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.
I am by no means an expert on trauma and PTSD but I live it every day and my path to it was more than incident-specific. I believe that there may be room to include emergency service PTSD in a category that reflects the damage inflicted by or 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 posttraumatic 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.
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 relived a fire service memory in real life. I can’t recall the dream but I know the numbing angst of PTSD well.
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 can not 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.”
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 many incidents we tried to fix. These incidents impact us sometimes moment by moment as we pretend they don’t exist.
I want to take the time to thank everyone in the emergency service community who risk their mental health with every call to action. From firefighters, paramedics, police to dispatches, nurses and doctors….. Thank you!
If you are struggling please go here: Crisis Services Canada