PTSD and First Responders

First responders are the heroes we depend on in emergency situations and natural disasters. These individuals are the first people on the scene when disaster strikes and include:

• Emergency medical technicians (EMTs)
• Firefighters
• Hospital personnel including doctors, nurses and technicians
• Military service members
• Police officers
• Volunteer civilians.

First responders save and protect countless lives during situations like:

• Airplane, automobile and train crashes
• Earthquakes, fires and floods
• Hurricanes and tornadoes
• Terrorist attacks
• Violent crimes.

Despite the excellent training many first responders receive, traumatic events may leave them vulnerable to PTSD. While the causes of PTSD in first responders may be varied, this condition is fortunately treatable.

PTSD and First Responders: Unique Stressors

Post-traumatic stress disorder can occur after exposure to a traumatic or terrifying event. An event is considered traumatic if it involves a perceived or actual threat of death or serious injury to oneself or others.

In addition to risking their own lives, first responders also bear witness to the terror, pain and tragedy of others. First responders have increased risk of PTSD due to the following:

• Chronic fatigue levels
• Cumulative stress because of repeated exposure to trauma
• Exposure to mass violence and destruction
• Prolonged or failed rescue operations
• Repeated exposure to death, dismembered body parts and human remains, which may include those of fellow first responders.
• Seeing a peer or partner killed or injured in the line of duty
• Witnessing the death of a child.

To complicate matters, many first responders see themselves as "tough" professionals who shouldn't be vulnerable to emotional stress. Some may hide behind humor or substance abuse rather than admit they're suffering from PTSD.

Recognizing PTSD in First Responders

Immediately after exposure to a traumatic event, a wide range of stress reactions is perfectly normal. Symptoms that last longer than two days, but less than four weeks, and negatively affect one or more areas of life will most likely result in a diagnosis of acute stress disorder. When these symptoms persist longer than a month, the problem is considered PTSD.

PTSD symptoms include:

• Avoidance: Trying not to think or talk about the trauma, not visiting the place where it happened and possibly being unable to return to work if the trauma was job-related
• Hyper-arousal: Increased heart rate, blood pressure and respiration, as well as anxiety, anger, fear and physical tension and difficulty sleeping
• Intrusions: Flashbacks, nightmares and other intrusive thoughts and memories.

PTSD Treatment

Fortunately, many treatment approaches are available to successfully manage PTSD in first responders:

• Counseling (for individuals, couples and families)
• Education
• Eye movement desensitization and reprocessing (EMDR)
• Medications.

PTSD isn't a sign of weakness; it's a normal reaction to an abnormal situation. By recognizing and treating PTSD, first responders can heal and get back to the important jobs they're passionate about.

Resources

Dryden-Edwards, R. (2010). Posttraumatic stress disorder (PTSD). Retrieved June 23, 2010, from: http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm.

Mental Health Matters. (2010). Victims of disasters: helping people recover - stressors of first responders: firefighters, police officers, and emergency workers. Retrieved June 24, 2010, from: http://www.mental-health-matters.com/index.php?option=com_content