Mental health is not talked about much in EMS or the fire department. My only "lesson" was from my EMT-Basic instructor way back in January 2000 (shh! It's just a number). He had just returned to work after a breakdown of his own, he warned us that EMS would have us putting bad things into boxes in our heads. Each bad thing will get shoved into that box. One day that box will be so full that when you try and shove the next thing in, it will all come pouring out. And you will have to deal with it. It seems like a harsh lecture, but for the time it was revolutionary even to acknowledge.
Like most of us in the field I have seen and dealt with my fair share of "bad things" some bigger some smaller. I dealt with flashbacks, anxiety, avoidance, and bad dreams for years after a particularly bad call and did not realize for even more years that I had gone through diagnosable PTSD. It was not in the language at the time. It was not on the radar.
And then it all adds up. The bad calls, the negative situations, the hurt that we see on a routine basis. The dark humor wasn't calming the nerves any more. The intrusive thoughts rarely stopped, it was either a slide show or constant noise in my brain. Or both. The hyperawareness, uncontrolled flashes of anger, insomnia, anxiety, social isolation.. It took COVID to realize I did not have to live this way. A dear friend and I would compare symptoms each day and harp on each other to go to therapy, this wasn't a healthy way to live. It took some time, but we both finally listened and began our therapy journeys. Each of our journeys have been our own; supporting, commiserating, encouraging, and venting to each other. Let me say, having a therapy/ptsd buddy really does help. Someone who gets it, who understands what a bad day means.
On that journey I have taken part in talk therapy, EDMR, and medication - all of which have helped. But they have not been enough. I attended a workshop earlier this year focused on nightmares, insomnia, and PTSD. It was an amazing 3 days of learning techniques. And they have helped. But still not enough. The symptoms were ruling my life, not me.
Then I found a women's first responder retreat for ketamine assisted psychotherapy being hosted by the non-profit Wabi Sabi Circle partnered with the amazing Alex of Emergency Resilience. I applied and hoped. I was chosen to be one of 8 women to take this journey.
Ketamine is a fascinating medication. Those of us in EMS are familiar with it as a pain management and excited delirium tool. Those in the military know it for pain management. Police know it as an illicit party drug. Horses know it as a tranquilizer. But we are learning about it as an amazing part of psychotherapy to treat symptoms of PTSD, depression, and anxiety. It has been proven to cause neuroplasticity and rewiring. Used as a part of therapy it can improve treatment outcomes and eventually even remove the need for medication. It can do amazing things at very safe, low doses.
In this 7 days retreat we received three doses of Ketamine in a safe, controlled environment with medical personnel present and monitoring us. We had facilitators that are trained therapists with their own personal history of ketamine experience that did not leave our sides. We had a wonderful "house mom" that managed everything from food to cleanup to laundry so our only focus was on healing. We got to experience equine assisted therapy, yoga, acupuncture, sound baths, and multiple group sessions each day. We had the freedom to cry, open up, laugh, ask questions, share fears.. and found unconditional acceptance. Somehow this group of 8 women who arrived in so much pain found a deep and lasting connection with each other. We had so much in common in unique ways, we could belly laugh like only old friends could. We had facilitators that accepted us, flaws and all without a thought or bit of judgement. They opened their hearts and minds to us. These are connections we will all keep for our lives. We found our long lost sisters doing drugs in the mountains.
What is ketamine assisted psychotherapy (KAP) like? First of all, you will not be reliving your calls or worst experiences in life. No flashbacks here. There can be physical reactions to the emotional release, crying to shivering to sadness, it is not a literal or linear experience. Each person experiences something different, and each time is different. Your KAP sitter will be with you the whole time, they will see tension or physical reactions and talk you through it and keep you safe. They will scribe what they see and anything you say or do. You enter a dream world, separate from your body, and explore what that world has for you. But you are not gone-gone.. say you have to pee. You can get to the bathroom, with assistance, and be aware of what you are doing. You might feel like Godzilla, but that adds to the entertainment for you and your therapist. The imagery, emotions, sensations will leave an impression on you. Reflecting on them later will bring out more meaning or understanding. And with integration therapy it allows your brain to process what you are consciously aware of, but also what you are not aware of. With each treatment your "baseline" level of symptoms improves. The neuroplasticity works its magic and you feel a bit like yourself again.
KAP is not a magic bullet, but it is a beneficial therapy in the treatment of PTSD, depression, and anxiety. Insurance plans do not cover IV/IM KAP at this time, but some facilities get the therapy aspects covered or work with non profits that assist first responders and veterans to afford it. IN therapy exists, but is a slightly different medication that works on a much lighter level. While it is beneficial, it does not nearly reach the same level of neuroplasticity or improvement that can be seen with IV/IM. Talk with your mental health provider. Google KAP in your area. Look for providers that will be with you at all times, that have done KAP themselves, that perform integration therapy or recommend someone who will, and will follow up with you. And ultimately a provider that you feel safe with. I highly recommend considering, if not taking part in KAP. It has been a huge positive for me and positively impacted my life.
I have been very open with this post about my mental health challenges. More than I usually am in any single sitting or conversation. I am happy to share, but finding words takes a few business days. There is always more detail or more experiences, but then it would be a book. Any first responder can write a book on their professional life and its impact on their personal life. For me, I have found that spreading mental health awareness is part of my healing journey. Remembering the light go off in my own brain when I understood what was happening with me, I want to help others have that moment. I can not fix others, but I can spread awareness to anyone that will listen.
I wish you luck in your own journeys and am happy to answer questions to the best of my abilities. Thanks for listening to my TED talk.
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