First Responder Exhaustion Syndrome: Taking Care Of Those Who Serve

Melanie BoyackPhoto byhttps://www.melanieboyack.com/

I often present to First Responders, whose response to my presence is all too familiar. At presentations across the state, I watch groups of first responders funnel into a conference room to listen to me speak about mental health. Police departments typically had little trust in outsiders; military groups acted like I was just another dreaded meeting. When I presented to groups of nurses and doctors, they seemed grateful for a minute to sit down. Still, nearly every time, the group’s arms were crossed, a sign they were determined there was nothing to gain.

I began each presentation with stories similar to their own, weaving in my experience and expertise. As the hour passed, I watched tears fill my audience’s eyes—often, they did all they could to maintain composure. After the meeting, a long line waited to talk to me, each using the familiar verbiage, “I need help.”

First Responder’s sacrifice is astounding. Comprised of firefighters, police officers, and emergency medical staff, this population is our community’s front line, protecting us and providing care when we need help or assistance.

The nature of these jobs means that First Responders can bear witness to some of the most horrific tragedies life has to offer—rape, murder, and suicide. 80% of First Responders are exposed to tragic events.

Here’s what First Responders’ exposure to trauma does to their bodies and brains:

Trauma’s Impact on the Body

When humans encounter trauma, our bodies release cortisol, the stress hormone. Following suit, our brains shut off the parts responsible for making decisions and rationalizing, reserving energy for the parts that keep us alive.

This isn’t always a problem. Most of us don’t have to think through a life-or-death situation.

But First Responders don’t have that luxury. This population is asked to make decisions through life-or-death situations, which can take its toll on their bodies. As a result, many live constantly in a state of shock.

It’s estimated that between 15-20% of First Responders suffer from PTSD. Depression, anxiety, substance abuse, and suicide follow suit: First Responders are much more likely to suffer from these compared to the general population.

85% of first responders experience symptoms of trauma, including poor performance, difficulty concentrating, tardiness, poor motivation, and memory loss. They can suffer shock, irritability, and even emotional instability.

All of this harms a First Responder’s sense of confidence and self-worth. Some develop a cynical worldview, feeling like the world is horrible and dangerous. Others experience a negative sense of self, believing they should’ve done more to help those in need.

Looking long-term, all of that stress and pain is embodied. Recent research points illustrates that trauma leaves an imprint on our soul.

Recurring memories and residual symptoms translate into bodily sensations and health issues like obesity, diabetes, and heart disease. First Responders suffer a 73% higher risk of mortality than the general population.

As a result, this population is left requiring psychological first aid.

First Responder Exhaustion Syndrome (FRES)

First Responder Exhaustion Syndrome is often the result of unaddressed trauma, including embodied memories, compassion fatigue, and negative beliefs. While FRES isn’t yet included in the DSM-5, it can affect all too many of our emergency force members.

Unlike PTSD, FRES can be the result of a combination of vicarious trauma and trauma itself. Its symptoms are similar, with sufferers experiencing depression, anxiety, insomnia, substance abuse disorders, isolation, and emotional and physical fatigue.

A hallmark of FRES is an inability to seek treatment. Many First Responders believe that treatment makes them ‘weak’ or ‘incapable,’ and others feel that their peers and supervisors will treat them differently or have less confidence in their skills. Even worse, some worry that a potential diagnosis would ruin their career.

Too many of them believe that residual trauma is just a part of their job description—a consequence of their backbreaking work. This is far from the case.

How to Heal

In return for all the aid and safety they provide us, we provide First Responders with little repose from the emotional pain they endure on the job.

The first step to helping these valued employees heal is changing the culture in these environments. Employers and departments can create a safe space that emphasizes this isn’t the case.

Trauma-informed training, particularly EMDR-focused training, and supportive resources can help cultivate this environment and offer First Responders a chance to heal.

Substance abuse can be a concern for those suffering from FRES, and offering intervention protocols can help educate employees and help those affected find necessary resources.

Another critical intervention is addressing workplace trauma and dysfunction before the fact—not after. Employers should examine protocols and processes to identify potential areas of difficulty, such as long hours, poor ‘return to duty’ standards, etc.

For all the help they give us, many First Responders are left bleeding emotionally and need help. Use the interventions in this article and the resources below to help these valued populations find peace.