Editor's note: This is the second in an 8-part series of weekly feature stories written in conjunction with the "Inside Out" community campaign to normalize mental illness.
Imagine arriving at the scene of a bad accident. You see two crushed cars laying on their sides in the road. It's your job to extract the crash victims from the insides of those cars. They're hurt, and scared. One is just a child - about the same age as one of your own.
You do your job, you do everything right, but still, one of the victims doesn't make it.
You step in and out of awful scenarios like this, over and over again, year after year after year. You can't talk about any of it with your loved ones; it's not allowed. You don't want to talk about it with your colleagues; it's not "macho." So you swallow your emotions and carry on with life as best you can.
That's what Scott Geiselhart did, for almost 20 years. As a longtime volunteer firefighter with the Frazee Fire Department, he witnessed trauma after trauma, and kept his feelings about it all bottled up. One day, that bottle got too full, and things started to spill over.
He started having horrible nightmares and jarring flashbacks of the accident scenes. To suppress the dark thoughts, he turned to alcohol, and to stay awake after sleepless nights, he started using meth. He isolated himself from his loved ones, trying to hide his addictions.
He felt scared, confused, and ashamed of his behavior. People around town always knew him as a good guy with a big heart, but at home his temper would flare, and he became verbally abusive toward his family. That led to more feelings of shame and guilt, and more drug use. He was spiralling out of control.
All the common signs of PTSD and depression were there, but he didn't see any of that.
"I thought I was losing it back then," he says today. "I didn't know what was going on, why I was yelling at my kids and my ex-girlfriend. The rage just came out. It was like I'd be standing back, watching myself and wondering, 'Why are you yelling like this? Why are you doing this? They don't deserve this.' The pressure just built up, and I'd explode."
After more than 15 years of his symptoms getting progressively worse and worse, the bottle Geiselhart had been so desperately trying to contain everything in, finally broke open. Alone in his office one night, he picked up his gun, pressed it to his head, and pulled the trigger.
That should have been it for Geiselhart. He was expecting it to be it. He wanted it to be it. But for some unknown reason, the gun didn't go off. Instead, he heard an empty 'click' of the trigger, and with that, something in his mind clicked, too. At that moment, he realized he wanted to live, and he felt a new determination to get his life back on track.
Turning to his computer for some initial answers, he typed his symptoms into Google. Links related to PTSD instantly filled the screen. Everything he read was eye-opening. He finally knew what had been plaguing him for all those years.
"It took a suicide attempt to find out I had PTSD," he says. "It was very unfortunate... I lost control of myself, so my suicide attempt was an attempt to regain control. But that was the worst decision I ever made in my life. I was confused. I was looking at things different than I do now... When I was in that place, I thought I was doing everybody a favor. That's the darkness. That's scary. When you lose control, you feel like you're all alone."
It wasn't always easy, but Geiselhart found the path to recovery. A national support program for firefighters and emergency medical technicians, called Share the Load, got him started, and from there he began working with local therapists. Diagnosed with depression and PTSD, he ultimately found his salvation in a type of psychotherapy that's often used in trauma cases, called Eye Movement Desensitization and Reprocessing, or EMDR.
He had six EMDR sessions in a month's time, "and I got it all out of my head," he says of how well the therapy worked for him. "To me, it was an infection, and I wanted it out."
That was about four years ago, and today, "I don't have any symptoms anymore," he says. "I haven't for awhile; therapy kind of took care of that for me. I feel like it's a whole new life."
Because of his history with addiction and suicidal thoughts, Geiselhart opted not to use any prescription medicines as a part of his recovery. He walked away from meth in August of 2014 and, after a week "of going through hell to come off it," he's never touched the stuff again. He was in therapy during that time, and that helped him get through it.
"There's a way out," he says. "PTSD isn't something that you do, it's something that happens to you. It's not really your fault, and it's okay to reach out for help. Go talk to a therapist, go talk to somebody - and be open and honest. The more you can be open with a therapist, the more they can help you."
PTSD, or post-traumatic stress disorder, is often associated with combat veterans, but anyone who's experienced a terrifying event can develop PTSD, and firefighters and other emergency responders are at a higher risk than the general population.
According to ptsdunited.org, an estimated 8 percent of Americans have PTSD at any given time (that's equal to the population of Texas); among firefighters, surveys have found the rate to be closer to 13 percent. There's a stigma of weakness that still surrounds PTSD in the firefighting world, Geiselhart says, so it's almost certain there are plenty more cases that go untalked about and undiagnosed.
"There's this macho image, and it's killing us," he says. "It's killing our families."
Today, Geiselhart's goal is to spread a message of understanding, acceptance and hope, to help erase the stigma surrounding PTSD, especially among first responders, and to encourage others who may be struggling to reach out. He travels the country now, sharing his story as a public speaker at conventions and other gatherings of first responders.
"Mental health's kind of taboo still, and nobody wants to talk about it, and that's gotta break," he says. "In the '50s, nobody wanted to talk about cancer, and now... I think a lot of people don't understand mental health because it's not a broken arm, it's not something you can see. But it's still treatable."
In addition to his public speaking gigs, Geiselhart now works as a certified peer support specialist for Stellher Human Services in Detroit Lakes. He counsels people who are experiencing the same kinds of mental health issues that he once was, showing them, by his own example, that things can change for the better.
"One time I was in crisis," he says. "But I got my life back. Now, I want to pass that along to others.... PTSD is not a death sentence. It's something you can recover from."
He attributes his own recovery largely to his faith, and to EMDR, which he says "got the infection out of my head."
"It felt great," he says of his EMDR sessions. "At the time I still had trouble admitting how much the car accidents affected me... Now, I was finally talking about it, finally hearing myself talk about it. And I was so much lighter, it was like taking a jacket off."
Whereas before he often felt "numb" and wouldn't let anybody get close to him, he says that after therapy, "I got my emotions back. I could start seeing things again - seeing colors, seeing people, seeing faces, feeling love, seeing squirrels, feeling the rain hit my face. It was just a totally different life. And I could sleep again. I didn't have to worry about the nightmares."
He's still an active member of the Frazee Fire Department, and he's seen that department, along with many others in recent years, take a big turn for the better when it comes to giving proper attention to mental health. The firefighters now have debriefings after every incident, so they have the chance to talk about and process what they've witnessed before going back home to their families. There are also trained peer supporters who can be called on for extra help.
"Life's still a rollercoaster," he says of where he's at today. "But I never go back into the darkness myself. I've got a peace now I never used to have, inside, that I can draw from any time I want. I want people to know that there's a way out."
What is it?
Post-traumatic stress disorder is a mental health condition that's triggered by experiencing or witnessing a terrifying event, such as: combat exposure; childhood physical abuse; sexual violence; physical assault; an accident; a life-threatening medical diagnosis; a fire; a natural disaster; and others.
In the "Inside Out" video about PTSD and other trauma-related mental health disorders, Chris Green, Outpatient Therapist at Northwestern Mental Health, says trauma is "defined by the person that experiences it." A traumatic event can be many different things, so "what we look at is how the experience has affected their day-to-day living."
Who does it affect?
Anyone, of any age, who has experienced or witnessed a terrifying event. Some risk factors increase the likelihood of developing PTSD, such as: experiencing intense or long-lasting trauma; having experienced other trauma earlier in life; having a job that increases your risk of being exposed to traumatic events (such as first responders); having other mental health problems or substance abuse problems; and lacking a good support system.
What are the signs and symptoms?
Symptoms are generally grouped into four types: intrusive memories (recurrent, unwanted distressing memories of the traumatic event, or upsetting nightmares); avoidance (avoiding places, activities or people that remind the person of the traumatic event, or avoiding thinking or talking about it); negative changes in thinking and mood (hopelessness, memory problems, difficulty maintaining close relationships); and changes in physical and emotional reactions (easily startled or frightened, self-destructive behavior like driving too fast or excessive drinking, irritability/angry outbursts).
Symptoms may start within one month of a traumatic event but sometimes may not appear until years after. Most people who go through traumatic events have temporary difficulty adjusting and coping, but if symptoms get worse, last for months or even years, and interfere with day-to-day functioning, that's when PTSD may be diagnosed.
How is it treated?
With therapy, usually Eye Movement Desensitization and Reprocessing, or EMDR, for adults, and trauma-focused cognitive behavioral therapy for those 18 and younger. Medications may also be prescribed, based on the patient's needs and wishes.
What can I do for my loved one?
Green says the best way to support someone you love who has experienced trauma is to educate yourself, and then apply that knowledge to the unique needs of your loved one. "Walk the journey with them," and "let empathy and love drive your interactions with them, so you don't worry so much about saying or doing all the right things." It's also important to have a support system in place for yourself.
*Information compiled from the "Inside Out" video, as well as from Mayo Clinic.
PTSD in emergency responders
A 2017 University of Phoenix survey on first responder mental health revealed that a high percentage of first responders are dealing with traumatic events related to their work, and many are also experiencing negative mental health symptoms as a result of that. The findings include:
• 85% of first responders have experienced symptoms related to mental health issues
• 69% have experienced lack of sleep
• 45% have experienced anxiety
• 34% have received a formal diagnosis of a mental health disorder (39% have sought out professional help)
• 27% have been diagnosed with depression (47% cited incidents at work that caused their depression)
• 10% have been diagnosed with PTSD
• 69% say mental health services are seldom or never utilized at their organization
• 42% say their supervisor does not openly discuss the importance of addressing mental health concerns
• 50% believe their supervisor will treat them differently if they seek mental health help
*Survey conducted within the U.S. by Harris Poll on behalf of the University of Phoenix, of 2,004 adults ages 18 and up who were employed as firefighters, police officers, EMTs/paramedics, lifeguards or nurses