EMS World recently posted a poll regarding first responders and post-traumatic stress disorder (PTSD). The question asks if a first responder is suffering from PTSD, are they ‘built” for the job? You can access the poll by following this link to answer and view the results, EMS World – PTSD Poll.
As per the Substance Abuse and Mental Health services Administration (SAMHSA), 33% of first responders have PTSD compared to 20% of the general population. The Institutes of Health (IOH) claims that 80% of us experience traumatic events on the job. I would suspect that the remaining 20% are limited to working for an interfacility transport agency. Coming back to the 33%, the IOH also states that approximately 400,000 first responders have PTSD and that works out to:
- Paramedics 15%
- Rescue Teams 13%
- Fire fighters 7%
- Police officers 5%
Looking at the percentages above leaves me to wonder why EMTs and AEMTs were not included in the data. Personally, I think the numbers are low. I do not know a single EMS provider that does not have some degree of PTSD. To take it a step further, 37% for EMS providers and fire fighters have thought about committing suicide, which is 10x higher than the general population.
The symptoms of PTSD are not limited to the flashbacks and bad dreams. PTSD can also manifest as sweating, headaches, chronic pain, dizziness, insomnia, weight gain, and even chest pain. And as much as we encourage providers to participate in health alternatives like physical exercise as an outlet, it is probably safe to say most of us have known or actively know someone who uses or has used alcohol or illicit substances as a coping mechanism, which of course on serves to compound the issue.
The identified barriers to treatment are:
- Cost, transportation
- Getting the need time off work
- Lack of effective treatments
- Stigma with getting help
- Fear of repercussions
Anecdotally speaking, it seems that the stigma, or “suck it up” mentality is falling to the wayside with the newer generation of providers coming into the industry.
Current treatment is limited to counseling, anti-depressants, and antipsychotics. Studies however show that anti-depressants are not effective in patients with chronic PTSD and that antipsychotics like risperidone are no more effective than a placebo. And these medications come with a host of side effects, some of which are life-threatening. But there is some interesting data coming out regarding the use a psychedelic drug, specifically psilocybin, a.k.a. “magic mushrooms.” A 2013 study found that psilocybin stimulates growth and repair of the brain cells in the hippocampus, which is responsible for our emotions and memories. The study was able to show that mice wear able to overcome “fear conditioning” at a higher rate than placebo. Dr. Steven Ross, psychiatrist, also conducted a study on terminal cancer patients and found that a one-time dose of psilocybin gave the patient’s stress relief that lasted for longer than 6 months in 80% of the participants.
I have also read that when psychedelics are used on veterans with PTSD that it allows them to be more empathetic and process the event more easily.
If you are struggling with PTSD, please ask for help. All our organizations have an Employee Assistance Program (EAP) that can help you find and access the available resources.
References:
EMS World. (2022). Are first responders suffering from PTSD “not built” for the job, or is no one immune to it. Retrieved from, https://www.hmpgloballearningnetwork.com/site/emsworld/article/220869/poll-are-first-responders-suffering-ptsd-not-built-job-or-no-one-immune-it.
Institutes of Health. (2022) PTSD in First Responders. Retrieved from https://institutesofhealth.org/ptsd-in-first-responders/#:~:text=According%20to%20the%20Substance%20Abuse,is%201%20in%205%20people.
NYU School of Medicine. (2022). Post-Traumatic Stress Disorder Treatment with Psychedelic Drugs. Retrieved from https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/medical-ethics/education/high-school-bioethics-project/learning-scenarios/ptsd-treatment-psychedelics.
