(KMSP) - They become firefighters to save lives, but what happens when, in their own minds, all they see is death?
Leaders within the fire community say the number of Minnesota firefighters experiencing PTSD (Post-Traumatic Stress Disorder) is alarming and more education is needed within the fire service to help those who are struggling with the heartache and tragedy seen while responding to calls for help.
Nationwide, it's estimated between 18 to 30 percent of firefighters and paramedics have PTSD. Even at the low end, it's a rate twice that of the general population and on par with military combat veterans.
THE DREAM TURNS INTO A NIGHTMARE
For Brian Cristofono, becoming a full-time St. Paul firefighter and paramedic was the fulfillment of a childhood dream.
An amateur body builder, he even looked the part, like Superman, with a firefighter's helmet. But he discovered the job held its own kind of kryptonite.
"I'd see a lot of kids and those were always the hardest ones," Cristofono said. "I can still have nightmares and sometimes my children's faces replace the victims' faces."
He recalled the case of Amir Coleman, a two-year-old who was killed in an arson fire in 2010. Cristofono was left to comfort his mother.
"When she came to the medic rig, she said, 'Where's my son?' I couldn't tell her. I had to sit in there for a half-hour with her, until someone finally told her," he remembers.
VOLUNTEER FIREFIGHTER STRUGGLES
Scott Geiselhart is a volunteer firefighter in Frazee, a small town three hours northwest of the cities. He knows there's always a chance he will know the victims, personally.
"We had a lot of bad fatalities and they were all back to back. Everything from burn victims, children, ice water rescues," Geiselhart recalled.
One of his calls involved a bartender he knew from the local bar.
One night he had complimented her on a necklace she was wearing.
The next morning when he and his crew responded to a car crash, he recognized that necklace at the scene of the accident. His friend from the bar was dead inside of the wreck.
"Every time I would see a necklace on a girl, It would remind me of that," Geiselhart said.
To deal with emotions tearing him apart, he turned to alcohol, and then, methamphetamine.
"When I went to sleep my kids were falling out of the sky on fire, falling in the water drowning in front of me and I was paralyzed," he said. "I couldn't reach them or the jaws of life were not working and they were in a car burning up and I couldn't get them out and that was every time I closed my eyes."
Geiselhart was relieved when he was diagnosed with PTSD and finally understood why he had become withdrawn and often angry.
"I wasn't crazy, I didn't have a split personality, I had PTSD," he said.
At first, Cristofono found it hard to believe when he was diagnosed.
"That's not me, those are the guys overseas who really fight, it's not me, but it was," he remembered.
SUICIDE ON THE MIND
According to a study from Florida State University, 47 percent of all firefighters have thought about suicide. Those with PTSD are six times more likely to attempt suicide.
Cristofono said he has known three friends and colleagues who have committed suicide. He even put a gun to his head twice, but stopped each time, after thinking about his kids.
Geiselhart went so far as to pull the trigger.
"I couldn't believe I was alive and that gun didn't work," Geiselhart said.
PROFESSIONAL HELP NEEDED
According to Dr. John Sutherland, a licensed psychologist of mental health and addiction care at North Memorial Medical Center in Robbinsdale, most firefighters will have a traumatic event in a lifetime.
Many will have a natural recovery, but it's when the symptoms continue for a month, a PTSD diagnosis can be made.
"There's a hero complex, 'If I get help, I'm not strong enough,'" said Sutherland. "'I'll go into the burning house, they're the ones taking the risks. I may be able to replay it in a different way."'
When individuals don't process a traumatic event it can result in intrusive thoughts of the memory.
"Often there's nothing the person could've done differently, but they play it over and over in their mind and that causes a lot of guilt and shame," he said.
Sutherland said he likes to have his patients talk about their past experiences that are causing the pain.
"When they talk about it they are able to fill in the gaps," he said.
Other treatments for PTSD can include:
Prolonged exposure and cognitive processing therapy - both help in challenging mal-adaptive thoughts which are the underlying cause of PTSD symptoms
Eye movement desensitization and reprocessing (EMDR) - patients focus on hand movements and sounds while talking
RECOVERING FROM THE TRAUMA FATIGUE
Talk therapy and EMDR allowed Geiselhart to cope with his traumas and kick his addictions.
His small volunteer department in Frazee now has regular debriefings after traumatic calls.
"There are more firefighters killing themselves, than dying in the line of duty deaths, that has to change," he said.
Cristofono blames PTSD for a failed marriage and ending his career.
The City of St. Paul denied his disability claim and last month he retired from the St. Paul Fire Department.
"They said unless there was an injury you couldn't have PTSD," he said.
WARNING SIGNS OF PTSD
According to the Mayo Clinic, some warning signs can include:
- recurrent, unwanted distressing memories of an event
- self-destructive behavior like drinking too much or driving too fast
- irritability, angry outbursts or aggressive behavior
- overwhelming guilt or shame
- trouble sleeping or concentrating
- hopelessness about the future
- avoiding places, activities or people that remind you of the traumatic event
Geiselhart said if your loved one becomes unengaged in family life or in his/her hobbies or life passions, it could be a sign they are having trouble with PTSD.
Firefighters who need to talk should call the “Share the Load Support Program” at 1-888-731-FIRE (3473). The line is answered by retired fire fighters who have been trained in peer counseling.
LISTEN TO GEISELHART
Scott Geiselhart will be speaking to Minnesota firefighters at the Delano High School on Wednesday, May 10.
The program is open to the public and is free of charge.
It starts at 6:30 p.m.
The event is hosted by the Montrose and Delano Fire Departments.
RSVP to firstname.lastname@example.org
INVISIBLE DANGERS: CANCER
The Fox 9 Investigators are doing a series of reports on the dangers which face firefighters.
In February, the focus was on cancer.