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What is PTSD?

Post Traumatic Stress Disorder (PTSD) is best understood as a traumatic stress injury. It involves reactions to extreme stress and trauma that can affect your thinking, emotions, physical sensations, and behaviour. These are natural responses to stress that usually subside when the stressful event passes. But with PTSD they get “locked on”.

Just like physical injuries, we as humans can be more or less resilient to stress injuries depending on a number of factors. But none of us are immune, and just like elite sports people who can be injured at the peak of their fitness, even the toughest of first responders can incur a traumatic stress injury if a particular thing hits at a particular time.

How Common is PTSD?

First responders with more than 10 years’ service are 6 times more likely to experience symptoms of PTSD

Poor workplace practices and culture were found to be as damaging to mental health as occupational trauma.

More than half of all first
responder employees
indicated they had experienced a traumatic event that deeply affected them.

In Australia, about 1 in 10 first responders develop PTSD compared with 1 in 20 in the general population.

PTSD often co-occurs with
depression, substance abuse, or some form of anxiety.

This resource is designed to help first responder families understand what you may be going through with PTSD.

Head to our resource library for additional tools to support yourself and others through challenging experiences.

What is Trauma?

PTSD is caused by trauma. Simply put, trauma is something that affects our sense of the world being safe. There are three broad categories of trauma experienced by first responders:

Physical Threat

This type of trauma involves threats to physical safety that cause intense fear, helplessness or loss of control. Examples include:

  • accidents
  • natural disasters
  • physical and sexual violence
  • armed law enforcement operations

Traumatic Loss

Another – often overlooked – cause of traumatic stress injury for first responders involves traumatic loss of life. This can cause intense feelings of shock, grief, guilt, and concerns for human dignity and vulnerability. Examples include:

  • sudden, horrifying, or violent loss of life
  • death of a vulnerable person (e.g. child, elderly)
  • personal connection or identification with the victim of an accident
    or crime (e.g. same age as own child)

Traumatic Stress Injury

Traumatic stress injuries can occur immediately after a particularly overwhelming event, or build up over time.

Sometimes there is a gradual wearing down of resilience where organisational factors, work-life imbalances, physical injuries, or other life stressors combine to overwhelm your capacity to cope. This can sometimes result in delayed PTSD reactions to events that you may have coped with in the past.

One particularly powerful mechanism of traumatic injury for first responders occurs when there is some personal connection to an event. First responders typically cope with the challenges they face by creating a degree of emotional distance from events. But even the strongest suit of armour has chinks. Sometimes trauma finds your vulnerable places and penetrates the usual barriers that protect you.

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Understanding the Diagnosis

PTSD involves a set of reactions that are remarkably common among people who have experienced traumatic stress injuries. These include:


Being “haunted” by traumatic experiences which may occur in the form of nightmares, memories, and physical or emotional reactions that can intrude unexpectedly in daily life or when triggered by people, places, objects and sensory experiences (sounds, smells, etc) associated with traumatic events.

Physical Reactivity

The body getting stuck in survival mode means that people with PTSD can feel constantly wired, hypersensitive to things like noise, and have difficulty winding down. It can be very difficult to relax, and sleep can become a big problem.

Changes in Beliefs and Mood

Trauma can change how you feel about yourself, the world and other people. You may feel guilty, blame yourself for certain events, or feel mistrusting or angry towards certain people or groups.


Survival through avoiding triggers or feelings of vulnerability – is a coping mechanism used to avoid the severe discomfort of these reactions. It can also cause people to withdraw and feel detached from people – perhaps even feeling numb and detached from feelings of love and connection.

Many people react to the word ‘disorder’ – but this is simply a technical term used to indicate that a mental health problem is having a significant impact on your wellbeing and functioning.

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What Does PTSD Feel Like?

If you are experiencing some of these signs and symptoms,
it may not mean that you would be diagnosed with PTSD.
If you are concerned, please seek medical advice.

  • Constantly on edge, agitated or vulnerable with a sense of dread.
  • Unable to settle or sleep, constantly tired or exhausted.
  • Feeling betrayed by the body – unable to trust your reactions, or feeling teary for no apparent reason.
  • Everything feels like a threat – seeing potential danger or wrongdoing everywhere, even in everyday activities.
  • Feel self-conscious – like everyone can see your vulnerability.
  • Preoccupied – distracted by past events or themes and can’t stop thinking about them. Replaying events, trying to change outcomes (what ifs, shoulds, if onlys).
  • Feeling broken, diminished and embarrassed.
  • Feeling contaminated/toxic.
  • Loss of functioning – unable to do tasks that used to be easy or find it takes a lot more effort.
  • Difficulty concentrating and remembering things.
  • Feeling isolated – like no one can understand.
  • Preoccupied with feelings of anger, guilt, or shame, and sense that you don’t deserve happiness.
  • Feeling emotionally numb and completely cut off from others.
  • Loss of trust and faith in people.
  • Needing to maintain vigilance – patrolling your house or sitting where you can see exits, creating an emergency strategy in public places.
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Understanding Triggers

When you have PTSD, there are many things that can trigger the body’s threat system, disturbing memories and strong emotions.

Just like when physical injuries are agitated, they can flare up – triggering or aggravating pain to protect us from further injury.

Triggers work in a similar way with traumatic stress injuries.

Common triggers include:

  • Sights, sounds, and smells associated with traumatic events
  • Anniversaries of events, a specific time of day or year
  • Certain seasons or weather
  • News or conversations about related events or
  • Crowds and situations that feel confining
  • Tension and conflict
  • Uniforms, service vehicles and sirens
  • Physical discomfort, such
    as fatigue, hunger, or
    sexual frustration
  • Bodily sensation that can relate to the trauma
  • Strong emotions, especially feeling frustrated, helpless, out of control, or trapped
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Treatment and Recovery

It is absolutely possible to recover from PTSD. Some people even say that they have grown in significant ways. As you heal, you learn to better look after yourself – increasing your connection to yourself, loved ones, and the things that are most important in your life.

While psychological interventions are considered first line treatments for PTSD, medication can also form part of recovery in helping to stabilise symptoms and mood.

There is also a growing body of research that demonstrates the benefits of exercise, yoga, and mindfulness practices for PTSD symptoms in addition to psychological therapy.

The core ingredients of PTSD treatment involve:

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Treatment usually involves weekly sessions with a psychologist and the time-frame for recovery can vary depending on how much trauma you have been exposed to, and how long you have been living with the injury.

Where to Find Support

Internal Supports:

  • Peer support officers
  • Chaplains
  • Psychologists and wellbeing support officers
  • Employee Assistance Program (EAP)

Specialist Services:

  • St John of God Hospitals, NSW
  • Westmead Traumatic Stress Clinic, NSW
  • Greenslopes Private Hospital, QLD
  • Toowong Private Hospital, QLD
  • Heidelberg Repatriation Hospital, VIC
  • The Geelong Clinic, VIC
  • Jamie Larcombe Centre, SA
  • Hollywood Clinic, WA
  • Black Dog Institute Online Clinic

Mental Health Information & Support:

Fortem Australia:

  • Specialist psychologists
  • Support coordinators
  • First responder and family/inner circle wellbeing activities
  • Mental fitness tools
  • Information resources

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