Emergency Service PTSD

Not all wounds bleed – Some are because of emergency service PTSD

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It takes a different breed of person to be a volunteer firefighter. The time commitment in non-emergency operations alone is tremendous. In fact, responding to calls makes up a very small percentage of one’s volunteer time.

Sadly, it is this small window of the hours logged that can have the most detrimental impact on a firefighter’s well-being. Of course, there are the obvious physical dangers in firefighting; running into a burning building is serious business, that’s for sure. Even though I was well aware of the potential physical danger, I was oblivious to the silent injury rarely discussed – the mental injuries I call emergency-service PTSD.

This, not-so-well-known injury that some firefighters are impacted by is a debilitating injury known as Post Traumatic-stress disorder (PTSD) A tragic consequence of helping one’s community – and unfortunately for some, it can end up being their ultimate sacrifice.

The notion that “a” single traumatic event is a must when diagnosing PTSD?

It’s quite understandable; we, those in the emergency services, see things that no human should ever have to see. However, someone has to step forward and do it. While this may be true, all these brave souls can hope for is that they get to the end of their service relatively unscathed. But for those not so lucky, it can be heartbreaking, mind-numbing and is something that keeps them up at night.

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I am by no means an expert on trauma and PTSD – however, I live it every day – and as a result, my path to my mental health injury was likely not incident-specific.

Therefore, I tend to believe that there may be room to include emergency-service PTSD in a category that reflects the damage inflicted, damage that comes as a result of being witness to multiple critical incidents. Exposure over an extended period of time doesn’t seem to fit the criteria the DSM-5 Diagnostic and Statistics Manual is looking for.

The American Psychiatric Association defines post-traumatic stress disorder (PTSD) as a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist attack, war/combat, rape, or other personal violent assaults.

Because EMS workers tend to have prolonged and repetitive exposure, the notion that “a” single traumatic event is a must when diagnosing PTSD, may not do these brave souls justice. In fact, it may leave a portion of the traumatized undiagnosed because it may be hard to discern that one particular incident.

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From my own experience, those accumulated scenes can play out in nightmares that are not incident-specific and are not recalled with any real regularity. Sometimes I awake feeling like I just re-lived a fire service memory in real life. I can’t recall the dream, but I know the numbing angst of PTSD well.

I truly believe that emergency-service PTSD could well be a subcategory of the original definition.

Recently, I have learned that I am not the only firefighter who is haunted by their traumatic experiences in this way. Other firefighters have told me that they have similar experiences. Many describe their symptoms as accumulative and cannot nail it down to just one event.

They also report creating emergencies in their heads as they navigate throughout their day. For example, speeders on the highway tend to piss us off. Many EMS workers hate to see people speed because they are well aware of the consequences of this behaviour. All they can think about is the potential situation the speeder is putting them in. “Jerk is going to kill someone and I’m going to be forced to help.”

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I truly believe that emergency-service PTSD could well be a subcategory of the original definition. We relive our most horrific incidents directly or indirectly (the speeder scenario). We don’t suffer from “a” specific trauma, we dream and replay them; many incidents we tried to fix. These incidents impact us sometimes moment by moment as we pretend, they don’t exist.

“Not all wounds bleed”

I want to take the time to thank everyone in the emergency-service community who risks their mental health with every call to action. From firefighters, paramedics and police to dispatchers, nurses and doctors….. Thank you!

If you are suffering from PTSD or another mental illness, please reach out. I thank you for your service and you are still worthy and mean something more people than you know.

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Jonathan Arenburg

Jonathan Reginald-Nixon Arenburg (Born January 14, 1976) is a Canadian mental health blogger, speaker, and published author. Retired from the fire service and long-term care fields, he has written and self-published an autobiographical account of his life-long battle with anxiety, depression and more recently, post-traumatic stress disorder (PTSD). Titled, The Road To Mental Wellness, he wrote it for what he calls “therapeutic release.” He published it in hopes it would help others going through similar mental health conditions. The sales of The Road To Mental Wellness have been steady selling over 300 copies since its release on October 10, 2021(World Mental Health Day). Arenburg has also been involved in a collaborative publication Called Lemonade Stand Volume III, a book featuring 20 authors who bravely tell their stories of PTSD. All authors where from the military and or emergency services. Published by Joshua Rivedal and Kathleen Myers for the i’Mpossible project, a mental health advocacy organization. Jonathan has also appeared on several mental health podcasts including The Depression Files, A New Dawn, and The Above Ground Podcast Arenburg has also consulted with the Government of Nova Scotia and the Minister of Mental Health and Addictions, the Honorable Brian Comer and Candidates for the New Democratic Party of Canada, on improving the mental health care system in Canada. Additionally, Jonathan was recognized in The Nova Scotia Legislature by the Honorable, Chris Palmer, Kings-North MLA, for his Book, The Road To Mental Wellness, his fight to make the mental health care system better. In addition, Chis acknowledged the support he gives to others.

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