First Responders & Mental Struggles: The Leading Causes of Brain Illness

Dr Daniel Amen and Tana Amen BSN RN On The Brain Warrior's Way Podcast

First responders are on the frontline of the war for our health, and as a result they can often suffer in silence. After all, who is going to help the helpers? In this episode of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Dr. Nancy Bohl-Penrod discuss the symptoms most often seen, the factors that are causing them, and the best, most effective ways of getting these heroes the help they deserve.

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Dr Daniel Amen: Welcome to the Brain Warrior's way podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
Dr Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years. Using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit
Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to
Dr Daniel Amen: Welcome back. I am here with Dr. Nancy Nancy Bohl-Penrod, and we're talking about first responders. And our podcast, it's called the Brain Warrior's Way Podcast, because we believe you're in a war for the health of your brain. Everywhere you go, someone is trying to shove bad food down your throat that will kill you early.
We often joke the weapons of mass destruction are highly processed, pesticide sprayed, high glycemic, low fiber, food-like substances stored in plastic containers. And it's not just the food. It's air pollution, it's water pollution, it's gadget pollution. And I was in the army for 10 years. I was an infantry medic. So in a sense, I was a first responder, actually drove an ambulance for awhile. And then later an x-ray technician where I learned to fall in love with looking at the brain. And then as as a psychiatrist.
And so I can relate to kind and wanting to help. But after a while, people can get compassion fatigue. And as a therapist you certainly can get that, especially if you're dealing with a lot of trauma situations. But let's talk about some of the common problems you have seen. The common mental health problems you've seen in first responders.
Dr. Nancy Bohl-Penrod Some of the mental health problems, you mentioned nutrition, their diet is awful. They eat fast food. If you ever take a picture of a trashcan outside a jail, it's unbelievable where they've been eating on their break. It's fast food, so you're right about the nutrition. But emotionally I think that they get blunted. Their affect can get real blunted. And they experience levels of depression. They don't call it depression, because if you say to them, "I think you might be suffering from depression." It's like, "I'm not depressed, I'm not depressed."
But I think depression at a low level, a mild depression, I think it's pervasive throughout their entire world. Because they deal with so much bad stuff over and over again. Right now, I think the times that we have in our country that are not supporting law enforcement. And the attacks, the active shooter events and the things that are done by city councils and unfortunately some, some rules that are made in laws that are passed that aren't supportive of law enforcement impacts them. And I think that has also has played a huge part in their depression.
You meet them and it's almost like they went from idealism. "I'm going to save the world, I'm going to help, I'm going to help, and I'm going to help." And it moves into realism, which is they're prevented from doing so much of that because of everything else going on. I experienced with them a lot ,sometimes anger. They become a little more short fused. And the short-fuseness is I think packing in the trauma, and not dealing with it.
They're told different things about why we need them as a country. When they went into it believing that everyone supported them and now people say "No, we don't support you like you like you think we do." And so I think that level of anger surfaces in some use of force incidents. Our firefighters are short-fused, you see how they sometimes overreact to things when they never acted like that before.
Families will tell us, "He never acted like that before", or, "She's never been like that before." And now they're on the job like 10, 15 years and that's affecting them. So I think anger. And sleep deprivation's huge. I was teaching this morning, 35 peer supporters, fire and police and I asked them, "How many of you get a good nights sleep? Raise your hand." Not one hand went up.
Dr Daniel Amen: Wow.
Dr. Nancy Bohl-Penrod Then I asked them, "How many of you believe that you spend enough time with your families?" Not one hand went up. That's an example. They're tired. They're exhausted. Because they don't have enough people to work the positions that the departments need people to work in.
A firefighter told me yesterday that he's on mandatory seven days a week. Now imagine seven days a week being away from your family, but also having to go to work when you're missing all the things with your family, and the exhaustion of getting up. The bell rings, the alarm goes off in the midst of an event, immediately. And then they try to go back to sleep and they can count. So sleep deprivation I think is huge too.
Dr Daniel Amen: So right after 9/11 I got hired by the NSA to look at the brain health of their employees and going to the NSA building, the big building in Maryland where they take away your phone. And it was really interesting. But as I talked to them, I became very disturbed, because they were working such long hours that I knew they were going to make mistakes. Because if the brain doesn't sleep seven hours at night, it can't clean itself. So that's what happens when you sleep. The brain cleans or washes itself. And if you don't sleep enough, trash builds up and then you start making really bad decisions.
And so when they asked for my report, I'm like, "You probably don't really want to see this, but unless you get these people to sleep more, they're going to continue to make mistakes, which is going to cause more national security incidences." And firefighters and first responders often are working so much, they're not sleeping, which then leads to mistakes and the mistakes then lead to self-recrimination. And a serious hit on their sense of self, because they see themselves initially as competent people and they like that. And when they're less competent because their brain health habits, their nutrition and sleep are hurt, it really hurts their ability to be effective.
Dr. Nancy Bohl-Penrod Absolutely. And you know, they also turn to alcohol a lot. You will have a lot of substance use disorders actually with them, because they turn to alcohol. They feel like that's the answer to some of their incidents and that that becomes their coping skills. So you'll find a lot of them that have problems with alcohol.
Dr Daniel Amen: What percentage do you think have ADD of one form or another? I often say there's people who run away from fires. It's like, "Oh, that's hot." And then there are people who run toward fires. And they react before they have a chance to have their frontal lobes kick in and go, "You could be hurt."
So when I was an infantry medic, I didn't really like it, because people were shooting at me and I just never really got used to that. Plus, I didn't like sleeping in the mud, but I'm not a person who runs toward a fire. I'm more like, "Oh it's hot. Somebody should go in there."
But our ADD population, they sort of like that. They jumped out of airplanes. They go toward excitement-seeking situations as opposed to away from it. So is that Nancy, anything you've thought of?
Dr. Nancy Bohl-Penrod I've thought of it, but not the way you put it. But, I usually call it like they're adrenaline junkies. They need that adrenaline high. Because if somebody gets in trouble, if they are disciplined, if they've done something wrong, and you look back in their history, you will find a lot of high-risk behaviors that that took place with that person prior to being hired, and then during the time that they work. And I think you're right. They love that adrenaline. They love everything about that feeling of getting involved in the middle of something and high, high energy, high, high energy. I never really put it in the terms of ADD, but I think you're absolutely right. High, high percentage.
Dr Daniel Amen: When we come back, we're going to talk about more mental health struggles, particularly understanding some of the psychological and emotional reactions to trauma. Stay with us.
Tana Amen: If you're enjoying the Brain Warrior's Way Podcast, please don't forget to subscribe so you'll always know when there's a new episode. And while you're at it, feel free to give us a review or five star rating as that helps others find the podcast.
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