What Do You Say to Someone Struggling from Emotional Trauma?

September 10, 2019

By Chief Jared Meeker

You might already know that mental health conditions occur at higher rates for first responders compared to the general public. We are routinely exposed to physical and emotional trauma, sometimes on a daily basis.

Most people in this world do not see what we first responders see, and they cannot relate to what we feel after a tragic call — the change of mood, the feeling of depression, the attempts to file away those images from that traumatic event in hopes they never return. It is not surprising, then, that for many firefighters a traumatic incident or the accumulation of witnessing trauma over time can have a significant impact on their mental wellbeing.

You may notice that a fellow first responder is struggling from one of those calls, or a series of stressful bad calls that just won’t leave their minds. You might have overheard them discuss their sleepless nights, their nightmares, and their increased anxiety. Or it might be the opposite; they may be isolating themselves or shutting down in response to the grief or sadness.

You want to help them, but you don’t know what to say. What if they get defensive when you approach them? What if they deny there is a problem? What if the depression has taken over and the person is having suicidal thoughts? What if they refuse your help?

It may seem intimidating to approach someone who is struggling, but we are firefighters and we don’t turn our backs on someone in need, especially one of our own. Reaching out may be the key to getting that responder the help they need.

First, it is important to be able to recognize the signs that someone may need help. Many in the fire service try to hide or downplay what they are experiencing, perhaps out of fear of how others might perceive them, or because the department’s culture doesn’t foster open communication, or maybe because of lingering misconceptions about mental health.

Some of the more common signs that someone is struggling include:

• Avoiding people, places, or activities that could remind them of the traumatic event(s)
• Trouble sleeping or nightmares
• Trouble concentrating as their minds wander easily
• Overwhelming guilt or shame
• Recurring distressing memories of an event or series of events
• Irritability with angry outbursts
• Drinking or using prescription medications too much

Unfortunately, I know all too well what it is like to walk in their shoes. I recently recovered from one of those situations that overfilled my stress bucket and placed me into a state of depression. I wrote about my experience in the last issue of the National Volunteer Fire Council’s Firefighter Strong newsletter. In that article, I explained how each of us has a bucket in our minds that gets filled with stressful moments over time. For some, their stress buckets can keep filling up and never spill. But for others, we reach a point where it just becomes too much, and the stress bucket starts to overflow.

What is it that will finally overflow that stress bucket? Will it be a traumatic stress incident, such as a senseless motor vehicle accident caused by a driver under the influence? Or will it happen unexpectedly, maybe while watching a movie, when a part of the film takes your mind back to one of those traumatic events in your past?

After my incident, many people would not approach me because they didn’t know what to say or felt they couldn’t help. At the same time, I didn’t reach out to anyone as I wasn’t sure what I wanted to hear. After many months of struggling with the depression and PTSD on my own, an acquaintance I ran into broke through the barrier I had built up. He asked me how I was doing and told me about resources that could help me. Although it still took me some time to follow through on getting the help I needed, that conversation was the first step and opened up the path to recovery.

So, what should you say or do when you know someone is struggling? Here are some tips to help you:

• First and foremost, be compassionate. We use compassion on every call. Talking to someone who is struggling with emotional trauma doesn’t require any special training. Let the person know you are there for them and that they are important to you.
• Notice what you are observing that creates concern and have a conversation with them. Explain to them the signs and symptoms that you have noticed and that you want to help.
• Periodically check-in with the individual. Volunteer firefighters can hide by just staying home and struggling in silence.
• Avoid asking questions that prompt limited or vague answers. For instance, when I ask my firefighters “How are you doing,” 99.9% of the time the response will be “I’m okay chief.” Instead, phrase the question in a way that will encourage a more detailed and open response, such as: “That child drowning call will stress me for a while as she was the similar age as my niece. How is this going to affect you?”
• Listen actively. When you get someone talking about the stress they are feeling, do not interrupt them. Just keep listening and let them open up.
• Do not try to compare one of your prior traumatic events in an attempt to lessen their traumatic event.
• All conversations must be in confidence. The only way an individual in crisis is going to open up is trusting that you will keep what they say in confidence. The exception is if they express that they are planning to commit suicide, at which point follow department protocol to get them through the crisis point.
• Only offer help to your ability, then suggest options for additional help, such as a local peer support team, a seasoned veteran, or behavioral health specialist.

A simple “I want to help” or “I will listen when you are ready” can go a long way, but sometimes you will need to give the person time to heal by themselves and then be there for them when they are ready to talk or show emotion. There is only so much you can do if the person is not ready or willing to open up or accept help.

I also want to say a few words to those who are struggling. Don’t be afraid of professional help. Many responders won’t seek the help of a professional because of the stigma that it shows weakness. That is so far from the truth. There are some things that we can’t fix by ourselves, and the way your mind works is one of them. It is important as first responders that we recognize when we truly need help. The treatment can only start with you standing up to say that you need help and that you want your life back.

It is always important that we prioritize taking care of ourselves, and also that we are there for our brothers and sisters to ensure their mental wellness and emotional health.

Stand up for yourself… life is too short.

Note: Find additional resources from the NVFC’s Share the Load program at www.nvfc.org/help.

Jared Meeker is a 30+ year fire service veteran currently serving as a fire chief for the Lake Shore Fire Department, a combination fire department in upstate New York. His passion for the fire service includes teaching incident command skills to aspiring fire officers and career survival skills to all first responders. Jared has written two prior NVFC articles, When the Stress Bucket Overflows: A Firefighter’s Story of Pain and Healing and Fireflies and the Fire Service, available at www.nvfc.org. He currently offers a training program on firefighter behavioral health; learn more at https://seeingincoloragain.wordpress.com/sizing-up-your-behavioral-health/