Tech Expert: PTSD In Firefighters Is High, Hard To Spot

Firefighters experience post-traumatic stress disorder at much higher rates than the general population.

Derrick Edwards is Principal Investigator of the Tennessee Tech Responder Health Lab. He said PTSD can be very challenging to diagnose in firefighters because they are already dealing with highly stressful situations on a regular basis. Edwards said it is important to separate PTSD from the standard levels and symptoms of stress that any first responder will experience throughout their career.

“We often don’t look at PTSD in firefighters, yet what we find time and time again: the prevalence is there, the risk for life-changing decisions such as suicidality or drugs and alcohol, those are still there as well,” Edwards said.

Edwards said firefighters suffering from PTSD are likely to shut themselves off and not reach out for help because they do not know how to communicate what they are feeling and dealing with. A new Tennessee law went into effect January 1 expanding the Worker’s Compensation program in the state to cover Post-Traumatic Stress Disorder.

Edwards said firefighters are not usually considered when discussing PTSD because their experiences are very different from those of people in the military or police force.

“I’ve been a firefighter for twenty years,” Edwards said. “There’s been very few occasions where someone was actively trying to kill me. Like that doesn’t happen a lot as a firefighter. Now it still happens, but it’s a big deal when it happens. And this might be a monthly occurrence for an LEO, right? A law enforcement officer.”

Edwards said a great way for people to help firefighters with PTSD is by letting them know how much they are appreciated.

“As we hopefully continue to have the social support, it is an amazing factor in the resiliency of all emergency responders,” Edwards said. “To know that what you do has meaning and that you are valued is helpful. So what I would say to any part of the community: just recognize that the job that responders are doing is difficult and then every now and then let them know that you see them and that you care that you appreciate them.”

Edwards said PTSD is often referred to as “the great mimicker” because it can present itself like a wide variety of other disorders, making it even harder to diagnose.

“It might present itself like any of the other disorders that are available in the mental health world, right?” Edwards said. “So if you’re a person who is more bent towards depression, well your PTSD might look a lot like a depression. Or if you’re a person who is bent towards anxiety, well your PTSD might look like a generalized anxiety. It might show itself as an obsessive-compulsive disorder or even might look like a borderline personality disorder or a bipolar disorder.”

Edwards said the tools that are normally used to diagnose PTSD are not calibrated to properly assess first responders.

“Most all post-traumatic stress disorder questionnaires will have a question in them which is: have you experienced or witnessed someone in a life-threatening situation? Well, for every emergency responder that’s a yes, so it gets really difficult,” Edwards said.