National First Responders Day takes place on Oct. 28, a day to show gratitude to our everyday heroes. In addition to honoring their service, it is time to shed light on how trauma affects the mental health of law enforcement officers, firefighters and first responders. More deaths by suicide than in the line of duty, chronic health issues, heavy turnover in the departments, poor morale and shortages in recruits all point to a dire need for us as a society to understand the impact of traumatic stress on the health of first responders and engage in discussions that seek real solutions.

Their daily battles include witnessing overdoses, suicides, deaths, physical and verbal assaults and life-threatening encounters. Experiencing traumatic events create normal reactions such as anxiety, feeling “revved up” or overwhelmed, fatigue, hyper-vigilance, exaggerated startle response, mood changes, impatience, anger and irritability, problems sleeping, change in appetite and withdrawing from family and friends. Living in a perpetual traumatic stress state, enduring long hours and overtime, suffering sleep deprivation, dealing with cynicism from the public, fearing judgement from co-workers and increasing physical demands of the job lead to a heavy, expected toll on the mental and physical health of first responders.

The long-term effects of stress on the body include anxiety, depression, anger, pain, inflammation, sleep issues, memory loss, inattention, elevated blood pressure, heart disease, digestion issues, joint pains, fatigue, recurrent infections, weight gain, hormonal issues and much more.

Research studies have suggested that the rate of PTSD among first responders may be between 15 percent and 30 percent, with 20 percent of all individuals with PTSD also having a substance abuse disorder. Often, they fail to seek help due to the fear of stigma, lack of time, poor access to providers, lack of trust and fear of job repercussions. The perfect storm of harsh work environments, heavy physical and mental demands and poor social support structure has led to a rapid rise in heart disease, cancer, anxiety, depression, substance abuse, alcohol dependency, divorce rates and suicide in this population.

How do we as a community build resiliency in our heroes? The key to building stress resilience is based on human connection, resiliency training, knowledge, cultural change and self-care. Trauma is a normal response to an abnormal situation. Increased knowledge concerning the body’s natural response to negative experiences and their ability to identify stress, seek help and obtain resources when needed is a key part of being trauma informed. It is very important to change the department culture that seeks to maintain an image of invincibility and an attitude that states “toughen up” or “deal with it” when encountering burnout or a post traumatic incident.

Supportive, approachable leaders and camaraderie among responders has been shown to help with first responders’ psychological well-being. Resilience promotion training programs during the academy or before starting the job can help reduce the stress of their crew by preparing them for the events they will encounter in the future. Ongoing regular self-care activities with nutrition, exercise and stress reduction creates a positive outlet for those that are faced with daily traumatic events and allows for a shift in mindset preventing burnout and compassion fatigue.

Experiencing the effects of trauma is still misconceived as weakness or failure, when it is what makes us all human and is a very natural reaction to tragedy, devastation and death. When we drive change to the institutional infrastructure and culture of fire and police to better support our heroes in creating true resiliency, then we create healthy, well-balanced and effective heroes working hard to keep us safe.