Studies estimate a high rate of major depressive disorder (commonly known as simple depression) among police officers, ranging in prevalence from 25% and up to nearly 50% when combined with a diagnosis of anxiety. These numbers suggest that depression among police officers should be taken seriously. Particularly concerning is, of course, that suicidal ideation is a symptom of depression.

Clinical symptoms of depression (easily identified by anyone with the help of “Dr. Google”) include depressed mood, loss of interest in activities you used to find pleasurable, a change in your weight, a change in the amount you sleep, fatigue, difficulty concentrating, feeling worthless and suicidal ideation. In first responders, the symptoms that are most prevalent include extreme fatigue, loss of sense of purpose in your work and feelings of hopelessness. 

A helpful metric for monitoring symptoms of depression (and, in fact, any mental health symptom) is the B-FIIT. The acronym B-FIIT is easy to remember and to utilize as a metric. The letters relate to the following evaluators: 

• Deviations from Baseline. An individual’s baseline is their “normal” daily functioning, including mood, sleep and appetite, as well as other factors. The baseline allows us to evaluate the impact of stress and trauma before and after an event. 
• Frequency. Refers to how often the symptoms occur.
• Intensity. Refers to how vivid or strong the symptoms are.
• Interference. Refers to the degree to which the symptoms create problems in your functioning or become apparent to others (family, co-workers, etc.)
• Time. Refers to the duration of the symptoms. 

We all know our own personal “normal” or “baseline.” Our baseline is how we generally interact with other people, our mood, as well as our appetite and sleeping habits. It is common for our baseline to temporarily shift after experiencing a trauma or responding to a critical incident (maybe you can’t sleep on the night after a shooting, for example). However, if the shift lasts for over a month, you may need to start incorporating new coping mechanisms. Use the frequency, intensity and duration of the symptoms to objectively evaluate what you were like before you started to feel depressed and what you are like now. If you or someone you trust notes that you are “acting different” or “not like yourself,” this should alert your attention.

What should you do if you notice symptoms of depression?

• Seek out social support. Spending time with friends, family and loved ones creates a buffer against the negative effects of depression and is a key factor in fostering resilience. 
• Practice effective communication. Acknowledge what’s going on and the impact it’s having. “Stuffing” emotions can create a missed opportunity to connect with support systems and can lead to an increase in stress symptoms. 
• Practice self-care. Prioritizing stress reduction, downtime and exercise are essential to avoiding burnout and maintaining resilience. Regular exercise helps prevent the buildup of stress chemicals. Research shows that just a 15-minute walk a day may be more effective than the use of anti-depression medication.
• Check out your gut health. Your gut is called the “second brain” for a reason. In fact, 95% of serotonin (the happy chemical whose deficiency is associated with depression) is produced by your gut. If you take care of your gut, you might drastically improve your mood. 
• Seek help if your usual strategies are not working, especially if you have been experiencing suicidal thoughts. Many first responders fear that they will be immediately prescribed medication if they seek help for depression. While anti-depression medication is an effective tool for many individuals, you decide the treatment course you want to take. There are many strategies that can and should be applied before trying medication.