Watch this incredible personal account of how one fire fighter emerged from a battle with years of suppressed thoughts and feelings; success over stigma.

WBNS - 10TV by LACEY CRISP PUBLISHED: 05/10/19 01:00 PM EDTUPDATED: 05/10/19 06:11 PM EDT

There is an approximately one in 10 chance that you or someone you know will attempt to end their life. Over 45,000 Americans kill themselves every year — more than all the annual deaths from terrorism across the world combined. In fact, there are twice as many suicides every year as there are homicides. And more than 500,000 people are treated in U.S. emergency rooms each year for injuries related to self-harm.

Massachusetts firefighters are more than twice as likely to kill themselves as civilians due to untreated depression and PTSD stemming from repeated exposure to death and destruction, according to a new report on mental illness and suicide among first responders.

The study by the Boston-based Ruderman Family Foundation, which advocates for people with disabilities, estimates that the suicide rate for Bay State firefighters is 20 per 100,000 people, compared to 9 per 100,000 for civilians.

46 officers were fatally shot last year. More than triple that — 140 — committed suicide.

Suicides left more officers and firefighters dead last year than all line-of-duty deaths combined — a jarring statistic that continues to plague first responders but garners little attention. 

With the suicide rate among firefighters becoming more prevalent, along with the number of mental health issues such as post-traumatic stress disorder, anxiety, depression, alcohol and substance abuse, the once taboo subject can no longer be ignored.

Firefighters who are diagnosed with PTSD are six times more likely to commit suicide, according to Jim Brinkley, director of Occupation Health and Safety for the International Association of Firefighters. Addiction adds another layer of risk for suicide.

By Christopher L. McKenna