Understanding Firefighter PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after experiencing a traumatic event. Symptoms vary in type, intensity, and duration. People of all ages and professions can develop PTSD.

This condition is an important consideration for first responders such as firefighters. First responders may have repeated exposure to traumatic events, which can cause PTSD.

If you’re considering a career in emergency services, it may be helpful to understand PTSD.

What Is PTSD?

An individual may develop PTSD in response to an event that threatens their life or physical, emotional, or spiritual well-being. The condition is associated with changes in certain parts of the brain:

• Hippocampus: Regulates motivation, emotion, learning, and memory. It decreases in size in people who have PTSD.
• Amygdala: Processes emotions and fear responses. It becomes overly active.
• Medial prefrontal cortex: Partly controls the emotional reactivity of the amygdala and appears smaller and less reactive.

A range of traumatic events can cause PTSD, including single events such as a car crash or repeated, long-term trauma such as war. Additionally, individuals don’t have to experience events directly to develop PTSD. Witnessing an incident or hearing about something happening to a loved one can also cause this condition.

The Mayo Clinic organizes PTSD symptoms into four categories:

• Intrusive memories:
  • Distressing memories of the event
  • Upsetting dreams or nightmares
  • Flashbacks, or mentally reliving traumatic events
  • Severe physiological reactions or emotional distress to reminders of the trauma
• Avoidance:
  • Attempting not to think or talk about a traumatic event
  • Staying away from places, people, and situations related to the traumatic event
• Negative thinking and mood changes:
  • Negative thoughts
  • Memory problems, including forgetting details of the traumatic event
  • Detachment from loved ones
  • Loss of interest in activities that once brought joy
  • Ongoing fear, guilt, anger, shame, and other negative emotions
  • Emotional numbness
• Physical and emotional changes:
  • Trouble sleeping and concentrating
  • Outbursts or aggressive behavior
  • Physical reactions, including sweating, shaking, rapid breathing, and a fast heartbeat
  • Self-destructive behavior
  • Constant feelings of being on guard for danger
  • Easily startled

According to the U.S. Department of Veterans Affairs (VA), most people who experience a traumatic event won’t develop PTSD, with only about 6% of the general U.S. population experiencing symptoms at some point in their lives. However, various studies show that, globally, the prevalence of mental disorders — such as PTSD — among first responders, including firefighters, may range from 10% to 35%. The condition is more common in individuals with risk factors such as other mental health concerns, childhood trauma, or a lack of social support after the traumatic event. The Cleveland Clinic notes there’s no way to predict who will develop PTSD following a traumatic experience.

A mental health professional may screen for PTSD using a short list of questions about thoughts, feelings, and behaviors. The results help the mental health professional decide if an in-depth assessment, including a structured interview such as a Clinician-Administered PTSD Scale (CAPS) or a self-report questionnaire such as the PTSD Checklist (PCL), is necessary.

PTSD symptoms may subside over time or disappear. Some individuals' symptoms improve with help from family, friends, or clergy. However, professional treatment is sometimes necessary and may include:

• Psychotherapy or talk therapy
• Cognitive behavioral therapy
• Medication
• Acupuncture
• Yoga

PTSD in Firefighters

According to research published in Societies, firefighters are considered a high-risk group for PTSD due to repeated exposure to potentially traumatic events.

Jonathan Mead, MPA, Criminal Justice and Fire Science faculty member at Purdue Global, says fire service personnel see people at their worst times. “Sometimes it’s a joyous moment when [victims] survive their ordeal,” he explains. “Unfortunately, there are times when that doesn’t happen, and survival is not in the cards. That’s something we have to deal with.”

When firefighters do experience PTSD, Mead says others may not recognize the condition. “Especially in the firefighting world, [others expect us to be] rough and tough, and [we feel] we can’t talk about our internal feelings. But we need to.”

Mead says it’s important to get to the point where people aren’t afraid to ask for help. He says this would have been different 20 years ago, but “now, it’s more out in the open. We need to recognize [PTSD symptoms] a lot more.”

A Closer Look at the Causes and Effects of PTSD in Fire Service Personnel

Factors such as genetics and neurobiology may play a role in why only certain people develop PTSD after traumatic incidents. The Substance Abuse and Mental Health Services Administration (SAMHSA) adds that PTSD is often related to elements including the trauma’s seriousness, whether it was repeated, and the individual’s proximity to the event.

“Everyone has a different tolerance for what we do,” Mead explains. “The movies can make an explosion look cool, but when you’re standing there on the scene, that’s a completely different issue.”

Mead highlights a few examples of traumatic situations, such as seeing someone’s family pet perish in a house fire or dealing with sick children.

However, the event doesn’t have to be catastrophic in order for it to be traumatic. “It could just be reaching your limit on nursing home calls or getting tired of dealing with heart attacks,” Mead explains. “Sometimes it gets to the point where you’ve had enough and need a break.”

“Most people don’t have any issues at first," Mead says. "Later on, when they really have a chance to think about [a traumatic event], things start changing.” He explains that family and colleagues may notice this. “It could be nothing more than saying, ‘Hey, what’s going on today? You just don’t seem like yourself.’”

“Some people will talk, and some won’t,” Mead says. “But we need to ensure that we take the time to listen to those individuals and try to [encourage them] to get help.”

Supporting a Firefighter With PTSD

Helpful resources from expert organizations include:

SAMHSA

SAMHSA offers a National Helpline for free, confidential referrals and information on mental disorders. It’s available 24/7.

U.S. Department of Veterans Affairs: National Center for PTSD

You can find a variety of online PTSD resources here, including how to help a loved one, how to get support, and a list of mobile apps for self-help and education.

Anxiety & Depression Association of America

This organization provides PTSD resources, such as blog posts, webinars, and brochures.

New York State Division of Homeland Security and Emergency Services

Here, you’ll find mental health resources for fire service personnel, including contact information for crisis support and medical professionals.

If you’re considering a career as a first responder, Mead has one more piece of advice. “As you enter the public safety sector, know that you’re going to face incidents where nothing you can do will change the outcome. Know when to ask for help and make connections. Communication is important.”

Learn More About Fire Service at Purdue Global

Mental health is only one part of an emergency services career. With an online bachelor’s degree in fire science, you can build skills in other areas such as firefighting strategy, interagency coordination, and life safety education.

To explore this or any other online fire science and emergency management degree, request information today.