Working As a Firefigher With PTSD – 

Smoke in the air.  The blaring alarm.  Every firefighter knows the rush of emotions that fill the heart when it’s time to roll.  Excitement.  Anticipation.  Fear.  Is this the Big One?  Is today the day my number’s up?

However, in the gung-ho fire environment, too often the feelings that haunt us are pushed down to the bottom.  Nobody wants to look weak in front of his or her teammates.  Nobody wants to be “that Guy”.  So we repress, force a grim smile, and get back to work.  The things we’ve seen stay with us, but there’s a job to be done.

With fire weather getting hotter and drier, and the country gradually becoming more densely populated, firefighters are called on more often than ever to work longer, hotter shifts.  As always, selfless EMS workers are ready to answer the call.  The psychological costs, however, can be tremendous.  The sad fact of the matter is, if you are in the business of fire long enough, you will eventually see some things you wish you hadn’t.

Much of the research conducted on PTSD has related to soldiers returning from war.  However, the mental trauma felt by firefighters all over the country is equally valid and equally painful.  By utilizing the studies done on soldiers and that done on firefighters, we can make a difference.  By keeping certain underlying principles in mind and adhering to some standard practices, we can help prevent PTSD in the workplace and aid those who are already suffering.

Like all behavioral disorders, PTSD can take a wide variety of forms and can bleed into other mental disorders. Many symptoms appear similar to those of other disorders like major depression, generalized anxiety, or eating disorders.  PTSD sufferers are also vastly more likely to turn to drug and alcohol abuse in an attempt to mask their feelings.

Some signs to watch for:

• You may notice yourself or a colleague becoming withdrawn. They may often look “spaced out”, and have trouble focusing on tasks or topics of conversation.   They might miss out on jokes, might rarely seem to want to talk, and might start avoiding other people altogether..
• The sufferer may have recurring nightmares, or find themselves unable to stop reliving a traumatic moment during the day. They may deal with constant, nagging feelings of guilt.
• The sufferer may start to avoid situations that reminds them of traumatic events, or, when faced with those situations, become jittery or “spaced out”. You may notice trembling hands, a change in voice, or restlessness.
• The sufferer may become anxious and jumpy, constantly on the lookout for danger, even at home or at the station. This state is known as “hyperarousal”, and it frays your nerves over time.
• They may find it difficult or impossible to sleep. You might notice a colleague looking unusually tired, struggling through daily tasks that were once easy.

Most fire departments and wildland fire crews conduct After Action Reviews.  This can be a good time to address feelings or traumatic events that you witnessed during the day, but don’t feel pressured to share anything too private.  Studies have shown that these less-formal reviews are a better format for sharing personal experiences than a more intense Stress Debriefing.  However, if you or a coworker do not feel comfortable opening up in front of the group, your next course of action might be to follow up with your supervisor.  He or she needs to know what is happening so they can take an appropriate response, and they are more likely to have the experience necessary to counsel and aid you or a suffering coworker.  This may include further counseling, either with the supervisor or a mental health professional.

Talking with a trusted fire buddy can also help alleviate stress.  As a firefighter, you may be the best resource another firefighter has.  Many firefighters don’t feel comfortable bringing up the details of work with their families.  Try to be empathetic, and listen to what your buddy has to say without making a snap judgment.  At the same time, it is of the utmost importance that you care for yourself first.  Just as we always avoid becoming casualties ourselves in the course of saving others, we must protect our own mental health so that we can be the best ally for those who are suffering.  Don’t make the mistake of thinking it’s your duty to “fix” a suffering coworker. Talking over the details of a tough shift can help us process our feelings, but If you or your buddy are suffering from PTSD, odds are good they may need professional mental health aid.

It’s normal to feel a mixture of extreme emotions after a traumatic event, sometimes for days or weeks afterwards.  Ultimately, if the symptoms persist for more than four weeks, treatment from a psychological professional becomes the only feasible option.  There are now many treatment models available to PTSD sufferers.  The most common is Cognitive Behavioral Therapy – also commonly known as “Talk Therapy”.  The doctor meets regularly with the patient to work through pain and grief in a safe setting.  This treatment is often combined with other forms.  Some sufferers find group therapy to be very effective, whereby a group of PTSD sufferers will come together to share their experiences and work through them mutually, supporting one another.  Another possibility is exposure therapy, in which the mental health professional will gradually help the sufferer to confront the traumatic events, sometimes reliving them if necessary, to eventually learn to control their feelings of the event.  One model is known as EMDR, or Eye Movement Desensitization & Reprocessing.  This process focuses on small, controllable movements like those of your hand or eye.  While thinking about your experience, the therapist will ask you to perform a simple movement like following his hand with your eyes.  These small actions lead up to a greater feeling of full control when dealing with trauma.  A doctor may also prescribe medication.  The most common is SSRIs, the same type of medication used to treat depression.

Dealing with trauma is one of the most difficult things a person, a family, or a team of firefighters can ever face.  However, with proper support and decisive, caring treatment, it is possible to come out the other side stronger and more resilient.  Too many EMS workers suffer in silence every day.  Don’t let yourself or a colleague become a statistic.

Any talk of self-harm should be treated seriously.  If you believe you or someone else may be at risk, contact the National Suicide Hotline at 1-800-273-8255.

Sources

“Dealing with PTSD in the Fire Service”, http://www.firefighternation.com/articles/2013/08/dealing-with-ptsd-in-the-fire-service.html

“A New Approach to After-Action Reports”,

http://www.firerescuemagazine.com/articles/print/volume-8/issue-7/firefighter-safety-and-health/a-new-approach-to-after-action-reports.html

“I’m a Firefighter with PTSD… Now What?”

http://www.fireengineering.com/articles/2016/01/im-a-firefighter-with-ptsd-now-what.html