Not the original commenter, but as a volunteer firefighter and EMT it is something everyone has to figure out for themselves.

There's tools like therapy, CISM, CBT, humor, and the support of your buddies. Too often there's drink, pills, and suicide. It's not a particularly widespread detail, but suicide is the largest killer of firefighters by a large margin. I think that is a symptom of putting too much work and pressure on too few people.

I have found CBT, exercise, fasting, and daily yoga help keep stress and depression at bay for me.

I also am lucky to be a volunteer, so I can afford to skip as many calls as I want after an upsetting call. The career folks I know have it much much worse, because they might be on a horrible call but if they want to get paid they have to keep working. They might have an entire 24hr shift with several troubling calls back to back.

I used to think all fire and ambulance should be paid career. However, there's an important side effect of a larger group of volunteers sharing the burden. If you see too much to handle, you can take off all the time you need to recover. You aren't trapped by the job into witnessing more than you can handle. My wife recently was on an ambulance call that troubled her. She has taken a few weeks off from ambulance to decompress.

That being said, volunteerism is seriously struggling in America. If you live in the 70% of America that is served by volunteers, it is likely your local is extremely understaffed. Too many companies only have a small handful of firefighters who still show up, and those heroes aren't "taking time off" to recover, because if they do, the engine doesn't move. Too much of the country is overly reliant on volunteers but isn't showing up to be a volunteer to share the load. It's a socialist program, but there aren't enough people showing up to share the work, so it's collapsing.

And just paying folks to do this full time comes with very real increased tax burden and acute trauma on those individuals. Paying career staff isn't cheap.

If you live in an area that is served by volunteers, please seriously consider volunteering yourself. A lot of people on this site are young and physically able to volunteer. Tech folks are often well situated to volunteer, as we are more likely to be financially stable, have flexibility to dip for a call if it's urgent, often work remote, and sometimes would really benefit from getting out in the sunshine and meeting folks. Also it's so rewarding to do something so real after a big day of mental labor.

In the volunteer service you don't ever have to do something if you don't feel comfortable with it. If you show up to a call and you don't want to go inside the building you don't have to. Plenty of work is needed outside of a structure fire. If the call comes and you're too tired or busy, no big deal. I only make ~20% of my local calls, and that is high for my company. I've said "no way" to my officer before, and he reconsidered or found someone else.

You also don't have to be in "perfect shape". I thought they were going to be making me do crazy fitness tests to join like in the movies. Then I realized, we are so desperate for help we'll take anyone if your doctor will sign a form saying you're fit for duty. We've got members who are 200lb overweight, members who weigh 100lb, need glasses, some are 14, and some members who are over 70. Some can't wear an air pack so they do fire ground support work outside. Kids under 18 and folks who haven't yet gone to fire school aren't legally allowed inside a structure fire anyway. If you want to show up and put on gear, we've got work for you. There's so much work, it's so hard, and so few show up that anyone who does is a help.

It can be extremely rewarding to be a first responder in a small town. We only have 4k residents in my local, and I like getting to meet them and help them.

After just a few years I can't go to the grocery store without waving to half a dozen people. My calendar is filling up with invites to backyard BBQs, music jam sessions, a pie baking competition club, DnD games, a computer club, and a lifting club, all discovered through just meeting cool local folks. Between volunteering and regularly visiting our local busy coffeeshop at peak "sit around and chat" times, I'm feeling connected to a community in a way I thought only happens in movies and TV.

Definitely reach out to me if you ever want to talk about it. I'll happily answer any questions you have. I will say I'm kicking myself for not joining sooner. For eight years I was next to an amazing firehouse and never knew!