways step in the blink of an eye. Last summer, while adjusting fire hydrants, I blew out my shoulder and needed surgery.
There were complications following the surgery and a recovery time of a few months turned into a year of light duty off the engine and out of the station. While there were some benefits to sleeping at home every night—like actually getting some quality sleep—there were also some major downsides that I wasn’t prepared for.
Suddenly, I was no longer living the station life. On one hand, this meant my stress level decreased remarkably; I wasn’t on edge every third day and I didn’t have to keep my mind compartmentalized, separating my work and personal life every third day either. I wasn’t stressing about the next call that might come in, the paperwork that was due, the reports I had to write, the upcoming training I had to participate in, or the next mechanical issue that might arise on the engine.
While less stress sounds like a refreshing change of pace, it actually had the opposite effect. Without all those things to keep me engaged and focused on a daily basis, I had time to think about and process 23 years of calls, many of which were traumatic.
Remembering all those bad calls began slowly and innocently, so I didn’t really notice them at first. But after about five months of light duty, one morning as I was driving into headquarters, I drove by an area where many years ago I had responded to a bad vehicle accident. As I rounded the curve, I had a vision of the scene as it was when we rolled up to it.
It was just a flash, nothing more, and the vision didn’t stay with me for long, but I couldn’t stop thinking about it the rest of the day. In the weeks that followed, I started having more frequent flashes; every time I drove past a location where I had worked a bad call, I would have such a flash. It got to the point where I started to actively avoid certain roads, but I didn’t see this behavior as a red flag. I thought I was solving the problem.
Soon the flashes were accompanied by more obsessive thoughts. I started actively second-guessing my responses to those incidents. On one occasion, I even reached out to a retired lieutenant who had been with me on that particular call and asked him whether he thought I had made the right decision by pronouncing someone dead on the scene. This change in severity of my mental response should have been a big red flag, but I didn’t think anything about it, and kept rocking on.
Around the same time, about six months into light duty, I started having trouble sleeping. I would go to bed and lie there tired but unable to fall asleep for as long as two hours. Once I fell asleep, I couldn’t stay asleep for more than four or five hours before I had to get up to go to work. This pattern continued for a few weeks and it left me worn out.
As the sleep deprivation continued, I lost interest in my photography hobby. I would rather try to take an afternoon nap than expend the energy it took to get out my camera and go out to shoot pictures. Before I knew it, I was sleeping every chance I could get. I became withdrawn and didn’t want to go out and do anything. On Friday nights, I chose to sit at home alone rather than go out with my wife or friends. I ignored this red flag, too.
When I was alone, I thought about ways to kill myself or ways to die and came up with a plan. Pretty much any time I was alone, I’d think about dying or killing myself. This was a severe red flag, and, fortunately, this is one I didn’t ignore.
Taking the Step to Get Professional Counseling
Luckily, I had a trusted psychiatrist whom I had seen in the past for my issues with depression. I sat with her and explained these recent experiences and feelings. She was very concerned for me. We tried first to get better control of my major depression with changes in my medications. That helped stabilize me with the suicidal thoughts, but the sleeping and visions of emergency scenes continued.
She asked if I would consider seeing a therapist who specialized in PTSD treatment. I almost laughed out loud. I thought, “I teach about PTSD and mental issues—I can’t have PTSD—I would know if I had it.” But she informed me that I checked every box, except substance abuse, on the PTSD checklist. It was a sobering reality. She explained that PTSD can come not just from what I’d seen on those bad calls; it’s how much of it I’ve experienced during my 23-year career.
She also helped me realize that by being off the engine and away from work, life had cracked open a door on my mental health that had been tightly closed by the non-stop activity of station life. That door-opening is something that often happens to firefighters when they retire and have more time to reflect on their career.
Don’t Wait to Get Help
My story of struggling to address my mental health doesn’t have an ending—yet. I began seeing a therapist who specializes in treating PTSD in police, military and firefighters; I’ve only had a few visits so it hasn’t been long enough for me to really say how it’s going.
However, what I can confidently say is that I know I need it; I know I need professional counseling to help me get through these issues and come out healthier on the other end. My hope in sharing my experience is that other firefighters will read this and identify with something that will make them say, “that sounds like me!” or “that’s happened to me!” and trigger recognition of it as a red flag and take action a lot earlier than I did.
I also want all firefighters to know that no matter how strong or resilient they think they are, they must consider the possibility that they’re suffering from stress-related or mental health problems as a result of their career.
Don’t dismiss those red flag situations; don’t think those issues will just go away on their own. They won’t. They may not fully surface until years from now, but they exist and the sooner you address them, the better off you’ll be. Take the initiative to seek professional help to make sure you aren’t jeopardizing your career or worse, your life.
About the Author: Lieutenant Robert Hiller has been with the Cobb County (Georgia) Fire Department for 23 years. During his tenure, he has served on both the HazMat team and The Squad. He studied history and psychology at Georgia State University and fire science at Chattahoochee Tech. Hiller was first introduced to mental health problems in the early 1980s when family members were diagnosed with problems. He has since been dealing with problems of depression and anxiety of his own since the early 1990s. One of his past times is working with his four therapy dogs and taking them to visit special-needs schools, children’s hospitals, and nursing homes. He is currently working on certification for one of his dogs to be a CISM response dog and hopes to be able to assist local departments, if called upon. To contact the author, email IPSauthor@apus.edu. To receive more articles like this in your inbox, please sign up for In Public Safety’s bi-monthly newsletter.