How Do First Responders Keep From Developing PTSD?

First Responders and Post-Traumatic Stress: Comprehension and Prevention

In the pursuit of community welfare and safety, first responders have to wade through the vast and murky depths of trauma. Despite popular belief, Post-Traumatic Stress—widely known as PTSD—is not just a state of mind. When a person experiences extreme or prolonged trauma, their brain regulates the chemicals and hormones released into the body. Thus, PTSD can cause the brain to get stuck in the high-stress “fight or flight” mode, which can have long-lasting effects.1 If the brain stays in ‘danger mode’ for too long, the memory center in the brain can shrink.

While not everyone who experiences trauma has PTSD, first responders are at a higher risk of developing it due to the repetitive nature of their exposure. That’s why it is important to understand the signs and treatment options.

Symptoms of PTSD

Post-Traumatic Stress can present itself in a variety of ways, but there are a few common symptoms. The American Psychiatric Association breaks these symptoms down into four categories: intrusion, avoidance, alterations in cognition and mood, and alterations in arousal and reactivity. In short, symptoms can vary from flashbacks, to avoidance of similar situations, to a slew of negative thoughts directed internally or externally, to anger and self-destruction.2

*This article is not intended to diagnose. For a more complete list, see the DSM-5. If you are experiencing any of these symptoms, please speak to a trained professional.

Preventing PTSD

Normally, the ideal is to avoid additional trauma, but that is not possible for first responders. There is no guarantee that PTSD is preventable, but there are some precautions.

As a first responder, your coworkers experience the same trauma you do. Develop open lines of communication with them and create a support network. If you notice others in that network are not behaving normally, reach out.5  If you can, extend your support network to family and friends. Let your loved ones in and let them help.

It’s also important to take stock of your own feelings to prevent burnout, which may make it harder to ease the stress responses. Take breaks when you need them and listen to your body and mind. You are not at your best if you work yourself too hard. Adequate sleep, healthy diet, and exercise are also important.5

To deal with the stress, some first responders turn to high-risk behavior or attempt to self-treat with substance use.4 While this is understandable, it only functions to worsen the brain’s processing abilities, and the relief offered is short-lived while the effects of these harmful behaviors can be long term.6 

Even if you feel okay, symptoms of PTSD may not appear until several months or years after experiencing trauma, so it’s best to take precautions.1

Treating PTSD

It is important to note that there is no cure for PTSD, but that doesn’t mean there is no way to treat it. Without swift action, PTSD symptoms could last a lifetime. That said, not every form of treatment works for everyone, so patience and open communication are necessary.

While PTSD can feel like an eternity of treading water, there are ways out, or at least ways to find a shallow end. Set goals separate from work, develop hobbies, take up sports, meditation, or journaling. Lean on your loved ones and occupy your time in a positive, fulfilling way.6

The best thing you can do is seek therapy. There are different forms of therapy used by trauma-trained clinicians, and not every method—or every therapist—may be the right fit. 

A few forms of therapy include:

  • Cognitive processing therapy (CPT): patients learn methods for challenging negative, harmful self-beliefs caused by trauma. In clinical trials, there has been a high success rate.4 
    • Trauma-focused CPT: this is like CPT, but the emphasis is on specific forms of trauma, like the kind experienced by first responders.7 
  • Prolonged-exposure therapy (PE): PE offers safe, controlled exposure to stress-inducing stimuli that can help process traumatic memories.4 
  • Eye-movement desensitization and reprocessing (EMDR): this approach requires the patient to concentrate on external stimuli, using a series of eye movements, auditory tones, and hand taps to encourage desensitization.4 
  • Didactic behavior therapy: this form of therapy encourages the practice of mindfulness to aid in the patient’s ability to process emotions.7

There are other, more experimental therapies like hypnosis and breathwork that have less research behind them, but some find effective.


Awareness and acceptance are key. Researchers and experts know PTSD is a significant problem for first responders, but not everyone understands what that really means.4

PTSD is just as serious as a physical injury—considering the impacts it has on the body, it is one. First responders have important jobs, but beyond that, first responders are people. In order to work more effectively and to live the best life possible, it is vital to take precautions against PTSD and to treat it when necessary. Be patient, find outlets and support systems, and take PTSD seriously. 

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