Behavioral Health Issues Fire Fighters Face

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IAFF members experience some of humanity’s most harrowing scenes day in and day out. These experiences leave many with lasting negative effects, including PTSD. It’s time to face PTSD and other behavioral health issues head on. Don’t suck it up. Ask for help.

When experiencing PTSD, fire fighters are prone to other behavioral health issues, including depression and anxiety, and are also more likely to experience substance abuse issues.
Fire fighters Tending to a semi truck fire
“We are great at taking care of the public, but we are not so great at taking care of ourselves.” — Frank Leto, FDNY Counseling Unit


For a long time, there has been a stigma associated with PTSD that it is a sign of weakness or an inability to handle the pressures of the job. It isn’t. PTSD is very real, and getting help doesn’t mean you’re weak. It means you’re strong.

Several symptoms can indicate the presence of PTSD

  • Avoidance of situations that resemble the event
  • Persistent mood swings
  • Difficulty performing duties or tasks
  • Difficulty concentrating
  • Chronic pain
  • Chronic feelings of hopelessness or despair
  • Substance abuse or addiction
  • Hyperactivity
  • Inability to relax
  • Insomnia
  • Jumpiness
  • Feeling disconnected from friends or family
  • Relationship difficulties
You may think PTSD isn’t treatable, that it could mean the end of your career or that it is “all in your head.” The truth is that PTSD is highly treatable and the symptoms can be managed.
Fireman Alone


Depression often accompanies the symptoms of PTSD. Fire fighters who have a weak support system at home or at work and are prone to self blame are most likely to develop co-existing disorders such as depression.

Symptoms of Clinical Depression

  • Feelings of pessimism or hopelessness
  • Feelings of guilt, worthlessness or helplessness
  • Loss of interest in former hobbies and activities
  • Decreased energy
  • Difficulty sleeping or waking up
  • Difficulty concentrating, remembering and decision-making
  • Appetite or weight fluctuations
  • Suicidal thoughts or attempts
  • Restlessness or irritability
Depression is more than just feeling sad. Depression can worsen over time and can affect almost every aspect of your life, including your career. The good news is that depression is highly treatable, and you are not alone.
Fire fighter Looking Away


Anxiety disorders are characterized by feelings of tension, worry and physical changes, such as increased blood pressure. Those with anxiety disorders are likely to avoid situations that worry them, and may experience sweating, trembling, nausea, dizziness or a rapid heartbeat when confronted with these situations. Anxiety and PTSD can go hand-in-hand.

Symptoms of Anxiety

  • Excessive worry
  • Restlessness or edginess
  • Becoming tired easily
  • Difficulty communicating
  • Feeling like your mind is “blank”
  • Irritability
  • Muscle tension
  • Sleep problems (insomnia, restless sleep)
Anxiety is treatable with talk therapy and medication. You don’t have to feel anxious in your daily life. You can feel peaceful, calm and secure.

Fire Fighters and Suicide

Because of the traumatic events you are be exposed to, behavioral health issues such as PTSD, depression and anxiety can eventually lead to suicidal thoughts or actions. In fact, more fire fighters kill themselves than are killed in fires or other catastrophes.

Suicidal Tendencies Among Fire Fighters

In a Journal of Affective Disorders study conducted in 2015 of 1,027 retired and current fire fighters and revealed that:
46.8% of fire fighters had suicidal thoughts or ideas
19.2% of fire fighters made plans to commit suicide
15.5% of fire fighters made a suicidal attempt
16.4% of fire fighters harmed themselves but did not commit suicide

Are you experiencing suicidal thoughts? We’re here to help you.

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The Journal of Affective Disorders study concluded that fire fighters experience an “alarmingly high career prevalence of suicidal thoughts and behaviors, indicating the need for … increased prevention and treatment efforts among fire fighters to decrease suicide risk.”
  • Chicago: Chicago Local 2 lost seven members to suicide within 18 months
  • Philadelphia: Philadelphia Local 22 lost at least one member per year to suicide over five years
  • Phoenix: Phoenix Local 493 lost four members to suicide within a year
  • Surrey, BC: Surrey, BC Local 1271 experienced a series of emotional losses within a three-month period, including two members who died by suicide.
There is help for behavioral health issues within the fire service. You are not alone, and there are caring professionals who want to help you rediscover fulfillment in your job and in your life. The IAFF Center of Excellence for Behavioral Health Treatment and Recovery was created specifically for IAFF members in the United States and Canada. Our doctors and clinicians specialize in addressing substance abuse with co-occurring PTSD. Getting help is the first step to rebuilding your life and excelling in your career.
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