Bottom line up front: Post-traumatic stress disorder (PTSD) is not a disorder. Not exactly. For too long, cops have been told that if they are affected by the things they hear, see and smell, they are deficient in some way. They’ve been told that if they can’t shake it off, they are weak and that showing emotion equates to not being able to “handle the job.” Some agencies even take disciplinary action on officers who raise their hand and say they are struggling. Not only has this outdated mindset contributed to many of the problems our officers are facing, like alcohol abuse and suicide, but equating trauma symptoms to weakness is just not accurate. I think you would agree there is nothing weak about cutting down a 12-year-old and then having to hold his mother back from the scene. There is nothing weak about being told you are a POS and hearing about all the things the subject wants to do to your family during the 25-minute ride to county, only to have them released before your report is done. There is nothing weak about working 18 hours on a skirmish line in a city you don’t know. Every action has an equal and opposite reaction … there is nothing weak about wanting to hold your kids and cry. There is nothing weak about feeling angry and helpless and wanting to be alone. And there is nothing weak about wondering why you still show up to work every day. So why is it the case that for so long this profession has operated under the notion that trying to better yourself for your kids, your work–life balance or your emotional and spiritual well-being means you are fragile or broken?

I have two answers to that question. The first is that we (health care professionals) haven’t done a good job of explaining to you how trauma and stress affect the brain and body, and how normal it is for you to feel that way. The second is that cops can be assholes.

Did you know that in the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short (basically the code manual for psychologists), policing is listed as a risk factor for PTSD? What this means is that regardless of all other individual factors such as age, childhood trauma, capacity for resilience, coping skills, relationship history … scientific evidence supports the idea that being a cop in and of itself puts you at a higher risk. Side note, for the record, PTS ought to be referred to as an injury rather than a disorder, not because it sounds more badass, but because it’s more accurate.

Trauma changes the brain — not only the thinking part, but also the structural part. Over time, exposure to the kid calls, the TCs, the OISs, the DV calls, the child sex crime cases, etc., physically alters a part of the brain known as the limbic system. The limbic system is a constellation of structures having to do with emotions and behavior. Much like if you bust your ankle in a foot pursuit and have trouble walking for a while, if your limbic system is damaged, you might have trouble making sense of your emotions for a while. If you don’t take care of your knee, walking, running and winning the fight might be more difficult. If you don’t take care of your mental well-being, the depression, anxiety, anger and so on might become unmanageable, and the happiness, joy and peace you used to feel become seemingly out of reach.

As a police psychologist specializing in trauma, I work one on one with officers struggling with PTS, and I am regularly dispatched to conduct critical incident stress debriefs for agencies after the sh–– just hit the fan. I get the honor of speaking about officer wellness and critical incidents around the country, sometimes to audiences of 25 and other times to rooms of over 1,000. Without fail, whether in my office, at a station or in an auditorium, officers walk in with the idea that if they are struggling to sleep, are angry all the time or can’t stand being home and would rather be at work, then there is something wrong with them. When in reality their brains and bodies are working exactly as designed. It reminds me of this quote, “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” I get the honor of sharing with the brave, badass men and women in law enforcement why they feel the way the feel, and how to change it.

Much like how injuring your ankle causes trouble walking and hurting your wrist makes writing difficult, when different parts of the brain are injured, the indicators (or symptoms) you have directly correlate with the affected brain structure. When one drinks trauma through a fire hose for a living, the limbic system is affected, and there are three primary structures that physically change: the hippocampus, amygdala and prefrontal cortex.

The hippocampus is a part of the brain responsible for learning, memory and problem-solving, and when exposed to trauma over time, the structure itself shrinks. What this looks like on the outside is that the memories related to critical incidents can become jumbled and less cohesive. Maybe you don’t remember getting the knife out of your pocket to cut the rope or driving code through a particular part of town. Or perhaps you aren’t sure if what you remember about the event is actually what happened. When overstimulated by trauma, the body releases a stress hormone known as cortisol, and excessive amounts of this hormone have a hand in damaging the cells within the hippocampus, causing it to shrink.

The second part of the limbic system changed by the job, the amygdala, is known as the fire alarm in your brain. Its primary function is to modulate your vigilance, situational awareness and fight or flight. When the brain and body experience stress and trauma, this part of the brain is activated and actually gets physically bigger. And as a cop, it’s activated a lot, as it should be. You need to be prepared for the fight, vigilant and aware of your surroundings. The consequence, however, is that you used to only be hypervigilant at work, but now it’s creeping into your home life. You used to go to the grocery store without pause, but now you approach it like you would a house you’re about to hit. You used to enjoy going to concerts with your family, but now everyone is a threat and you would rather stay home. What this looks like on the outside can be anything from low-level anxiety, like a constant humming, to having a panic attack. In addition, the amygdala is also responsible for flashbulb memories. Evolutionarily speaking, the brain wants to remember the awful, terrible, horrible things (like the teeth on the railroad tracks, the blood splatter, what the front door looked like), so that you don’t do that thing, whatever that thing was, again. As a cop, that’s not really an option you are afforded. You do the death notification anyway — regardless of how horrendous the last one was. It can feel like you are fighting everything in you to knock on that door, but you do it anyway. In a real sense, you are fighting your amygdala. It’s one of the reasons compartmentalization is so effective within this profession.

And finally, there is the prefrontal cortex, a part of your brain that is responsible for impulse control, emotion regulation, decision-making and regulating your attention and awareness. It’s a pretty important part of the brain, especially for a cop who must read the room and make split-second decisions while unholstering or holstering, all while being told you are on Facebook Live. When exposed to trauma over time, this part of the brain becomes impaired. It doesn’t wire and fire as effectively as it used to. What this looks like is it takes longer to make decisions, you develop brain fog, you start snapping at your kids or your spouse and maybe even make some impulsive decisions, sometimes the kind you can’t take back.

So there you have it. You are not crazy, or weak or less than — you are injured. And just like you would go to the doctor to set your ankle straight, you go to the doctor to get your brain straight. And just like if you choose not to go to the doctor, you will continue to have trouble walking and it might get worse; if you choose not to take care of your mental health, well, you get the idea. Yes, there is a chance that you do nothing and everything turns out fine, but hope is not a plan, and you deserve to take back a bit of what the job has taken from you. In addition, nothing I mentioned about the brain can’t be mitigated, reversed or fixed. Nothing I mentioned about the brain excuses knucklehead behavior either. What I’m offering is a reason for why you feel and behave the way you do, not an excuse.

So if you find that this article resonates with you on some level — that you have become aware of some of the ways in which the job has changed you — you have a choice to make. Understand you cannot choose to have PTSI because you want to; you have to earn it. And know that you cannot choose not to have it either just because you want to feel better. What you can do is recognize a part of your body is injured and that there are professionals and resources who are at the ready to help you through your pain. All you have to do is ask.