How to Identify a Mental Health or Substance Abuse Problem

Author: IAFF Staff

March 12, 2018

“I was starting to have nightmares. I was starting to be more angry than I typically was. I started isolating. I continued to get promoted. Outwardly, things seemed to be okay, but inwardly … I felt completely alone,” recalls Chuck Talbott, a retired fire fighter of Yarmouth, MA. Research indicates that 1 in 5 fire fighters and paramedics will suffer from post-traumatic stress disorder in their career. Whether you are a veteran or still in training, knowing how to identify when a crew member is in trouble is a critical function of your job. To determine if you or someone else needs help, be aware of the following signs and symptoms of a serious mental health problem:

  • Feeling sad for most days for two weeks or more
  • Intrusive thoughts, dreams or images of traumatic calls or events
  • Difficulty falling asleep or staying asleep
  • Lack of interest in usual hobbies, social activities or family activities  
  • Persistent irritability or mood swings that cause problems at work or home  
  • Difficulty concentrating or staying still
  • Expressed or felt apathy (a “Nothing helps, so why bother?” attitude)
  • Not eating or excessive overeating, leading to weight loss or weight gain
  • Increased risky behavior (physical, sexual, financial, etc.)
  • Changes in social behavior (suddenly very withdrawn or very outgoing)
  • Talking or thinking about suicide or finding “a way out”


Additionally, common warning signs and symptoms of a substance abuse problem are listed below. These often occur simultaneously with a concurring mental health problem, but sometimes occur on their own:

  • Strong cravings to use drugs or alcohol
  • Changes in hygiene, weight or appearance
  • Using drugs or alcohol in larger quantities than intended
  • Changes in social circle or friends
  • Financial problems
  • Changes in personality
  • Continued use of drugs or alcohol, despite continued social, family, occupational or medical problems

Whether an individual is struggling with a mental health problem, substance abuse problem, or both, symptoms rarely exist in a vacuum, and usually begin to interfere with one’s ability to function at work or home. Have you seen these changes in yourself, a crew member or a loved one? While a comprehensive evaluation with a qualified mental health professional is the only way to accurately diagnosis a mental health or substance abuse disorder, you can the first step. Acknowledge the problem to yourself or your friend. While this takes tremendous courage, the good news is you don’t have to have any answers today. You just have to want to learn more.

Resources are available today to start the process of healing and recovery. The IAFF Center of Excellence is a 64-bed comprehensive treatment center is designed exclusively for IAFF members struggling with PTSD, addiction and other co-occurring mental health problems. Call 855-999-9845 today for a no-obligation, free and confidential screening for yourself or a friend.

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