by Dave Papandrea, LLPC, NCC

Dave Papandrea is one of the newest members of the Trinity Family Counseling Center team. Dave’s personal counseling philosophy is that he is a traveler on YOUR journey.  He believes YOU are the expert of you, and that the power of change is already within you.  It is his goal to walk with you on your journey to wellness, allowing you to lead at your own pace, hoping to point out items in your blind spots along the way.

Returning a fire company to service following a difficult call takes many different forms throughout the fire service.  In some areas, it may mean clearing to go to the next emergency.  Other jurisdictions offer tailboard defusing in the form of, “...you good?”  This typically prompts the auto response, “Yeah I am good.  You good?”  Repeat said process, and we check the box of crews defusing before returning to service.  It has escaped me for years how firefighters can work tirelessly one minute with life hanging in the balance, and transition seamlessly back to the kitchen table to finish a lukewarm meal.  But after a deep dive into the subject, I have realized that this oddity is not without a cost.  A debt we often pay and share with the people we love the most.

Have you ever approached the firehouse for your shift, and before entering the bay you knew the prior crew had a good fire?  We are not part bloodhound, so what is happening?  Our bodies are becoming hyper alert or hypervigilant.  We are about to spend the next 24 hours in our uniform, in the station, never far from the apparatus, and with a heightened sense of readiness for whatever is toned out for us.  This hypervigilance is comparable to fight or flight, but knowing firefighters, we are all fight!  For the next 24 hours, the part of our brains that control fight or flight (the amygdala and hypothalamus) will remain out of neurochemical balance with peaks and spikes when critical calls tone out, only partially reducing before tones drop again for the next call.  Each call, regardless of whose company is responding, helps to thrust those levels of neurotransmitters in the brain (cortisol) further out of balance.  Our levels rise and fall but never quite return to baseline, and never return to where a “normal” brain functions.  So, what’s a firefighter to do?  The brain dislikes imbalance, so how do we restore balance while on duty?  

When I started the job there were a lot of common practices that we have removed from our culture. If we went back in time to visit the 1950’s firefighter, having a beer with dinner was commonplace.  As a young firefighter in the late ‘90s they were just removing the taps.  Alcohol still remains culturally significant in the fire service, and it is a part of every tradition and party from probation to promotion.  But there was pathology behind what seemed like a social club mentality.  Drugs and alcohol are threats to firefighters for obvious reasons, but a silent threat they play is the role of activator for the brain's pleasure pathway.  Remember, after activation of the amygdala and hypothalamus the brain experiences imbalanced levels of cortisol and is working hard to return to homeostasis or balance.  If there is no “dump,” then one way to level the playing field is increasing dopamine, or the happy sauce.  One way dopamine is released is consuming alcohol.  Alcohol is a way for the brain to maladaptively cope with the stress it was under.  But it isn’t the only way to cope, and firefighters are extremely resilient at solving problems.  Stacks of pornography collected in firehouse bathrooms for decades not because the fire service was a male dominated chauvinist club.  Sex and pornography also served as maladaptive coping strategies for releasing dopamine and restoring balance.

Also central to firehouse culture and lore is our ability to cook… and eat!  This coping strategy may be the most devastating of all.  How many firefighters began their career looking like a CrossFit athlete and ended their careers unable to pass the fitness exam that earned their spot in their department?  In that vein, we still experience a high rate of cardiovascular emergencies on scene.  We love cooking meals loaded in fats, salts, and sugar!  We crave ice cream! Overtime guys usually had to throw in extra for dessert, and each day there were snacks of cookies and brownies on the table.  Again, this was more brain based than sweet tooth based.  It served a function in our recovery, and thus earned a place at our cultural table.  This may add new and literal meaning to the phrase, “comfort food’ and “stress eating.”  Think about the times on duty or coming off when you find yourself famished or experiencing cravings.  Dopamine releases resulting from food and sex serve a very important primal role for survival.  But as our brains try to survive the trauma that accompanies the job of firefighter, we often struggle personally with addiction and dependency, and our loved ones and families are footing the bill right along with us.  

Just as important as reporting for duty mentally fit, is making sure we return home to our families in good mental condition!  Understanding that our agitation and difficulty relaxing upon our return to the home is a bi-product of our fight or flight status, and acknowledging there isn’t an off switch, is a step in the right direction.  Helping our families realize what is happening is also very helpful, but that is difficult if we haven’t done our own personal work and possess a healthy self-awareness.  Enter in the importance of defusing and debriefing our critical incidents.  When you see peer support approaching, don’t run and hide in closets or under the bed!  Isn’t that what we teach kids about fires?  Do your part.  If not for yourself, do it for your family that doesn’t understand your aggressiveness, but knows to keep some distance after you get home from a shift.  Firefighters are willing to put the time in at the gym with weights and cardio routines.  We love doing RIT drills, and we train for every possible obstacle when extracting victims.  But we rarely step foot in a counselor’s office, dare I ask if we even have a relationship with one should we enter dire straits.  We keep pushing through our RIT drills despite the evidence that suggests we are losing more firefighters to suicide then collapse.  We pride ourselves with readiness, yet we are frequently surprised and ill prepared when a mental health crisis arises.  It is time we are champions of our own mental health by engaging in debriefings, defusing, and individual counseling sessions.  It is time to change the culture making the aforementioned as normal as physical fitness.

Not every call requires defusing or debriefing from peer support services.  But a healthy awareness of what each difficult call (from which we proclaim our “good-ness”) is doing to our psyche is valuable.  Excluding the occasional stubbed toe emergency, we need to visualize stress inducing calls as a piece of straw that is handed to you at the end of every shift.  Some shifts you only have a single piece; other shifts may have 10 or 20 pieces of straw.  None of this seems like much, but you never actually put the straw away.  You carry it with you.  Compound the straw by the number of years you spend serving in your communities, and if you have ever driven across northern rural Michigan in late summer, you will see huge rounded hay bales that could crush a man under its weight.  Each bale is made up of individual straws.  That is what a career of critical incidents brings each firefighter.  It is a lot to carry around, and it can feel crushing at times.

When supporting our mental health, the mind-body connection is one of the best places to start. Someone could have all the coping skills in the world, but if they’re not also taking care of their body, they might be at risk for issues like anxiety, depression, and stress. It doesn’t have to be difficult—even small changes, like the one I’m going to teach you today, can make a big difference!
 
In the first blog in this series, I want to talk about your body’s biorhythm. Every person (plants and animals too!) has built in “body-clocks” that work to keep us in a state of balance. Geese migrating when the seasons change are due to the same body-clocks that tell us when to go to bed and when to wake up. In fact, this “circadian rhythm,” or the human daily sleeping and waking cycle, is one of the most important when it comes to mental health. We’ve all heard the advice that we should go to bed and wake up at the same time every day; but why does the timing matter?
 
When we sleep and wake at the same time every day, it gives our biorhythms a chance to do their jobs properly. When our body doesn’t need to spend precious energy resetting its clock every night, it can focus on sleeping deeply, improving other biorhythms (like digestion), and directing energy towards the next day! However, not letting your sleep biorhythm do its thing can lead to insomnia, daytime sleepiness, concentration issues, and even symptoms of depression and anxiety. Especially if you deal with any of those symptoms already, it’s so important to support your mental health by supporting your sleep cycles.
 
Of course, we won’t always be able to maximize our biorhythms—changing work schedules, family needs, and other aspects of life may take priority. And that’s okay! Even if you can’t go to bed and wake up at exactly the same time each night, doing it when you can is still beneficial. Even if you’re an hour or so off, you can still experience benefits you may not see if you were two or three hours off.
 
At the end of the day, our bodies have an incredible capacity for adapting to all sorts of schedules and situations. But if you’re looking to improve your mental and physical health, try using your natural body-clock to your advantage!