Responding to Post Traumatic Stress in Veterans & First Responders

In the face of traumatic experiences (a regular part of the day-to-day routine of first responders and a significant risk for many in military service), individuals sometimes experience the effects of post traumatic stress (PTS). PTS “occurs after an individual has seen or experienced a traumatic event that involved injury, the threat of injury, or death.”

PTS and PTSD

More than 80% of the first responder community reports experiencing a traumatic event at some point in their career, and approximately 1 in 3 first responders will develop Post Traumatic Stress Disorder, or PTSD. While PTS shares many similarities with PTSD, and both are a prevalent concern for first responders, they are not the same. Fortunately, there is hope for first responders experiencing PTS, and a variety of solutions to dealing with symptoms of PTS.

Similarly, more than 90% of our nation's veterans have experienced at least one potentially traumatic event, and 23% of those receiving care related to a service-connected illness or injury at the VA will be diagnosed with PTSD. 

While PTS shares many similarities with PTSD, and both are a prevalent concern for first responders and veterans, PTS and PTSD are not the same. Fortunately, there is hope for clients experiencing PTS, and a variety of solutions to dealing with symptoms of PTS. 

The first time I experienced PTS as a first responder was approximately a month into my career. While I had been warned about the things we would see in this profession and had experienced the presence of a dead body before, my crew encountered a gruesome call in which a single person had been involved, and the experience was completely foreign to my young first responder mind. The call began well into the night, so by the time we wrapped up and headed back to the station, the sun was rising, and it was time to return home. I do not remember the car drive home. What I do remember was white knuckle gripping the steering wheel, turning off the radio so I could think straight, and attempting not to close my eyes for fear of seeing the incident again in my head. For the next few days, the memory of the scene played on repeat and finally culminated in a nightmare vivid enough to wake me up in a panicked sweat grasping for my wife to make sure we were both safe. I suspected something was wrong.

Fortunately, the department I work for has an outstanding peer support program and a large number of caring colleagues willing to step up and help. I remember texting one individual on the peer team with a bold-faced lie somewhere along the lines of “hey man, I’m totally fine, but would you want to meet up soon?” It’s difficult to admit when you need help, especially when you are brand new in a department and believe you have everything to prove, including how well you can manage on your own. Gratefully though, the guy I texted wanted to meet up as soon as possible and was able to put words to what I had already suspected but not wanted to say audibly, “Heath, you know, this sounds like post traumatic stress.” I was initially frustrated by the statement, but after talking with my colleague and hearing about his similar experiences there was a weight lifted off the situation. While dealing with PTS is not always as simple as talking it out over lunch, for me the images soon faded, no more nightmares were experienced, and life went on as normal, albeit this time with a better understanding of my own reactions in the face of stress. Post traumatic stress does not always end in a diagnosis of Post Traumatic Stress Disorder, a life full of frustrating symptoms, and a career spent angry and afraid of whatever call awaits us the next day

While the whole incident was a learning experience, the lesson about PTS was the most important. There are consequences we as first responders face following emotionally charged or chaotic calls. Contrary to popular belief, not every person experiencing PTS necessarily has PTSD. While PTSD can appear to be a simple label to throw on actions and feelings in the wake of a traumatic event, an actual diagnosis can not be made without time and severity along with a specific set of diagnostic criteria. However, PTS symptoms and PTSD criteria have an overlap. While not comprehensive, the most often experienced symptoms are listed below:

Post Traumatic Stress Symptoms

Intrusive Thoughts – unavoidable flashbacks and memories, often causing the person to feel as though they were back in the moment of the event

Nightmares – dreams related to the traumatic experience which can be frightening or unsettling in nature

Avoidance – attempting to distance oneself from the location of the traumatic event or any triggers which may cause the individual to think about the event

Mood Swings – sudden irritable behavior, angry outbursts, aggression towards self or others, sudden hypervigilance, and/or intense problems with concentration

Negative Thoughts and Beliefs – persistent unrealistic expectations of oneself such as “I should have done more,” or “I am a bad person,” and/or feelings of detachment or loss of interest in others and activities usually beneficial to the individual

These symptoms can be confusing and frustrating for both the individual experiencing them, and their family members or people who they spend the most time with. To combat PTS symptoms, learning to cope appropriately is key. Some positive coping mechanisms for PTS may include:

Coping Skills for PTS

Relaxation – breathing exercises, meditation, mindfulness

Self-Care – eating healthy meals, exercising, sleeping, and taking care of your physical needs

Talking – finding another individual to confide in who will be beneficial to your stress

Grounding Techniques – utilizing skills to ground yourself in reality rather than focusing on the trauma experience

Substance Avoidance – do not slam energy drinks, alcohol, nicotine, or really any harmful substance in order to feel better

If you notice the signs of PTS in yourself or another in the wake of a traumatic event, keep track of the symptoms and see how they progress. If coping mechanisms alone are not helping, or the PTS symptoms become persistent and detrimental to your life, please seek help. Addressing PTS with a counseling professional can be a difficult step to take, but one worth taking if you are watching your mental health decline in real time. PTS is a regular occurrence for first responders, and you are not alone in the wake of experienced trauma.

If you're a veteran or first responder looking for help managing stress or therapy in the Dallas, Texas area, you can reach out to connect with me at Lifeologie Counseling Rockwall at (214) 357-4001, or find a trauma and PTS specialist at a Lifeologie Counseling location near you!