First Responders and Mental Health, Let’s Talk About It…


By JESS HARMON, O2X Mental Performance & Resilience Specialist (Psy.D, U.S. Army)

Focusing on Mental Health

While Mental Health Awareness Month may technically be over, the concerns about mental wellness in the first responder communities don’t stop just because we’ve moved past the month of May. 

In fact, it shouldn’t be surprising to hear that many mental health conditions are more prevalent in the first responder community, which is why this issue is of critical importance.  After all, our front-line workers endure continuous levels of high stress in physically demanding and potentially dangerous jobs.  

These jobs require intensive training, yet training and education regarding the mental demands are often lacking (or non-existent). Conditions such as depression, anxiety, post traumatic stress, and substance abuse issues are among the most commonly experienced within these communities.  

Why First Responders are at Risk:

Several unique challenges exist within the first responder community. They constantly face life-threatening and potentially traumatic situations and events, and then leave “the office” with an expectation that there is a mental and emotional separation between work and off-duty. One obstacle is that there is often very little separation between work and home.  

Many first responders remain on high alert, ready to respond at any moment, even when they are not working. Their brains and bodies are doing exactly what they were designed to do – survive high stress situations. Their “fight or flight” systems work brilliantly to help them thrive in those critical moments, but many will tell you that they struggle to turn that off when they’re not on duty.  

Physiologically and mentally, first responders are ready to react without hesitation at any moment. When the pressure is on, they are in the zone. Strangely, when there is no emergency, many will say that they feel the least at ease. Their brains and bodies remain on high alert. “Relax. Take it Easy. Enjoy the time off.” These concepts often sound great but do not exist for many first responders.

Healthy and Unhealthy Coping Mechanisms

One goal of O2X is to help break down the science of stress and explain why relaxing feels impossible and a sense of calm seems to only exist in the midst of chaos. There are a few ways to approach mitigating these mental health issues and building resiliency. Within those options, there are healthy and unhealthy coping mechanisms.  

It can be helpful to understand that most everyone tries to do the best they can with the tools they have at the moment. For example, substance use disorders are much higher in the first responder community than the general population. Often, substance abuse occurs because alcohol, in the short-term, can lead to a reprieve from anxious thoughts, difficulty sleeping, etc. It is maladaptive, because in the long run, it actually leads to increased anxiety and sleep issues, but many individuals do not realize this when they first begin using it to cope with issues.   

Similarly, in what is actually a normal response to experiencing high stress, dangerous events might make people feel like they are “going crazy.” These feelings, however, are normal and expected stress responses. That said, experiencing disturbing thoughts, difficulty concentrating or paying attention, feeling on edge or irritable, or feeling nothing at all – these are potentially symptoms of anxiety and/or post traumatic stress.  

Additionally, lacking energy, loss of interest in previously enjoyed activities, low sex drive, appetite changes, and suicidal ideation are all common symptoms of depression, and research shows that these occur at higher rates within the first responder communities. Not knowing why these symptoms are occurring or how to manage them can be just as difficult as dealing with the symptoms themselves. 

It’s Not Just You

One significant treatment challenge is that we do not typically facilitate open conversations about experiencing these symptoms, nor do we do a good job of normalizing these experiences in high stress occupations. When individuals are experiencing them, there is often shame associated with the symptoms. Many people feel as though they are the only ones who cannot deal with the job or that the others seemingly manage it all better. They begin to feel weak, embarrassed, ashamed and/or angry, and these are a few common feelings related to experiencing anxiety, depression, or PTS. Most people don’t hear what happens behind the closed doors of therapy or realize just how many people are actually experiencing some or all of the aforementioned mental health issues. The truth is that experiencing these symptoms is a NORMAL and EXPECTED response to these abnormal situations.  

Our goal is to help individuals within the first responder community realize that stress responses, whether physiological, emotional, or mental are real and occur far more frequently than it may seem. Stress is NOT “just in your head.” More so, the very things that keep these brave men and women alive in these dangerous situations are the very things that can make coping in the aftermath so difficult.  

When to Get Help

Many people ask questions about when to seek help or if it’s ever too late to get better. It is never too late to seek help. It is also never too early.  From a preventative perspective, finding a trusted resource before you develop a mental health condition would be hugely beneficial.  However, most people tend to seek help when they have exhausted all other resources or when loved ones urge them to do so. Regardless of where someone is in their journey, finding a resource who can help to relieve symptoms while simultaneously helping to develop coping skills is so important. Issues like anxiety, depression and PTS (or PTSD) are all very treatable conditions. Unfortunately issues with stigma, availability, and counselors who understand how to treat this community can be scarce.  

If I could urge a few things on the topic of seeking help: Don’t give up; There are always options; It may take a few different counselors to find the right one; Sometimes things feel like they are getting worse before they get better, but they can and do get better. It doesn’t matter how long these issues have been going on or how bad they feel, there are resources and options to help get to a better place. Know that you’re not alone, you’re not the only one going through the things that you’re experiencing, and there are people in the mental health field that can and want to help you get to a better place.