The COVID-19 crisis has affected the entire globe, with people dying in record numbers from the virus. Essential workers, which includes all first responders, nurses, doctors, nursing aides, and others who must go to work, are on the front lines.

This article will examine various methods that first responders can utilize to help decrease stress in their working lives.

Essential Workers and Stress

Unfortunately, many essential workers also live with the effects of complex post-traumatic stress disorder (CPTSD) struggle to manage stress. This lowered ability to manage stress is costing front line workers mentally. Also, there will be effects in the lives of first responders long after COVID-19 is only a memory.

Typically, complex post-traumatic stress disorder leaves essential workers feeling overwhelmed and inadequate, which raises their stress to harmful levels. The increased pressure is especially toxic during the current pandemic as first responders struggle to maintain their professional edge.

A few examples of stresses essential workers face are direct or indirect exposure to death, grief, injury, and pain. First responders must also deal with threats to their personal safety and long hours of work. All those stressors lead to poor sleep, physical hardships, and mental health issues. (Botha et al. 2015)

The Long-Term Effects of Stress on First Responders

There has been research conducted to try and measure the long-term effects of stress experienced by front-line workers to see what mental health difficulties these folks face.

The results are sobering.

Because first responders are always facing highly stressful and risky situations at a quick pace, they are unable to process and integrate their work experiences. A good example is how 69% of emergency medical system professionals are not given enough time to recover between traumatic events. (Bentley et al. 2013) The result of this lack of time to heal leads to depression, substance abuse, and suicidal ideation. (Plat et al. 2011)

People who experience elevated levels of stress that lasts for prolonged periods also have a shorter life expectancy. The Indo-Asian News Service related that researchers found a shorter life expectancy is significantly influenced by risk facts, including heavy stress.

Secondary Traumatic Stress During the COVID-19 Pandemic

Front line workers such as doctors, nurses, EMTs, and firefighters are faced with a difficult to manage problem called secondary traumatic stress. Also known as compassion fatigue, the condition is characterized by physical and emotional exhaustion that can lead to a diminished ability to feel compassion for others.

The traumatic stress response helps to protect the first responder and other medical workers who face COVID-19 realities every day.

Some signs of secondary traumatic stress include:

  • Physical signs of stress
  • Nightmares
  • Recurrent thoughts about the traumatic event
  • Excessively worrying or fearing about what happened
  • Internalizing others’ trauma
  • Hypervigilance
  • Hopelessness
  • Inability to embrace complexity
  • Anger and cynicism
  • Sleeplessness
  • Fear
  • Chronic exhaustion
  • Physical ailments
  • Minimizing Guilt

Especially during the COVID-19 crisis, men and women in the helping and healing professions are finding themselves experiencing compassion fatigue. Because of this, it is highly difficult for doctors and others to empathize with their patients and themselves.

The Triad Approach

Being on the front lines of the COVID-19 pandemic is harrowing and exhausting. To prevent the stress from injuring first responders and others further, some positive steps can be taken.

The most vital strategy to keep secondary traumatic stress from forming is to utilize a triad approach of education, skills training, and supervision.

Education. Those on the front lines need to know and understand that they are stressed and what to do to mitigate its effects on themselves. Removing the stigma that can accompany reaching out for help is vital to preserving the mental and physical health of first responders. These brave men and women need to know they are not less heroic because they need to speak to their supervisor or a therapist about their being overwhelmed. They need to know they are humans first.

Skills Training. It is not enough that first responders are skilled at the jobs they perform. Training should be held that teaches first responders not to ignore the symptoms of stress they will experience and methods to mitigate its effects.

Supervision. Supervisors need to receive training in how to recognize when one of their supervisees has become or is becoming overwhelmed. With so many people dying of the COVID-19 virus, close attention needs to be paid to first responders who are exhibiting either numbing or angry outbursts. Both spectrums of behavior signal that the person needs intervention to help them deal with what they have encountered while taking care of COVID victims.

The triad approach has its limitations, but it is a good start at helping first responders to handle the stress involved in helping those of us who need them.

Ways First Responders Can Help Themselves

The Centers for Disease Control (CDC) in March of 2018, long before the coronavirus disrupted the world, wrote up a report outlining many ways first responders and those who are on the front lines can help themselves.

The first advice the CDC gives first responders is to continue treatment for any preexisting mental health conditions. This allows for mental health professionals to help front line workers watch for any new symptoms or signs of trouble.

The CDC site also offers a list of responder self-care techniques which are quoted below:

  •  Limit working hours to no longer than 12-hour shifts.
  • Work in teams and limit the amount of time working alone.
  • Write in a journal.
  • Talk to family, friends, supervisors, and teammates about your feelings and experiences.
  • Practice breathing and relaxation techniques.
  • Maintain a healthy diet and get adequate sleep and exercise.
  • Know that it is okay to draw boundaries and say “no.”
  • Avoid or limit caffeine and use of alcohol.

Not only does the site offer first responders a list of techniques, but it also outlines important reminders they need to incorporate into their daily routines. These reminders include (and I quote):

  • It is not selfish to take breaks.
  • The needs of survivors are not more important than your own needs and well-being.
  • Working all of the time does not mean you will make your best contribution.
  • Other people can help with the response.

By following these tips, those on the front lines of the COVID pandemic can help themselves so they can remain mentally healthy while caring for the needs of others.

Six More Recommended Stress Busters While On-Duty

Front line workers need awareness and knowledge to hand exposure to direct and indirect trauma. Awareness empowers them to explore and use preventative strategies that will reduce the risk, and they will increase their resiliency.

There are six recommended stress-busting activities that first responders can do to help them avoid the effects of damaging stress.

One, listen to calming and recharging music on shift breaks or after a shift ends. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends this strategy because it signals to your brain and body that it is safe to relax.

Two, avoid using alcohol, tobacco, or other drugs when feeling particularly stressed. It is tempting to turn to substances when one is stressed. However, they will interfere with your ability to recuperate and often lead to possible substance abuse issues later.

Three, make sure to take a break for a few minutes during your shift to go outside and take a short walk. Sunlight is vital for resetting an essential worker’s circadian clock and help sleep to come more naturally. Vitamin D from sun exposure is necessary for optimal health and can fight off depression and fatigue.

Four, when faced with distressing information, take a moment to pause and focus on inhaling for five seconds before exhaling the same length of time. This movement allows one to calm down the amygdala, the part of the brain responsible for the fight/flight/freeze response.

Five, make sure to set aside some recovery time after a particularly stressful event. It is vital not to return immediately and go to the next patient but take time to collect your thoughts and recharge.

Six, before a stressful shift begins, take time to identify your top, “I am stressed” signals. Learning how to listen to yourself and recognize when your batteries are running low can guide you to when to take microbreaks throughout your shift. Some common signals include having strong negative emotions, difficulty in thinking clearly, and unnecessary risk-taking. When you see a sign, be sure to take a pause to reset yourself.

In Closing

Most first responders took up their profession because they wanted to help others, not understanding the toll doing so can have on their lives. It is critical for first responders and others on the front lines of the COVID-19 battle to take aggressive measures to take care of themselves.

“To know even one life has breathed easier because you have lived. This is to have succeeded.” ~ Ralph Waldo Emerson

“There is no higher honor than to be given the responsibility to care for another human being.” ~ Richard K. Schachern

“Next to creating a life, the finest thing a man can do is save one.” ~ Abraham Lincoln

During this challenging time with the COVID-19 crisis, the CPTSD Foundation wants to reach out to you.

If you or a loved one are living in the despair and isolation that comes with complex post-traumatic stress disorder, please, come to us for help. The CPTSD Foundation offers a wide range of services including:

Daily Calls

The Healing Book Club

Mindfulness, Prayer, and Meditation Circle

Support Groups

Our Blog

The Trauma-Informed Newsletter

Daily Encouragement Texts

All our services are reasonably priced, and some are even free. So, to gain more insight into how complex post-traumatic stress disorder is altering your life and how you can overcome it, sign-up, we will be glad to help you.


Bentley, M. A., Crawford, J. M., Wilkins, J. R., Fernandez, A. R., & Studnek, J. R. (2013). An assessment of depression, anxiety, and stress among nationally certified EMS professionals. Prehospital Emergency Care17(3), 330-338.

Botha, E., Gwin, T., & Purpora, C. (2015). The effectiveness of mindfulness-based programs in reducing stress experienced by nurses in adult hospital settings: a systematic review of quantitative evidence protocol. JBI database of systematic reviews and implementation reports13(10), 21-29.

Plat, M. J., Frings-Dresen, M. H. W., & Sluiter, J. K. (2011). A systematic review of job-specific workers’ health surveillance activities for fire-fighting, ambulance, police, and military personnel. International archives of occupational and environmental health84(8), 839-857.

Too much stress may shorten life expectancy: Study. (2020). Indo-Asian News Service. Retrieved from:

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