By: Bryan Fass
Suicide claims more lives than line of duty fatalities. This headline statistic is both shocking and concerning. But what if we are approaching the issue with only half the perspective needed? Simultaneously with our mental health and suicide problem has been a decline in provider health and wellness. Couple that with an almost rampant occupational inability to sleep and we have the making of an epidemic in our profession.
A decline in physical wellness
Personally, I point to one major and predictable issue, food. Or in this case the lack of healthy food in our diet. Our diet has become so over processed, fast food based and chemically laden that it’s entirely possible that you may go days without eating something that has not been processed. A vast majority of EMT’s rely on the vending machine, fast foods and convenience stores for their ‘nutrition’. Add to that hormone and antibiotic laden meats and the endless supply of sugary drinks (both natural & artificial), especially the energy drinks, and we have a major wellness issue on our hands.
We have forgotten or perhaps we just never learned how to eat to heal. Frankly, in half the classes I teach the majority of responders have no clue what their diet is doing to their bodies. All these processed and chemically laden foods coupled with antibiotic use has effectively killed off one of the key balances in the body, between the brain and the gut. Three studies just came out clearly linking gut health to mental health.
-Gut Bacteria Linked to Depression Identified in Landmark Study 1
-Role of gut microbiota in posttraumatic stress disorder: More than a gut feeling 2
-Posttraumatic Stress Disorder: Does the Gut Microbiome Hold the Key? 3
The ‘fix’ is relatively simple. Cut out the sugars (real and fake), cut out the boxed/packaged foods with ingredient lists full of chemicals. Add in natural foods like lean meats, meat substitutes (impossible burgers anyone), green veggies, dark fruits and nuts.
Then get yourself on a strong probiotic supplement. By strong I mean 50 billion+ microorganisms per pill. You get what you pay for here so don’t skimp, and switch brands frequently as they all have different formulations.
At bed time take ZMA. It’s an OTC supplement of zinc and magnesium that not only promotes sleep but cardiac, brain and muscle health. When you sleep better, eat better and stay hydrated your gut microbiome will naturally start to rebalance it’s self.
Resiliency specific exercise
As your body continues to wear down from stress, fatigue and lack of healing foods so does your cardiovascular health. In fact after a 24 hour shift or multiple bouts of insufficient sleep your hear rate response is drastically altered for up to 2 days.4 So it would seem prudent to do some more cardio to help right the ship but with shift work in mind that’s actually the opposite think you should do. With shift work our cortisol response and HPA (hypothalamus, pituitary, Adrenal) response is essentially messed up. High intensity (cross fit type / HIIT raining) or long duration cardio (running) is in fact the wrong thing to do.
To boost your physical resiliency and help balance your HPA axis do primal lifts. That’s right, Deadlift, squat, leg press, barbell row and pull ups. Heavy weight with low reps and longer rest periods will not only balance you out but all these exercises will help to prevent line of duty soft tissue injuries. Plus, primal lifting helps to boost Testosterone levels and they happen to be job specific. On almost every call you deadlift, squat, step and pull so these types of exercises are also key to an injury prevention and career longevity program.
Lack of accountability
Is part of the problem simply a lack of a standard? If we hold employees to a physical abilities standard via an annual physical abilities test and we require annual medical physicals with blood work we could very easily right the ship on physical wellness. The job is 100% physical and a validated job specific PAT is the perfect vehicle to keep employees accountable for their wellness. Annual blood work, which you should do anyway, can and will save your life. Early detection is the key and married to a physical standard we can take a big and relatively easy step forward to improving employee health.
A consistent habit that has been handed down in ems and to some extent fire fighting is to conserve any and all energy just in case you need it, for the big call. So, we have generations of EMT’s that have been taught to sit in a dark room or lounge in the truck for the shift.
Unfortunately, this is the opposite of what your body actually needs. As humans we are creatures of movement, we were not designed to be still and sedentary. Your body craves movement to keep your muscles strong. Activity keeps you alert and will help to balance your brain. In fact, simple walks in the sun are a key component in PTS/PTSD rehabilitation.
So get off you butt and do something. Walk, do some body weight exercises, throw a frisbee but do something to burn a calorie.
As you can see the impact of physical wellness on all the facets of mental wellness, physical health, injury prevention, sleep and yes suicide is complex but when we step back and look at the issue from a wholistic perspective many of the issues we are facing are easy to address and you should be doing on a daily basis anyway.
- Can J Psychiatry. 2016 Apr; 61(4): 204–213.. Published online 2016 Feb 24. doi: 10.1177/0706743716635535
- Stellenbosch University. “Role of gut microbiome in posttraumatic stress disorder: More than a gut feeling.” ScienceDaily. ScienceDaily, 25 October 2017. <www.sciencedaily.com/releases/2017/10/171025103140.htm
4. Int J Occup Med Environ Health 2017;30(3):433-444