Rescuers Depression and Clinical vs Hidden Depression

Rescuers Depression

• Men often seek to mask feelings of depression, using things like substances, sex, and gambling.
• Many men prioritize independence which may lead to social isolation.
• This can create a "tough guy" persona which prevents men from being open and vulnerable with others.
• Depression in men is often connected to their desire for independence.
• Men often need to find a healthy balance between independence and maintaining relationships.

Clinical Depression vs Hidden Depression

• Clinical depression is characterized by intense symptoms that impact daily life.
• In contrast, hidden depression is a state of depression often masked through activity, often found in men with an instrumental personality.
• People with clinical depression may avoid activities they previously enjoyed, while those with hidden depression use activity to avoid emotions.
• Clinical depression symptoms include low energy, overeating, sad thoughts, loss of interest, sleeping more, decreased sex drive, increased thoughts of drinking, insomnia, addictive behavior, stopping exercise, avoiding social activities, boredom, anger, crying, and neglecting daily tasks.

Anger as a Sign of Suppression

• When men feel sad or lonely they may choose to feel anger instead.
• Suppressing anger can contribute to outbursts due to its proximity to the surface.
• Anger can be a mask for deeper underlying emotions.
• Sleep disturbances are linked to a greater chance of developing depression or suicidal thoughts.
• Research suggests that sleep deprivation might be a major contributor to depression among firefighters, due to their constant readiness for emergencies.

The Busy First Responder

• First responders often keep themselves busy, even on days off, in order to avoid confronting uncomfortable thoughts and feelings.
• Busy lifestyles can make first responders feel connected, empowered, and needed.
• Their constant busyness can be seen as a badge of honor, and a way to avoid dealing with emotions.
• First responders often find themselves exhausted by the demands of their busy lives.

Addiction and First Responders

• The downtime or retirement of first responders can lead to uncomfortable feelings and thoughts.
• Addiction is a coping mechanism for these uncomfortable feelings, serving as a distraction.
• Addictive behaviors help people cope with the need for comfort, pleasure, stress-relief, connection, and relief from pain.
• Relapse is common if individuals do not develop healthy coping mechanisms for stress.

The Importance of Emotional Vocabulary

• Addiction often stems from a lack of emotional vocabulary and the inability to process emotions in childhood.
• Expanding your emotional vocabulary in adulthood is a crucial step towards connecting with yourself and others.
• Understanding and naming emotions is essential for emotional wellness.
• Communicating feelings to others is vital for emotional well-being.
• Expanding your emotional vocabulary helps identify emotional needs and meet them in a healthy way.
• Learning to recognize different emotions is crucial for addiction recovery.

Feeling Wheel

• The Feelings Wheel can help identify and communicate feelings, especially with family, friends, and colleagues.
• The model includes different categories of emotion that an individual may experience regularly, starting with the key emotion and moving outward.
• By practicing recognizing emotions, individuals can develop a better understanding of their needs and express them effectively.
• Developing a robust emotional vocabulary is key to self-connection and regulation of emotions.
• The emotional vocabulary is a foundation for addiction recovery.

Intellectual Wellness

• Involves staying up-to-date on industry's latest best practices
• Stimulates the mind, reading a variety of literature
• Can be built through attending courses and workshops, learning new languages, earning new certifications, reading, subscribing to interesting podcasts, choosing mentally stimulating hobbies, and learning to appreciate the arts

Social Wellness

• Communicating in healthy ways, connecting intimately within safe relationships
• Creating a support network of friends and family members
• Interacting with your global community positively
• Respecting others and yourself
• Building a sense of belonging in your family and community
• Can be built by investing time in healthy relationships, getting involved in community events and friendships, and communicating thoughts, emotions, and ideas with those around you

Spiritual Wellness

• Assessing your values and priorities and choosing faith, hope, and commitment to a belief system
• Seeking meaning and purpose, questioning, and appreciating the things that cannot be understood
• Looking outside the physical world for answers to existential questions

Rescuers' Depression

• First responders have a boatload of traumatic or potentially traumatic memories to draw from on a daily basis
• Many first responders also have childhood pain
• Secret pain, whether from childhood or adulthood, festers until it becomes darker and darker
• Running from emotional pain will not heal it; it needs light to shine on it
• Avoiding emotion in high-intensity situations is essential for survival at work
• Avoiding emotions off the job, however, can create a pattern of shutting down painful thoughts and memories, making it hard to connect with oneself and with others
• A literature review by E.C.Nielson and others found that many first responders feel they must adhere to society's picture of masculinity, which means self-reliance, strength, and avoidance of emotion
• The same study found that restriction of emotion in both male and female firefighters has been linked to higher rates of PTSD
• First responders are subject to many things that can lead to depression: bad calls, pressures from family and spouses, interdepartmental strife, potentially traumatic events, pediatric death, the death of a coworker, and city politics
• Combine the events first responders see on a daily basis with the childhood trauma or neglect that many first responders grew up with, and you have a whole group of people who are wrestling with psychological injuries that they need to talk about
• Healing means starting to talk about that psychological injury
• In order to start talking about the psychological injury, however, a firefighter must move from the safe, socially accepted confines of his or her hidden rescuer's depression out into the vulnerable, somewhat uncomfortable, and unpredictable state of feeling the pain and loss
• The injury may be from psychological trauma or neglect, either from the deep past or something more recent
• Whatever it is, it must be acknowledged and discussed for healing to begin

Healing from Rescuers' Depression

• The first step for first responders as a whole to break the bonds of rescuer's depression is for all of them to change their language toward emotional wellness
• Joking, making fun of emotions, and talking about people who cannot cut it as first responders, only breed a culture that makes it unsafe for people to talk about their emotions
• Instead of creating a toxic environment, we need to begin creating a safe environment, and that starts with the leaders
• Leaders who share pieces of their story with others create a culture of vulnerability in which people can bond over their humanity, genuinely caring for one another and becoming stronger as a unit together
• People who do not bond over vulnerability often bond over scapegoating, and one person becomes the outsider
• Choosing vulnerability at the top is critical for the wellness of the whole department and the fire service at large
• You can begin to find personal healing by slowing down and allowing yourself to recognize your feelings; opening up with safe family members, your spouse, or friends; and starting to live an emotionally aware, connected life
• This means you allow yourself to rest, restore balance in your life, get healthy sleep, address traumatic memories, and overcome the need to be needed
• Connection is where healing lives

Seven Dimensions of Wellness

• A person's overall well-being is influenced by seven areas: physical, emotional, intellectual, social, spiritual, environmental, and occupational.
• Physical wellness includes adequate sleep, exercise, hydration, nutrition, and avoiding harmful habits like smoking, drug use, and excessive alcohol consumption.
• Emotional wellness involves processing experiences, growing from them, and managing feelings.
• Intellectual wellness emphasizes engaging in creative and stimulating activities to challenge and inspire the mind.

Rescuer's Depression

• First responders often experience rescuer's depression due to the demanding nature of their work.
• First responders may suppress their emotions due to a "hero mentality" and societal expectations.
• This can lead to unhealthy coping mechanisms like substance abuse, pornography use, and isolation.
• Lack of emotional vocabulary from childhood can make it difficult for first responders to communicate their feelings.
• Self-medication with alcohol or drugs is a common attempt to numb emotional pain.
• Sleep disturbances and high levels of cortisol are linked to depression and suicidal ideation in first responders.

Overcoming Addiction

• Overcoming addiction requires building strong social support networks and learning to trust others.
• Therapists, accountability partners, and peer supporters offer crucial support in the recovery process.
• Connecting with other retired first responders provides a sense of community and understanding.
• Trusting others can be challenging for those with adverse childhood experiences, as they may find it easier to trust substances than people.
• Recovery hinges on both self-connection and connection with others.