The importance of staying mentally healthy as a firefighter

In this guest blog Tara Lal, manager of the Critical Incident Support programme in Fire and Rescue New South Wales, considers the importance of staying mentally healthy in a challenging career:

I’ve been a firefighter for over 10 years now. As time has passed I’ve become increasingly aware that maintaining and caring for our mental health can protect us from the effects of trauma that we’re often exposed to in this line of work. Building mental resilience may even enable us to experience post-traumatic growth – the positive psychological changes that can occur as a result of facing adversity.

As firefighters, the nature of our job means that we never know exactly what the next traumatic event will be or when it will occur. So, how do we prepare psychologically for something so unpredictable? Often, it’s surprising to find that the incidents that appear to be the most distressing are not the ones that affect us most deeply. How many times have you questioned, having served at numerous fatal house fires or removed countless bodies from cars, why some relatively innocuous incident has left you so shaken ?

My own experience taught me how confusing this can be. I have witnessed trauma, both within the job and outside it. It was, however, a call to assist police following a suicide that had the greatest impact. There was no body to attend to. It had already been removed. We were simply called to wash down the blood that stained the pavement. Yet I found my chest tightening and my body shuddering. I experienced something like a flashback in which I literally felt the impact of the man’s body as it landed. Some 20 years before, my own brother had died by suicide in exactly the same way, by jumping from a window.

What makes an event traumatic is not the incident itself but rather our own perceptions of and reactions to it. Perhaps it’s just one disturbing call that results in a stress reaction or maybe it’s the accumulated effect of several or many incidents over time.

Whatever the nature of the traumatic event, it can leave you with an altered view of the world. You may question why you are having difficulty sleeping, why you are arguing with your partner, why you don’t want to be around people, why you feel the need to drink more than usual, why you have woken in the middle of the night in a sweat …

We do, however, have some degree of control over how likely we are to experience such reactions, the intensity of them and how quickly we may recover. The effect of any incident on any individual will be significantly influenced by many external and internal factors, such as:

 Physical state Are we sleep deprived? Have we been eating a healthy diet? Are we fit? Are we hungover?
 Psychological state Are we suffering from an underlying mental illness such as depression or anxiety? Are we dealing with other life stressors such as relationship breakdown, financial hardship, recent bereavement or young children?
 Past experience Does the incident relate directly to our own lives in some way, such as a trauma or loss previously endured, or having children the same age as those at the incident we are attending?

All these factors will affect our psychological resilience. If we are physically run down and experiencing a high level of stress in other aspects of our lives, it is more likely that a traumatic incident at work will cause a significant stress reaction ultimately rendering us more susceptible to post-traumatic stress disorder, depression and anxiety. That’s why, as firefighters, it is vital that we maintain and build our mental resilience.

Think of your mental health working in just the same way as your physical health. They are inextricably linked. If you are unfit and haven’t been training, your risk of muscle or tendon injury when fighting a fire or lifting and dragging equipment is far higher and your recovery will be longer. The same is true for your mental health.

Mental fitness is trainable in the same way as physical fitness. Think of a fire engine and all the equipment it carries. In most incidents we may use several different tools to complete the job at hand. The greater variety of equipment we have available to us, the more training we complete, the more likely we are to be able to resolve a problem no matter what it is. Your mental health is like a fire engine. The more tools you add over time, the more drill you do using these tools, the more likely you are to have a successful outcome.

The key to psychological fitness is resilience. So how do we train and build resilience?

Top 10 tools in your mental health toolbox
1. Close relationships Being able to relate to other people protects mental health. Invest time in building relationships with friends, partners and family. Talk about your feelings with people you trust.
2. Self understanding and self compassion Seek to understand your emotions and thoughts better. This connects you to yourself, allowing a more authentic expression of who you are. The mismatch between the face we show to the world and our internal thoughts and feelings feeds mental illness.
3. Engage in voluntary work and build a strong social support network Research has shown that people who are connected to others within their community are more likely to bounce back from stressful life events. Going beyond the self in the service of someone else helps develop positive emotion.
4. The ability to ask for help if you need it Firefighters are very good at helping others but often struggle to accept help themselves. Asking for and getting help is a key factor in resilience.
5. Self-care through exercise, healthy nutrition and sleep
o Exercise It takes only 10 minutes of exercising in nature to produce positive emotion through the release of the feel-good chemicals endorphins and serotonin in our brains. In fact, research shows that exercise is as effective as medication in the treatment of mild to moderate depression. Doing something you enjoy, outdoors and with friends is the most effective. But, ultimately, just do something!
a. A healthy diet More and more evidence is accumulating regarding the effects of nutrition on mental health. A balanced mood and feelings of wellbeing can be promoted through a diet that provides adequate amounts of complex carbohydrates, essential fats (omega 3s), amino acids (Tryptophan), vitamins (folate), minerals and water.
b. Healthy sleep patterns Getting plenty of sleep helps reduce stress levels. This is especially important when working shifts.
 Mindfulness meditation Or even just focused breathing. Mindfulness is effectively the ability to engage in the present moment and has been found to have many health benefits including relieving anxiety and depression. I recommend the Headspace app (www.headspace.com) but there are many available now to download on a smartphone. Just 10 minutes a day has been to shown to have beneficial effects.
6. Keeping a gratitude diary Write down three things every evening that happened during the day that you have to be grateful for. Gratitude builds resilience.
7. Finding and pursuing your passions Whether your favourite activities are creative or physical, engaging in them helps to create ‘flow experiences’ (that feeling of being ‘in the zone’). This allows us to access positive emotions. The more positive emotion we can access, the more mentally healthy we become.
8. Expressive writing helps us to process trauma. Just 20 minutes of writing about your thoughts and feelings for four days in a row has been shown to result in greater psychological wellbeing and fewer symptoms of post-traumatic stress.
9. Building your character strengths Identify them and use them to overcome adversity. Kindness, courage, perseverance and optimism all help us move through difficult periods in our life and protect us against depression.

Beyond resilience there is also the capacity to grow through trauma. When a life-changing event shatters our assumptions about life, it leads us to question, ‘What does this mean for me?’ It is through that questioning that we can learn and grow as people for it brings with it a greater value and appreciation of life and a deeper dimension to happiness. Living through adversity can enable us to discover strength we didn’t know we had. It can guide us in finding meaning and purpose in our lives. It can teach us to place more importance on our relationships forging closer connections with other people.

We all owe it to ourselves, and to those we love, to care for our mental health with as much attention as we care for and protect others.

For more information on positive psychology please visit www.authentichappiness.org.

Tara Lal’s book, Standing on My Brother’s Shoulders: Making Peace with Grief and Suicide, is published by Watkins, priced £8.99