SHOULD TROUBLED
OFFICERS TAKE
ANTIDEPRESSANT
MEDICATION?
http://www.forcescience.com
Are
antidepressants
dangerous
medications for
cops?
That question
was raised
recently on the
listserv for the
IACP's
Psychological
Services
Section. A psych
professional
from south
Florida reported
noticing of late
"a marked
increase in
police officers
being
prescribed"
antidepressants,
known
pharmacologically
as SSRIs
(selective
serotonin
reuptake
inhibitors).
These include
common
brand-name drugs
such as Prozac,
Paxil, Zoloft,
Luvoc and
Lexapro.
The staffer
was curious
about the
possible
negative effects
of SSRIs on an
officer's
reaction time.
Other
respondents, in
effect, told him
to rest easy.
"Little evidence
supports a SSRI
problem," wrote
a PhD from
Louisiana, who
cited studies in
the journal
Psychopharmacology
for Apr. 2001
and Jan. 2002.
"Also recall,"
this
correspondent
suggested, "that
untreated,
emotionally
impaired
officers may
also have a
reaction-time
risk."
A police
psychologist
from Colorado
noted that he
used to treat
airline pilots
who were
depressed but
could not take
antidepressants
because they
would not be
allowed to fly
if they did. "I
always thought
this was odd,"
he wrote,
"since I would
rather have a
depressed pilot
on an SSRI who
was feeling good
than have a
depressed pilot
not taking
anything and
feeling lousy. I
feel the same
about police."
Dr. Bill
Lewinski,
executive
director of the
Force Science
Research Center
at Minnesota
State
University-Mankato,
emphatically
agrees. A
specialist in
law enforcement
psychology for
more than 30
years, Lewinski
is an
internationally
recognized
expert in police
reaction times
in lethal force
encounters.
"Most of the
time that's
required for you
to react to a
threat is taken
up with
perceiving the
danger,
processing that
information,
deciding what to
do and then
sending commands
from your brain
to your body to
react,"
Lewinski
explains. "The
actual
mechanical
action of
pulling a
trigger to
defend yourself
requires only
6/100 of a
second, a very
minute portion
of overall
reaction time.
"The 'front
end' of
reacting, so to
speak, depends
on your ability
to pay attention
to what's going
on around you so
you pick up
danger cues. If
you're not or
can't be
attentive
because of your
emotional state,
the rest is
irrelevant.
"If you're
depressed you
are preoccupied
with your own
suffering, your
own bleak view
of the world.
You're focused
inward, not
focused on
what's important
'out there' in
the environment
around you.
"Any effect
on reaction time
by
antidepressant
medication is
miniscule
compared to the
profound
impairment of
cognition,
information
processing and
survival-oriented
decision-making
caused by
untreated
depression."
The case of a
Midwestern
officer who shot
and killed an
assailant and
who was himself
slightly injured
in a gunfight
serves as a
dramatic
illustration.
This officer's
reactions were
so blunted by
untreated
post-traumatic
depression that
he had
difficulty even
tracking radio
calls.
"By the time
he tuned in to a
dispatch, the
message was
almost over,"
says a therapist
who knew him.
"He'd ask the
dispatcher to
repeat, fully
determined to
pay close
attention to
what was said,
but he couldn't
remember long
enough after
hearing the
words to write
them down. You
can imagine how
unprepared he
was for any
tactical
challenges."
"You
shouldn't even
be working if
you have a
seriously
depressed frame
of mind,"
Lewinski
declares. "Yet
many officers
won't seek help
for depression,
either with
medication or
through
counseling,
because they're
afraid they'll
be stigmatized
for getting
psychological
aid. Instead,
they compromise
their safety and
effectiveness by
trying to tough
it out."
Depression
can arise from a
number of
causes,
including your
life
experiences,
your body
chemistry,
mental illness
and
post-traumatic
stress disorder.
Lewinski advises
that if you have
any lasting
symptoms from
the following
list, it would
be wise to seek
professional
investigation
and
help:
--Persistent
sad, anxious, or
"empty" mood
--Feelings of
hopelessness,
pessimism
--Feelings of
guilt,
worthlessness,
helplessness
--Loss of
interest or
pleasure in
hobbies and
activities that
were once
enjoyed,
including sex
--Decreased
energy, fatigue,
being "slowed
down"
--Difficulty
concentrating,
remembering,
making decisions
--Insomnia,
early-morning
awakening, or
oversleeping
--Appetite
and/or weight
loss or
overeating and
weight gain
--Thoughts of
death or
suicide; suicide
attempts
--Restlessness,
irritability
--Persistent
physical
symptoms that do
not respond to
treatment, such
as headaches,
digestive
disorders, and
chronic pain.
"Ironically,"
Lewinski says,
"when a
depressed
officer knows he
is responding to
a high-risk
call, the
adrenalin surge
will tend to
counteract the
effect of his
depression and
his judgment,
alertness and
reaction time
may well be
appropriately
sharp for the
situation.
"But on
seemingly
'routine' calls,
such as
'ordinary'
traffic stops,
the depression
will dominate
his mental state
and
significantly
affect his sixth
sense and
tactical
awareness,
making it more
difficult for
him to perceive
an evolving
threat. He'll be
way behind the
reactionary
curve and detect
any danger cues
too late. And we
know that most
officers die not
on known
high-risk calls
but in common
patrol
situations that
appear benign at
the outset."
Lewinski
strongly
advocates
combining
antidepressant
medication with
psychological
therapy and a
self-administered
program of
positive
self-talk, such
as described in
the popular
police text "The
Tactical Edge".
"The combination
of medication,
therapy and your
own positive
belief system
can have a
powerful impact
on your
survival," he
says.
The effects
of
antidepressant
medication vary
from individual
to individual,
and in a small
minority of
cases SSRI drugs
may not work at
all, Lewinski
told Force
Science News. It
may take some
experimentation
for a physician
to find the
right drug and
dosage for you.
"Once you find a
helpful
medication with
minimal personal
side effects,
the better
you'll operate
on the street
and in life,"
Lewinski says.
"If you feel
better, you're
going to be more
attentive...and
much safer."
[Thanks to
Force Science
News member
Wayne Schmidt,
executive
director of
Americans for
Effective Law
Enforcement, for
bringing this
subject to our
attention.]
