• Kim May

First responders: burnout, substance use & getting support

Updated: May 27


First responders routinely show up on lists of industries with high burnout rates. First responders are comprised of police officers, EMS, firefighters and 911 dispatchers. Burnout is a form of stress that is usually associated with our work environment. Although anyone in any career is susceptible to burnout, there are several components of being a first responder that increase the odds of experiencing burnout in that field.


Left untreated, burnout can lead to increased stress, depression, medical issues and increased use of alcohol and drugs. Although the job of a first responder is stressful and demanding at any time, the coronavirus pandemic enhances the existing challenges. Changes to daily operating, efforts to mitigate the spread and being at risk of contracting the virus are something that first responders are facing daily. They are also not immune to the stressors the rest of us are currently facing, including a lack of social support and financial strains through family job loss.

What is burnout?


Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It is different from ongoing stress in which you may feel overwhelmed, or like you are drowning. Burnout often feels more like you have nothing left. In my opinion, the best description of burnout comes from Peter in Office Space when he is talking to his therapist. “…ever since I started working, every single day of my life has been worse than the day before it. So that means every single day that you see me, that’s on the worst day of my life.”


Certain aspects of being a first responder increase the likelihood that burnout may occur: lack of control over job, extremes in activity in the workplace and work/life imbalance and long hours, combined with irregular shifts. Unfortunately, the coronavirus has worsened existing stressors and created new problems for first responders.


Signs and symptoms of burnout


Once burnout has crept in, it can affect us in a multitude of ways, including our behavior, our physical health and our emotional functioning.

Behavioral:

· Procrastination

· Isolation

· Increased anger or short temper

· Diminished hygiene

· Using food, drugs or alcohol to cope


Emotional:

· Loss of motivation

· Feelings of failure/self-doubt

· Feeling helpless/trapped/defeated

· Increased cynicism

· Feeling alone

· Thoughts of suicide or self-harm


Physical:

· Near constant fatigue

· Lowered immunity (thus more likely to get sick)

· Headaches, tension in the body

· Changes in sleep and appetite


Mental health, left untreated


Many people turn to substances to help cope, or numb the effects of pain, exhaustion or depression. Although this is not an uncommon coping mechanism, the rates for first responders are significantly higher than the general population. Police officers are approximately three times as likely to have a substance use disorder than the general population and are 200% more likely to abuse alcohol.


Although in general, men consume more alcohol than women, studies have indicated that male and female officers tend to abuse alcohol at similar rates. Studies with firefighters produce similar findings. Firefighters tend to have a 47% prevalence of alcohol use disorders, compared with 29.1% in the general population. Unfortunately, there are fewer studies available for EMT’s and 911 dispatchers, though they are exposed to many of the same stressors and working conditions.


Burnout combined with a worsening substance use problem and other issues such as relationship issues and/or PTSD can create a recipe for disaster. PTSD and depression rates are 5 times higher for first responders than for civilians. Heartbreakingly, first responders are more likely to die by suicide than in the line of duty. For the general population, death by suicide is the 10th leading cause of death in the U.S., with the rate at 13/100,000. For police officers, the rate is 17/100,000 and for firefighters, it climbs to 18/100,000.


Take steps toward self-care


First responders dedicate their lives to putting others first. It is not wrong, selfish or weak to divert some of that energy back to yourself. It doesn’t matter where you start, just begin making changes that resonate with you. (Exception: if you are considering harming yourself or considering suicide, please seek help immediately).


· Reduce physical tension, by walking, exercising or a breathing exercise

Combat, or box breathing is often effective. Combat breathing is done in 4 cycles. 1) Breathe in through your nose for a count of four 2) hold breath for count of four 3) exhale through your mouth for count of four 4) hold breath for the count of four, repeat cycle.

· Utilize peer support programs if they are available

· Prioritize sleep and healthy eating

· Develop a “buddy system” with someone at work and set times to check-in with each other

· Learn to recognize your own signs of heightened stress or depression that may lead to burnout

· Connect with your friends or family

· Decrease your alcohol consumption, if you are able too

· Get support now with your burnout or substance use

Additional support is available for first responders through:

National Suicide Prevention Lifeline: 1.800.267.5463

Fire/EMS helpline: 1.888. 731.FIRE (3473)

Copline: 1.800.267.5463

Sources:

https://www.psychologytoday.com/us/blog/sure-recovery/201803/police-and-addiction

https://www.policeone.com/coronavirus-covid-19/articles/protecting-the-mental-health-of-first-responders-during-a-pandemic-U1LTkVxHYf09u8Ql/

https://www.csems.org/covid-19-understand-and-identify-burnout-and-secondary-traumatic-stress/

https://leb.fbi.gov/file-repository/archives/jan99leb.pdf/view

https://emergency.cdc.gov/coping/responders.asp

https://www.michigan.gov/documents/mdhhs/First_Responders_Final_685545_7.pdf

https://www.firerescue1.com/legislation-funding/articles/texas-now-recognizes-911-dispatchers-as-first-responders-bSQLsywGJWTM5e9M/

https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm

https://rudermanfoundation.org/white_papers/police-officers-and-firefighters-are-more-likely-to-die-by-suicide-than-in-line-of-duty/

http://anxietyreliefsolutions.com/combat-breathing-a-technique-to-reduce-anxiety/



About the Author:

Kimberly May, LPC, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by substance use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, burn-out, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation. *Note: telephone and telehealth sessions are currently available.


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