Stress and Disease

Stress. Something we often think about, deal with, then move on. While there can be a lot said about "Eustress" aka. "good stress", when it comes to first responders we rarely mean "good" stress. The overwhelming amount of negative stress that First Responders experience has lead to the national recognition that Post Traumatic Stress Disorder as a "workplace hazard". We have heard about PTSD often in the media (and it has been spoken to on this site, and many others). What we hear about are the immediate impacts of this disorder; however, if those effects weren't horrific enough, there is some shocking research suggesting the impacts might be much further reaching!

As research progresses, we are growing to find that the mind and body are connected. This may seem intuitive, but this has been debated for years between psychologists and philosophers alike. It is a psychological paradigm shift to have therapists now paying attention to how the body is reacting to different issues from depression, to anxiety, to trauma. What is more, is that this is rarely something that First Responders are oriented to pay attention to, let alone spend any time considering.

In a discussion with Dr. Andy Brown, he asked me to reflect on a moderately stressful call. "Focus on an event, not one that was very traumatic, but one that was a little bit stressful". Once I had one in mind, Dr. Brown led me through a "Body-Scan", identifying areas that were strained, sore, or otherwise abnormal. While this experience was void of the typical clinical approach or atmosphere (you can only get so much of that via phone), I was still able to find areas in my body that seem to be triggered when I recalled the event. This is not to say that I, or you, have PTSD, but rather that the traumatic calls and stress from them can be "remembered" by our bodies. Dr. Brown hypothesized that trauma gets "stuck" in the body. If this is left long enough without intervention, the body may turn these experiences into pain.

This is the basis behind a lot of the newer research, especially that of psychiatrist Bessel van der Kolk. His book, "The Body Keeps Score" culminates his journey in psychiatry that had led him to uncover the importance of the body in understanding trauma. " Not the emotions such as anger, anxiety or fear", Bessel writes, "but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow and so on".

The research is becoming quite clear on the impact that this disconnection between mind and body can have. From the relatively basic and somewhat harmless concern or attempt to supress a thought, which ironically increases the desire and obsession of the very thoughts we want to avoid (Baird, Smallwood, Fishman, Mrazek, & Schooler, 2013), to the severe and significant impact of “Alcohol dependency… considered a dissociative reaction of individuals with difficulties in identifying, expressing, and regulating emotions” (Craparo, Ardino, Gori, & Caretti, 2014).

But, studies are beginning to link a connection between the effects of on-going stress and the development of dementia. Quershi and colleagues made this link when looking at Veterans with PTSD (2010). Alarming was the finding that those with a PTSD diagnosis were twice as likely to develop dementia. This was a similar conclusion of researchers Maziab and colleagues whom found comparable results with their work with Veterans and POWs (2014).

And, while all these studies are not specifically looking at First Responders, I assume it is only a matter of time before the link is made within the ranks. While the severity and frequency of those events experienced by our military friends is significant, the accumulated experiences by First Responders can add up as well. And, of course, in some extreme cases the experiences can be almost identical. This is made ever more true by the increase in terrorist attacks on civilian targets.

Unfortunately, there is also a growing body of research finding connections between stress and fibromyalgia (a chronic pain disorder).  In one study, for example, of the participants with PTSD, 45 percent had fibromaylgia and 65 percent had chronic pain (Hauser et al., 2013). Though it's too soon to make any solid conclusions, one could certainly argue the connection between stress and disease.

It is easy to see, therefore, why EMDR (Eye Movement Desensitization and Reprocessing) therapy found such great success so quickly. While the modality (type) of therapy matters little, a therapeutic focus on integrating the mind and the body is going to yield the best results.

Keeping in touch with how you are responding both psychologically as well as physiologically will go a long way in ensuring your flourishing mental health. There are many different ways to reconnect with your body. The body scan is one simple, but effective way. There are many sites that can outline these processes. Just choose the one that works for you.

In the meantime, a friendly challenge: Try to notice the first thing that happens when you grow upset. Where do you first feel frustration?