PTSD – What is it? Gender Differences in Military/First Responders and How to Cope
- Kathy Rolfe
- Jun 25
- 5 min read
Updated: 4 days ago
June is PTSD awareness month, and as a psychologist and certified clinical traumatologist who works with clients who are living with PTSD on a daily basis, I am excited to share some information with you all about this important topic.
While this blog topic could be an entire textbook, here are some highlights...
Classifying PTSD
The DSM-5 has specific criteria to diagnose PTSD. They are:
Exposure to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following ways (1 required): Direct exposure, witnessing the trauma, learning that the trauma happened to a close relative or close friend, vicarious exposure to trauma, usually in the course of professional duties (e.g., first responders, medics, firefighters, military)
Re-experiencing/Intrusions (1 required): Nightmares, intrusive thoughts, flashbacks.
Avoidance behaviour: (1 required): e.g. Avoids people, places, topics, etc. that will evoke thoughts, feelings, or reminders of the trauma,
Negative alterations in cognitions and mood: (2 required): e.g. exaggerated blame, survivors’ guilt, depression, isolation, negative view of self and/or others etc.
Changes in arousal and reactivity (2 required): e.g. hyper-vigilance, paranoia, sleeplessness, heightened startle response, etc.
Other criteria include that the symptoms must result in life interference/impairment, last longer than 1 month in duration, and cannot be due to other influences such as medications or other substances, traumatic brain injuries, or other physical/ medical factors such as strokes.
Types of PTSD
There are 2 types of PTSD:
Single incident – one event that caused such stress and overwhelm that it impacted your ability to cope. (e.g. car crash, robbery, becoming subjected to or witnessing a violent act).
Cumulative – this is called Complex PTSD or C-PTSD. This is more of a “death by a thousand cuts” type of PTSD. A person is exposed repeatedly to above mentioned events that eventually wear away at their tolerance and develop PTSD as a result. Examples of people who would develop this kind of PTSD are first responders, refugees, children raised in abusive homes, and military members.
Gender Differences in PTSD Presentation
PTSD is a condition that results in life-altering mental health concerns for all genders. The National Center for PTSD (2025) reported that 8% of women and 4% of men will develop PTSD over their lifetime – which equates to approximately 13 million Americans nationally. In the first responder world, PTSD is significantly higher, with the overall PTSD rates increasing to 10-12% in women and 5-6% in men.
The traumatic event exposure that leads to PTSD also varies between genders. Women tend to develop PTSD due to sexual violence, while men experience physical assaults, accidents, witness death/human suffering or develop PTSD due to combat/first responder duties. Cultural considerations are also important to note relative to PTSD rates among various populations.
It is a forgone conclusion that PTSD would present differently in men vs. women. Males tend to cope with stress and trauma through substance use, anger, and engaging in antisocial behaviours such as road rage and/or physical assaults. Alternately, females tend to become more anxious and depressed.
In the first responder and military world, gender bias in PTSD symptom presentation becomes particularly evident given that many females feel that they must prove themselves or behave differently to fit into a male-dominated profession. Gender-based stereotypes and cultural influences regarding gender roles and expectations can exacerbate their feelings of being unsupported/misunderstood in a primarily male profession. This can lead to increased burnout, poor coping, and higher attrition for female members over males.
Coping with PTSD
The most important thing to know about PTSD is that it doesn’t have to be a life sentence.
Here are a few things you can do if you do have PTSD...
Grieve. I know, this is a weird one to have at the top of the list. As a therapist, I have sat with countless first responders, military members and members of the public who “know” they have PTSD – but they have not accepted it. The first step toward healing is to accept (but not surrender to) the fact that you have PTSD. This is not a mistake. You are different – something happened that changed you - and it will be ok. You are not broken, but you do need help. With time, patience and a lot of hard work, you WILL get there. This is not the end of your story.
Put the stress somewhere. Find an outlet: journal, exercise (punching bag, sports, heavy lifts, run). Trauma lives in our body; exercise, processing our thoughts helps you get it out in a healthy way.
Attend to your nervous system. Practice being present using grounding/ meditation, breathwork, active rest, mindfulness exercises.
Build a community of support. If you're a first responder or military member, find people to hang out with who are not in this profession. Volunteer, coach, join a sports team. Find people that you trust to spend time with. They will remind you that there are good people in the world and the work/life balance that they provide is exceptionally helpful.
Get a few checkmarks in the “win” column! Say “yes” even when you don’t feel like it: to family outings that fit within your window of tolerance, go play with your kids, walk your dog with your partner. Do your best to engage even if it feels hard, you won’t regret it! Positive experiences help a lot.
Be kind to yourself. Self talk matters! Try and integrate self-compassion and be your own best friend – we are all our own worst critic and when you have a PTSD diagnosis it can be so much worse, and it’s harder to be kind to yourself. None of us are perfect, we all make mistakes. You are not a bad person – you have PTSD.
Get into therapy. If you are a first responder or military member, get into therapy early and demystify the process. Don’t wait until your first trauma event to seek help. Develop a relationship with a therapist and go regularly – even if it’s a monthly check in. Consider it an oil change for your mental health. Personal maintenance is just as important for your mental health as it is for your vehicle. 😊
If something traumatic happens, find yourself a trauma therapist. Talk therapy is helpful, but you need directed trauma therapy which is different from “regular” therapy.
You Are Not Alone
Navigating PTSD can feel like a very lonely journey. The most important thing to remember is that you are not alone. Whether you are a first responder/military member or not, there are a wide variety of people who want to help.
Reaching out can feel hard, but doing it alone is harder. You are loved, you matter, and you have more people in your corner than you realize.
Related Posts
If you found this blog post helpful, considering checking out these other posts...
"Married to the Army" – Navigating Life as a Military Spouse
The Emotional Impact of Occupational Stress Injuries on First Responders
Shift Work – How It Impacts Your Mental Health
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Disclaimer
Information provided through Balance Psychological Services' blog posts is meant for educational purposes only. This is NOT medical or mental health advice. If you are seeking mental health advice, please contact us directly at (587) 985-3132.
