PTSD in First Responders


First responders are the first people to arrive at the scene of an emergency. We rely on them to be the first to bring us to safety and take control of the situation, whether through administering medical aid or helping people evacuate the situation. They are integral to our communities, but having such an intense, fast-paced job can take its toll. Many first responders are responding to high-risk, high-stress situations that are often traumatic not only to the victim, but to anyone on the scene. Having to experience these traumatic emergency situations on a daily basis is difficult for anyone, and can lead to several stress and trauma-related disorders. Post-traumatic stress disorder (PTSD) is a mental illness that can be triggered by either experiencing or witnessing a traumatic event, and often results in symptoms of flashbacks, avoidance and depressive moods (Mayo Clinic, 2018). First responders who are witnessing these traumatic events often are at high risk for developing PTSD. In fact, approximately “30% of first responders develop behavioral health conditions including…depression and posttraumatic stress disorder, as compared with 20% in the general population” (Substance Abuse and Mental Health Services Administration, 2018). 

PTSD in first responders is especially concerning because several aspects of the job can exacerbate the symptoms associated with the disorder. For example, many first responders such as EMS personnel and firefighters have erratic schedules with long shifts. Because they are first responders, they have to be ready to go at any time when there is an emergency. As a result, many first responders suffer from lack of sleep and fatigue. These are two conditions that are detrimental to mental health and can result in issues with being able to regulate emotions (Kelley, 2019). A common symptom of PTSD is changes in emotional reactions such as irritability, aggressive behavior, fear, suspicion, or overwhelming guilt or shame (Mayo Clinic, 2018). Lack of quality sleep can make this symptom even worse, and first responders with PTSD are especially at risk for this. Furthermore, many first responders turn to alcohol for comfort after a stressful experience at work. There is a sense of camaraderie and support that comes with getting a drink with coworkers after work. This is normal for many individuals, not just first responders; however, another symptom of PTSD is substance abuse and drinking with coworkers can easily turn into binge drinking. Alcohol abuse along with an erratic sleep schedule can make symptoms of PTSD worse and make it very difficult for first responders to keep from spiraling into depression or suicidal tendencies (Kelley, 2019). This is why it is increasingly important to spread awareness about PTSD in first responders and how their jobs can affect them.

Many first responders often suffer in silence. They prioritize their job first, helping those in need, but are unable to help themselves. There is a stigma surrounding PTSD and they are unable to speak up comfortably about what they are experiencing (Fitzpatrick, 2020). There is an attitude that mental illness is weakness—that by being affected by the atrocities they are witnessing everyday, they are somehow inferior to others. This fosters a negative environment where first responders are forced to bottle up and push aside their emotions or avoid seeking help lest they be looked down upon. This stigma against mental illness and PTSD in first responders is so pronounced that in a survey of 2,000 first responders, 40% stated that they would have faced negative repercussions at work for seeking help (Ebersole, 2019). Preventing our first responders from getting help services no one. By damaging the mental health of our first responders, they will not be able to do their job effectively and more importantly, they will be more at risk for exacerbating their symptoms and suffering. It is vastly important that the stigma against mental illness in emergency workers is eradicated and resources are being offered for help. Our first responders sacrifice so much to help society; it is only fair that they receive help and support in return when they need it. For anyone who knows a first responder, be aware of the symptoms and signs of PTSD and encourage the individual to seek help if needed. Above all, offer your support and be aware of triggers. First responders often receive questions about the worst emergency they have been called to or if they have experienced a highly dangerous situation before (Kelley, 2019). These can be triggering questions and bring up painful, traumatic memories. Although the intention is innocent, the effect on the individual can be devastating. 

First responders are more at risk for developing PTSD compared to others due to the stressful nature of their job and their constant exposure to traumatic events. PTSD can develop just from witnessing a traumatic event, which is something these individuals do almost on a daily basis without having enough time to fully process and recover from it. Reducing the stigma surrounding mental illness in first responders and offering resources and support is incredibly important to allow first responders to heal from the traumas they are witnessing. 

 

References

Ebersole, R. (2019, October 26). First responders struggle with PTSD caused by the emergencies, deaths, tragedies they face every day. The Washington Post. https://www.washingtonpost.com/health/first-responders-struggle-with-ptsd-caused-by-the-emergencies-deaths-tragedies-they-face-every-day/2019/10/25/9c4c9a0e-d4b8-11e9-9610-fb56c5522e1c_story.html

Fitzpatrick, A. (2020, July 28). First responders and PTSD: A literature review. Journal of Emergency Medical Services. Retrieved April 8, 2021, from https://www.jems.com/administration-and-leadership/first-responders-and-ptsd-a-literature-review/

Kelley, R. (2019, October 28). America’s first responders’ struggle with PTSD and depression. EMS1. https://www.ems1.com/ptsd/articles/americas-first-responders-struggle-with-ptsd-and-depression-LsgD4lAsb0ycVuQH/

Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD) – Symptoms and causes. Retrieved April 8, 2021, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

Substance Abuse and Mental Health Services Administration. (2018). First responders: Behavioral health concerns, emergency response, and trauma. https://www.samhsa.gov/sites/default/files/dtac/supplementalresearchbulletin-firstresponders-may2018.pdf

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