Matthew saw unimaginable scenes in his work as a firefighters for over a decade. He witnessed the death of an overdose of a teenage boy, his son’s age.
He said that the worst thing was when an infant or child died. Matthew was treated in my clinic for post-traumatic stress disorder (PTSD) and depression.
Unfortunately, images of destruction and tragedy from deadly wildfires in West Texas have become all too common. The public doesn’t hear much about the pain and suffering of firefighters who risk their lives and are often away from their families for several days or weeks. While firefighters are most well-known for their ability to respond to fires, they also tend to be among the first to arrive at other types of disasters or accidents, as Matthew’s case shows.
Although the decision to become a firefighter is often based on a passion and mindset for helping others, it comes with a price. Being constantly exposed to injury, death, and suffering can be costly. Cumulative stressors are the physical toll on your body, long work hours, sleep disturbances from work, and inability to take care of daily family life.
I am a psychiatrist and trauma expert. I often work with first responders, refugees, and war crime victims. Although firefighters are often seen as happy heroes, their real-life experiences can seriously affect their mental health.
Firefighter’s life
Firefighters can relate to their peers because they have their own “culture” and lifestyle. Many teams spend entire 24-hour shifts together, sometimes for decades, and often share holiday meals when they cannot be with their families.
Firefighters often work together for long periods and form close-knit relationships. Maskot/Getty Images
When I was visiting a Dearborn firefighter team, one of them, who was of German descent, prepared a complete German meal, including schnitzel and sauerkraut, potatoes, and dessert. As I sat in my assigned seat, waiting for others, the firefighter beside me said, “If you wait, your dinner might never be served.” Sure enough, we were called out five minutes later. During the ride, I thought about how stressful it was to drive at high speed to a potential catastrophe where you must solve problems to save lives – or fail to do so.
Firefighter life requires switching between a laid-back lifestyle at the station and racing to avoid unimaginable scenes. This could include anything from light car accidents to terrible car crashes. First responders must pull victims or bodies out of burning cars.
It is part of the job to witness tragic scenes and take risks to their lives and their colleagues. These traumatic experiences are often re-expose to firefighters through stories in the media and videos posted by others on social media. One firefighter shared his thoughts about this re-exposure during the ride-along. “You see it all over the local TV channels and the frequent updates.”
Stress and trauma hurt mental health.
Traumatic experiences like shootings, natural disasters, war, and motor vehicle accidents can lead to PTSD. You can be expose to trauma yourself or someone else.
People are more likely to hear about PTSD when it is associated with war and combat-expose veterans. Combat veterans can often return to civilian life soon after returning from deployment. However, firefighters, police officers, and emergency medical service workers must regularly be expose to traumas for years or decades.
The PTSD brain keeps looking for danger and is always on alert. Symptoms include nightmares, flashbacks, and avoiding trauma reminders. Research has shown that 20% of firefighters and other first responders have passed the threshold for PTSD. This is in contrast to 6.8% who are in the general population. A more significant number of first responders have symptoms that don’t meet the full criteria for PTSD.
Effects of cumulative trauma exposure are depression, anxiety, and substance use. These conditions are more common in firefighters and first responders than in the general population. Alcohol abuse is often use as a coping strategy. Recent research has shown that suicide is a leading cause of death for firefighters and police officers.
The solutions and challenges
Sometimes, firefighters’ ability to problem solve and be in control can become a barrier when seeking help. They might view vulnerability as a sign that they are failing. First responders often feel ashamed and worried that others might view them as weak for speaking up about these issues. Sometimes first responders tell us they have difficulty trusting mental health professionals, who might not have firsthand experience of first responders’ lives and challenges. Many firefighters struggle to share their complex work experiences with their families.
A first responder’s job requires problem-solving and teamwork. This is how firefighters and police help to move a car in Dearborn, Michigan, at a crash site. Arash Javanbakht, CC BY-ND
Chronic stress and trauma can have severe consequences for your mental health.
Moving forward
It is encouraging that serious efforts are being made to raise awareness and combat the stigma around mental health. First responders can access peer-support programs to offer empathy support and encourage people to seek mental health care. These programs can used to combat stigma and explain the brain and body’s mechanisms of stress and trauma. These experiences can viewed as strengths and not weaknesses through this approach. Instead of trying to avoid or deny trauma, firefighters can shift their mindset and encourage fighting it.
Many effective interventions and treatments exist for PTSD, depression, and substance abuse. These include talk therapy and lifestyle modifications. It is possible to overcome trauma with the right interventions. This helps to reduce the stigma associated with mental illness. This can help people to see that PTSD is a treatable condition and not something to live with for the rest of their lives.
Researchers are developing novel trauma therapy methods, including augmented reality. This will help civilians, first responders, and other personnel to heal and improve their well-being.
Other comprehensive programs provide education, support, and intervention for first responders, their families, and their families across the country. A Michigan state-funded initiative, including my department and research center, was launch at Wayne State University. This program provides education, prevention, peer support, and a statewide network of mental health providers familiar with the specific needs of first responders. We also work on novel trauma treatments using cutting-edge augmented reality technologies and telemedicine.
Over the past ten years, I have seen hundreds of trauma victims and their families recover. I believe we can create awareness and improve the well-being of first responders’ well-being.
