A Thing Called "Hope"

The stigma attached to mental illness is beginning to fade. People understand that our brains can be injured just as easily as our bodies. People are quick to offer support to veterans suffering from physical injuries or PTSD, or both. They are also quick to assume that the service dog by my side means that I am a military vet with a war injury, either physical or PTSD, or both.

I do have a physical injury. And I also have PTSD. But I am not a veteran. I did not serve overseas protecting the borders and ideals of our country. I'm a medically retired police officer. I served here in the US, protecting the streets and homes of our citizens.

Several years into my career as a police officer, I began experiencing depression, nightmares, and mood swings. My level of awareness swung between irrationally heightened and frighteningly numb. I felt threatened when people were too close to me. My work suffered. Where I used to be proactive and busy with traffic stops, encounters, and building checks, over time I became reactive, just taking dispatched calls and rarely initiating anything.  I no longer took overtime shifts, stopped caring how my uniform looked, and used all my sick time. My personal life began unraveling, too. I lost interest in things I'd always enjoyed, gave up on working out, refused to socialize, and rarely left my home except for work. To avoid being labeled "weak" at work, I secretly sought medical help but none of my doctors or therapists associated PTSD with police work so I was diagnosed with depression and prescribed medications that actually made things worse. In desperation, I called our "confidential" Employee Assistance Program. The EAP accused me of exaggerating my symptoms and said they'd have to alert my Chief if I admitted to taking antidepressants.

At a police training course in the mid 1990s, an instructor asked us to complete a "test" on police stress. The officer seated closest to me had attended the police academy with me. After catching site of my score, he leaned over and whispered, jokingly, "You should be dead."  He was joking because it was the 1990s. Cops were supposed to be too tough to have emotional reactions to the things they experienced at work. Off-color jokes, drinking, and, most of all, silence were the only acceptable responses to burned bodies, mayhem, and dead babies. So, I sucked it up, managing to keep it together for most of my shifts and then falling apart at home alone.

Years later, a psychologist told me the development of PTSD is like trying to hold a beach ball under water – you struggle to keep it down and when you inevitably lose your grip, the ball explodes up and practically takes your head off. To maintain my social mask, I'd been struggling to stuff a beach ball full of emotions and memories and symptoms under the surface. I finally lost my grip when a cherished police friend was killed in the line of duty (https://uneflic.blogspot.com/2007/05/lost-friend.html). 

The resulting explosion did almost take my head off.

I felt like I was falling down a hill backwards. I was having flashbacks, avoiding public places, waking up a dozen times a night from violent, terrifying dreams, and isolating for days or weeks at a time. Even though I often felt completely numb inside, I could be sparked to irrational anger or to wallowing anguish for no reason, often in the same hour. I was fearful and hypervigilant. I had to carefully censor what I watched, listened to, and read to avoid being "triggered" to a flood of tears, or to unwanted memories, or to the depths of despair, or into a flashback. I turned into a hybrid of a sloth, a snarling rabid wolf, and Eeyore, the donkey from Winnie the Pooh.

When I did leave my house, I engaged in risky behaviors like driving too fast and tempting fate where a rational person wouldn't. Even my core beliefs began to change. I developed trust issues, felt any betrayal viscerally, and laughed or smiled so infrequently that even strangers commented on it. I began to see people in two categories; they were either a threat or they were blocking my view of a threat. I was angry too often – wrap rage, apple core rage, coffee cup sipping lid rage – and I started filling my sentences with profanities. One of my brothers joked that I needed a DEFCON-type T-shirt to warn friends and relatives about my mood levels.

I finally asked my police supervisors for help, telling them that work stress was getting the better of me. They listened impatiently, and then accused me of shirking my duties and looking for unwarranted time off. Feeling lost and abandoned, I poured my feelings into three essays that were published locally and then nationally. Still, except for a note from a supervisor acknowledging my writings and suggesting I call our EAP, no one reached out to me, not even coworkers who were members of our regional police stress team.

In the midst of struggling with the "depression," I was physically injured on patrol. When my Chief insisted on an involuntary disability retirement, the career I loved was terminated against my will.  I was unceremoniously shoved out of "the brotherhood" where I'd spent my entire adult life. My years of service to my community were not recognized with a party or even an official farewell, just a call telling me I didn't "need to bother" coming to work anymore.

The "depression," coupled with forced retirement at age 37 and the physical pain from injuries that wouldn't heal, swamped me. Because of my career, my past contained nothing but monsters and without my career, my future contained nothing, period. My soul felt empty while my head and heart were overflowing with filthy trash that bubbled up from a brimming cauldron. My super power became a total lack of affect and I shielded everyone from my deepest thoughts. I spent a lot of time seesawing between figuring out how to commit suicide and figuring out how to stop myself from committing suicide.  Many friends suggested that I was "just depressed" and needed to "stop thinking about it" because "people are as happy as they choose to be" and when I didn't "just shake it off", they stopped coming around. Other friends, along with family, watched me withdraw from the world – the woman they'd known for years was disappearing. I let them think it was entirely due to the relentless physical pain. Only my dog knew the truth, and when things were at their worst, I hugged her tightly to me while I sat on the floor with a loaded gun and a 3-minute egg timer, tangling my fingers deep into her fur and letting her lick the tears from my face while I told myself that I could pull the trigger when the egg timer went off if I still felt the need.

"Hope" was no longer in my vocabulary.

A few months after retiring, I was finally diagnosed with PTSD. My police department hadn't been supportive when I was a cop, and even though my now former department was aware of my PTSD diagnosis, I didn't receive any support when I was a civilian either. I used my personal insurance and my personal savings for treatment. I attended week-long residential workshops for First Responders at On-Site Academy (https://onsiteacademy.org/) in Massachusetts – twice – and at The West Coast Post-trauma Retreat (https://www.frsn.org/west-coast-post-trauma-retreat.html) in California.  I spent many hours on the phone with Dr. Bobby Smith (http://www.visionsofcourage.com/). I practically memorized Allen Kates's book CopShock (http://www.copshock.com/). I embraced treatments like EMDR, more medications, more therapy, meditation, and a service dog. Those tools helped me better understand and accommodate the PTSD but I came to realize that unless getting hit by a bus could be considered a cure, PTSD can't be cured – it can only be managed.

But living with PTSD is not the same thing as having a life. It's a battle to maintain real courage under fake danger. And being torn between wanting to enjoy memories and being tormented by them is maddening. Sadly, though, when you stuff down the bad memories, you stuff down the good ones, too. When you dull the emotional pain, you dull the joyful moments, too. So, I become an empty shell of the person I used to be.

In recent years, police PTSD has received more attention and more respect. Officers are receiving mental health care from their departments. Organizations are sending officers on cruises and to retreats so they can bond with other First Responders with similar diagnoses. And PTSD is now being treated as a line-of-duty injury. While it's heartening to witness the positive changes, it's been difficult to be excluded from the benefits that seem to be reserved for the newer generation. Recently, when a Massachusetts officer retired from PTSD with an exclusive pension that generously exceeds the statutory standard, I met with the politician who had spearheaded that special pension exception. He said "ALL cops have some level of PTSD," and since I "didn't have your best friend's brains splashed across your face," my PTSD is not remarkable or worth compensation. I left the meeting in tears, chastising myself for thinking that the State would support me when my Town and police department never had.

A year later, a friend sent me information about a new PTSD treatment developed by Dr. Sean Mulvaney in Annapolis.  

(https://drseanmulvaney.com/stellate-ganglion-block-for-ptsd)  After some reassuring research, I was able to get an appointment and a hotel reservation. I drove 9 hours clutching a credit card to pay for Dr. Mulvaney's Stellate Ganglion Block (SGB) for PTSD procedure.

Dr. Mulvaney's professional, direct, and friendly manner cultivated the trust I needed to allow him to stick a long needle into my neck.  After a short period of rest and a couple of evaluations, I was released. I was too distracted until later to notice that my service dog greeted me very differently when I returned to the car but I would have seen it as a good omen. Within an hour of the procedure, I felt different. It was as though my head had been a noisy, bustling, overcrowded room and suddenly the people left, leaving an open, clear, quiet sensation. I felt lighter - not physically but mentally - the way I used to feel when I finally arrived home and dumped the day's events (as well as my duty belt and bulletproof vest) after a long shift. I even felt spiritually taller because the weight my shoulders had carried for so long was lessened.

There were a few minor side effects that lasted a few hours but the changes were extraordinary and immediate. I caught myself smiling for no reason, which was startling. Although I normally went to bed early to escape the chaos in my head, that night I stayed up until I was physically tired. In the morning, I was shocked that I felt rested and that I hadn't had a single nightmare or been startled wake from a single insignificant noise. As I prepared for the journey home, I had a persistent, strange, elusive feeling I couldn't shake. I finally identified it as a thing called "hope," something I hadn't felt in two decades. That's when I realized that my service dog had been treating me differently since I'd had the procedure. He'd recognized the transformation instantly.

At home, I surprised myself by readily accepting the first social engagement that was offered. Friends said they could hear a difference in my voice. I slept through the night again, and again, and again. I continually smiled without provocation. The clear-headed feeling remained; the chaos in my head had settled, replaced by a quiet composure. I no longer lost my temper over trivial things and the sensation of being constantly emotionally overwhelmed was gone. My dogs were confused, and delighted, when I started singing, even when there was no music playing.

But the procedure did not take away the PTSD. It only quieted it. Whereas most of the symptoms used to strike many times a day, they now only occur once or twice a week, some only once or twice a month. And I am still susceptible to the triggers that used to overwhelm me but now my reactions are muted and they pass when I acknowledge them. It's disconcerting but there's peace in knowing the symptoms won't last and there's power in realizing I can better control my reactions to them.

Continual hope has replaced constant thoughts of suicide. I am rested and more focused because I sleep through the night; the few times my Service Dog has awakened me, I assume he sensed a nightmare but I have no memory of one – a far cry from waking almost every night covered in sweat with tense muscles and clenched teeth, unable to fall back to sleep with the nightmare spinning through my head like a movie reel.  In public, I am situationally aware – like a cop – rather than paranoid and hypervigilant, and when my service dog steps between me and others, instead of feeling relief that I have a safety barrier, I feel relief that now I can actually breathe in the midst of other people.

I'm still figuring out which behaviors are continuing from habit rather than from the PTSD symptoms that linger. And I still have to deal with the daily physical pain from the physical injuries that forced my retirement. Discovering how tangled the PTSD and physical pain were is staggering. In some ways, the PTSD masked the pain by upstaging it but in other ways, it magnified the pain by heaping more stress onto my body. Unfortunately, since the procedure, there have been times when I've longed for the numb emptiness of PTSD that veiled the physical pain.

I have always thought that having some control over the PTSD would make me the person I used to be but now I know that I am no longer who I was and that I will never be what I was going to be. And now that there's space in my head and a desire to move forward, I'm starting to build a new me. It is a struggle to figure out who I am, what I will enjoy, what makes me happy, how I will live, and how I will love.

Prince Harry, the Duke of Sussex who is a military veteran and founder of the Invictus Games once said, "You do not have to be defined by your injury or your disability. You may not realize or appreciate it but do not underestimate the incredible impact you are having on those around you, by simply being yourself."

Having the PTSD under control means I can be myself again, whoever that may be, and I have begun waking up for my life rather than to my life. I, not the PTSD, can dictate how I move through the world.

So, six months after the SGB procedure I am still unraveling the snarled knots that muddled the PTSD and the physical pain, and trying to accept the pain as its own entity. In that endeavor, I have posted a single quote on my normally blank refrigerator door from a quadriplegic man named Chad Hymas, "Let go of the illusion that it could have been any different."

There's something to be gained from living through what Dr. Mulvaney's procedure erased. When I find out what it is, I'll be able to let go of the illusion.

Jill Wragg is a retired police officer in Massachusetts.
She can be reached at JKWragg@yahoo.com

Jill Wragg

Yarmouth Police Department 

Chief Frank Frederickson

Christopher Van Ness

Steven Xiarhos

@yarmouthpolice

http://www.yarmouth.ma.us/