– First Responders

Currently in the United States there are over 25 million First Responders, millions of active duty military and just as many veterans. These numbers do not take into consideration the millions of individuals in the health care industry with many more individuals choosing to go into these fields on a daily basis. With these career choices also comes the toll on an individuals mental health that unfortunately can have devastating effects. It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population.  The numbers are just as staggering with the Military population both active and veteran status. Currently more than 1.7 million Veterans receive treatment at the VA and many more go without treatment. For active duty military it is estimated that 1 out of 4 show signs of a mental health condition but struggle with finding and receiving help.

In a recent study about suicidality, firefighters were reported to have higher attempt and ideation rates than the general population. In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year. First responders are usually the first on the scene to face challenging, dangerous, and draining situations. They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.

At Emily Boris Counseling and Consulting Services, we are trained in trauma informed care, have certifications in trauma therapy and are Certified First Responder Counselors. We have a long history of working with individuals both in the military, retired from the military, first responders in various fields of service as well has those in the health care industry. We are aware of the unique needs that first responders present with and strive to work within the first responders realm so that they can have flexibility in services without compromising the quality of care.

Find out more about common mental health concerns by clicking on the + symbol:


Depression is a chronic mood disorder that affects every aspect of an individual’s life, causing feelings of sadness, hopelessness and apathy. These symptoms can range from mild to severe and generally can make it difficult to get out of bed, go to work, be social and engage in everyday responsibilities. It can also lead to suicidal thoughts and substance usage. Symptoms of depression can include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness
  • Feelings of guilt, worthlessness, and/or helplessness
  • Irritability, restlessness
  • Loss of interest in pleasurable activities, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Sleep issues including insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Thoughts of suicide, suicide attempts
  • Persistent aches or pains, headaches or other physical distress

First responders are often at a greater risk of suffering from depression than other professions because of both the nature of their jobs and the culture in which they operate. The idea that seeking mental health services is a weakness for first responders can hinder individuals who are suffering in silence to get the help they need often times leading to an increase in severity of symptoms. However, if the individual engages in therapy, they can develop healthy coping skills needed to maintain a healthy lifestyle and manage the depression.

Anxiety Disorders

Anxiety disorders are a mental health concern characterized by disproportionate feelings of worry, fear and anxiousness that arise in response to normal situations. Highly distressing, anxiety disorders are persistent and can make even daily, routine tasks seem overwhelming. Some people may have panic attacks or feel uneasy in social situations, while others struggle with phobias and obsessive behaviors. There are several different kinds of anxiety disorders with various symptoms and triggers, but they all have the potential to negatively impact your quality of life, especially if they remain untreated. The major types of anxiety disorders include:

  • Generalized Anxiety Disorder
  • Social Anxiety Disorder
  • Panic Disorder
  • Post Traumatic Stress Disorder
  • Phobias

In the United States, anxiety disorders affect more than 40 million adults and are especially prevalent among law enforcement, firefighters, EMTs, dispatch, corrections and other first responders and public safety professionals. Unfortunately, only a small percentage seek help due to the stigma associated with mental health but delaying treatment can make you susceptible to more severe symptoms.


PTSD is an anxiety disorder that usually develops after experiencing or witnessing a traumatic event. PTSD is a condition that can impact anyone after a natural disaster, serious accident, physical or sexual assault, abuse and other distressing or life-threatening experiences — all of which many first responders are exposed to regularly. Due to the demands of their jobs, First Responders are at particularly high risk of developing PTSD. Generally, most individuals that experience PTSD will experience symptoms in the following 4 categories:

  • Intrusive Thoughts: Involuntary, recurrent thoughts regarding the traumatic event, and a resurgence of related feelings or memories. Some individuals will also experience vivid dreams, nightmares or flashbacks.
  • Avoidance: Many individuals will avoid places, people or activities that may be a “trigger” or a reminder of the trauma. They may isolate from friends and family and will resist getting help.
  • Hyperarousal/Reactivity: Individuals with PTSD will experience feeling on edge, irritable, angry or jumpy. They will have intense emotions, exaggerated startle reactions and physical symptoms such as high blood pressure and increased heart rate.
  • Negative Thoughts: They will have feelings overwhelmed by negative thoughts and distorted feelings related to the traumatic event. These feelings can be accompanied by guilt, shame and self-blame.

Despite many First Responders experiencing these PTSD symptoms, they will continue to ignore them and “push through” their daily lives in the hope that relief will happen. Unfortunately for many, when the symptoms don’t subside they often will turn to self destructive behaviors such as substance use, excessive gambling and even suicidal thoughts and actions as a way of coping. PTSD left untreated drastically impacts the quality of life for an individual however with proper treatment, PTSD can become manageable for the individual so that they can live a healthy and happy lifestyle.