Why ‘Just Pushing Through’ Isn’t Enough: Mental Health Strategies for First Responders

First responders—firefighters, paramedics, police officers, and other emergency workers—are trained to stay calm under pressure. The job demands quick thinking, resilience, and the ability to push through even the most distressing situations.

But here’s the reality: pushing through is not the same as coping.

The nature of first responder work means regular exposure to trauma, high-stress situations, and long shifts. Over time, this can take a toll, leading to burnout, anxiety, PTSD, and even depression. According to a 2018 study, first responders experience PTSD at rates five times higher than the general population (SAMHSA, 2018).

If you’re a first responder, taking care of your mental health is not a luxury—it’s a necessity. Let’s talk about why pushing through isn’t enough and what practical strategies you can use instead.

1. Understand That Stress Adds Up (Even If You Feel Fine Today)

One of the biggest challenges for first responders is cumulative stress—the gradual buildup of tension from repeated exposure to emergencies. Unlike a single traumatic event, cumulative stress creeps up over time.

At first, it may feel like nothing. But as months or years pass, it can lead to:

• Emotional detachment or numbness

• Irritability or anger at minor things

• Difficulty sleeping

• Physical symptoms like headaches or chronic pain

• A constant feeling of exhaustion, even after rest

  
  

Research shows that untreated cumulative stress increases the risk of PTSD and burnout among first responders (Carleton et al., 2019). Recognizing that small stressors add up is the first step in preventing long-term mental health issues.

2. Build a Mental Health Toolkit (Beyond ‘Suck It Up’)

Coping with stress doesn’t mean ignoring it—it means having tools to manage it. Here are a few strategies backed by research:

🔹 Peer Support: Talk to Someone Who Gets It

Talking to colleagues who understand your experiences can be incredibly powerful. Peer support programs for first responders have been shown to reduce stress and increase resilience (SAMHSA, 2018).

Try this: Instead of brushing off a tough call, take five minutes after a shift to check in with a trusted coworker. A simple, “That was rough—how are you holding up?” can make a difference.

🔹 Decompression Techniques: Find What Works for You

High-stress jobs require high-quality recovery time. Science-backed ways to decompress include:

✔️ Physical activity: Exercise releases endorphins, reducing stress (Salmon, 2001).

✔️ Mindfulness techniques: Studies show that mindfulness reduces symptoms of PTSD in first responders (Joyce et al., 2018).

✔️ Creative outlets: Music, writing, or hobbies can be effective stress relievers (Stuckey & Nobel, 2010).

Try this: After a stressful shift, engage in one small activity that helps you reset—whether that’s hitting the gym, playing an instrument, or walking in nature.

🔹 Tactical Breathing: Reset Your Nervous System in Seconds

High-stress situations activate the fight-or-flight response, flooding your body with adrenaline and cortisol. Tactical breathing (also known as box breathing) is a simple but powerful way to regulate your nervous system in real-time.

How to do it:

1️⃣ Inhale deeply through your nose for four seconds.

2️⃣ Hold your breath for four seconds.

3️⃣ Exhale slowly through your mouth for four seconds.

4️⃣ Hold again for four seconds.

5️⃣ Repeat the cycle four times.

👉 Studies show that controlled breathing techniques reduce stress, lower blood pressure, and improve focus under pressure (Grossman & Christensen, 2008). Many military and emergency response teams use this method to stay calm in high-intensity situations.

🔹 Sleep Hygiene: Why First Responders Need Quality Rest

Irregular shifts and high adrenaline levels can wreck sleep patterns, leading to chronic fatigue, impaired decision-making, and increased emotional distress. Research shows that poor sleep doubles the risk of PTSD symptoms in first responders (Pigeon et al., 2018).

Tips for better sleep:

✔️ Follow a post-shift wind-down routine (e.g., stretching, reading, deep breathing).

✔️ Use blackout curtains and white noise machines to create a restful sleep environment.

✔️ Avoid screens and caffeine before bed—blue light suppresses melatonin, making it harder to fall asleep.

✔️ Try progressive muscle relaxation (PMR), a technique where you tense and release muscle groups to signal your body that it’s time to rest.

👉 Even small improvements in sleep quality can boost mood, energy, and overall resilience (Walker, 2017).

3. Recognize Warning Signs Before They Get Worse

It’s easy to dismiss stress, anxiety, or irritability as “just part of the job.” But certain red flags should never be ignored:

🚨 Constant nightmares or flashbacks

🚨 Feeling emotionally numb or detached from loved ones

🚨 Increased drinking or reliance on substances

🚨 Losing interest in activities you used to enjoy

🚨 Feeling hopeless or thinking about quitting the job

These can be signs of PTSD, depression, or burnout. Early intervention is key. The sooner you address stress, the easier it is to manage.

Try this: If you recognize these symptoms in yourself (or a coworker), don’t brush them off. Reach out to a therapist, peer support group, or crisis helpline.

4. Normalize Getting Professional Support (It’s Strength, Not Weakness)

The idea that first responders should be "tough enough" to handle everything alone is outdated—and dangerous.

Seeking help doesn’t mean you’re weak. In fact, research shows that first responders who seek therapy early are less likely to develop PTSD long-term (Haugen et al., 2017).

Try this: If you’re hesitant about therapy, start with a single session. Many therapists offer first responder-specific counseling, which means they understand the job's unique pressures.

Final Thoughts: You Can’t Help Others If You’re Running on Empty

As a first responder, you spend your career taking care of others. But here’s the truth: you can’t pour from an empty cup. Taking care of your own mental health isn’t selfish—it’s essential.

✔️ Recognize that cumulative stress is real.

✔️ Build a toolkit of coping strategies.

✔️ Pay attention to warning signs in yourself and others.

✔️ Seek professional support when needed.

The goal isn’t to eliminate stress (that’s impossible in this job). The goal is to manage it in a way that keeps you healthy, strong, and able to keep doing the work you love.

If you’re a first responder, what strategies help you cope with stress?

Sources 

• Substance Abuse and Mental Health Services Administration (SAMHSA). First Responders: Behavioral Health Concerns, Emergency Response, and Trauma.

• Carleton, R. N., et al. (2019). Assessing the impact of PTSD, depression, and anxiety symptoms on first responder well-being.

• Joyce, S., et al. (2018). Mindfulness-Based Resilience Training in a First Responder Community.

• Haugen, P. T., et al. (2017). Mental health stigma and barriers to seeking care for first responders.

• Salmon, P. (2001). Effects of physical exercise on anxiety, depression, and sensitivity to stress.

• Stuckey, H. L., & Nobel, J. (2010). The Connection Between Art, Healing, and Public Health.

• Grossman, D., & Christensen, L. W. (2008). On Combat: The Psychology and Physiology of Deadly Conflict in War and Peace.

• Pigeon, W. R., et al. (2018). The Impact of Sleep Disturbances on PTSD Symptoms in First Responders.

• Walker, M. P. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams.