First responders suffer mental fatigue, isolation

LOS ANGELES — Some workers pull a muscle or get carpal tunnel syndrome from their jobs. Cheryl Valentino's work induced a tumor.

Valentino was a social worker in child and family services for 19 years in both Hawaii and California. While the 53-year-old spent nearly two decades helping others – about 3,000 families, she estimated – the work began running her down, causing fatigue, and, eventually, a tumor formed.

"I was so stressed work-wise," Valentino said. "It was taking a toll on my body, and I was in dis-ease, and I got this disease."

Valentino is one of the millions of first responders in the U.S.: people serving on the front lines in the military or as police officers, paramedics, fire fighters and social workers.

Like the leading bird in a V-shaped flock, these first responders find a way to protect themselves from the wear and tear of cutting through harsh winds and weathering turbulence.

Because of this, first responders are susceptible to stress-related and anxiety disorders, such as acute stress disorder, post-traumatic stress disorder and depression.

Society tends to hold first responders to a higher standard than everyone else – after all, they willfully choose their path. The responders often hold themselves against a tougher measure, too.

"You begin to identify yourself as the strong one," said Randall Hagar, director of government relations for the California Psychiatric Association.

When first responders get pigeonholed in this role, any lapse of this strength often becomes unacceptable and unspeakable. And excuses emerge.

It's part of the job.

I signed up for this.

I can handle this.

I'm OK.

"Well, you go through life and you say, ‘I'm OK, I'm OK,'" said Rick Miglia, captain of Monrovia Police Department in LA County. "And it builds up and after a while it's not OK."

Responders' desire to help people can become their own downfall. The constant giving and one-sidedness of the job is naturally draining, some said.

"Sometimes you just get tired of dealing with other people's problems," Miglia said. "You have to raise their kids, you have to separate them with their fights, you have to be all that kind of stuff and sometimes that wears on you. You get tired of it."

Coping with crisis

In a sweep of budget cuts and downsizing, Valentino was one of the more than 60 CFS social workers Contra Costa County laid off in late 2008. Optimistic and somewhat relieved to be out of the exhausting work, she has been visiting career centers and exploring new paths. Valentino took a vocational survey – like an aptitude test – to guide her search.

The results: The "Helping" bar on her personality chart spiked to 96 percent, with "Social" and "Communicative" close behind.

It's perhaps not surprising that a first responder's personality would score this way when her job is to help people.

"All these people, with their family dynamics, with all sorts of issues, and you're over there trying to help all of them – and you're required to," Valentino said. "This (job) is where you go to bust your balls, if you have any."

But even more detrimental is responders' self-negligence: Their habit of helping everyone else leads them to sometimes ignore their own needs.

While drive and passion for their work may carry first responders through a few years or even decades of work, many develop an unhealthy balance of give and take in their off hours. Valentino called the type of work "a bad addiction."

"Addictive personalities – it doesn't have to be substance abuse – tend to be attracted to this work. (They're) addicted to adrenaline (or) addicted to being abused," she said. "You're in crisis mode every time you walk in (to work)."

Instead of asking for help, many first responders find alternative coping methods. Some are positive, such as Miglia channeling his anger at a criminal into dedication to make a better case for court. A healthy lifestyle and ability to leave work at the office are also recommended to protect their bodies and minds.

Other self-help habits, on the other hand, only worsen the symptoms they're supposed to alleviate.

"(First responders) are very good at taking care of other people, and they're really crappy at taking care of themselves," Miglia said. "(Police) are here to go to a scene that's out of control and put it under control.

"When my job is out of control, how can I reach out for help?" he asked, adding, "What I can do is I can go home and drink, or I can go home and isolate from my family."

"They can never understand"

Family is an integral part of the equation. Whether responders withdraw from or lash out at their family, their job and their families are never discrete.

But some first responders try to keep the two from intersecting. In line with the theme of self-negligence, some responders keep mum about what happens at work, whether to spare their family the burden or to avoid reliving an already unpleasant event.

For others, this silence is not by choice, but rather out of their family's unwillingness to listen.

"Imagine being in a relationship where a significant part of the relationship cannot be talked about," said Joel Fay, the president of the West Coast Post-Trauma Retreat in Marin County, Calif.

"If you have something you need to talk about ... you'll find someone else you can talk about it with, and that can lead to divorce and other problems," he said.