How do I know if I need therapy as a first responder?

As a first responder, you are used to handling things.

​You show up.

You do the job.

You move on to the next call.

​When something starts to feel off, it’s easy to brush it off and tell yourself:

​“This is just part of the job.”

“I’ve handled worse.”

“I’ll deal with it.”

​Sometimes things don’t resolve on their own. That doesn’t mean you’re broken. Feeling off is a normal response to this work. Have you ever sat in your car, outside the station, thinking, “I’m not sure I can handle another day of this?” Yet you get out and work, because bills need to be paid.

Do you remember the excitement of the job when you were a probie and new to the career? This not-so-subtle feeling of losing the joy of work is a good indicator that it is time to talk to someone. Looking back over the years, you might be able to see a pattern:

• Calls replaying in your head.

• Trouble sleeping or shutting your mind off.

• Feeling on edge.

• Feeling completely numb.

• Irritability, snapping at others you care about.

• Isolating from others.

• Second-guessing decisions on a call.

There is nothing wrong with you. These are often signs that you have not had a chance to work through what you’ve witnessed.

It’s not always about trauma, either. A lot of first responders think therapy is only for PTSD symptoms. It is not only for major incidents or critical calls. Therapy is more than just trauma; it is about the cumulative stress experienced over the years in the department. Sometimes it shows up as a moral injury, when something about a call doesn’t sit right, even if you did everything you could.

You don’t have to wait until you are falling apart. One large myth about therapy in first responders is that you have to be in full crisis to benefit from therapy. You don’t. Many first responders reach out when they notice they are not getting the sleep they need. Or they feel like they are always on edge and never have a moment to relax. Noticing these early warning signs and seeking help early is a great way to prevent burnout.

If you’re one of the first responders who believes they should be able to handle the stress, you are probably thinking:

“Other people have it worse.”

“This is what I signed up for.”

“I’ve handled everything so far.”

But you don’t have to handle everything by yourself. Having support can help you carry the load. There is a difference between doing the job well and having a place to process what comes with it. You don't have to carry it alone.

If you’ve never been to therapy, you might be picturing lying on a couch, talking about events from your childhood. Or, if you know a first responder who has been to therapy and it didn’t work for them, you might think, “Therapy isn’t for me,” or, “Therapists don’t understand me.” The reality is different.

Therapy for first responders looks like a place where there is no pressure to talk about everything right away. You shouldn’t feel forced to talk about the most traumatic call in session. Conversations stay practical and grounded in what is happening now. What are the big blocks currently? How are you responding to stressors? What coping mechanisms do you have that are working for you? Do you have any maladaptive coping strategies you are using?

Therapy should also be a space where you don’t have to explain the job. Your therapist should be culturally competent and knowledgeable about first responder culture. If you don’t feel like you’ve connected with your therapist, you can find another one. Not every therapist is the right fit for every client. You can search for one that you trust. Don’t give up on the first try. Therapy is about making sense of what’s been sticking with you.

Finally, you don’t have to wait until it gets worse. Many first responders wait until their sleep is off, and they are getting less than 4 hours of sleep every night. Or they wait until their partner forces them to seek help due to strain on the relationship. You don’t have to wait until things feel out of control. If you feel off, even slightly off, that’s reason enough to talk to someone.

Talk to someone who understands first responders.

If you’re a first responder in Orlando and you're noticing these signs, you don’t have to figure it out on your own.

Confidential. No Pressure.