PTSD is an emotional, sensual, psychological and physical disorder. Several or all of these may be displayed through symptoms.

Unless already diagnosed, a person with PTSD usually cannot tell you “I have PTSD”.  It’s not like having a cold or the flu, or a broken leg. The person may or may not remember the traumatic event. They may, in fact, outright deny that they are having any problem, other than the day to day stresses of the job, when in fact they feel inside that they are going crazy. Another difficulty with PTSD is there is generally a period of time that elapses between the trauma and when the behaviors start to show. With acute PTSD this is a much shorter time than with chronic PTSD, which can conceivably be years between the trauma and the fallout.

Listed below are behaviors and symptoms that may be experienced. This list is not all-inclusive, and, again, may be indications of something other than PTSD. If it is PTSD, a person will exhibit more than one symptom from each of the three areas, though you may not see more than one or two.

A word of caution: a few of these behaviors are normal for first responders. It’s when they go from “normal” to the extremes that they become abnormal. If you know the person, you know what’s normal. Watch out for these changes.

Intrusion

  • extreme nightmares
  • extreme paranoia
  • sense of shortened future, impending doom

Avoidance

  • loss of interest in sex
  • depression
  • isolation-especially from loved ones
  • avoiding work: increased absenteeism
  • avoiding certain previously visited locations that were favorites
  • diminished interest in previously interesting activities, sports, people
  • lack of motivation, constantly fatigued
  • loss of Faith in God
  • sleeping too much
  • addictions: alcohol, drugs, sex (repeated affairs, or found with a prostitute)
  • previously active in their work, significant shift to doing little or nothing
  • weak work performance, quality of work drops significantly
  • just plain numbing out
  • stops exercise and previous self-care (poor hygiene)
  • memory loss or poor recall
  • disappears for periods of time from home or work

Arousal

  • problems falling asleep, or problems staying asleep
  • irritability
  • worse than usual problems with Police Management and/or the public
  • more than usual contempt/exasperation with supervision, peers, public
  • increasingly cynical, maybe at most everything
  • sudden outbursts of anger or rage, especially overkill for the situation at hand
  • hypervigilance (paranoia)
  • exaggerated startle response
  • obsessive behavior (what is repressed is obsessed and acted out)
  • compulsive behavior (shame can power compulsion, which can become addiction)
  • overeating: noticeable weight gain
  • anorexia: noticeable weight loss
  • they were previously balanced in their work, or maybe even one of the best, but now it’s insatiable, like a crusade
  • more violence
  • more hyperactive, and maybe now most all the time

Somatic Problems

  • problems urinating
  • frequent headaches
  • chest pains
  • intestinal pain
  • diarrhea, constipation, irritable bowel syndrome, blood in stool
  • frequent, meaning very frequent, belching
  • very high use of antacids

Chances are you will see only a few of these things, not all of what is really going on. Some of these behaviors a person will outright hide, such as the addictions, for obvious reasons. These symptoms are a window to the soul. These symptoms are digressive, meaning over time they will probably get worse if not treated.

PTSD does not go away by itself.