Station Pride Articles

Is it PTSD or Is it Something Else?

Post Traumatic Stress Disorder (PTSD) in Firefighters is becoming a hot topic in the fire service. It’s not a difficult idea to wrap your head around, we all know it’s a constant struggle for some of our brothers and sisters. Managing the raw mortality of the general public is not for the faint of heart. Our experiences with risk, death, trauma, and merely bearing witness to the personal ttick-tockragedies of others is just another Wednesday at the office. The first responder (Police, Fire, EMS) job experience cannot be matched in procedure, process, or practice in any other profession.
Firefighting began with neighbors helping neighbors, entire communities banding together for collective survival in bucket brigades and it has morphed into a massive complex industrial entity, quilted together in inconsistencies. The idea of neighbors helping neighbors remains the same, but the process has changed dramatically. Instead of entire communities standing up to shoulder the load, a select few are standing up, swearing-in, and accepting the life of experiencing all the tragedies and miracles for the sake of others. “So others may live.”

For the last ten years, there has been extensive research into military combat-related PTSD; it’s the majority of research that currently exists with PTSD. What doesn’t exist is extensive research into the propensity and prevalence of PTSD in Firefighters. In every instance of trying to understand firefighter PTSD the only example that can be referenced is combat and war, however, the comparison is not apples to apples. Firefighter PTSD can not and should not be compared to what soldiers experience in combat.combat-veteran-depression-ptsd

Combat-related PTSD occurs because of what soldiers experience and the tasks that he/she performs while they are deployed. The symptoms of combat-related PTSD generally surface when the soldier attempts to reintegrate into society. In short, a soldier leaves the safety of home, inserts into a combat zone; experiences and/or does awful things for a defined term of time (deployment); the soldier returns home and tries to carry on as if nothing happened. No other profession can compare or match the reality of taking another person’s life in combat while accepting the feeling of being hunted or targeted for death.

In a differing experience, Firefighters are nearly always and fairly consistently on the verge of experiencing, if not in the middle of mitigating, a traumatic event (whether there own or witnessing others). Firefighters live in society, and there is no reintegration unless you attempt to measure it after every shift. The exposure to traumatic incidents is spread across years and even decades, over one’s career.

For the first responder, the consistent exposure to traumatic events becomes a way of life. It’s that reality that begs the question; are firefighters ever “post” trauma? 

Sure, there is a moment when the traumatic pic-layers1incident ends,  followed by an inconsistent amount of unmeasurable time until there is another traumatic experience which will have its own “post” block of time. The repeated exposure to traumatic events creates layers of exposure like an onion, one layer on top of another. You may remember one specific traumatic incident for the rest of or life; it may be an awful memory, but it doesn’t always give you PTSD symptoms. It’s not fully known WHY some people get PTSD and others don’t. Again, PTSD isn’t about what’s wrong with you; it’s about what happened to you and how you’re able to process it. Clearly, we’re all different.

To complicate matters, after a while, all the traumatic experiences start to become relative to one another. The worst call you’ve ever experienced will always stick out until it is matched or topped by another call, leaving lesser, moderately traumatic situations to feel not so bad, because you’ve had worse. If you took the average resident of your community and had them bear witness to a traumatic car accident, that event is likely to be more traumatizing to them, because you’ve been exposed to worse or similar incidents.image

As you can probably conclude, it’s not entirely simple to break down the prevalence of PTSD in Firefighters. There are several types of firefighters. Career, volunteer, wildland, airport, industrial, federal, shipboard, and more. Each segment of our profession has vastly differing experiences related to trauma. The airport firefighter could work his entire career without experiencing a traumatic event, while the career firefighter in a metropolitan environment could experience multiple traumatic experiences per week for an entire career.

To make things even more complex, volunteer firefighters in rural areas may experience a fair amount of traumatic experiences related to people they know personally, as opposed strangers, which adds another barrier to research. To further complicate the volunteer research challenge, volunteers lack the PTSD protective factors (social support, kitchen table discussions, access to EAP) available to career firefighters. Volunteers who 574f8b57f3c15-imagerespond to a traumatic event and then return home to their family brings it’s own dynamic that has the potential for marriage and family implications.

If you’ve made it this far, you might be feeling that you’re completely fine, as if nothing could possibly affect you, and you could be right. However, desensitization is the key theme here. Desensitization is the diminished emotional responsiveness to a negative or aversive stimulus after repeated exposure. This has long-term implications which could affect your social relationships outside of the fire department, including your family.

More research is needed in this area so we can begin to understand the bigger picture. With more research, we’re able to create better solutions for firefighters, their families, and the industry. Please take this short survey to help Station Pride gather the data needed to realize a global picture of the greater fire service. The more firefighters that take the survey, the clearer the picture. Please be as honest as possible.

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About Jon Marr (29 Articles)
Jon Marr is a 18-year fire service veteran originally from the Rhode Island area. Jon is a Station Captain with the U.S. Army Garrison Kwajalein Atoll in support of the Space and Missile Defense Command. Prior to Kwajalein, Jon spent 8 years as a Fire Captain for the Area Support Group Kuwait Fire & Emergency Services Department supporting the U.S. Army Central Command in Kuwait. He was also a Fire Lieutenant at Forward Operating Base Falcon in Southern Baghdad, as well as 3 years working for AMR Seattle. Jon is a certified Fire Officer III, Fire Instructor II, Haz-Mat Tech/IC, holds a Bachelors degree in Fire Administration from Waldorf College and has been an EMT for 17 years. He is currently a Graduate Student at Central Connecticut State University studying Marriage & Family Therapy. Jon enjoys scuba diving, traveling, and watching his 7-year-old son see the world in wonder. Jon is a firm believer in maintaining a healthy balance of pride, tradition, and safety within the fire service.

9 Comments on Is it PTSD or Is it Something Else?

  1. Best article to date regarding the challenges in understanding the complexity of FF stress leading to a disability of social acclimation. Thanks for writing.

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  2. Matthew Peterson // September 15, 2016 at 10:22 pm // Reply

    Interesting thoughts for a tough diagnosis.

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  3. Brandon Edwards // September 17, 2016 at 6:52 am // Reply

    Link to Survey don’t work

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  4. I believe that one of the reason these symptoms are on the rise is the changes occurring in the Fire Culture. The “fun and games” that used to take place in the fire stations have been greatly supressed over the past 10 years. I am an 18 year firefighter in Los Angeles and have seen dramatic changes in what is acceptable behavior. That, along with the evolution of individual dorms has limited the day to day interactions between firefighters on duty. This translates to less interactions off duty as well. These are all things that allowed firefighters in tge past to deal with the daily stresses of the job. Coping mechanisms if you will. They only exist in moderation now…Thank you for the article.

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  5. It’s a double whammy for those of us that are career firefighters/paramedics, and that have served in the military in combat zones.

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  6. Great article. Best one yet, that I have read. Thank you.

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  7. I feel as if this survey fits any person that is an emergency responder. I would like to see it opened to EMS and police as well. I feel that this would help with your data collection and help all of our brothers and sisters in the emergency response system.

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  8. No matter how seasoned you are. Or how many calls you have been on. There will ALWAYS be ones that stick with you your entire career. Paid or volunteer, you can’t “unsee” something. Ask for help. Use EAP. And learn to teach those behind you.

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