When people are seriously hurt in horrific car accidents, burned in fires, or injured in violent crimes, first responders rush in to treat injuries and to offer emotional support. But who provides support to the first responders? Repeated exposure to gruesome injuries or loss of life can lead to emotional trauma for these everyday heroes.
It is estimated that 1 in 10 first responders will develop a trauma-related problem. And this puts firefighters, law enforcement personnel, paramedics, and others at increased risk of anxiety, depression, substance abuse, marital conflict, sleep disturbances, trouble concentrating, anger, and suicide. It is estimated that 30% of first responders will develop mental health conditions compared to 20% of the civilian population.
In addition, first responders are more likely to die by suicide than in the line of duty, according to the Ruderman White Paper on Mental Health and Suicide of First Responders. This study reported that in 2017, 140 police officers and 103 firefighters died by suicide compared to 129 police officers and 93 firefighters who died on the job. However, the research suggests that not all suicides are reported, so the numbers could be even higher.
What Brain Imaging Reveals about Suicide
Amen Clinics has done brain imaging studies on more than 300 people, including some first responders, who have attempted to take their own life. Some of the common traits found in these people include past head injuries, exposure to trauma, impulsivity, anger, and negativity.
- Concussions and traumatic brain injuries (TBIs): First responders are at heightened risk of head injuries due to falls, blows to the head, vehicle collisions, exposure to explosions, and more. A 2018 study in JAMA shows that people with a TBI are nearly twice as likely to take their own life compared with those who have no history of head trauma. At Amen Clinics, 40% of the people we see have evidence of past head trauma on SPECT scans even if they don’t recall having experienced a concussion or TBI.
- Exposure to trauma: People who have been exposed to trauma and those who have post-traumatic stress syndrome (PTSD) are at a higher risk of suicide. Brain imaging studies on over 1,000 patients with PTSD demonstrates increased activity in the limbic system (the brain’s emotional center), basal ganglia (the brain’s anxiety center), and anterior cingulate gyrus (the brain’s gear shifter that helps you go from thought to thought) in what looks like a diamond pattern. In 2005, Amen Clinics evaluated and treated 6 police officers who had been involved in on-the-job shootings, developed PTSD and were placed on medical leave. The “diamond pattern” was seen in all of their brain scans.
- Impulsivity: The area of the brain that is involved in impulse control is called the prefrontal cortex (PFC). When there is low blood flow to the PFC, it increases impulsivity. Suicide is considered an impulsive act.
- Anger: Irritability, aggression, and violence—traits associated with suicide—are commonly seen in people who have abnormal activity in the temporal lobes. An Amen Clinics study found that 62% of patients with suicidal thoughts or a past attempt showed abnormal activity in the left temporal lobe.
- Getting stuck on negative thoughts: Some people may fleetingly think that the world would be a better place without them in it. But they quickly move on from that thought. In people who make suicide attempts, they are generally unable to stop these thoughts from looping inside their heads. This is often seen in people who have too much activity in the anterior cingulate gyrus (ACG).
Change Your Brain, Heal Your Mind
The good news is you are not stuck with the brain you have. You can make it better. If you’ve had a head injury and been exposed to trauma, or if you struggle with impulsiveness, anger, or negative thinking, there are numerous therapies that can help you change your brain and heal your mind.
- Healing head trauma: People with head trauma have shown great benefit from therapies called neurofeedback and hyperbaric oxygen therapy (HBOT). In addition, it’s important to have hormone levels tested as they are often low in people with head injuries.
- Soothing trauma and PTSD: The 6 police officers suffering from PTSD underwent a special psychotherapeutic technique called EMDR (eye movement desensitization and reprocessing). All of the officers reported significant improvement and went back to work. Their follow-up scans showed calming of the overactive areas.
- Controlling impulsivity: There are many solutions to improve blood flow to the PFC to boost impulse control. A higher protein, lower carbohydrate diet tends to help, as does physical exercise and certain stimulating supplements, such as green tea, rhodiola, and ginseng.
- Taming anger: To support temporal lobe activity, natural supplements such as GABA, magnesium, theanine, and taurine have been found to be helpful. Neurofeedback also enhances temporal lobe functioning.
- Getting unstuck: Optimizing the ACG involves training the brain to become more flexible and see options and new ideas. The supplements 5-HTP, saffron, and St. John’s wort are the most helpful to calm the ACG. In addition, learning to recognize when you’re getting stuck and distracting yourself is a helpful technique.
Our first responders deserve more support. Helping them understand that “mental health” problems are really “brain health” problems is an important step in ending the stigma associated with seeking treatment. Thinking of these issues as biological rather than psychological may encourage more of these heroes to get the help they need so that heartbreaking suicides may be prevented.
If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
At Amen Clinics, we have treated hundreds of people who have attempted suicide, including first responders, and many more who have considered taking their own life. We use brain SPECT imaging to help identify underlying brain abnormalities that increase the risk of suicide and offer personalized treatment plans to optimize the brain so you can have a healthier outlook on life.
If you or a loved one is experiencing suicidal tendencies and would like more information on how to heal your brain and save a life, call us at 888-288-9834 or schedule a visit online.
Dr. Amen and staff, thank you for all you have done and continue to do. Yes, I agree it is time to “rescue” law enforcement and first responders from suicide. We are excited to have you speak at next year’s PSPSA Conference in San Diego! We are finally putting forth efforts to combat PTSD and police suicide. Your research and work will help the first responders and our families become healthy and address mental health concerns at the earliest point possible if we seek assistance early.
Comment by Lorenzo Glenn — December 14, 2019 @ 9:47 AM
Dr Amen and staff, this information is well received . As a trauma nurse and 20 plus years of ER experience, the front line responders to include doctors and nurses are at the highest risk for PTSD . My question is why do we choose these professions ? What in our childhood directs us to play superhero ?
Comment by Lynne L. — December 22, 2019 @ 9:54 AM
As a 31 year cop, I’ve suffered 7 concussions, 2 TBI from crashes and being run over by a drunk driver. After dealing with years of mandatory rotating shifts and sleep deprivation my wife of 22 years divorced me leaving me with nothing. Now I’m dealing with severe depression and suicidal thoughts trying to fight each day to find a reason not to give up. Yet when I try to explain to the medical experts what’s going on in my head they all look at me like I’m nuts & no one knows how to help.
What do I do?
Comment by Andrew — January 20, 2020 @ 4:12 PM
I was in law enforcement for years and suffered multiple traumas, sudden death of a loved one, ptsd from working the Pulse night club shooting scene and getting sexually assaulted by a trusted colleague who is an FBI agent and still has his job. The retaliation that came down on me when I tried to get help was absolutely horrible and just added to my ptsd symptoms. No one would listen not even when I asked to have my desk in a quite place. The medical profession is lacking when dealing with mass shootings, ptsd and sexual assault victims. The only treatment that has helped me so far has been UCF restores its hard to face your trauma but it worked the best for me so far. I’m struggling with the constant shame and blame and failure of the FBI and law enforcement in general because I couldn’t get anyone to prosecute an FBI agent. They truly protect their own. I wish you good luck and you are not alone.
Comment by Mary — February 6, 2020 @ 4:32 AM