PTSD in Paramedics
Jonathon T. Akers
PSYC317: Crisis Intervention
Professor Robert Clark
October 8th, 2025
PTSD In Paramedics
Paramedics encounter traumatic events on a daily basis. These can include severe injuries, death,
violence, and completely unpredictable emergencies. This is compounded over the years due to
the long career that a paramedic will endure. This places them at a heightened risk for
posttraumatic stress disorder or PTSD. Over time, these exposures accumulate, leading to
significant cognitive, emotional, and even physiological distress. Research shows that
paramedics have considerably higher rates of PTSD than that of the general civilian population.
One study shows a PTSD prevalence rate of 20.0% compared to 3% in the general population.
This goes on to illustrate that the risk of the development of post traumatic stress disorder is a
serious occupational risk factor for first responders. (Hoell, Kourmpeli, & Dressing, 2023).
It is also important to note the significance of chronic trauma exposure compared to acute-setting
traumatic exposure. Now Trauma is most commonly described between acute and chronic
exposure. In a typical person, an acute trauma response could be most commonly understood as
an “adrenaline rush.” This is a sympathetic response that activates the bodies “fight or flight”
mechanism causing the body to flood with catecholamines and an increase in cortisol which is
the bodies stress hormone. Now to move on to the subject of chronic trauma, if we analyze the
overall position of a first responder, namely a paramedic. We can generally assume that every
shift, multiple days a week, that this individual will be called to the scenes of emergencies in
which he or she is expected to bring order to chaos or to provide a remedy to a high stress
situation that would otherwise be unavailable. If we take into consideration that this responder
must do this over and over for 20 years or more of his/her career, then we must be able to
reconcile with the idea that this responder is going to develop several psychological and
physiological deficits over the course of their career. These can include:
•Hyperarousal states
•Avoidance behaviors
•Trauma-associated memories
•Altered cognitions and moods
Acute stress disorders are defined in the article to last less than a month, while chronic and PTSD
are defined to last longer than a month. Repeated traumatic exposure further complicates this as
repeated trauma can lead to Complex Post Traumatic Stress Disorders(CPTSD). CPTSD involves
the aforementioned PTSD symptoms as well as a dyfunction in self, personal affect, and
relationships.
Intervention
Onto the subject for the most effective interventions that are available for the treatment of PTSD,
First on the list is Cognitive Behavioral Therapy or CBT. CBT is widely understood to be the
most effective treatment for post traumatic stress disorder as it tends to manage the underlying
causes of the stress. CBT aims to address the maladaptive coping factors/beliefs, avoidance
behaviors, and the conditioned fear response.(Cusack et al., 2016) This is particularly important
for anyone suffering from post traumatic stress disorder as the only way to truly treat the patient
suffering from post traumatic stress disorder is to treat the underlying stressor, otherwise we risk
further development of physiologically detrimental effects to the human body. These
manifestations can occur as obesity/weight gain, anorexia/weight loss, cardiac arrythmiogenesis,
most commonly atrial dysrhythmias, chronic substance abuse disorders, myocardial infarctions,
cerebrovascular accidents, chronic fatigue syndrome, dysautonomia, thyroid dysfunction, and
many more. (National Center for PTSD, 2025)
The second recommended treatment is EMDR or eye movement rapid desensitization therapy.
This therapy, according to statistical data tends to perform on par with cognitive behavioral
therapy. The therapy primarily focuses on bilateral sensory stimulation combined with traumatic
recall and processing. This therapy is more effective for singular traumatic events versus chronic
exposure however. (Watts et al., 2013)
The third recommended treatment is pharmacological therapy, this is the least recommended
therapy. Even though pharmacological agents are effective, they do not tend to treat the
underlying cause of trauma. Essentially you are only numbing the pain. Used in conjunction with
other therapies however, has shown greater promise as it allows the patient to endure the
treatment with greater efficacy. (Hoskins et al., 2015)
Critical Analysis and Biblical Application
Post Traumatic stress disorder among paramedics, is a crisis that intertwines emotional problems,
exhaustion, and even moral injury. While we have things like CBT, EMDR, and even
pharmacological therapy to help, and while these methods have shown significant and
measurable success rates, the reflection shown through the studies is that the psychological
healing alone is incomplete if we do not consider the patient’s spiritual and well-being as well as
their general sense of purpose. The most recent research goes on to emphasize that holistic care
supporting not just symptom management but also reconstruction of individual identity and
moral repair is significantly more important. (Bryant et al., 2020). For the paramedics that are
frequently exposed to traumatic events, recovery that can sustain itself will depend on the ability
to obtain measurable resilience, as well as spiritual grounding and social connections that foster
healthy environments, not just at work but everywhere else as well.
If I were to assess this through a biblical lens, I would turn to Romans 12:2 which speaks of the
renewal of the human mind through the Holy Spirit. This verse underlines that healing is more
than just management of the symptoms, It also involves the spiritual renewal through the Holy
Spirit. Psalm 34:18, “The Lord is near the brokenhearted and saves the crushed in spirit.” That is
a powerful reminder that God is near those who are most broken. Applying these principles in the
medical field suggests that services like faith based counseling, chaplaincy programsm and peer
support groups will help as well as complement regular PTSD treatments. This is why it is
important to understand the need to bridge the gap between medical science and spiritual renewal
and restoration. A biblical approach does not wholly replace traditional professional therapy,
however, it can expand the scope of healing to include a spiritual renewal as well.
References
English Standard Version Bible. (2001). Wheaton, IL: Crossway Bibles
Hoskins, M., Pearce, J., Bethell, A., Dankova, L., Barbui, C., Tol, W. A., van Ommeren, M., de
Jong, J., Seedat, S., Chen, H., & Bisson, J. I. (2015). Pharmacotherapy for post-traumatic
stress disorder: Systematic review and meta-analysis. The British Journal of Psychiatry,
206(2), 93–100. https://doi.org/10.1192/bjp.bp.114.148551
Hoell, A., Kourmpeli, E., & Dressing, H. (2023). Work-related posttraumatic stress disorder in
paramedics in comparison to data from the general population of working age: A
systematic review and meta-analysis. Frontiers in Public Health, 11,
1151248. https://doi.org/10.3389/fpubh.2023.1151248
Feriante, J., & Sharma, N. P. (2025). Acute and chronic mental health trauma. In StatPearls.
StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK594231/
Cusack, K., et al. (2016). Psychological treatments for adults with posttraumatic stress disorder:
A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-141.
https://doi.org/10.1016/j.cpr.2015.10.003
National Center for PTSD. (2025, August 25). Trauma, PTSD, and physical health. U.S.
Department of Veterans
Affairs. https://www.ptsd.va.gov/professional/treat/cooccurring/ptsd_physical_health.asp
#five
Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J.
(2013). Meta-analysis of the efficacy of treatments for posttraumatic stress
disorder. Journal of Clinical Psychiatry, 74(6), e541– e550.
https://doi.org/10.4088/JCP.12r08225
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