By Pat Matuszak

First responders by definition respond to someone else’s emergency, not their own. So the emotional aftermath firefighters, paramedics, military or police personnel experience may be overlooked — even by the first responders themselves.

If you’re a first responder and are experiencing symptoms like sleeplessness, anxiety or depression, you are not alone. You or your loved ones may wonder if you have post-traumatic stress disorder (PTSD) when memories of emergencies and stressful situations you’ve handled through your job come back to haunt your dreams or startle you during the day.

It might help to know that, according to psychological studies of rescue workers, you are in the majority rather than the minority. According to the American Psychiatric Association, about 75 percent of rescue workers have some symptoms of psychological trauma after working a disaster.1

Rescuing the Rescuers

Firefighter bootsEmergency personnel are used to being the rescuers, not the ones who need help. Inside their fraternity of heroes, popular mythology subtly supports the belief that the strong person is one who faces death and horror without any side effects. This is not a realistic image, according to the National Fallen Firefighters Foundation: “The ongoing work of first responders in the community can also take a toll on workers’ mental health … a fire department is three times more likely in any given year to experience a suicide among its staff than a line-of-duty death.”1

According to, depression and PTSD have been shown to be the strongest predictors of suicide among first responders.2 Instead of waiting for these predictors to progress to the point of despair, we encourage you to take them seriously and talk with your supervisor or colleagues about getting treatment if you experience any of them or recognize them in a coworker or loved one. Talk therapy, counseling and group discussion are some of the ways to cope. The important thing is not to ignore trauma symptoms.3

Mentoring and accountability partners have been other successful practices among first responders. One group discussion program developed by the military, the After Action Review, has been used by first responders. AAR participants analyze events together, discuss how they reacted, put things in perspective and air out feelings that might be suppressed or denied.3

Making It Safe to Seek Help

Although most first responders’ departments have mental health care in place to deal with depression, PTSD and other work-related issues, surveys show that up to 40 percent of responders said they believed there would be negative results if they used those services. They worried about the stigma of needing psychological help affecting the way colleagues treated them, whether it would defeat their chances of promotion and if they would be seen as weak.1

Counselor and first responder Asa Don Brown explains the problem for Psychology Today:  “The first responder community must begin recognizing that mental healthcare and mental illness are no different than any other health care need … Regrettably, a number of those who are serving as officers and leaders in various first response fields believe that mental illness is an issue of the weak and vulnerable. As a clinician and a first responder, I am adamant about eliminating the stigmatization of mental healthcare and mental illness … First responders must be taught to be EMPATHETIC not only to the public, but to those that are serving with them.”4

First responders also need to show empathy to themselves. Brown recommends that first responders and their leadership treat mental health issues the same as physical illness. “If someone has a broken leg, we do not send them away for an amputation,” says Brown, “rather we send them to the hospital to receive a thorough examination, medical treatment, x-rays, and physical care.” He advises those in need of psychological help to seek effective therapeutic care in the same way.4

Dr. David Sack, a psychiatrist who specializes in trauma treatment, encourages emergency workers to remember that they are experiencing unusual and extraordinary situations, even though those events are part of their daily job. “Trauma is a normal human response to an abnormal situation,” he explains for Psychology Today. “It would be strange, after all, if you had no negative reaction to putting your life at risk each day or seeing terrible things happen to people and being powerless at times to help. Understanding this allows you to move from a mindset of ‘what’s wrong with me?’ to a more empowering ‘this is what’s going on with me.’”5

How Valley Hospital Can Help

Therapy programs like the one at Valley Hospital in Phoenix, which is specifically designed to meet the needs of emergency service professionals, can help when mental health issues do arise. Doctors and clinicians with deep experience and training in trauma treatment guide patients to handle stressors in emotionally intelligent ways. Fellow first responders work together in groups to give each other support and share strength so no one feels they are alone with these struggles.

Fourth-generation firefighter and crisis stress intervention expert Mark Lamplugh advises first responders to rescue themselves by accessing various types of treatment available to deal with PTSD and similar issues:  “The important thing is that you seek help if you are experiencing symptoms of PTSD. It’s not easy, especially when reaching out seems harder than pushing others away. But, with a robust support system, you can learn to live with the past and make a better future for you and others.”3


1First Responders Face Mental Health Challenges.” American Psychiatric Association, October 2, 2017.

2 Martin, Colleen, et. al. “Depression & PTSD Shown to Be Strongest Predictors of Suicide.”, November 25, 2016.

3 Lamplugh, Mark. “I’m a Firefighter with PTSD…Now What?” Fire Engineering, January 19, 2016.

4 Brown, Asa Don. “First Responders and Mental Health.Psychology Today, May 12, 2017.

5 Sack, David. “Trauma and First Responders: When the Helpers Need Help.” Psychology Today, January 31, 2017.