As originally published in Fire Chief Magazine

It’s chilly here. My husband’s lips are getting chapped. He purses his lips and a piece of skin pulls. I can see the switch flip behind his eyes and I freeze.

Instantaneously, his mind scrolls through the Rolodex he keeps tucked deep inside his head. Within seconds, he is spinning along with that Rolodex. He is feeling the skin of that baby’s mouth stick to his as he tries to resuscitate her. The Rolodex spins and he smells the charred skin of a toddler.

The Rolodex flips again and he looks upon the once beautiful face of the pre-teen girl after a drunk driver hit the car in which she was riding.

Flip. Flip.

He sees the faces of an elderly man he couldn’t save.

Flip.

There’s the most recent entrapment.

Flip.

He feels the weight of bloated body pulled from the river.

Flip. Flip.

He senses the loss of control as he falls through that roof.

Flip. Flip.

There’s an infant in cardiac arrest who didn’t make it.

Flip. Flip.

Then there are the childhood atrocities inflicted by the same people who were supposed to love and care for him.

How to console?
It takes only seconds, but the effects last for hours. He sees it all — the things nightmares are made of. The Rolodex stops after a while; it gives way to the anger.

I’m like a deer caught in the headlights when these flashes happen. I don’t know which way to turn. I don’t know what is safe to say.

Even a loving sentiment sounds to him as if I am criticizing or demeaning him. I try to say nothing, but my lack of communication only makes it worse.

I want to stop this roller coaster. I want to get off. I know it will be hours before the anger subsides and the total despair sets in.

I love this man. On a normal day he is kind, loving, gentle, considerate, giving and so much fun. He is a good man, a great father and the perfect husband. Today, he’s tortured.

My husband is a firefighter. He has post-traumatic stress disorder. And my husband’s PTSD kicks my ass.

Hidden triggers
PTSD is common in the fire service. Yet they rarely talk about it among themselves, and they certainly don’t talk about it with their spouses.

It affects them dramatically. It affects their wives and their children. PTSD affects their relationships and their day-to-day activities.

I want my husband to talk to me about the cards in his Rolodex. I try to tell him he is keeping too much in, that his mind can only contain so much before it explodes. By talking about the memories, I’m hoping it will allow them to leave.

I don’t always know what will trigger him. He doesn’t always know what will trigger him. On calmer days, we talk about it. I ask what I should do during the bad times, but he doesn’t know either.

My best friend of 25 years is a mental health therapist. In the six years I’ve been with my husband, I’ve never talked to her about my husband’s PTSD.

Why is that? She’s a professional and my friend. How can we expect our firefighters to seek help when we, as wives, don’t talk about it either?

I have so many questions.

  • Can you recognize PTSD?
  • What do you do when he comes home after a really bad call?
  • How do you deal with that?
  • How does he deal with it?
  • What do you look for?
  • How do I recognize his triggers?
  • What if he doesn’t have an official diagnosis?
  • Where do you go to get help?
  • How do I help stop the Rolodex?
  • How do I get him back on track?

Scope of the problem
The Mayo Clinic defines PTSD as a mental health condition that is triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Firefighters often resist getting professional help. Many behavioral health professionals do not understand the firefighter culture and have not been trained to work with our firefighters.

Not surprisingly, many firefighters prefer to talk to each other. And while many of them have similar experiences, they still aren’t always eager to discuss it.

Because it’s hard to get my husband to talk about his problems and harder yet to watch him suffer with them, I sought outside help. I needed those questions answered to preserve my own well being and to keep my husband from falling further into his dark place.

There are more firefighter suicides than line-of-duty deaths each year. I refuse to let this become our reality. So, I turned to help from the firefighting community.

Wife to wife
South Carolina has an excellent statewide peer support program — the S.C. Firefighters’ Association Firefighter Assistance and Support Team, or FAST. The FAST members are men and women in the fire service who have completed extensive training, can provide invaluable support and can assist with referrals if needed.

You too can intervene in your husband’s PTSD.

Your husband’s department should have an employee assistance program. If he doesn’t feel comfortable with the department related resources, private therapists are readily available. A licensed counselor can make an official diagnosis.

Treatments and drugs are available. You don’t have to do this by yourself. Talk to a professional about what types of therapy may help your firefighter — there are several types.

Cognitive therapy helps you recognize certain ways of thinking — like how he perceives normal situations. Cognitive therapy can be used in conjunction with exposure therapy.

Exposure therapy helps you face what you find frightening so that you can learn better coping skills.

Eye movement desensitization and reprocessing combines exposure therapy with a series of guided eye movements, such as a therapist’s hand movements, a light bar, etc., that help you process traumatic memories. Several sessions can help change how you react to those traumatic memories.

Medications such as anti-depressants and anti-anxiety drugs may also help.

Some of these treatments can also help if your firefighter has developed other problems related to your traumatic experience, like depression, anxiety, or misuse of alcohol or drugs.

So, talk to your firefighter.

Help him with his Rolodex. For every traumatic event, help him enter a positive, happy memory into the file — your wedding day, the birth of a child, a special recognition, etc.

Get help if you need it.

I’ve said it before: The only thing tougher than a firefighter is a firefighter’s wife.