Burned out, drink too much, overweight, slightly depressed, and probably suffering from PTSD

[portland medic]

First post. Looking for a place to vent. Been a paramedic for 11 years in the Portland, Oregon area. Work for a very large national ambulance company who shall go unnamed but whose initials rhyme with lay-en-bar. I loved this job when I started, and loved it for many years. It was magical. Every person I helped, every diabetic woken up with D50, every SVT treated with adenocard, every severe respiratory pt treated with RSI, every CHFer treated with ntg / lasix, every trauma rushed straight to the OR, I glowed. Every time someone thanked me, or told me that they appreciated me, I was happy I chose this profession. It has been one wild ride. I wouldn't trade it for the world.

But everyone knows this job has consequences. Several years ago, I responded to a co-worker who had passed away, and worked the code. I pronounced my friend, FTO, and co-worker dead at the scene. Whilst doing my best, I could not save one of my own. I don't think I have ever recovered from this trauma. That, coupled with holding dead babies, wading in human filth for 11 years, and seeing the general carnage, violence, waste, and human suffering that one witnesses while working as a medic, I think I am reaching the breaking point.

I drink too much, am prone to eating binges, drinking binges, cocaine binges, and sloth binges. Generally, I want to do nothing. Sometimes I think there is nothing wrong with me. Sometimes I start crying for no reason, or start crying when I hear a sad song. Recently, I found myself crying (quite a lot) over the HBO miniseries "The Pacific", about the horrific WW2 campaign against Japan, and all the PTSD that one of the main characters had. I've been diagnosed by mental health people with PTSD before, but hadn't given it much thought, subscrbing to our professions' unfortunate "tough guy" syndrome. But tonight, sitting here remembering 11 years of pain and suffering, I realize that I have been carrying some serious emotional baggage. Tonight has been sort of a wake up call to me, and I am looking for some catharsis. Is there any one out there who is feeling the same way? Am i alone in feeling that this job is slowly eating away at my soul?

[systemet]

But everyone knows this job has consequences. Several years ago, I responded to a co-worker who had passed away, and worked the code. I pronounced my friend, FTO, and co-worker dead at the scene. Whilst doing my best, I could not save one of my own. I don't think I have ever recovered from this trauma.

That would suck. I can't imagine it being easy to put behind you.

That, coupled with holding dead babies, wading in human filth for 11 years, and seeing the general carnage, violence, waste, and human suffering that one witnesses while working as a medic, I think I am reaching the breaking point.

I think you're going to get a range of responses here, not all of them positive. I've been out of EMS for a couple of years, and am now looking at going back. I've had something approaching a 9 to 5 job for a couple of years. I can say that about a year out of EMS, I realised how much I'd endured, and what it was like to be part of the regular world, where you just don't see these things. I got used to sleeping in bed with my wife every night, and having stressful events being things like meetings and presentations.

On the other hand, I've missed the sense of purpose that came with EMS. Knowing that I was helping people, and contributing to my community, and doing something I could be proud of. I also felt like I spent a little too much time just doing my job, and not enough working to improve EMS.

We see a different side of society from the ambulance. I used to argue this point with my wife a lot. That her view of the world (coloured by being a research scientist) was of a bunch of educated people working in a university setting, arguing over who emptied the lunch room dishwasher last. I used to make the point that this set of experiences was very unrepresentative of the world as a whole. I think it's only now I've started to understand that so is the perspective of being a paramedic.

We often see people at their worst, in terrible situations. It's easy to generalise this to the world around you. To think that this is representative. It's not. It's a warped view of society, it's not the truth about who we are as human beings. It seems to me, at least, that we're hard wired to take some responsibility for the events around us. You respond to a child killed by abusive parents, and you feel responsible for that somehow. Like just by being there, you're accountable for the event happening. But this is an illusion. I think it's important to realise that these things are external to you. You didn't make them happen, in fact, you turned up to try and make it better.

As I'm growing older, I'm still learning that we chose to shape our own realities. Most of the things I've failed at in life have been because I've lacked the courage to tackle them, or placed some limitation on myself. I think the same can be true for being a paramedic. If you choose to only look at the negative around you, you can find yourself in a pit of despair, and it can be hard to climb out. You do get to choose what you focus on. If you look at the things you can change, the good you can do, instead of focusing on societal issues, and problems that someone else is responsible for, I think you end up making the choice to be happier and more optimistic.

I drink too much, am prone to eating binges, drinking binges, cocaine binges, and sloth binges.

You might want to stay away from the cocaine and the alcohol. Both are good ways to become an asshole.

Generally, I want to do nothing. Sometimes I think there is nothing wrong with me. Sometimes I start crying for no reason, or start crying when I hear a sad song. Recently, I found myself crying (quite a lot) over the HBO miniseries "The Pacific", about the horrific WW2 campaign against Japan, and all the PTSD that one of the main characters had. I've been diagnosed by mental health people with PTSD before, but hadn't given it much thought, subscrbing to our professions' unfortunate "tough guy" syndrome. But tonight, sitting here remembering 11 years of pain and suffering, I realize that I have been carrying some serious emotional baggage. Tonight has been sort of a wake up call to me, and I am looking for some catharsis.

Honestly, you want advice? Go see a doctor. Get set up with some sort of counselling. Consider taking an antidepressant. Get some exercise. See if you can get some sort of stress leave from work, or take some vacation time. Take up a hobby that has nothing to do with EMS, and just get some distance between yourself and the job for a bit, if it's at all possible.

If you can't make peace with this, then you've got to start making some more positive moves towards changing careers than getting drunk and coked up. Not judging you, but it's pretty obvious neither of those activities are going to help.

Is there any one out there who is feeling the same way? Am i alone in feeling that this job is slowly eating away at my soul?

I think that a lot of people have probably felt that way at some point in time. For me, when EMS has been difficult, it's mostly been factors outside of work that have made it hard. Family, relationships, money problems, lack of time off, etc. When I've found it easier, those things have been taken care of first. And they should be, because they're the priority.

It sounds like you need some help. Don't be too stupid or too stubborn to get it.

[DwayneEMTP]

Man Systemet, I wish that I could give that more than one point...That is probably the post of the year.

As he said Brother, the world hasn't changed, your view of it has.

I saw Garth Brooks in an interview once and they were asking him how he can sing the same songs over and over, year after year. He said something to the effect of, "It got to where I hated it. I didn't want to do the old favorites any more. Then one day it occurred to me that though I've sung them a million times, there are people in the audience that have never heard them before. And most have never heard them live. And that made them new for me too."

If you can't find the love for your patients any more man, then it's time to bounce on out. And I don't believe that there is an ounce of shame in that. We change, we grow, we get lost, and then find ourselves...if we're lucky.

But maybe you can begin again. Start brand new and look at each patient. Instead of just curing their physical ills, listen to their stories, see their faces, find out what poison runs through their spirit and not just through their bodies. And then I think that you'll see that though you've become to feel like nothing, that that is the choice you are making, not the burden that the world has thrust upon you.

The frequent fliers that you hate? Take about half of the people that you love and respect at the hospital and imagine them in the unemployment line should the FF'ers go away.

But you know what? The vast majority of the people you are treating are hearing this song for the first time. You're a big deal. Whether or not you are still seeing them, they are seeing you. They are seeing your face, and hearing your voice, and being changed by the way that you behave...whether you want them to be or not. No way to drink that away.

It sounds like you've put yourself into a corner, and you're going to need to sack up now and make some decisions. Either decide to get the help that you need. (We all need to stop with the whole pussy, "We're too macho for that..." bullshit. If we're really macho then we make the choices that keep us healthy so that we can fulfill our responsibilities, right?)

And/or move on. I refuse to believe that you don't know, what, maybe half of the medics that you work around that don't wish that they were doing something else? We change man...some grow into this, some grow out, most just choose to remain unhappy, impotent shitheads for the rest of their careers. I truly hope better for you.

Good first step though, coming to your brothers and sisters in EMS. There are some wicked cool, smart, kind folks here. Stay and continue to participate. There are many, many that come through here that can benefit from this conversation. They just don't know how to get it started.

Good on you..

Good to have you here..

Dwayne

[WelshMedic]

Portland Medic,

Let me tell you the good news: you have already taken a very big step to you recovery by seeing the problem. Let me explain:

I have been in the same position as you. My "battle stress" almost cost me my marriage, my children and my health. I, too, became very fond of the bottle; had eating binges and was generally a a$$hole to all of those around me that I love and cherish. Mine was also caused by the traumatic death of a colleague followed by 3 child deaths in 3 weeks. I won't dwell on that though, this is your story, not mine.

I finally came to see that I was losing it all. I went to my employer and took sick leave. The next thing I did was go to my doctor, who put me on anti-depressants. All I can say is that although they are great for some, it didn't suit me. I didn't like all the emotions of depression but the pills gave me no emotions at all. My saviour was a psychologist who was specialized in PTSD from the Dutch Military. She really opened my eyes to me behaviour and why I was doing the things I did. Recognition is the first step, that the only way to do it properly.

You have the added complication of an addiction to cocaine (or I assume, at least. Please correct me if I 'm wrong). The thing is, you need to tackle that as a priority. For the simple reason that the addiction is a barrier to solving all the psychological issues you have. Please, for the sake of your own health and of your loved ones, seek professional help. We can and will help you all we can with this here but we are no subsitute to professional help.

Take care and don't hesitate to contact me if you feel I can help or add anything here.

WM

[Bieber]

Hey man, I know System and Dwayne already pretty much nailed this one, but if I can I'll share a few words with you too. I haven't been in this profession for long, and though I have my own woes with the job I haven't yet experienced the kind of hopelessness you're finding yourself in, and I can't even imagine the things you've seen over the span of your career, but I hope at least some of what I say might help.

Like I said, I haven't been in this job for long, but I can see in the eyes of my colleagues and in the stories like yours that this job takes it out of you. Mentally, physically, emotionally. I wish there was a better way for man to cope with this sort of trauma, but the truth is we were never designed to face it head on but to run away from it, and going against our natural instincts strains us. There's nothing weak about it, it would happen to anyone without the right coping mechanisms; and unfortunately we haven't yet embraced proactive implementation of healthy coping mechanisms and continue to hold onto the "sack up" philosophy.

The coke and the alcohol, you've got to get away from that stuff. You already know this, but the temporary relief it gives you from your stress is outweighed by the long-term strain it adds to the stress you've already got from the job. And like Dwayne said, ultimately, it may just be your time to move on. Nothing weak about it, nothing anything about it. People change. The things we once loved fade on us, and things we used to hate we embrace. Either way, I think you've got to get yourself healthy first and foremost. Maybe you just need a break from EMS, or like Dwayne said to change your perspective if you can, but you don't have to fight this battle alone and you shouldn't. Get psychiatric aid if it helps, get drug and alcohol abuse counseling, continue to talk to people who understand what you're going through; folks who've been in this job forever (there's plenty of them on this forum!)

I think, and tell me if I'm wrong, that the foggy lens of the world that we see through EMS has made it difficult for you to see why you got into this to begin with. The world goes from vibrant colors and excitement to this shadowy, black and grey hue when you only see it through the back of an ambulance. Take some time away from work, go experience the world and people when they're at their best as opposed to what we see at work: when they're at their worse.

Above all else, you have to get your mind clear so you can see what's right for you. In this case, being the strongest is making the right decision for YOU. If that's finding new life in EMS, then that's the courageous decision; and if it's recognizing that this chapter of your life is over, and that it's time for you to move onto the next part of your life, then that's the courageous decision too. You don't have to stay in EMS if it's not right for you anymore, and you don't have to leave it either if the right thing is to get yourself clean, physically, mentally, and emotionally, and return to the "next" chapter of your EMS career.

Find what you love about your life and the world, and mold your life around the concept of making your life and world your love.

Edited October 28, 2011 by Bieber

[Kiwiology]

Seen many people in your boat mate, I wish I had the answers, you think I have the answers? If I had the answers I wouldn't be in this shit hole I'd be on some beach somewhere soaking up the rays while getting a blowjob and my private jet refulled.

I've gone off twice to hang myself from things I've seen and/or experienced as a result of the Ambulance Service and I'm still here.

It gets better bro.

[Kaisu]

First of all, thank you for posting. That took courage and honesty. Those two traits will serve you well as you learn to understand and manage your PTSD. I call it that because your symptoms are classic. I have been living with a combat vet for 13 years, as well as my own case of PTSD from my childhood and tho not a mental health professional, I feel qualified to tell you these things. Take what is helpful to you from the following and trash what isn't.

The first thing to understand is that PTSD is NOT a weakness or a character deficiency. It is a normal response to traumatic experiences. As an analogy, if you put enough stress on an arm, no matter how strong the arm, it will break.

PTSD is a wound to the human spirit. Part of the solution is often spiritual.

Trauma changes the way your brain operates. It is a survival mechanism and extremely useful at the time of the events. It allows you to numb your emotions so that you can function. "Normal" people do not calculate drip rates and prioritize transport decisions when faced with brutally injured children. We do. The problem is that we don't know how to process the event after it is over. It stays bottled up and does it's damage.

PTSD is often misdiagnosed and mistreated IF you are dealing with someone who doesn't understand it. People with PTSD often self medicate with alcohol, drugs and even food. It is often accompanied by depression, anxiety, relationship difficulties and isolation.

When you try and open up to people who don't know what you are talking about, you are often met with misunderstanding, indifference and cruelty.

The good news is that while it never goes away, you can learn to understand and manage it. Into every life, bad things come. Once you stop the self destructive behavior (that originally helped you cope but is now hurting you), you become one of the enlightened ones on the earth that helps others in ways that are deeper and more meaningful than any you can imagine.

Get some qualified, professional help. If the person you go to see doesn't help (if you feel worse instead of better after 2 sessions), dump them and find someone else. I personally went to 18 mental health professionals over 15 years before I finally found a good one. She saved my life. (I still call her number 19,)

The most important thing to remember is that you are not alone and you are not crazy or bad. Millions have dealt with this successfully and you can too, and believe it or not, it will make you better.

God bless you my friend.

Love

Kaisu

edited for a dumb mistake

Edited October 28, 2011 by CrapMagnet

[Kiwiology]

Should have mentioned trying Niacin (Vitamin B3) it was originally used by Bill W (founder of AA) to cure alcoholism, has been used to cure depression since the 1940s.

At 3,000mg qd my suicidal depression went away in about a week.

[HERBIE1]

Portland- I feel your pain, brother- I really do.

First and foremost, I need to say this- GET HELP NOW. For the depression, for the bad coping mechanisms, for career issues- all of it. DO NOT WAIT. PLEASE.

I have buried more coworkers and friends than I care to remember due to either direct suicide, or destructive behavior that was essentially the same as a suicide.

Most of us come to a crossroad in our career where we question our desire- or even ability- to continue. Maybe personal issues stack up and couple those with the stressors of the job, it makes for a bad combination. Maybe it's a single overwhelming event- as in your case- that is the clincher. Take a step back, take a leave- or at least a few sick days if you can- and talk to someone. See someone who specializes in PTSD. cCheck if your company has someone, use clergy if you are so inclined, a therapist, your doctor- ANYONE. You will certainly not solve your problems immediately but you will feel better that you are taking a positive step towards getting your life back.

[hatelilpeepees]

Your job is not the problem, it is your depression, everything else is a related symptom. You can change careers 10 times in the next 10 months, it will not change your habits. Go see a counselor immediately.

Once you fix the depression, it might be a good time to add some spice to your career as doing anything for 11 years can get you in a rut. You can think about a new company or location, but it might be a good challenge to accept new challenges at your current place (management, committee work, become an instructor). And if you are doing EMS as a part-time job in addition to your full-time job, STOP IT.