First Responders

If you are a first responder, you are exposed to high levels of stress daily that place you at risk for front line trauma as well as secondary trauma. You know this and your passion for helping people in need outweighs the risks you take every day. You are a family amongst yourselves that have each other’s backs. Whether you are an officer or a firefighter or a medic, your mentality is based on staying strong, setting feelings aside and getting your job done. This is very similar to a military mentality. However, chronic exposure to lights, speed, intensity, fatality, tragedy, and danger place you in one of the highest categories for suicide, alcoholism and drug abuse, divorce and anger. Yes, anger.

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You see events every day that the public is not privy to. You internalize images and sounds unlike other professions that are less dangerous. You have a job to do, and when you are in the field, the lights and sounds and sirens and speed and noise stay in the background of your mind as your nervous system supplies you with all the energy you need to tolerate and bear what you must. When the danger and/or risk levels are reduced or decelerate, some of you feel tired and some of you still feel wired-or worse, you feel a little of both. Your nervous system has been on high alert whether you knew it or not. Emergency personnel have hidden body tension and arousal rates that blow most other jobs out of the water. Even if you think of yourself as being level headed and controlled under extreme pressure, the hidden stress response, day after day catches up with you; your body and mind will fall victim to 'high wired express', (otherwise known as hyper vigilance) through no fault of your own. Then problems can sometimes develop and you are faced with “battle fatigue” that takes you down when you least expect it.

We call this PTSD and all First responders are at risk. You want a drink at the end of your shift to help you relax. You go out with a co-worker who was exposed to the same incident you were. You both identify with the hardship and intimacy starts to develop. That person is there and knows what you have gone through. Or you go home to your wife and kids and she asks you to complete a chore and you’re irritated, finding fault with her. These are just a few examples of how chronic stress begins to creep into your daily activities and relationships, which now impacts your sleep and peace of mind. If you identify with this description, you are either in trouble or on your way to having troubles. The biggest problem for emergency personnel (and this also includes 911 operators and emergency room trauma doctors and nurses) is staying aware of how the chronic stress of your jobs on a day-in and day-out basis is impacting you. Most of you become aware after the problem has become out of control. You find yourself yelling at someone for no good reason. You notice you are driving too fast and it has become a habit. It could be anything other than you realizing that chronic trauma and exposure to high-alert events have taken a toll on your nervous system, crept into your body and soul and is sitting there taking up a huge amount of space.

Another problem is knowing you need help and asking for it. First responders do not like asking for or admitting they need help. If this is you and you have a “toughen up” mentality, the bad news is that the problem is going to get worse. The good news is that you can contact me and have 100% confidentiality -- no one at work has to know. Not a sergeant or a captain or a peer leader or a chief or your wife for that matter. So take advantage of a service that will help you to let go, stay aware, build resilience and help you feel like a normal human being again.

Dr. Siegel is a Certified First Responder Counselor

She is a former employee of UCI Medical Center, a Level I trauma hospital in Orange County. Dr. Siegel worked Critical Care, The Emergency Room and Burn Unit.

Dr. Siegel participates in regular ride alongs with the Long Beach Police Department.


If you do not want to use your insurance due to confidentiality issues, an out-of-pocket fee can be arranged.


Ride Along for Beth