PTSD: Its Causes, Effects, and Possible Strategies

PTSD or Post Traumatic Stress Disorder is the term used to describe the human reaction to an overwhelmingly stressful experience. PTSD manifests itself in many ways, including: (a) an avoidance of family, friends, or colleagues, even human contact in general; (b) a constant feeling of being threatened and a parallel need to be wary; and (c) intrusive images and/or flashbacks. These symptoms impair the sufferer’s ability to function, and can persist for a month or so, and sometimes much longer.

The general public first became aware of PTSD when it was publicized as a common disorder affecting military combat veterans. Less well known is the fact that many first responders also suffer from the disorder. When faced with overwhelming events, members of the nation’s general population at large also can suffer from the disorder.

Although some events, such as the 9/11 terrorist attacks, are so overwhelming that they can be anticipated to cause PTSD, various “routine” incidents may also cause PTSD, as can the cumulative stress developed from months or even years of emotionally harrowing events – which is usually why it affects first responders.

Social Support, Internal Strength & the Exercise of Common Sense

Resilience is the term used to describe the cumulative factors that allow an individual to continue to function in spite of facing severely stressful events on a continuing basis. Those factors include but are not limited to such internal strengths or characteristics as personal competence, a tolerance of negative results, the positive acceptance of change, and individual spirituality; also some external features such as the social support provided by family and friends. The combination of these factors is believed by many if not all psychiatrists to improve the individual’s ability to cope not only with stress in the short term – during a specific incident, for example – but also with the aftereffects of stress, including PTSD, in the long term.

Many of the factors that create or strengthen the resilience of an individual are his or her personal choices – that person’s spirituality and religious beliefs, for example – and cannot (and should not) be dictated by an employer. However, it is possible to encourage spirituality by accommodating employees’ work schedules so they can attend services and/or pursue their faith in other ways; this must be done, of course: (a) without promoting any particular faith; but also (b) by establishing and adhering to a zero-tolerance policy for those who may be tempted to ridicule or discourage another’s faith.

Promoting physical exercise – on the job, if and when necessary – is another step the employer can take that will improve the resilience of individual members of the responder team. Installing workout equipment or allowing on-duty time to exercise may seem to some, of course, like an extravagance; however, a reasonable and properly planned workout program has a payout on many levels, including the probable (but difficult to quantify) reduction of PTSD symptoms by a reduction in overall individual and team stress.

Leaders, Peers, and Professional Help 

Here it is worth noting, and emphasizing, that fostering a corporate culture that supports the individual employee and helps build a social structure that is also supportive – and that does not allow intolerance in either the pre-event or post-event time periods allocated – may decrease the impact of stressful events.

Coaches, psychiatrists, and other health care professionals credit the support of one’s peers as an invaluable asset not only for the individual but also for that person’s team (or other social structure). Respected senior staff members are usually theeal leaders, and examples, for peer support teams; however, they themselves have to believe in what they are doing. Any staff member, no matter how highly respected otherwise, who is required (another way of saying forced) to assist in building peer support will seldom if ever be as effective as another member of the same team who truly believes in what he or she is doing.

Finally, there must be strong support, from mental health specialists, for those who continue to suffer from the disorder. Ignoring it can and often will lead to loss of staff – or, worse, to staff suicides. It must be recognized, moreover, that there are some sufferers who need more support than the team leader, or employer, can directly provide – in which case those suffering from PTSD must be referred to professionals who are able to provide greater in-depth help.

To briefly summarize: As long as there are courageous men and women able and willing to step into the line of fire and cope with extreme events, personally shouldering the stress of saving others – and at times trying, unsuccessfully, to save others – there will continue to be cases of PTSD. The United States has the obligation, as a society, and the first responder community has the same obligation, as a true band of brothers (and sisters), to provide the support those men and women need and thereby remove all stigma from this terrible disorder and the treatment it requires.

Your Opinon Matters! 

DomPrep is conducting a brief survey on PTSD; if you or someone you know has ever experienced PTSD, your feedback is greatly appreciated.  Take Survey!


For additional information

9-11 PTSD study

PTSD story about Aspen SAR staff member

Resilience research

Joseph Cahill
Joseph Cahill

Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.



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