Carl von Czoernig, a deputy sheriff in a small county in Ohio, started every workday with an involuntary ritual. After showering and shaving, he'd vomit in the toilet. Then he'd grab a fistful of Rolaids (known in law enforcement as "cop candy") to keep his stomach settled during the day ahead.

No doubt about it, police officers work a dangerous beat. Every year, close to 60,000 cops are attacked on the job. Police work is among the three occupations with the highest rates of homicide -- about 56 officers are murdered nationwide each year. But the biggest threat to police officers' safety and well-being isn't violence. It's stress, according to Rich Roberts, director of special operations with the International Union of Police Associations. Nothing brings down more cops and ruins more lives than stress, he says.

This stress shows up in different ways. Police officers are eight times more likely to die of suicide than by murder (their suicide rate is roughly double that of the general public). About 10 to 30 percent have varying degrees of post-traumatic stress disorder. They're also more likely to suffer from high blood pressure -- a disease with strong connections to stress.

At first, von Czoernig (pronounced von CHUR-nig) kept his stress under control. He hated the paperwork and the politics -- most cops do -- but the actual police work didn't faze him. As he puts it, "I could eat a ham sandwich and process a suicide scene at the same time."

But after a few years on the job, the tragedies started to get to him, especially those involving children. Once he broke down crying at the scene when paramedics couldn't revive a 7-year-old drowning victim. Worse, he became haunted by the memory of a raid on a house where a fugitive was holed up with his young son. Four officers were shot in the raid -- von Czoernig himself narrowly avoided a spray of bullets -- and the fugitive and his son died of bullet wounds to the head.

Von Czoernig decided he never wanted to see anything like that again. Whenever a dispatcher called about an incident that might involve children, von Czoernig would always claim to be on the other side of town.

But the damage was already done. He struggled to sleep. He dreamed of getting shot, often by children. His legs shook constantly. He had diarrhea for two years straight. He took regular trips from Ohio to Canada just to get codeine without a prescription. He drank a 12-pack of beer every day. Two marriages failed. And in November of 1998, he sat in his squad car for half an hour with the barrel of a revolver in his mouth.

After his close call with suicide, von Czoernig found the strength to see a psychiatrist. She diagnosed him with post-traumatic stress disorder as well as anxiety and depression. He never wore a badge again.

Von Czoernig, 38, now takes seven different psychiatric medications and still struggles with flashbacks, but he's one of the lucky ones: he never pulled the trigger on himself. Two officers in his department, including the sheriff, shot themselves to death in recent years.

The stress that pushes cops to the brink comes from all directions, says Roberts of the International Union of Police Associations, a former cop himself. Every day, officers face the bleakest aspects of our society and the most frustrating aspects of a paramilitary bureaucracy -- that is, the police department. The job routinely involves stupefying hours of boredom punctuated by moments of sheer terror. One minute a cop could be sitting in his car eating a doughnut, and the next -- as an officer named Thomas Greenly discovered -- he could be attacked by seven men and thrown through a plate glass window. And after being attacked, like Greenly, many police officers endure years of chronic pain from cuts or bullet wounds, further exacerbating their stress levels.

The strain of the job is only made worse by poor sleep, unhealthy diets, bad exercise habits, and, more often than not, the rocky marriages so common among police officers, Roberts says. "Cops have an innate need to be in control of every situation, and that often spills over into their family life," he says. Anecdotal evidence suggests that divorce rates among police officers are similar to those for lawyers, surgeons, and other high-stress professionals, far higher than the "50 percent" figure for Americans generally.

Stress is also linked to strained marriages and suicide attempts. A 1994 study found that officers with marital problems were nearly five times more likely to attempt suicide, and officers who had been suspended were nearly seven times more likely to try to end their lives. Differences explained by age, race, gender, and substance abuse were all insignificant.

For many cops, the job takes a physical toll as well. A recent study conducted by researchers at Iowa State University found that retired police officers were more than twice as likely as other men of similar ages to suffer from heart disease. (Many of the officers chalked up their heart trouble to stress and poor eating habits.) They were also much more likely to smoke and to have hypertension, high cholesterol, and diabetes.

Another 1998 study at the State University of New York at Buffalo found some unexpected results -- compared to the general public, the police officers studied were 10 percent more likely to die of any cause, 25 percent more likely to die of cancer, and 50 percent more likely to die of cirrhosis of the liver. In particular, death rates from esophageal cancer, colon cancer, kidney cancer, and Hodgkin's disease (a type of lymph node cancer) were nearly two to three times higher than the rates seen in people who weren't police officers.

Police work will never be completely safe, but officers can and should take several steps to protect themselves. One crucial aspect of safety, Roberts says, has to do with the availability of high-quality tactical training. Not only does such training prevent assaults and injuries, it also helps nurture confidence. Unfortunately, he says, many officers receive no training at all once they graduate from the police academy; you may want to ask your department or union for additional training.

Cops can also use healthy lifestyle changes as a buffer against stress. A good diet, regular exercise, and enjoyable pastimes outside of work are all essential to peace of mind, Roberts says. Even working in three 20-minute walks a day can help ease tension and help the heart beat more efficiently.

Most of all, cops need help coping with the traumas of the job. According to a 1997 article in Psychological Reports, after shootings or other highly charged incidents police offers may be involved in, debriefings can significantly help prevent divorce, alcoholism, and even suicide. And while police officers almost always refuse to go near a psychiatrist or therapist on the department payroll, many have turned their lives around with help from mental health professionals in the community, Roberts says.

If nothing else, police officers should try to build close ties with their coworkers and draw on their support, Roberts says. "A cop will never walk into a squad room after a shooting and get high-fives," he says. "But he might get a pat on the shoulder, and someone might tell him it's OK." It's a small comfort, he says, but it just might be enough.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

Further Resources

International Union of Police Associations http://www.iupa.org/

National Institute for Occupational Safety and Health (NIOSH) 800/232-4636 http://www.cdc.gov/niosh

Occupational Safety and Health Administration (OSHA) 800/321-6742 http://www.osha.gov

For more information on the stress of police work, or to chat with other officers, visit Carl von Czoernig's website at http://www.help4cops.netheaven.com

References

First published October 3, 2000
Last updated March 27, 2008