Webinar presenters Amy Morgan and Dr. Stephen Odom answered a number of your questions after their presentation, Depression: Myths, Signs, Prevention and Treatment. Here are just a few of their responses.
Audience Question: Dr. Odom, the first question is for you, could you state again, what TMS means?
Dr. Stephen Odom: Sure. It stands for Transcranial Magnetic Stimulation. A lot of the clinical trials got finished about 17 years ago, UCLA —– and it’s a little bit like an MRI but on the outside of your head. And it seems kind of rework the neurotransmitter systems and it stays completely away from medication. So, a lot of people who get through with it either go off the anti-depressants or didn’t actually need to be on it. It’s pretty amazing stuff.
Audience Question: What suggestions do, either of you have for first responders on how to ask for help when they need it?
Amy Morgan: I love that question. I love when someone’s thinking they want to ask for help, that’s a bigger step than even five years ago. Start with peer support. I would start with peer support. If you have a peer support team, they should be connected to professionals and resources that can help you. If you don’t have peer support, can call a crisis line. Something like CopLine, retired officers who have volunteered their time and have been thoroughly trained to answer that line and you don’t have to be suicidal or in crisis. You call and say, “Hey, do you guys have a culturally competent therapist in my area and go by zip code. It’s confidential, they don’t have to know who you are when you call. There are lots of ways to get help. The first thing is to just, you know, ask somebody else. If you know someone in your department who has gotten help, or who used to have depression or struggle, and you know they are better now, ask them how, what did they do? If you remember back in your past, won’t work for you during another difficult time, trying to repeat whatever worked for you.
Dr. Stephen Odom: You covered it really well, I think the only other thing I would add is the concept of employee assistance programs. If your organization has one, A, that’s a good sign; B, you need to make sure that it’s a culturally competent EAP so that they do know what to do when they work with first responders. So always ask those two questions.
Audience Question: Are there things we can do to help our children become more resilient?
Dr. Stephen Odom: Yeah, absolutely. Again, that’s a whole another webinar in a lot of ways. But I mentioned some things at the end there. It’s the whole concept of self-efficacy. It’s that idea that you can be in control of your feelings, that everything is not done to you. That you’re an actor in your world, in your environment. The concept of having gratitude and acting with kindness goes a long way towards building resiliency. Learning how to, sounds silly, but learning how to breathe really makes a big difference for kids. Taking a pause before they do the next thing. Learning how to center yourself. Getting out and being physical. Being really careful to be in control and limit social media time and know what social media kids are getting into. Because the longer it goes, and the older they get the less they listen to us, and the more they listen to what they’re reading and seeing out there, and that’s where a lot of the trouble begins. So, staying close and remaining tight, as a family helps with resiliency also.
Audience Question: What kind of physician should one see in order to diagnose depression, PTSD, and anxiety? Is it a regular medical doctor, psychologists, psychiatrists, therapists, what do you recommend?
Dr. Stephen Odom: Well, let me, again, do the caveat. The caveat is, especially with public safety occupations, we need to go see someone who’s culturally competent. And so, if I’m going to see a physician, my primary care doc, that guy or that girl needs to know what it is to work with first responders. So that’s the key question. Generally speaking, a psychiatrist is an excellent choice, as is potentially a psychologist or a therapist. But the way medicine works nowadays, maybe you get to see the primary care doc faster and one more time, I can’t say it long enough and loud enough. They’ve got to be culturally competent. They can’t be someone who’s going to minimize it or act like they understand what you go through when they don’t really get it. So, a lot of times, going through the EAP is a good step, because they have a good resource list of culturally competent, psychiatrists, primary care docs, etc.
Audience Question: Are there any blood tests that can indicate depression?
Dr. Stephen Odom: We wish, we’re not quite there yet, it looks like we’re not going to find any specific genetic marker. We’re going to find a lot of little things on a lot of genes that kind of leads us in that direction. What is interesting, though, is some of you guys may have heard or been through that experience of trying different anti-depressants. Because, in some ways, finding the right one is a little bit of an art as much as it is a science. But we do have some, what we call, genetic testing now that you can do, it’s lab work, blood work. And it tells a profile of which medications might work better for you and which ones definitely wouldn’t work for you so that you can kind of eliminate some of the guesswork. And you can hone in on the right category of medications to use because it really is about how your body metabolizes those medications. Some are fast and some are slow and they both have different indications for whether that’s good or bad for you. So that’s where science is right this minute.
Audience Question: Have you seen any studies that indicate whether children of first responders have a higher rate of depression?
Dr. Stephen Odom: I have not seen anything that is telling us that yet. I have a feeling that someone’s probably doing a study as we speak. What we do see are studies that show that first responders have double the rate of alcoholism and substance abuse, and that tends to lead down into their children. Because the children of first responders tend to have at least as high rates as their parents do, and that actually goes up a couple of generations. So, what I know is more about how it comes out, and it affects the substance abuse side. But I would expect that depression doesn’t look all that different.
Amy Morgan: Yeah. And I know somebody who studies, a Suicidology Expert, who’s also studying first responders right now, and watching it through the COVID experience and through the, you know, divide we have kind of going on in the country right now and is including that in part of that study. But that’s probably five years away before we actually get the results of anything from that study. But a very good question, because that’s it’s definitely, you know, studying the effects of a first responder career on this, on the spouse and the children. And you’ve got to just remember that they are part of that first responders’ life, and they do vicariously experience, a lot of the things that responders go to just because it affects the responders so greatly.
Audience Question: You both use the term culturally competent in reference to seeking help, can you explain what that means? What do you mean by culturally competent? What kind of questions should people be asking?
Amy Morgan: So, that first responder counselor program that I have. That was why I created that, as telling first responders to go see counselors, and they were like, “No, I’ve tried that. It didn’t work. They don’t get me.” Culturally competent means you understand the population that you’re working with. So, if you have a clinician who is seeing first responders, they need to get, understand the culture of first responders and that’s different than just your civilian regular citizen. First responders experience a lot of things that citizens don’t see; they deal with a lot of things in different ways. They have a culture of a brotherhood-sisterhood. The environment around them is a very small circle of trust and that sort of thing. A clinician and a physician both should understand that if and if a first responder comes into the office and says something, “I’m going through this from experiencing this”. Whatever that is, it’s going to mean something different when a first responder says it than when just your general citizen says it because they have seen different things, they’ve gone through different things, their culture and the way they communicate with each other and communicate their emotions is very different. You’ve got to have a clinician and a physician who just understand not to overreact and understand how important confidentiality is and not overreacting to things, but instead helping, staying, and working with them to help them, rather than just saying, “Oh, my gosh, you have serious problems. You need to turn you in, you can’t do your job.” You just need to help them. You’ve got to have somebody who understands that.
Dr. Stephen Odom: I think it kind of I think you covered it really well. We’re a special population and some of the things that we may have to talk about or how we present can be a little alarming to regular clinicians. But first responder-oriented clinicians understand it’s just the way it is, and we’re going to work through it, and it’s going to be okay. I think the crucial element for cultural competency is that first responders will only give a therapist basically one chance, right? If we screwed up the first time, we’re never going back to see anybody else. So, that’s why it’s so critical that we go to the right person the very first time because that’s the only opportunity we may ever get to do some good.
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