Last time, we discussed Post-Traumatic Stress Disorder (PTSD) and it's prevalence in the American fire/EMS community. Now let us discuss the consequences of untreated PTSD. Not only does PTSD have an effect on your own well being, but it also can affect your department. Sufferers of PTSD are going to be less productive firefighters.  We all know the firefighter who has burnt out, nothing that happens is going to make this person happy. At my station the joke is you could give them 20 bucks and they would complain because it wasn't in fives. At least in my experience, in the departments I have been in, no one recognized firefighter burn out with PTSD. No effort is ever made to see what the root cause of the problem is. The assumption is just that they are bitter at the world and have always been that way. Well I can tell you that is a load of bull. No one ever gets into the fire service because they hate it. At one point that bitter firefighter was really excited about their job. They used to love the thrill of it, but now they are so burnt out that it makes them and those around them miserable.

While burn out is bad for the individual and the department, suicide is a much more permanent problem for sufferers of PTSD. Folks who have suicidal ideation are twice as likely to make an attempt if they also suffer from PTSD. It is very difficult for the U.S. Fire Service to get a handle on how big a problem suicide is. The Firefighter Behavior Health Alliance found a confirmed 360 U.S. firefighter suicides from 2001-2013. Suicide reporting for the fire service is very difficult to track. The majority of firefighters, in the U.S., are volunteers so their death certificate will probably not represent their firefighting activities. Also, suicide is not usually listed as a cause of death. Suicide is a mode of ending one's life, it is not however a cause of death.  Firefighters maybe especially susceptible to suicide. We put our bodies on the line. Every day we are exposed to pain and death. This exposure to pain and death may make the firefighter more accepting of their own mortality. Frequent exposure to pain makes us more accepting of it. On top of all this the numbers game is against us. White males make up the majority of the U.S. fire service. White males are also one of the most susceptible groups to suicide. Firefighters in their early careers are in one of the worst demographics. This maybe because of genetics, but it also may have to do with not having the mental resilience to all the pain and suffering they see. Firefighters near the end of their careers are also in a vulnerable demographic. These men and women are facing separation from the group that has helped them cope with all the pain and suffering for so long. As they retire there is going to be an inevitable sense of loss from the firehouse mentality.

We all know that fire/EMS personnel are a hard drinking bunch. There is a long standing tradition of drinking hard in the fire service. Where does that come from? We all are educated individuals and we know it's bad for us. Maybe, substance abuse is a coping mechanism for PTSD. I know tons of firefighters who after a bad call want to get a drink. I know a few firefighters who have ruined their lives and careers through alcohol. The real problem is alcohol and drugs do not help. This is not a healthy way to deal with PTSD. Alcohol is a depressant and can just make the depression from PTSD worse.

A higher rate of violence among veterans suffering from PTSD has been researched and noticed by the professional community. It stands to reason that firefighters who suffer from PTSD may also be at a higher risk for violence. On top of that many members of the U.S. fire service are veterans themselves. This is a dangerous combination. 

It is important to get help now. If you have ever had any of these problems it is important to seek professional advice. Reach out to your local suicide hotlines if you have any suicidal thoughts. You are too important to lose, we need you to stick around. Next time we will discuss how we can perhaps treat PTSD.