A trauma scene can trigger stress for EMTs and paramedics. Strong feelings of overwhelm might flood their thoughts. The physiological levels of cortisol and adrenaline rise in their bodies.

It’s part of the job, but it’s also something to watch and manage. Stress can build up over time.

“Stress reactions like fear, palpitations, anger or emotional numbness—even nightmares— are a normal part of the human response to trauma,” said Dr. Kim Gushanas, a licensed psychologist and assistant professor in the Department of Psychiatry and Behavioral Sciences at UTMB. “It’s just the brain trying to sort all of that out. Usually, those acute reactions decrease over time, but when someone is exposed to it over and over again, it can become harder for the body to naturally cope.”

Many EMTs and paramedics work split shifts and some also work for more than one agency. That work schedule alone is enough to cause stress.

But stress is not a “bad” thing. Stress helps medics when they respond to emergencies.

Stress is a natural hormone and a motivator that is part of an important process in our nervous system, one that historically has been the reason for our survival when we face threats or traumatic experiences.

Stress becomes dangerous when people judge themselves—thinking thoughts like “I can’t deal with this” or “This is too much”— or when they avoid the issue, pretending like it’s not there.

“Try to remind yourself when you’re stressed that your body is just doing its job,” Gushanas said. “There’s a great video of a TED Talk from a well-known health psychologist, Kelly McGonigal, on making stress your friend that is worth a watch.”

Mental health matters for first responders because they have a significantly greater risk for being exposed to trauma. Even simple exposure is just as much of a predictor of stress as being directly involved, Gushanas said.

The stigma of getting help for mental health issues has decreased significantly in recent years. More first responders participate in therapy and treatment, and they continue to learn about their experiences and what helps and what hurts.

“If we aren’t taking care of ourselves in ways that are within our control, this can become harmful to our emotional and physical health and how we function at work, socially or emotionally,” Gushanas said.

Flight attendants tell people to put on their own oxygen mask before trying to help others. It’s a simple metaphor but it’s very relatable. If you aren’t saving yourself first, you will run out of oxygen and will be useless to the rest of the world.

“In my field, we are trained that self-care is an ethical responsibility—an obligation if you are caring for others’ wellbeing,” Gushanas said.

“There’s no way anyone got into being a medic without a desire to help others, so remember your values that got you there, and add yourself to the top of that list if for no other reason than being able to do your job the best you can, when you’re at work,” she said.