Editor’s Note: This story is the second part of a two-part series on the impact of crisis incidents. Part one focused on how these incidents affect physical, mental and emotional health.

For first responders such as police officers, paramedics, firefighters, ski patrollers, medical providers and even teachers and social workers, dealing with crisis situations can be part of their everyday jobs.

But working through one acute incident after another can take a toll on mental, emotional and physical health.

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“It can be real cumulative,” said Molly Lotz, a licensed clinical social worker and crisis support counselor at UCHealth Yampa Valley Medical Center, and the executive director of Routt County Crisis Support. “The compounding can really add up.”

Though first responders may deal with acute incidents for years without noticing an impact to their well-being, that can shift suddenly.

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In addition to the weight of responding to hundreds or thousands of crises, having to respond to a call involving an acquaintance or to a call that’s unusual can have a sudden and surprising impact.

“If a call is so outside of the ordinary that the brain can’t find a file for it, it can be a struggle,” Lotz said. “Even if the outcome is fine, it can really bother a responder.”

Another trigger can be if a first responder has to help in a crisis situation when they’re not on the job.

“If they’re involved in a critical incident when they’re in a civilian role and don’t have the equipment and colleagues they usually do, that can be really traumatic,” Lotz said.

Most first responders have rituals at work that help normalize what’s happening, such as putting on specific gear or driving to the scene with colleagues. To have to act without those can feel unmooring and give a sense of powerlessness, resulting in stress.

While addressing the stress from these incidents hasn’t always been a focus in the first responder community, that’s changing.

“The culture has been more of, ‘Suck it up, this is what you signed up for, this shouldn’t bother you,’ but that culture is rapidly changing,” Lotz said. “There’s new discussion, new opportunities to learn that if you are impacted by a call or series of calls, it’s perfectly normal. There are resources that allow you to process it, so you can come to work the next day or next week or whenever your next shift is.”

It’s critical that those resources are easy to access when someone decides to take advantage of them.

“Someone might one day say, ‘I’m ready to do it.’ We need to make sure in that moment, we’re ready to support them,” Lotz said. “Otherwise, we may miss the opportunity.”

With the right support to process through these stresses, first responders can establish a new resiliency in their careers and develop a healthier approach to work.

If issues aren’t addressed, they may struggle with a range of symptoms, such as poor sleep, agitation at home, feelings of grief and intense anger, difficulty focusing, increased sensitivity to stressors and more. Some may turn to substances, such as alcohol, to self-medicate.

“Alcohol is a depressant. If you’re coming off your shift and you can’t quite regulate, one of the easiest ways to do that is chemically with alcohol,” Lotz said. “But that can lead to a host of other issues.”

Lotz encourages first responders to have an established relationship with a peer or therapist, so when struggles surface, there’s a place to turn. Attending debriefings after an incident and taking steps to regulate the nervous system, such as deep breathing and connecting with others, are also helpful.

Remember that as human beings, it’s natural to have an empathetic response.

“The concern would be if the tragedies you’re expected to deal with don’t affect you,” Lotz said. “We want to support our first responders early on so they know it’s OK if an incident affects them, and that they have resources and tools to process it so they can have a long career.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.