Invisible Injuries
/ Author: Alison Brown
/ Categories: Guide magazine /
3992 Rate this article:
4.5

Invisible Injuries

There’s a growing understanding within the medical community that PTSD is not a disorder. It’s an injury, as real as any physical injury, and it’s time to treat it like one

By Alison Brown, Associate Editor

ON JUNE 14, 2017, Captain Jake Sopiro arrived on the scene of a suicide. He had been waiting for his friend and fellow Local 920 member Logan (name changed) to pick him up for training at the fire station, where they both served as volunteer firefighters, when his pager went off. It was an emergency medical call.

When Jake arrived at the scene, he discovered to his horror that the call was for Logan. His friend and coworker had taken his own life.

The two had worked with each other for 15 years at the Clarence-Rockland fire department and side-by-side for the city of Ottawa’s paramedic service. 

“We were on the same platoon,” Jake says. “I would spend 14 hours a day with him, and we’d see each other outside of work as well. We even carpooled together.”

Unknown to Jake and his fellow Local 920 members, the harrowing scenes Logan had seen over the years as a volunteer firefighter led him to develop severe posttraumatic stress disorder (PTSD). His PTSD ultimately culminated in suicide.

PTSD is much misunderstood and much maligned. Many sufferers do not get the help they need, and it continues to be widely stigmatized.

But that’s beginning to change. New research indicates that the pain associated with traumatic events that trigger PTSD are more akin to a brain injury than a mental disorder. In coming years, the repercussions of this research for how PTSD is understood and treated will be profound.

THE KIND OF TRAUMA JAKE experienced arriving on the scene as a first responder and discovering that the victim was a close friend and colleague led him too to develop PTSD. Although he returned to both his full-time job and volunteer firefighting shortly after the incident, the shock and trauma never left him.

“I began to feel increasingly awkward and uncomfortable when responding to emergencies after that,” Jake says. “The following month, I had to respond to a medical call at a neighbour’s house a couple doors down from me. When I arrived on scene, I found him lying on the floor in his bedroom, and it all came flashing back. The first thought that popped into my head was, please don’t be dead, too.”

It was a different call from Logan’s, and the neighbour ended up being fine, but the scene haunted Jake.

“It was the straw that broke the camel’s back,” he says. “I started experiencing severe symptoms of PTSD—difficulty sleeping, nightmares, panic attacks, claustrophobia, feeling anxious in public. Any sudden movement—the cat jumping up on the counter, someone dropping a dish, my cellphone beeping—can destabilize me and throw me off. 

“My other big trigger is emergency vehicles. I can be out getting groceries, and if a firetruck goes by with its lights flashing and sirens blaring, it’ll set off a panic attack.”

Since July 2017, Jake has been on leave from both his full-time job as a logistics technician with the paramedic service and his volunteer firefighter position. He is unsure when he’ll return. 

He’s made a claim through the Workplace Safety and Insurance Board (WSIB), and although he is now receiving counselling for his PTSD symptoms, it took quite a while for the claim to be processed.

“If I had broken my leg, WSIB would see the X-ray from the hospital and say, ‘Well, obviously you can’t work with a broken leg,’ ” Jake says. “Then they’d approve the claim, no questions asked, and cover any lost wages. But because PTSD is in your head and it’s a mental health issue, it took three months just to get in touch with a psychologist who specializes in trauma.

“Having gone through this, I keep hearing that we need to reduce the stigma around mental health issues and that people need to reach out to get help. But then when you actually do that and admit you have a problem, systems like WSIB will say, ‘Okay, hold on. We need to process this and we’ll get back to you when we can.’ 

“The wait to get help and begin healing is way too long. If I had broken my leg, I’d go to the hospital, get a cast, and my leg would heal in a matter of weeks. But with my PTSD, it’s a guessing game as to what’s going to help me. I’ve been on a couple different medications trying to see what will work.”

Jake has received lots of support from both of his employers. He also routinely stays in touch with other members who responded to the call when Logan passed away.

“We were all close beforehand, and we were all buddies with Logan,” he says. “Everyone has dealt with that traumatic night in their own way. I’m sure some of them are probably experiencing PTSD symptoms like I have, but they haven’t reached out for help yet.”

The key to coping is knowing he’s not alone, and relying on support from his wife and children and fellow Local 920 members. 

“It’s just too much weight to carry on your own shoulders,” Jake says. “At your workplace, everyone works as a team to accomplish a task. If anyone’s hurt and struggling—whether it’s physically or mentally—you have to lean on your team to get through the hard times.” 

THE TRAUMA JAKE AND HIS coworkers experienced did lead to one positive development: the creation of PTSD Awareness Day in Canada.

Jennifer Kennedy, CLAC representative in Ottawa, attended Logan’s funeral and saw first-hand the impact his death had on the Local 920 members she represents and on his community.

“It was hard for these members to go to his funeral and see his wife and daughter grieving, to hear all the stories about him,” she says. “Logan was quite the joker and a positive force to have around.”

Shortly after, she was speaking to some Local 920 Board members about the tragedy, and a steward expressed his desire to create an initiative around PTSD, something similar to breast cancer awareness campaigns. The idea snowballed and CLAC spearheaded a PTSD Awareness Day campaign, to be observed on May 3 in alignment with National First Responders Day on May 1 and Mental Health Week from May 7 to 13. 

“After Logan’s death and in speaking with my members, I knew CLAC needed to do something more to shed light on the reality of PTSD,” Jennifer says. “We have such a large voice, and our hope is that PTSD Awareness Day will catch on with other unions and organizations across Canada. We want to educate people on the signs and symptoms of PTSD, encourage those affected to seek medical attention, and continue to have the conversation to help reduce the stigma.”

Jennifer is used to having these conversations on a regular basis with her members who work as volunteer firefighters.

“Every time we meet as a large group, they’re always sharing their experiences—whether it’s a bad motor vehicle accident, a fire, a medical emergency,” she says. “There’s always these jaw-dropping moments—it’s no wonder they’re affected by what they see and go through every day.

“I definitely think the nature of Logan’s work contributed to his PTSD symptoms,” Jennifer says. “And responding to his tragic death has led to PTSD symptoms in his fellow members. Some of these members, like Jake, are on leave. Some are coping in silence. But I know that for a lot of them, sharing with each other and having a dialogue about what they’re going through has really helped. It doesn’t totally take the pain away, but it helps.”

While Jennifer hears the most incidences of PTSD from first responders, she knows that experiencing symptoms are not limited to that profession.

“PTSD is usually associated with war veterans and emergency personnel,” she says. “But anyone in any profession can experience it. It could happen after a sexual or physical assault, the unexpected death of a loved one, a natural disaster, or an accident. Pain does not discriminate. That’s why we want to educate people on just how far-reaching it is. Trauma can happen to anyone at any time. All it takes is one moment.”

THAT LIFE-CHANGING MOMENT HAPPENED four years ago for Local 66 member Scott McLeod when his big rig hit a patch of ice on a mountain highway in BC.

“I crossed over the median into oncoming traffic,” he says. “I impacted another vehicle. One individual was dead on the scene, and the other had over 60 broken bones.”

Scott came out of the accident physically unhurt but emotionally injured. He was charged under the Motor Vehicle Act, but was not criminally charged. 

“I don’t believe I could’ve done anything differently,” he says. “I can’t control the weather and road conditions. But I was guilty and I will live with that for the rest of my life.”

Scott took four months’ leave from work and received counselling because he was experiencing nightmares, flashbacks, and panic attacks. Getting back behind the wheel wasn’t easy, but it was something he felt he had to do.

“I more or less forced myself to get back to work because I needed to support my family,” he says. “And I didn’t want to develop a fear of driving.”

Three years after that event, Scott witnessed a major vehicle accident that triggered his past trauma.

“I relapsed and started to have the nightmares, flashbacks, and panic attacks again,” he says. “But I kept struggling through the symptoms, denying that I had a problem. Then months later, I had a near-miss behind the wheel of my truck on an icy patch of road. At that point, I threw my hands up in the air and said enough is enough.”

Scott reached out to WorkSafeBC, the province’s workers compensation board, and asked it to reopen his case file and assist him with finding treatment. He spoke with his manager and was able to modify his duties so that he doesn’t have to drive in icy or snowy conditions. Instead of driving up in the mountainous regions of BC, he stays in the Fraser Valley, where the weather is less likely to cause such extremely dangerous driving conditions. 

“The weather is what triggers the worst of my symptoms,” he says. “It can be ten degrees and sunny down here in the Lower Mainland, but up in the mountains, it’ll be minus five degrees and icy. So I modified my duties so that I only have to drive down here and only if the weather’s okay. That removes my triggering cause.”

Like many others struggling with PTSD, talking to others helps Scott get by.

“You talk to a lot of people,” he says. “You reach out to other drivers and people who have been through similar situations. My cousin is a truck driver, and although he hasn’t been through anything fatal, he’s had a serious accident, so I reach out to him and talk it out. And I have a couple of fairly close truck driver friends who let me call them and ramble on when I need to.”

Scott wishes he had gotten help immediately following his accident four years ago.

“If I hadn’t let pride or stubbornness stop me from asking for help right away, I don’t know if I’d be fighting what I’m fighting today,” he says. “I had about three years of a relatively symptom-free life, and then all it took was witnessing another accident and it came back—worse than it was before.”

As a steward, Scott is constantly fielding questions from fellow members and offering advice and support. 

“The one piece of advice I give to others experiencing similar issues is to get professional help,” he says. “Don’t let alcohol or drugs be the help. I know a lot of people who have self-medicated for their inner pain, and while it may take away the pain momentarily, it doesn’t solve it.”

FULLY UNDERSTANDING THE PAIN CAUSED by traumatic events, and the range and complexity of PTSD symptoms, is something the medical and psychology fields are still grappling with. Strides have been taken by the federal government in funding PTSD research, with $30 million recently invested in the Canadian Institute for Public Safety Research at the University of Regina to study its effects on public safety personnel. 

But there’s still much more work to be done. 

There’s a push, driven by the federal department of public safety, to use the term posttraumatic stress injury rather than posttraumatic stress disorder. The rationale for this semantic shift came from consulting public safety officers who said that the term disorder can have a negative connotation and may prevent people from seeking help or treatment. 

“PTSD is not really a disorder, because a disorder implies that there’s something wrong with the brain,” says Dave Phillips, CLAC health and wellness manager. “The brain is working perfectly—it’s just experienced an injury.”

Dave stresses that looking at all mental disorders, especially PTSD, as stemming from mental pain is in its earliest stages but will rock the psychology field in years to come. As a result, the way that this pain is understood, destigmatized, and treated will look completely different.

“If you witness a horrific accident, that’s a trauma to the brain, and the brain is where emotional processes happen,” he says. “The brain doesn’t know the difference between a concussion and witnessing a horrible accident—it just knows that something bad happened, and it doesn’t want it to happen again. And the way the brain prevents anything from happening is by using pain.”

Dave compares experiencing or witnessing a traumatic event to injuring his shoulder. 

“My body and brain are hardwired to prevent me from moving my shoulder because it doesn’t want to be reinjured and it wants to heal,” he says. “So how does my body keep me from moving my shoulder and reinjuring myself? It gives me pain.

“It’s the exact same thing with emotional injuries. The brain can’t experience physical pain, so instead, it gives us anxiety, guilt, shame, depression, addictions. All of those things are very effective in keeping the brain from getting hurt again. Those symptoms are the brain’s attempt to protect you. The brain tries to maintain balance, so when emotional distress and personal pain get too high, the brain finds a way to relieve that pain.”

Dave acknowledges that first responders are especially at risk for developing PTSD.

“It’s a hazard of their profession,” he says. “These people are exposed to death, dying, and horrific scenes all the time.”

Some provinces, such as Ontario, have passed legislation creating a presumption that PTSD diagnosed in first responders is work-related. Under the Supporting Ontario’s First Responders Act, the presumption allows for faster access to WSIB benefits, resources, and timely treatment. 

“This is a step in the right direction, but it’s not enough,” Dave says. “New research is telling us that you don’t even have to experience a big or unusual event to develop PTSD. It can be environmental, especially for people with preexisting conditions like depression or anxiety. If you’re living or working in an environment with lots of bullying and harassment, and it’s causing you distress, years from now, the door will be open for a claim of systemic PTSD.”

Dave stresses the importance of seeking help and getting treated by a counsellor or psychiatrist who knows what they’re doing, even though reaching out isn’t the easiest to do when you’re in pain.

“Having to ask for help can be like an insult to injury,” he says. “You’ve been injured through no fault of your own, and now you have to take the necessary steps to get treated. But you’re not going to regret it.

“You have a right to not be injured at work, and if you are, you should be compensated. That’s black-letter law in Canada, and unions have been fighting those battles for hundreds of years. There’s no real reason why psychological injuries should be any different than physical injuries.” 

 

Posttraumatic Stress Disorder

What Is It?
PTSD is the lasting consequence of traumatic events that cause intense fear, such as sexual or physical assault, serious injury, the unexpected death of a loved one, an accident, war, a natural disaster, and more.

9.2% of Canadians will suffer from PTSD during their lifetime.
According to a study by NCBI, Canada has the highest prevalence of PTSD of the 24 countries that were studied.

How Does It Develop?

PTSD can develop after someone has experienced or witnessed a traumatic or terrifying event.
Families of victims can also develop PTSD.
Trauma can happen to anyone in any profession, but those whose jobs put them in dangerous positions are at greater risk of developing PTSD.

Professions with High Rates of PTSD

Military personnel
Paramedics
Firefighters
Police
Doctors
Nurses

Signs and Symptoms

Flashbacks
Nightmares 
Severe anxiety
Difficulty concentrating
Anger
Depression
Social withdrawal

Sources: ptsdassociation.com, cmha.ca, cbc.ca

Getting Help

Help for Helpers

For emergencies, always call 911 and then contact your family doctor. 
Contact your CLAC representative or steward. 
Get immediate, free, and confidential help through your workplace employee and family assistance program. If you are covered by one of CLAC’s health benefits plans, you can find help on workhealthlife.com.
Through counselling, identify your triggers and prepare appropriate coping strategies. 
Develop a support network. 
Use medication as prescribed. 
Get connected with a Canadian Mental Health Association facility by visiting cmha.ca. 
Find resources, crisis hotlines, support groups, and mental health facilities in your area at ementalhealth.ca.

How You Can Help

If you have a loved one or coworker who is experiencing PTSD, here’s how you can help.

Educate yourself on PTSD and recognize the signs and symptoms.
Some people who experience PTSD may withdraw from friends and family. Don’t force them to talk, but let them know you’re willing to listen when they’re ready.
Ask what you can do to help, but don’t push unwanted advice.
Take care of yourself and your own mental well-being, and seek outside support if you need it.
If your loved one’s symptoms are affecting the whole family, it may be helpful to seek family counselling.

Source: cmha.ca


Beyond Shellshock

Although there’s still more work to be done in understanding the complexities of PTSD, and removing the stigma attached to it, we’ve come a long way from the way it was viewed and treated following the First World War. Shellshock was the blanket term applied to soldiers who broke down under the strain of war, and medical professionals at the time believed the symptoms were the result of physical damage to the brain by the shock of exploding shells.

But military authorities often saw the symptoms as expressions of cowardice or lack of moral character. Doctors diagnosed approximately 10,000 Canadians with shellshock during World War I, and medical treatments ranged from gentle to cruel, from hypnosis to electroshock therapy.

Source: warmuseum.ca 






Previous Article In Memoriam – Alfie Pyle
Next Article How Do You Measure Success?
Print

Name:
Email:
Subject:
Message:
x