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First Responders First - Physical, mental, & emotional toll of stress



Any disturbance of the human body, such as temperature changes, infections, emotional responses, or any of the situations described in other course modules can produce a stress response. Regardless of the source of the disturbance, the body responds to different types of stressors similarly.

In some cases, stress can be positive as it helps people overcome challenges. These are often short-term stressors, like responding to sudden loud noises, that activate the fight-or-flight response through the sympathomedullary pathway or SAM. A stress trigger causes the hypothalamus to send action potentials, or messages, to the adrenal medulla, stimulating the release of epinephrine and norepinephrine. This causes a temporary increase in heart rate, blood pressure, and blood glucose as well as bronchiole dilation. Nutrients like blood, glucose, and oxygen get redirected to essential organs like the brain, heart, and skeletal muscles. Usually, people experience a pounding heart, faster breathing, sweaty palms, and trembling hands.

Though short-term stress is helpful, long-term stress can become detrimental. Prolonged stress involves the interaction between the hypothalamus, pituitary, and adrenal glands, also called the hypothalamic-pituitary-adrenal or HPA axis, and initiates a cascading hormonal response. The hypothalamus secretes corticotropin-releasing hormone, triggering the anterior pituitary gland to release adrenocorticotropic hormone, signaling the adrenal glands to release aldosterone and cortisol. Aldosterone increases blood volume and blood pressure. Cortisol increases blood glucose, facilitates the breakdown of proteins and fats, and temporarily suppresses the body’s immune response

Chronic exposure to stressors like financial difficulties, career concerns, relationship problems, and deadlines can lead to persistent elevations in heart rate, blood pressure, and blood glucose, eventually leading to health problems like heart disease and diabetes. Continual diversion of blood circulation away from non-essential organs can cause problems in the skin and digestive systems. People in this phase may experience difficulty concentrating, fatigue, depression, and anxiety.

Although prolonged stress can have a marked physical effect on the body, studies have shown that chronic stress can inhibit the brain’s prefrontal cortex. This creates difficulties in concentration and memory and also interferes with decision making, negatively affecting the ability to appropriately respond and recognize client status changes. Eventually, unresolved chronic stress can also lead to the development of mental health disorders. One study showed that healthcare providers exposed to chronic stress during the COVID-19 pandemic reported heightened levels of depression, anxiety, insomnia, and distress. Often, the first steps to promote mental well-being include incorporating stress management techniques and seeking mental health resources and services from employer programs, mental health professionals, support groups, and/or nonprofit organizations that specialize in mental health support for healthcare providers.

In times of stress, here are some interventions that may help. First, identify signals that may indicate impending burnout. These may include increased heart rate, difficulty concentrating, negative emotions such as irritability, depersonalizing relationships or concerns, and social conflicts with friends, family, or coworkers. Use these signs as guideposts to inform your physical, mental, and emotional breaks throughout the day. 

Second, take moments to unwind. This can include stretching or elongating your spine at different points throughout the day, taking a walk outside during a break, practicing deep breathing techniques, or listening to a calming song during breaks or when a shift ends. 

  1. "Helpful Mental Health Resources for First Responders Under Stress"  (2020)
  2. "The Impact of Stress On Our Brains and Our Work"  (2020)
  3. "Frontline Nurses WikiWisdom Forum"  ()
  4. "Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019" JAMA Network Open (2020)
  5. "Human Anatomy & Physiology" Pearson (2017)
  6. "What is the Stress Response?"  (2010)
  7. "The Emotional PPE Project"  ()
  8. "Principles of Anatomy and Physiology" Wiley (2013)
  9. "Welcome to The Compassion Caravan"  ()
  10. "Self-Care Microsteps"  ()