Firefighters and Stress: Just Breathe

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Fight or Flight

More than anyone, firefighters know that in an emergency situation, their natural reaction is “fight or flight”. If the danger is surmountable, we may choose to stand our ground and fight. If we can outrun or avoid the danger, we will flee. However, there is another response that can occur when a danger seems so overwhelmingly hopeless that there is no chance of survival. We may freeze, like the deer in the headlights.

The Freeze Response

Even firefighters can have this response in life-threatening situations, and it is not always healthy in the long run. A 1989 study by van der Kolk and van der Hart showed that dissociation or “freezing” in wake of an event is a precursor to Post-Traumatic Stress Disorder (PTSD), along with phobias, panic attacks, obsessive-compulsive behaviors and various anxieties that may be traced to a “freeze” state that never had the chance to “let go” or “thaw out”.

The purpose of “freezing” is to give us a chance to disassociate from the trauma we are experiencing. However, when are asked to “freeze” or mimic the freeze response when we are physiologically ready to flee or fight, we cannot benefit from dissociating from the event. Instead, our body’s heart rate races, our muscles tense, etc. in preparation for the fight or flight. If we can’t do either, our levels of cortisol, the “stress hormone” that regulates our body for the response, builds up within us. Without a release, this cortisol can wreak havoc on our minds and bodies.

Firefighters, or anyone in life or death stressful situations, should remember that the freeze response is never your friend. Movement is good for us to release cortisol, and also to take action for our survival. In situations where movement is not possible, there is another suitable substitute to lower our cortisol levels and focus our action: intentional breathing.

Mind-Body Intervention

From managing pain during childbirth to handling cases of shocking news, intentional breathing has been found to be soothing and effective in stressful situations. If you add light movement to the breathing, you have a formula for stress relief that has been proven effective, even in scientific experiments.

For example, a recent study of nurses from the University of New Mexico Hospital with positive PTSD symptoms were asked to participate in 16 sessions of 60-minute mind body intervention (MBX) sessions led by a trained instructor over a 8-week period. The program consisted of stretching, balancing and breathing with a focus on mindfulness.

The group was asked to attend to their breathing, concentrating on inhalation, retention and exhalation. At the end of the program, the MBX group showed significant reduction in PTSD symptoms, serum cortisol and “improved sleep, stress resilience, energy levels, better emotional regulation under stress, and resumption of pleasurable activities that they had previously discontinued.”

On a call, firefighters aren’t able to lower their cortisol with yoga, but back at the station or in preparation for a call, performing mindful breathing can be surprisingly helpful as well as physically and mentally healthy for a firefighter. Back at the station, performing breathing and stretching exercises like those outlined below can help firefighters prepare mentally and physiologically for the next time our “fight or flight” response is activated, but we can’t fight or flee.

Relieving Stress Through Physical Motion

In an emergency situation, our bodies typically ramp up physically in preparation for the flight or fight response, dumping cortisol (the stress hormone) into our system. Our heart races, our muscles tense and energy surges through our body. If we are asked to sit still or “freeze” while we are in a stressed state,  an unhealthy amount remains in our system, awaiting release so we can relax. How can we productively reduce our cortisol? Mindful deep breathing and simple stretches can do the trick. Here is a possible start:

Breathing
Try on the way to a call, when awaiting dispatch or any situation where you may feel anxious.
Close your mouth and inhale quietly through your nose to a mental count of four.
Hold your breath for a count of seven.
Exhale completely through your mouth to a count of eight.
Repeat the cycle three more times for a total of four breaths.

Belly Breathing
Place your hand on your stomach.
Breathe in deeply, attempting to make your hand rise.
Hold for a count of seven and exhale, mindful of your hand falling with your exhalation.

Child’s Pose
On your hands and knees, spread your knees wide apart while keeping your big toes touching.
Sit up straight and lengthen your spine up through the crown of your head.
On an exhalation, bow forward, draping your torso between your thighs while extending your arms in front of you, palms facing down.
Hold for a count of eight, then sit up and repeat.

Thread the Needle
On hands and knees, place your right arm underneath your left arm until your shoulder is resting on the ground. Hold for three breaths.
Come back to all fours and repeat, placing left arm underneath the right.

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