Here is some valuable information providing a differentiation of services available to Firefighters. Is there a difference between counseling and therapy? Is a Psychologist the same as a psychiatrist? How do I know which on I need? What can I expect? FireStrong provides the answers to your questions… here.
What is Counseling?
Each therapist is different, but they all are trained to help you with your issue. Look up different therapists using your insurance to ensure they are a licensed therapist. In order to find the right therapist for you read reviews online.
The initial thought of therapy can be intimidating, especially for those who have never really been into talking about their “feelings.” Finding a therapist that you mesh well with is a major key to success in getting the help you need. While searching for a therapist it is important to have a conversation with them beforehand. A phone call can help you determine if they are able to help you with your personal issues. If the conversation is awkward or does not feel natural at all, then that therapist might not be the best fit. It is completely normal for people to contact a couple of different therapists before picking the best one for them!
Therapy sessions are all about making sure you are comfortable with sharing your thoughts and feelings in a safe, protected, and relaxed environment. The ultimate goal of a therapy session is to have you leaving feeling more at ease every time prior to your previous session. While you won’t be lying down on a couch like you often see in commercials, you can often expect to be sitting on a comfy couch in a warm and inviting room.
What to expect when going to see a therapist:
Each therapist has a unique style, and a large part of therapy is the rapport between you and the therapist. If you don’t feel you can achieve this with the counselor you are seeing, you can always try out a new one. Most therapy can help and start to improve your life in less than 10 sessions (you have 30 sessions to work with!) The process of talking to a stranger about our issues/problems is foreign to many of us, but once you reach your comfort zone and start express yourself you can feel the weight of anxiety being lifted off your shoulders!
One therapy session won’t cure all of your problems overnight. Often in life we have to remind ourselves that good things take time! When first starting therapy, it is okay to feel lost or not even realize what some of your issues are. Once you start opening up about your hardships in life it will be easier to connect with your therapist and pin-point some events that might have triggered some personal issues. Sit back and be patient with this new experience.
3 Common Types of Talk Therapy:
•A therapist will help you change harmful ways of thinking. If you tend to see things negatively, it teaches you how to look at the world more clearly.
•Example: You drop by to see a friend, but he says he doesn’t have time to talk. Your first thought is that he’s angry with you. This makes you feel worried and anxious. Soon you are trapped in a flood of negative thinking.
•Cognitive therapy can help you focus on your reaction to your friend’s behavior. Perhaps what he said has nothing to do with you. Maybe he was having a bad day. Perhaps he was late for an appointment. Thinking of other reasons for his actions help you see the event in a more positive and accurate way.
•Helps you learn to relate better with others. You’ll focus on how to express your feelings, and how to develop better people skills. Might be helpful with strengthening relationships.
•Example: You and your wife are not getting along. The fighting seems to be getting worse, but you can’t break the cycle.
•Interpersonal Talk therapy can help you see your wife’s point of view and vice versa. Perhaps she feels you don’t spend time with her anymore. Finding new ways of talking to your wife may help you both feel better.
•Remember that talk therapy doesn’t have to be difficult. The simple act of discussing your feelings allows you to gain new insight and perspective. Talk therapy can also help to enrich your life by bringing the people that you love closer to you.
•Helps you change harmful ways of acting. The goal is to get control over behavior that is causing problems for you.
•Example: You were on a pediatric drowning, and now you are terrified of taking your family to the pool. This paranoia starts to affect your family life.
•Behavioral Talk therapy can help you to face your fears. Discussing your problems with a trusted person can help you to begin to overcome those fears and take control of your life.
What is the difference between a Counselor, a Therapist, Psychologist, and Psychiatrist?
A counselor is a person who is a master level licensed clinician who has completed a counseling focused program. They are trained to assess, diagnose, and treat numerous issues that people face. They cannot prescribe medication, however they work closey with physicians who can.
A Therapist is a person who has a Master’s or doctoral level degree in a counseling field and a license from a Board of Behavioral Health. Both the degree and license take years to achieve, so rest assure that the person should experience in talk therapy. They can’t prescribe medications, however they work closely with physicians who can.
A Psychologist is a person who has their Ph.D. in a counseling related field. Psychologists have more training and schooling than a therapist. They provide counseling, support, perform psychological tests. Psychologists cannot prescribe medication but work closely with psychiatrists and physicians if prescribed medication becomes necessary.
Psychiatrists are physicians who had to do a residency in the area they specialized, ie child psychology, neuropsychology. They can prescribe medication (prozac, ativan). Some provide talk therapy. Some will prescribe and provide both.
Secret Signs of Hidden Depression
People who suffer from secret or concealed depression usually do not want to acknowledge how serious their feelings are. They often put on a “happy face” for others so they do not feel judged. Click HERE to find out what the six signs of concealed depression are.
Depression is a mood disorder that causes a constant feeling of sadness, hopelessness, anger, and loss of interest in everyday life for a long period of time. The exact cause of depression is unknown, however, many researchers believe that depression is caused by chemical imbalances in the brain. Norepinephrine, seratonin and dopamine are neurotransmitters (chemical messengers that transmit electrical signals between brain cells) thought to be involved with major depression. It is believed that there is an increased risk for developing depression if there is a family history of the illness. However, people who do not have a family history of depression can still develop this mood disorder.
About 19 million Americans battle depression annually. Depression is estimated to contribute to half of all suicides. About 5%-10% of women and 2%-5% of men will experience at least one major depressive episode during their adult life. Depression affects people of all races, incomes, ages, and ethnic and religious backgrounds, but it is three to five times more common in the elderly than in young people.
“Some types of depression seem to run in families”
Causes, incidence, and risk factors:
Certain personality traits such as low self-esteem, physical or sexual abuse, financial issues, and the death of a loved one can often times trigger depression in some people. While it has long been believed that depression caused people to misuse alcohol and drugs in an attempt to make themselves feel better (self-medication), it is now thought that substance abuse can actually cause depression. Some illnesses such as heart disease, cancer, and certain medications may also trigger depressive episodes. It is also important to note that many depressive episodes occur spontaneously and are not triggered by a life crisis, physical illness or other risks.
There is no single cause of major depression. Psychological, biological and environmental factors may all contribute to its development. Whatever the specific causes of depression, scientific research has firmly established that major depression is a biological, medical illness.
A number of factors can play a role in depression:
- Life events or situations, such as: Breaking up with a significant other, illness or death in the family, or parents divorcing (for adolescents)
- Repetitive traumatic calls
- Childhood events, such as abuse or neglect
- Divorce, death of a friend or relative, or loss of a job (for adults)
- Social isolation (common in the elderly)
- Medical conditions such as hypothyroidism (underactive thyroid), medications (such as sedatives and high blood pressure medications), cancer, major illness, or prolonged pain
- Sleeping problems, Sleep deprivation
- Alcohol or drug abuse
- Agitation, restlessness, and irritability
- Dramatic change in appetite, often with weight gain or loss
- Extreme difficulty concentrating
- Fatigue and lack of energy
- Feelings of hopelessness and helplessness
- Feelings of worthlessness, self-hate, and inappropriate guilt
- Inactivity and withdrawal from usual activities, a loss of interest or pleasure in activities that were once enjoyed (such as sex)
- Thoughts of death or suicide
- Trouble sleeping or excessive sleeping
- Depression can appear as anger and discouragement, rather than as feelings of hopelessness and helplessness. Use of alcohol or illegal substances may be more likely to occur.
- Even Medicines that you take for other problems could cause or worsen depression, check with your doctor.
- Medicines that you take for other problems could cause or worsen depression. You may need to change them. DO NOT change or stop taking any of your medications without consulting your doctor.
- People who are so severely depressed that they are unable to function, or who are suicidal and cannot be safely cared for in the community may need to be treated in a psychiatric hospital.
- Most people benefit from antidepressant drug therapy, along with psychotherapy. As treatment takes effect, negative thinking diminishes. It takes time to feel better, but there are usually day-to-day improvements.
- Antidepressant medications work by increasing the availability of neurotransmitters or by changing the sensitivity of the receptors for these chemical messengers.
- Take medications correctly and learn how to manage side effects.
- Learn to watch for early signs that depression is becoming worse and know how to react when it does.
- Try to exercise more, seek out other activities that bring you pleasure, and maintain good sleep habits.
- Avoid alcohol and illegal drugs. These substances can make the depression worse over time, and may also impair your judgment about suicide.
- When struggling with your depression, talk to someone you trust about how you are feeling. Try to be around people who are caring and positive.
- Try volunteering or getting involved in group activities.
“therapy teaches depressed people ways of fighting negative thoughts”
Types of help (See also Types of Counseling)
- Cognitive behavioral therapy teaches depressed people ways of fighting negative thoughts. People can learn to be more aware of their symptoms, learn what seems to make depression worse, and learn problem-solving skills.
- Psychotherapy can help someone with depression understand the issues that may be behind their behaviors, thoughts, and feelings.
- Joining a support group of people who are experiencing problems like yours can also help. Ask your therapist or doctor for a recommendation.
You can take a personal assessment here.
What is resiliency?
One of the most important aspects of a firefighter’s life and mental health is resiliency. Resilience is often defined as one’s ability to bounce back from setbacks and to properly adapt to stressful situations. Resiliency is so important to us all because no one is immune to stress whether it’s daily irritants or major life-altering events.
Building resilience takes time. In order to help improve resiliency make sure to get enough sleep, exercise, and practice on thought awareness. Being more optimistic and seeing the glass half full in the long run will help change the way you think about negative or stressful events. If we improve the health and happiness in our individuals and workforce as a whole, then we will produce a higher performance overall.
Building resiliency is important for the following reasons:
- It protects against heart disease (the #1 killer of firefighters!)
- Potentially increase life expectancy by up to a decade
- Inoculates against daily hassles and life altering events
- Improves job satisfaction and productivity
- Boosts your immune response
- You’re at lower risk for injuries and pain, including headaches
- Lowers risk of alcohol and dependency
Four pillars of resilience:
- Mental toughness
- Social connectivity
- Mind body “muscle memory”
- sparking positive emotions
Tactical breathing is used to gain control over physical and psychological responses to stress. Through practice one can gain control over heart rate, oxygen intake and emotions to increase concentration in various situation. Please see the link below for more information.
THE BIOLOGY OF SLEEP
Every person needs a different amount of sleep to awaken feeling refreshed. Individual sleep requirements are genetic and may be hereditary. Scientists consider six to 10 hours of sleep a normal range, with most people requiring 7.5 to 8.5 hours of sleep in a 24-hour period. At least four to five hours of uninterrupted core sleep is necessary to maintain minimum performance levels. Sleep requirements may change slightly with age and can be affected by general health. Illness, stress, and depression cause the body to require more sleep to heal and recuperate.
WHAT IS SLEEP DEPRIVATION?
Sleep deprivation occurs when a person does not get sufficient amounts of quality sleep. Work demands, family life, and lifestyle choices may cause a person to sleep fewer hours than his body needs to maintain wakefulness and energy levels. In the Fire Service most of us to Shift work and have to interrupt the body’s natural wake/sleep cycle. Over time deprivation of sleep can have both an acute and cumulative effect on our bodies and minds.
THE EFFECTS OF SLEEP DEPRIVATION
Sleep loss is cumulative and creates a sleep debt. Larger sleep debts require greater amounts of restorative sleep to return the body and mind to normal, rested levels. Sleep deprivation affects mental processes and intellectual abilities. It reduces performance on challenging tasks and negatively affects psychomotor skills. Mood, productivity, and communication skills suffer. Extended periods without sleep may cause hallucinations and paranoia. Lack of sleep may slow glucose metabolism by 30 to 40 percent and increase levels of the stress hormone cortisol. Sleep deprivation has also been linked to inadequate levels of the hormone leptin. Leptin signals the body to stop eating when it’s full. Decreased levels of leptin lead to increased carbohydrate cravings and eating.
“Physical and mental performances are not the only casualties of sleep deprivation. Even a minimal loss of sleep impacts general health. Chronic lack of sleep can contribute to serious health problems and even shortened lifespan. In a 1983 study at the University of Chicago, rats kept from sleeping became sick and died after two and a half weeks. Sleep-deprived rats that became ill but were then allowed to sleep, recuperated fully.”
Other effects of chronic sleep deprivation include:
• Adult-onset diabetes
•Menstrual and infertility problems
•Increased use of drugs and alcohol
•Impaired sexual function
•Less satisfaction in personal and domestic pursuits
•Increased appetite and weight gain
•Personality changes, particularly loss of humor and increased ill temper.
COUNTERMEASURES AND COPING STRATEGIES
“Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night”
Quality sleep is the primary weapon in the battle against sleep deprivation. Firefighters must take advantage of opportunities for sleep, both on and off duty. Sleeping areas at home and at the fire station should be quiet and dark, and the room temperature should be cool. A comfortable, good-quality mattress is a must. Invest in comfortable bedding and pillows as well. Good sleep habits are essential. Firefighters need to get an adequate amount of uninterrupted sleep every off-duty night. Going to sleep and waking up at the same times every day, even on weekends, is important for maintaining the body’s natural rhythms.
Other tips for quality sleep include the following:
- Avoid eating, reading, and watching TV in bed.
- Restrict caffeine intake, and avoid caffeinated drinks at least six hours before bedtime.
- Eat healthful foods. Do not eat large meals within four to five hours of sleeping.
- Do not use alcohol to induce sleep. The effects of alcohol-induced drowsiness last only a few hours and cause poor-quality sleep.
- Avoid long-term use of over-the-counter sleeping pills. Habitual use can reduce effectiveness and lead to addiction.
- Reduce life stress as much as possible.
- Use relaxation techniques to relieve stress and invite sleep.
- Exercise, but not more than four hours before bedtime. For 24-hour shift workers, outdoor exercise during daylight hours can help the body maintain natural biological rhythms and increase sleep quality off-duty.
- Napping is an effective coping strategy that can be used in anticipation of a long night or during extended operations. Naps as short as 20 minutes can be effective. Two-hour naps during around-the-clock operations are highly restorative.
- Daytime sleep after a night shift is essential to staying well rested, but trying to sleep when the rest of the world is awake can be challenging at best. The shift worker must emphasize to friends and family the importance of restorative sleep. Go as far as having daytime sleep scheduled on the family calendar along with ballgames, school meetings, and other activities.
- Melatonin may help promote better sleep, particularly during the day. However, this supplement is not FDA-approved, and current research is contradictory on short-term and long-term effects.
- People who are regularly unable to sleep should consult their physicians to rule out underlying health problems. Doctors may also be able to prescribe medication to help with sleep. Sleep disorders can be aggravated by shift work. Shift workers with diagnosed sleep disorders need to work closely with their physicians to effectively manage their disorder.
A great insomnia program is available through Mindability. Please click on the link to learn more.
This article is provided as a service by FireStrong.org
Firestrong is an independently operated online resource for members of the Fire Service and their families. The mission of Firestrong is to offer mental, emotional, and physical support to each member of the fire department and their families by providing educational tools, resources, crisis intervention assistance (crisis line) and peer support services.
- 24/7/365 Independent Fire Crisis Network Line: 602.845.FIRE (3473)
- Mental health information and assessments
- Peer support and testimonials with confidentiality
- Live online chat with professionals
- Counseling & what to expect FAQs
- Free counseling services contact our Experts tab on the Landing page
- Online self help tool through a partnership with Mindability
- Education regarding current medical insurance mental health benefits
- Resources for financial fitness
- Legal backup options
- Crisis Intervention steps
- Member and family services
- Free mental wellness assessments
Firestrong overall goals:
Firestrong.org is designed to be a point of reference for fire service members and their families. Most of this site is available to anybody and is not restricted in anyway. However, departments can use this site as a starting point for their members and have their departments personalized resources placed on this site for additional support. Interested departments should contact us for more information.
Firestrong can also offer a tailor log-in for your department:
- Secured log-in for your members to gain access to a variety of your tools including testimonials
- Placement of your departments logo within the site
- Marketing tools
- Ongoing informational updates and upkeep of websites resources and social network
- Access to Mindability, an online self-help, self-paced program designed to build resilience in your members
Future goals include:
- Ongoing Research for Retiree education
- Ongoing resiliency training