This post is going to be intensely personal and somewhat difficult to write, mainly because this is about me. I am not talking about anyone else in this post and everything you read here comes from my own experiences and struggles. I’m taking a bit of a risk with this topic but I feel it is important to discuss openly and has been something which has been at the forefront of many trade journals and reports lately. Because this is such a personal subject and because it is one which carries with it a certain amount of stigma I am going to personally moderate any and all comments associated with this post. While I am all about free and open discussion, even if it differs from my view, this is one time where I will invoke the editor’s privilege and will refuse to publish any comments that are derogatory, attacking or otherwise meant to cause hurt. This I promise you.
I suffer from depression. There, I said it. Or typed it. There are very few people outside of my immediate family that have ever heard me admit this or speak about it. Even though I know that I should not be, there is a bit of me that is embarrassed to admit it. After all, I’m a firefighter. One of America’s Bravest. A hero. Someone who sees the worst situations humans can find themselves in and then just deals with it. Right? Turns out not so much.
When I look back on my life I can point to different periods of time where I felt down or sad or just didn’t really want to be around anyone else. But never did I associate it with depression. These periods began in my early twenties. Many would be surprised to hear me say that because of who I was back then. Fresh out of college, a firefighter, making good money with great benefits for a young single guy. Most thought I had the world by the horns. I acted like it too. I loved life and tried living it to the fullest with sports and friends and girls and bars. I had a great time, made some mistakes, learned some lessons and moved on, but in general everything was all good. There would just be some times when I was really sad or angry and I didn’t know why. A week or more would go by and I wouldn’t return friends calls or I’d hide upstairs in my room when they dropped by my place to see if I was home. I just didn’t want to see anyone. Then, one morning I’d wake up and I’d be fine or I’d finally answer someone’s call and go do something and it would be over for a while. “Oh well,” I’d think, “everyone has ‘down’ times in their life.” I never found any pattern or trigger or anything like that. Then again, I wasn’t looking. These episodes went on in greater or lesser degrees for about 12 years without ever being addressed or really thought about. I just kept shrugging my shoulders and chalking it up to being a “down time.” Then something happened that slapped me in the face.
I had gotten married and my wife and I had had our first child. Not long after daughter #1 was born (seven months to be exact) we found out we were expecting again. We hadn’t been trying to get pregnant but we weren’t exactly trying to prevent it either so while we were a little surprised and a bit apprehensive we were nonetheless overjoyed at welcoming another baby to our little family. Then, while at work one day, I got hurt. At first I thought I had just tweaked something and it would go away by morning or at worst take a couple days to calm down. When I woke up in the middle of the night to go on a call and had difficulty functioning I really got worried. After an ER visit, a CT and an MRI I finally had a diagnoses and was told I was looking at surgery. Our new-born was only about a month old when this happened. Our house was pretty crazy with all the visitors, a 15 month-old, a new-born and a dog running around. My wife and I discussed our options and we basically came to the conclusion that to wait and put off the surgery would only cause further damage and possibly jeopardize my career and that it might actually be easier to do it while daughter #2 was an infant and slept a lot, during the day anyway. So we decided to have it done and next thing I know the anesthesiologist is saying, “Goodnight. See you on the flip-side.”
Surgery was a success and I began the healing process. At first I was ok emotionally. I was at home with my family and my newest daughter. I had some time off work and I had an excuse for not changing poopy diapers or doing any chores around the house. It was great! For the first couple weeks anyway. I distinctly remember one day, sitting on my couch in my living room, and offering to feed the baby for my wife. I figured I could just sit still, cradle her and hold a bottle. That shouldn’t be too tough, right? Wrong. She was wiggly that day and the experiment ended in near-disaster as she just about fell off my lap onto the floor and I was unable to stop her. The milk from the bottle was everywhere, she was crying and I felt terrible. As my wife came to the rescue I broke down crying. My wife tried to comfort me and tell me it was o.k. but all I could sob was, “I can’t even feed my own daughter.” I was consumed with guilt that my wife was being saddled with everything around the house, taking care of the kids and having since returned to work. My parents, both of whom are retired, were at my house every day my wife was at work to help with the kids. I say “help” but that really is a misnomer since I really couldn’t do anything to assist them. I think if we are all honest with ourselves we could all admit that spending that much time with your parents once you are an adult and on your own is not healthy for anyone. So another brick was piled onto my back. I was extremely grateful and appreciative of all the help my folks were giving us but I really just wanted them gone and my house back to myself. I remember having mental struggles with myself and calling myself an a-hole for even feeling that way considering everything they were doing for me. Soon, going to my three times a week physical therapy became the highlight of my existence. A PT mind you, that was brutal. A PT that saw me tear holes in the pleather cover of the exam table with my fingernails, break down into tears on numerous occasions and taught some of the other clients some colorful language they may have not been familiar with before. What can I say? I’m a giver.
I found myself leaving early for my appointments, doing extra reps or just kind of hanging around talking to the staff and other patients and taking the long way home. I wasn’t talking to my wife, I couldn’t play with my oldest daughter and I had nothing to do. I was on different fire service websites and blogs all the time, read the Charleston report about three times and did lots of research and dreaming for drills for when I got back to work. But even that was a double-edged sword. I remember feeling like I was exiled from “the family”. I was still a firefighter, but in name only for that period of time. Anyone who knows me knows that being a firefighter is intertwined with my identity and makes me who I am. I guess that’s not supposed to be healthy either, making your job or anything else that big a part of your identity but I think many of us are programmed that way. I just kept telling myself that it would be ok once I got back to work. I just need to get through this and get back to what I love and I’d be fine. Problem was, that wasn’t going to happen any time soon as I was off work for more than 6 months. During that time I just continued to slide into a deeper and deeper hole. My wife knew something was wrong but hadn’t quite had an epiphany as to what yet. We fought a lot, I was easy to anger, short with the kids and my parents. My friends all thought maybe I had died in surgery or something because, once again, I wouldn’t return calls or texts or e-mails. The guys from the firehouse would check-in every once in a while but I avoided them too. I can’t say everyone forgot about me or that no one cared, because that was not even remotely true. I was just so down and so wrapped up in my dark cloud that I couldn’t see it or care. It was somewhere around this point that my wife first uttered the “D” word. Sort of in an accusatory, “I’m sick of this s**t” kind of way. I blew it, and her, off and just kept telling myself I needed to get back to work. For everyone waiting to hear that I turned to drugs or alcohol, sorry to disappoint you but that luckily never happened. Even though I was on some heavy-duty pain meds I was fortunate enough to not have any issues with them or turn to a bottle. Well, eventually I went back to work and things got better for a while. I was happy to be back and in the community again. I returned with a new vigor for training and an enthusiasm I had not felt in a while. My wife noticed the difference and I think she thought that maybe everything was past us and that being home hurt had just been a proverbial valley in our lives. Anyone familiar with the disease knows that it doesn’t just magically disappear and so it was for me as well.
Thankfully my wife stayed on me and mentioned the big D a few more times. I finally started thinking about it and being honest with myself. I realized I wasn’t myself and I needed to do something about it or I was going to do irreparable damage to my marriage and other relationships. I didn’t have a family doctor (I’m a medic, I just ask the ER doc for a Z-pack) and didn’t really know where to turn so I went to our department doctor. I never got to see him however as the receptionist told me that unless it was work-related they couldn’t see me. I left with my head down and my tail between my legs. I used the “I tried, but…” excuse for a while but in the back of my head I knew I had to do something. I wasn’t feeling myself, I knew my temper was worse and I knew my wife was unhappy. I got a referral for a doc from a friend and gave him a call. A week later and I was in his office telling him everything and looking at him for a miracle cure. He talked to me for quite a while and asked me a bunch of questions (something I later found out is called the DSM-IV exam) and then told me what I pretty much already knew; I had a moderately-severe to severe case of depression. He urged me to find a counselor and prescribed me a medication and told me he wanted me to come in for regular visits for a while to monitor the affect of the meds and make sure I was doing better (i.e. that I wasn’t going to kill myself or anything). I partially took his advice. I made my regular appointments and I filled the prescription and took the meds as I was supposed to, but I didn’t call a counsellor. I was looking for a quick-fix.
As I’ve learned through this process most meds that are prescribed for depression, as well as other psychiatric and emotional issues, take time to enter your system and begin working. This is usually somewhere around 10 days to two weeks. I swear I started feeling the affects within days of beginning my med. Within a couple weeks I was feeling much better. I was much slower to anger, I started looking at things on the brighter side and I was happier overall. My wife noticed too but the real validation came one day when my oldest girl blurted out, “Daddy’s happy again”, and threw her arms around me. I almost cried. I lulled myself into thinking that the meds alone were doing the trick and everything was good. As also happens with many of these meds they seem to wear-off or their affects lessen over time. Within a year or so I was taking them only because it was now my habit to do so. I really didn’t think I was feeling any affects from them anymore and noticed that things slowly started sliding back to where I was before. Then I had another issue that pushed me over the edge.
I started to blog partially to help with the depression. I thought that if I could get my thoughts out there and have an outlet for some of the things that irritate me or things that I feel need to be discussed that it would help. Sort of like journaling, just over the ‘net. I have also always wanted to be some form of writer. I have a couple unfinished books sitting here on my hard drive. But I have no idea how to get a book published and I hear it’s expensive so I thought a free blog-hosting site like WordPress and a cheap domain name registration was the way to go. I was realizing something I had always wanted to do and perhaps receiving some cheap therapy, so to speak, at the same time. And it was very positive for a while. I started to to see some success with the site, hits were up, comments were positive, a couple articles received some attention, there were a couple offers to publish some posts and most flattering of all I was nominated by readers for the “Blog of the Year” contest that Rhett Fleitz and Black Diamond hosted over at The Fire Critic. Never in my wildest imagination did I see anything like that happening for me just because I decided to sit down at my computer and put my thoughts out there. I was extremely pleased. Unfortunately not everyone felt as good about my blog as I did and I soon found myself facing “an issue” regarding my endeavor.
As this issue with my blog unfolded I went emotionally downhill fast. Not the slow sink into depression that I experienced the first time but a hard and fast crash. My mind was constantly racing with “what ifs”, playing scenarios out over and over, having hypothetical conversations in my head with those that were coming after me, not sleeping, not eating, suffering physical effects from the stress and the depression and for the first time in my life I was having thoughts that truly scared me. I never had what I would term an outright suicidal thought, as in “I’m going to cut my wrists, or eat a gun” but I did have thoughts about dying. The most vivid and startling one was while I was driving one evening. The weather wasn’t the best and the roads were slippery and as I made my way along I focused on a very large tree just off the side of the road ahead of me. As I looked at the tree getting closer the thought popped into my head of losing control of the vehicle, colliding with the tree and dying. It wasn’t so much of an inner monologue as it was kind of a quick picture of the event unfolding. The whole time I was thinking to myself, “I’d be o.k. with that. It would certainly be easier.” I never steered the vehicle toward the tree or anything like that. I passed it by and kept going to my destination arriving safe and sound. But that thought and that mental picture of the events scared me enough that when I saw my wife I relayed the events to her and said, “That’s enough of this crap. I’m calling Dr. So-and-so tomorrow and talking to him about changing my meds and I’m calling a counsellor.” My wife was surprised in a good way and very supportive. Within a week I was back in my doctor’s office.
My doctor listened to everything, asked me some more questions and agreed to up the dosage of my medication as a first step in evaluating things. He said if that doesn’t work we’ll look at changing drugs or classes of drugs. He also told me I needed to get someone to talk to and I assured him that I was. I called a counsellor that I had known from the past in a different capacity and he got me in quickly. We caught up on my life in general since we had last known each other and then I filled him in on everything that had taken place from my early 20’s, to getting hurt, to my current situation. It felt good to talk about everything openly and receive feed-back and techniques to assist in dealing with things. I can’t stress enough that if you find yourself identifying with any of this or know someone who sounds like me, meds alone aren’t going to fix the situation. Counseling is an integral part of the total treatment and needs to be taken seriously and openly for it to help.
My “issue” has not been resolved as I write this so there is still a bit of apprehension and anger that resides within me on a day-to-day basis, but I’m doing much better than I was. During the course of events I was questioned and provided truthful and accurate answers to those questions. Once that day of questioning was over I experienced an amazing lessening of stress and agitation. It was incredible. The saying goes that, “the truth will set you free”, and in my case and in this situation it was absolutely so. I had answered everything posed to me honestly and with a clear conscience and had nothing to hide. That feeling that the interrogation was over and I had presented the facts and my side went a very long way in helping my emotional state and my being. Since that day I have improved greatly. It is hard to say if the meds have had a major impact or the counseling or the lifting of the weight of the interrogation. It’s probably a combination of it all, but all I do know for sure is that I feel better and I would certainly not be o.k. with dying any time soon. That in and of itself is enough for me.
So why ramble on about all this? It isn’t so that you feel sorry for me or so that I’ll get a bunch of supportive comments that make me feel better about myself. It’s so that anyone who is reading this and can identify with it or can think of someone who sounds like this can recognize it and hopefully get help. I had intended to provide statistics and scholarly research on firefighters and depression but I couldn’t find any. Most of the research I found dealt with studies that were conducted on survivors and participants in the terrorist attacks of September 11th and Hurricane Katrina. Some other studies I did find were conducted over 20 years ago and didn’t seem relevant since so much has changed with the research and understanding of this disease. So those of you that are stats lovers or just really love to read medical research papers I’m sorry to disappoint. But there has been numerous articles of late in our trade journals regarding firefighter suicide and the depression that may lead to that and our great fire service cartoonist Paul Combs also penned a very poignant cartoon on the subject. It’s something we need to talk about and recognize in our profession.
Now, let me be clear about something. I don’t believe that being a firefighter caused my depression, exactly. I believe that I am a person who suffers from depression and who just happens to be a firefighter. I do think, however, that the things we see and deal with in our line of work can exacerbate a condition someone might already have. I also believe that firefighters have some general personality traits that make them less likely to seek help. We are the ones who help others, not who need to be helped. We are the ones that solve problems, no matter what, and you can’t “fix” something that’s in your head. We are the ones who are strong and un-waivering, not the ones who feel weak and uncertain. Attitudes such as these can prevent us from seeing what is going on with ourselves and looking to get help. Therefore it may take others to recognize the signs and intervene on our behalf. Please, if you think you might suffer from depression or think you know someone who does find a way to let someone know. Find someone you trust and ask for help. It will not get better on its own and it won’t just go away. You cannot just “try harder” to “be a better person.” The list of signs and symptoms of depression below comes from the Mayo Clinic’s website here.
Feelings of sadness or unhappiness
Irritability or frustration, even over small matters
Loss of interest or pleasure in normal activities
Reduced sex drive
Insomnia or excessive sleeping
Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
Slowed thinking, speaking or body movements
Indecisiveness, distractibility and decreased concentration
Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
Trouble thinking, concentrating, making decisions and remembering things
Frequent thoughts of death, dying or suicide
Crying spells for no apparent reason
Unexplained physical problems, such as back pain or headaches
Now I know what some of you are thinking, especially the medics out there. You’re thinking that a lot of those S&S’s are vague or could be chalked up to the regular, every day stress of life. Kind of like everything has nausea and vomiting as a possible indicator. I agree. But you know when something is not right, when you’re just not yourself. I did, I just didn’t know why or what to associate it with. Hopefully, after reading this post, the list of S&S’s and maybe doing some of your own research you can recognize that those symptoms you or someone you know are experiencing may not be every day stress. I have provided some links below that could help you with that research. Please, take the time to look around and be honest with yourself or for you friend or family member.
National Institute of Mental Health
Family Practice Notebook
It is important to note that I do not endorse or have any personal or financial interest in any of the above listed organizations. They are simply starting points for anyone wishing to look further into depression. This post is also not intended to be a singular source for diagnoses or treatment of depression or any other mental or emotional issue. It is simply an attempt to encourage my brothers and sisters to invest in themselves and seek help for themselves or someone else that may be suffering from depression.
I hope that my story will help someone out there. Until next time,