The Mental Health Toll of Carbon Monoxide Injury

THE MENTAL HEALTH TOLLS WHEN THE MIND FALTERS

By Dr. Barbara Bartlik

Photo courtesy: FF Marissa Halbeisen

Before her injury, firefighter Marissa Halbeisen was defined by competence, confidence, and command. A veteran California firefighter, she thrived in high-stakes environments that demanded clarity, decisiveness, and physical endurance. Carbon monoxide poisoning changed that trajectory—not through visible trauma, but through a quiet neurological disruption that slowly altered how she thought, felt, and related to herself.

From a mental health perspective, Marissa’s experience reflects one of the most under-recognized consequences of toxic exposure: the psychological fallout that occurs when the brain no longer functions as it once did. After her wildfire exposure, she developed persistent cognitive symptoms—brain fog, slowed processing, memory lapses, and sensory overwhelm. These were not merely inconveniences; they struck at the core of her identity. When a person whose life depends on mental sharpness suddenly cannot trust their own cognition, the emotional consequences can be profound.

Patients with carbon monoxide–related brain injury often describe a painful disconnect between intention and ability. Marissa knew what she wanted to do, how she wanted to show up, and who she had always been—but her brain could not reliably execute those intentions. This gap frequently produces anxiety, frustration, grief, and a corrosive loss of confidence. Individuals begin to withdraw, not because they lack motivation, but because repeated cognitive failure erodes the sense of safety in participation. When thinking itself becomes effortful, engagement feels risky.

There is also a unique emotional burden in being told—explicitly or implicitly—that nothing is wrong. Normal lab results and unremarkable scans can leave patients questioning their own reality. For Marissa, this medical invalidation compounded her distress. She was not depressed in the traditional sense, but she experienced what many neurotoxic injury patients report: a loss of agency. The will to perform, to teach, to lead—once effortless—became fragile. This is not a character flaw; it is a neuropsychiatric consequence of injury.

Carbon monoxide poisoning affects brain regions responsible for executive function, emotional regulation, and stress tolerance. As a result, individuals may experience irritability, emotional lability, diminished resilience, and heightened sensitivity to stimulation. These changes often masquerade as mood disorders, yet treating them as purely psychological misses the underlying biological insult.

Marissa’s story is emblematic of a larger population suffering in silence—first responders, industrial workers, and civilians whose mental health struggles originate in toxic brain injury. Her willingness to speak openly reframes advocacy in its truest form: awareness born of experience, coupled with prevention and early detection.

Mental health care for neurotoxic injury must begin with validation—recognizing that when the brain is injured, emotional suffering follows. Healing requires integrated attention to both brain biology and psychological resilience. Marissa’s journey reminds us that restoring confidence and will is not about pushing harder, but about helping the brain recover its capacity to support the self it once carried so reliably.

 

The Descent Into the Invisible Injury

In the weeks that followed, Marissa began experiencing symptoms that alarmed her: mental fog, slowed processing, and memory problems. Tasks she once performed effortlessly suddenly felt foreign. Teaching at the fire academy became difficult. Studying for her captain’s exam—material she knew cold—was impossibly hard. “I looked fine on the outside. Inside, it felt like someone unplugged my brain.”

By April, her once-rigorous workouts stopped. By May, she pulled herself off duty—a decision firefighters rarely make without extreme cause. She underwent blood tests, autoimmune panels, imaging, and routine assessments. Everything came back “normal.”

But nothing was normal.  She developed overwhelming fatigue, full-body aches, slurred speech, and balance problems. At her worst, she could not drive. “It felt like being intoxicated all the time without having touched a drink,” she said.

An ER visit revealed nothing on standard tests. Yet deeper investigation finally uncovered the truth: hypoxic brain injury linked to CO exposure. MRI imaging, a toxicology assessment, and evaluations by occupational medicine specialists revealed she had experienced significant carbon monoxide poisoning—followed by delayed neurological decline.

She was left with the classic signs of DNS: cognitive impairment, motor coordination issues, hormonal disruption, and chronic neuroinflammation.

The System Misses What It Cannot See

Marissa’s ordeal highlights a troubling reality: CO injuries are wildly underdiagnosed, especially among firefighters. Wildland operations, unlike structure fires, often lack formal rehab protocols or CO monitoring. Firefighters frequently operate in heavy smoke without SCBA, believing the risk is acceptable or temporary. The consequences can be catastrophic. Research shows that mild to moderate CO exposure can trigger:

• Memory loss and slowed processing

• Personality changes and irritability

• Balance and gait disturbances

• Hormonal dysregulation

• Autonomic nervous system impairment

• Increased risk for long-term neurodegenerative disease

Yet because CO clears from the blood within hours, by the time a firefighter seeks help, measurable evidence has vanished. Only MRI, neurocognitive testing, and clinical experience reveal what the bloodstream no longer does. “They told me my tests were normal. My body was telling me I was drowning.”

Marissa’s experience reflects the silent epidemic affecting many firefighters, veterans, athletes, and civilians exposed to toxic air.

 

Finding a New Model of Care

When traditional medicine failed to explain her symptoms, Marissa found a different path through Dr. Leslie Valle-Montoya and the Brainwave Wellness Institute—an organization dedicated to non-invasive brain performance therapies and recovery from toxic exposures.

Dr. Valle-Montoya conducted deeper diagnostic testing, including mineral and heavy metal screening, autonomic assessments, and inflammatory mapping. The results confirmed what Marissa felt: her body was carrying a toxic burden, and her nervous system was in distress.

Treatment included:

• Mild hyperbaric therapy to improve oxygenation

• Ozone nebulization to clear the mucus membranes damaged by smoke

• Bioenergetic frequency therapy to support detox and brain recovery

• Niacin-assisted sauna detoxification

• Nutrition protocols and hormone-balancing strategies

Within weeks, Marissa noticed sparks of improvement. Her clarity brightened. Her energy rose. She still faced challenges—but now she finally had a plan.

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A Broader Crisis: Many Suffer in Silence

Marissa’s story echoes across the fire service. For every firefighter diagnosed, many more quietly struggle. Symptoms like irritability, “forgetfulness,” trouble concentrating, unexplained fatigue, or emotional volatility are often written off as stress. Departments lack consistent monitoring, education, or long-term tracking of neurological symptoms.

The truth is stark: CO poisoning and neurotoxic smoke exposure may be one of the most overlooked occupational diseases of modern firefighting. Organizations such as the Brain Injury Alliance, Carbon Monoxide Safety groups, IAFF wellness programs, and emerging CO survivor networks are beginning to push awareness forward. But most sufferers still remain undiagnosed—soldiers in a silent war against toxins that do not show up on standard lab panels.

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Marissa’s Mission: Turning Injury Into Advocacy

Despite ongoing recovery, Marissa’s spirit remains anchored in service. She refuses to let this invisible injury silence her. Instead, it has sharpened her purpose. “If I make it back, I’m coming back better than before—and I’m taking others with me.”

She now hopes to educate firefighters on early detection, advocate for CO monitoring protocols, and support national organizations fighting for recognition of toxic exposure injuries. Her story represents both a warning and a roadmap—proof that invisible injuries are no less devastating, and no less deserving of care.

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A Call to Action

Marissa’s experience makes one thing clear: the fire service must evolve.

• CO monitoring must become standard.

• Rehab must be mandatory on wildland incidents.

• Neurological screening must be built into occupational health.

• Firefighters must be taught to recognize—not hide—signs of cognitive decline.

For every Marissa who speaks out, dozens remain unheard. This newsletter—and this story—is for them.

Because the smoke may clear from the hillside, but for many, it lingers in the brain long after the fire is gone.