Ep.3: Managing Stress and Trauma with Annette Zapp

Lt. Annette Zapp on Managing Stress and Trauma with John MacAdams.

Active service 17-year fire service veteran and health and wellness expert Lt. Annette Zapp, tells her own story of recovery from occupational stress injuries and her work in supporting firefighters in managing stress and trauma exposure while optimizing their health, wellness and relationships, her own experience of healing from accumulated fire service related traumatic stress, the significant health risks and symptoms by firefighters due to ongoing exposure to high stress and both primary and secondary trauma. Body-mind, nutrition, sleep and wellness strategies for firefighters and other first responders to mitigate occupational injury risks and maintain health and wellbeing.

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Managing Stress and Trauma with Annette Zapp Transcript

John McAdams: 

Hello. Welcome to this session on day one of the Global First Responder Resilience Summit.  My name is John McAdams from the Center for Mindfulness and Public Safety. I'm your co-host  for this session, and I am truly excited to welcome Annette Zapp to the summit. How are you  today, Annette? 

Annette Zapp: 

Hi, John. I'm great. Thank you so much for having me. I'm looking forward to our conversation. 

John McAdams: 

Well, I want to start with your bio to let our audience know a little bit about your work and  background, and then we'll get into the conversation. Sound okay? 

Annette Zapp: 

I'm excited. Let's go. 

John McAdams: 

Okay. A 17-year veteran of the fire service. Annette Zapp holds the rank of Lieutenant and  owns Fire Rescue Fitness, a coaching business elevating the wellness of firefighters  worldwide.  

She earned a master's degree in biochemistry and molecular biology from the  University of South Dakota School of Medicine, and is also credentialed as an NCSA, CSCS and  TSAC-F, precision nutrition level one coach, CSNS through the Society of NeuroSports, and  CISSN through the International Society of Sports and Nutrition. She was recently named to an  Illinois Senate task force focusing on mitigating first responders' suicide. 

Annette Zapp is an adjunct faculty at the University of Denver in the graduate program  for sport coaching, and is a proud member of the panel of experts that recently reviewed and  revised the TSAC practitioner course for the NCSA. She is a highly sought-after public speaker,  and has appeared on at least a dozen podcasts in the last year.  

Annette, it's really great to have you.

Annette Zapp: 

Thank you so much. And now that you're reading my bio, I realize that all of those letters just  really mean I didn't know what I wanted to do when I got big, so I just started collecting things.  I'm a collector. Thanks for having me today. 

John McAdams: 

But it also means you're an incredibly accomplished strength and conditioning coach from way  back. 

Annette Zapp: 

This is true. I have almost 30 years’ experience in the health and wellness industry before or  concurrently with my fire service career, so that they do overlap a little bit. I'm not a hundred  years old, but I'm pretty old. I have both strength and conditioning background and fire service,  and I use those two skillsets to really relate to first responders, and to help them with their  health and wellness. 

John McAdams: 

Well, that's great. So, our theme today of course is around building physical fitness and  resilience and wellness. In a few minutes, we're going to dive deep into your methodologies  and your approaches to the four key pillars of managing physical and mental health. But right  off the bat though, for all the first responders watching right now, will you please talk about  what drives you forward? What really brings you to this particular work and the development  of your work ongoing? 

Annette Zapp: 

Absolutely. Primarily, I work with firefighters. But these principles apply to law enforcement  officers, EMS as well. And what we're finding is that for the last decade, suicide is outpacing  all other line of duty deaths almost every year.  

And so, primarily what killed firefighters for the longest time was cardiovascular  disease, heart attacks, and strokes. But again, suicide is far outpacing all of those other line of  duty deaths. And so, my goal is to help educate first responders so that they know upfront  before they even start their career, the challenges that they might face, and then also give  them the tools that they can put into practice so that they never have to fall into that despair  and that area of suicidal ideation. And so, bottom line, my goal is to go upstream of the problem, and give them the tools  there so that they can start solving those issues upstream. 

John McAdams: 

Great. Will you tell us a little bit of your story of coming into the fire service? 

Annette Zapp: 

No one ever prepared me. That's why I'm so proud now to do this work of preparing first  responders prior to their careers. But no one ever prepared me. No one ever let me know how  sleep deprivation was going to affect my life. No one ever prepared me for the trauma that I  would see. And no one ever prepared me for the fact that seeing that trauma and not  adequately sleeping was going to cause a lot of issues for me.  

I came into the fire service pretty much an extroverted personality. I was doing a lot of  things in the health and wellness realm. I had a lot of friends. I had a lot of communication. Things got really, really dark for me really soon after I started the fire service. So, within about  a year of commencing the fire service, I was isolating myself, I was canceling plans with  friends. 

The biggest thing that I was seeing, the biggest behavior that I was exhibiting was I  was just so angry all the time. I had a fuse that was micrometers long. And so, something that  should not upset me, something that should not set me off would put me into an irrational  rage.  

And so, I didn't identify these feelings that I was having. I didn't realize that those were  depression. Because for me, depression looked like I can't get off the couch or I'm sad, I'm blue.  I didn't realize that depression can manifest itself in a lot of different ways. And so, for me, it  took almost a slap in the face for me to realize what was going on in my own life.

John McAdams: 

How did you start managing that? I mean, you had such a background in physical wellness. 

Annette Zapp: 

Absolutely. I talked about upstream a moment ago. We can never absolutely prove that an  upstream solution is saving a life. We can't necessarily prove that someone wearing a helmet  saved their life. We can speculate that it did, but something such as sleeping or nutrition, it's  even harder to prove that it saved someone's life. But I absolutely credit the fact that I was always dedicated to my off duty sleeping, I was always dedicated to good nutritional practices,  and I always kept my body moving. I was always exercising without fail. I credit those  upstream items to saving my life. 

And so, our viewers might wonder. What was the big deal? What were these items  that accumulated to make you feel the way that you were feeling? I can't attribute it to any one  certain thing. That would be really hard. But what I say is it's a culmination of the not so big  things that just kept adding up.  

It's very much like having a file cabinet. You can keep putting the papers in the file  folders, but if you don't organize that filing cabinet sometime and pull out the things you don't  need anymore and get rid of them, shred them, eventually that filing cabinet is absolutely just  going to belch its contents out at some point, and it's not necessarily going to be the most  convenient point for you. 

And so those little, little things. Like when I first started, there was a heroin overdose  epidemic going on. And so, several times a week we'd be going out and either resuscitating a  heroin addict, or we would be having a dead-on-arrival patient. And so, that just started to add  up little by little by little.  

I remember early on in my career, an officer, we had an EMS call early in the morning.  At my agency, we run with a fire company and a medic unit. The fire company got there first. It  was a full arrest of a little boy. He was seven years old. The officer came running out of the  house with this little boy. He handed me this little boy. 

I took the little boy, ran into the ambulance, and I started frantically trying to resuscitate  this child. It was only a couple minutes into this transport and I realized this child was in rigor.  This child was not savable. And so, I absolutely did not process that trauma well. I felt  responsible for something that wasn't my fault, and it just added up. It was another incident,  and another document, and another file that wasn't processed properly.  

And so, I could go into a lot of examples of things like that. And for the longest time, I  kept that little boy's obituary on my bulletin board. That's not a healthy thing to do, but I had  such a feeling of responsibility for that little boy's death that it just was something else that I accumulated and I carried.

John McAdams: 

In the fire service, the exposure to primary trauma and primary traumatic experiences is  ongoing, right? At least that's one aspect of the work. 

Annette Zapp: 

Right. It absolutely never stops. And we become almost numb to it, or we think we're numb to  it, but we really aren't. We continue to accumulate these traumas, and then we don't process  them properly because we're not sleeping properly, and sometimes we don't take the time to  maybe talk to someone about what we've seen. We just toughen up and we forge forward.  Because the thing is, those tones are going off again.

That little boy's name was Matthew, and I still remember his last name. It's not  appropriate to share that. But Matthew's death, I came back to the station and then I just went  on another call, and another call, and another call, and never properly processed that trauma. 

John McAdams: 

And the sites, the sounds, the smells. We can't unsee, unhear and unsmell those things. 

Annette Zapp: 

That's absolutely true. And as a perfect example, one of my first days as an officer, we had a  really interesting call, would be the best way to explain it. It was just an unknown problem  person down. That’s a typical sort of a dispatch.  

We got to the call and there were probably seven or eight, maybe nine squad cars  there already. My index of suspicion, what's going on, was a little bit high at this point. What  actually had happened was a father had tried to murder his two-year-old stepdaughter, and  then he had hung himself on the back of the door. 

That little girl, ultimately, we weren't able to save her. We tried really, really hard. I  didn't have a lot of contact with that little girl, but my medics did. My medics, one of them, still  have an issue. When he goes shopping in the Target and he sees Hello Kitty pajamas, that  little girl was wearing Hello Kitty pajamas. And so, he's still had sort of a trigger every time he  sees those pajamas. So, you're absolutely right. Sights, smells, they're very, very real for us. 

John McAdams: 

What a lot of the research is telling us is that it's held in the body. A lot of this trauma is held  in the nervous system. The primary traumatic exposure, and the secondary traumatic and vicarious trauma exposure when we hear from our colleagues the calls that they've been on  and the experiences they've been through.  

So, at this point, you're well-placed to start to pull it apart and work with that puzzle. You described to us how you got to a point where it was pretty dark. You were in a really  tough spot, and yet you had all these tools. So, how did you start to piece that together? Clearly, you've come through this to a point where you're extremely highly functioning. Tell us  a little bit about that. How did you start to piece it together? How did it start to make sense for  you? 

Annette Zapp: 

I had what I call light bulb moments. That light bulb moment came when I saw on the drill schedule one day, it said ‘peer support training’. I didn't know what peer support meant. I had  no idea what that meant. But it said with Matt Olson.  

I knew who Matt Olson was. He was a firefighter in a neighboring town. Matt Olson  was the founder, actually, of the Illinois Firefighter Peer Support Network. And so, he was  doing his good work coming around to fire departments and telling his story.  

He spoke for about an hour, and I say that I don't think I took a breath during that entire  hour because I knew I liked Matt, I knew that whatever he had to say was going to be honest  and authentic, and his story spoke to my soul. 

One of the things he said was, "I never went into the fire service knowing that I was  going to be an absolutely dysfunctional, suicidal alcoholic. That was not my expectation, but  that's where I ended up." And so, just him telling his story and telling us how he felt and how  he had issues sleeping sometimes, and how he relived calls in his head, and how he went and  got help, those things turned on a light bulb for me. It was like a switch because everything  made sense.  

He made what was happening to me relatable, and I think that is such a powerful tool.  And so, Matt Olson told his story. And then, subsequent to that, or just keeping with that story  theme, I had the great honor of meeting Chris Fields. Chris Fields is the fireman that was  holding the baby in that iconic Oklahoma City bombing picture. 

And Chris Fields, he also has a story that's very dark and it's very dramatic. It's a  wonderful ending to his story. But Chris Fields said, "If you have a story to tell, you need to tell it because someone else needs to hear it." And so, I think these stories that people can relate  to are super powerful, and at least for me to answer your question, that was the switch that  turned on the light bulb and sort of ignited the bomb. And that's where all of my work came  from. 

John McAdams: 

Wow. So, there's a lot of affirmation in there, a lot of relation. I mean that you're connecting  and relating to your peers, your colleagues who are experiencing. You and I had a talk earlier. I  think that this is pointing at the normalcy of these kinds of challenges. And so, I'm going to ask  you to talk a little bit about how normal is this? How normal is this in the fire service? What  you experienced and those two other men, is it just you three? 

Annette Zapp: 

I think we could use a word common because none of this that happens is normal. It's not  normal in our brains, it's not normal in our bodies, but it is absolutely common. I can go back to  another story with a coworker. I had just started. He and I were around the same age. We liked  training and running and things like that.  

I said to him, "Hey, you guys have all of these fun stories and anecdotes that you tell  and these little quotes." And I was like, "That's so cool. I don't feel like I'll ever have that." And  he goes, "Give it three weeks, and you'll have stories too." And so, that was a fun example, but  it's the absolute same thing with the trauma that we see.  

And to revisit that vicarious trauma that you were speaking about, I'm trying so hard to  get my firefighters to stop telling those stories in the morning because they truly don't  understand how being exposed to someone else's story in that fashion is giving them vicarious  trauma. So, it's an uphill educational battle, but we're fighting the good fight every day. 

John McAdams: 

Okay. So, you've really started developing your program. I'd like us now to get into more of the  detail and the weeds of the program and the approach that you have and your four pillars. So, I'm going to ask you to do a thumbnail of that program, and how are you approaching wellness  and resilience building for your firefighters? 

Annette Zapp: 

Absolutely. So, the 10,000-foot view is this; the research tells us that sleep is critical. It's  critical for mental health. It's critical for physical health. Seven of the top 15 killers of people in general can be directly related to sleep deprivation or sleep problems. And so, the research is  clear, sleep is imperative.  

I always call that my first pillar, because if you're not sleeping, you can be doing  everything else right and it's still not going to go great for you. That said, if you are having  trouble sleeping, it's even more critical to optimize all of the other things to just give yourself a  fighting chance. And so, sleep is number one.  

Number two is nutrition. Again, data is clear. People that eat a healthier diet, less  processed foods, more fruits and vegetables, less alcohol, the data is clear. Your mental and  physical health are both hinging on a good intake of nutrition. 

Pillar three is that mindfulness/meditation/counseling/spiritual, whatever you want to  call it. It's that bucket of having a good rope around what's going on in the brain. And then the  last one would be that movement piece of it. So, it's really clear also that just 15 minutes of  exercise can decrease your mortality risk by 20%. So, 15 minutes, six days a week or 90  minutes a week can decrease your mortality by 20%. That's a really good investment.  

If you want to get another 20%, you're going to have to exercise about seven hours a  week, so that's a big jump. But if we can get our first responders exercising 15 minutes most  days, then their physical health is going to be better, their mental health is going to be better. 

Those two things feed into each other, and it's kind of a chicken or an egg situation. If  you've got a preexisting mental health challenge, a lot of times you're going to have a physical  health challenge too. And vice versa. And so, getting them moving, not even necessarily in our  vigorous training program sort of way, just getting them moving is great for their mental and  physical health. So, those are the four pillars. 

John McAdams: 

Okay. Are you ready to go a little deeper into those pillars? 

Annette Zapp: 

Let's take a dive. Let's do it. 

John McAdams: 

Tell me how I can go to sleep better at night. I have my own personal history. I've spent many  years sleep deprived, and I wore it as a badge. I worked at a very high energy industry where we worked super long shifts. It was very exciting work, and we were paid to not sleep. We  were paid a lot to not sleep and to ignore our body. So, tell me, how can I go to sleep? 

Annette Zapp: 

First thing that we have to realize is that mentality of I will sleep when I'm dead is a self fulfilling prophecy, and you're accelerating the process by not sleeping. So, first thing we have  to tell ourselves is you're not special, you don't thrive on two hours of sleep just because you  say you do.  

Statistically, you need seven to nine hours of sleep. Period. Less than seven, greater  mortality risk. More than nine, greater mortality risk. So, seven to nine is that sweet spot. And  the first objection is, "Yeah, but I work shift work." Understood. Understood. You will have a  hard time optimizing your sleep on duty.  

However, we need to really focus then on your off-duty time. We need to really focus  in on are you working a second job? Are you working a second job as a first responder? That  would be a very bad idea. Are you taking a lot of overtime so that you are sleeping multiple  nights at the firehouse? None of those things are great ideas.  

If you can stick to your regular schedule or your regularly scheduled shift and duty days  only, that's going to be a great first step. The second step is we need to decrease the stigma or  this message that firefighters are getting that we don't pay you to sleep. I understand where  that comes from.  

However, cognitively, we don't make good decisions when we're sleep deprived. And  so, our citizens should not be fans of us not getting sleep because we're doing medical  calculations, we're driving million-dollar ladder trucks, and we're going to do that much more  successfully when we are not sleep deprived. And so, it is important for firefighters to have a  bedtime on duty, and to also try to really weaponize the power of a nap, and at least one  during the day. So, optimize off duty, and to do your best on duty.  

We can go a little bit deeper into the sleep hygiene, but I think most people by this time  are pretty aware you need to sleep in a cool dark room, you shouldn't have external stimulus  so you shouldn't be sleeping with the TV in your room, you shouldn't have a lot of lights in  your room, things like that.

There's some data that says a magnesium supplement before you go to sleep might  help you sleep better. But using those principles of sleep hygiene, and then simply having a  plan to go to sleep at a certain time so you get your seven to nine hours, that's key because  you can't leave it to chance. Because otherwise, it's going to be 12:30 at night and you're looking at your watch and you're going, "Wow, I got to get up at 5:00 for shift." So, sleep, like  anything else. You need a plan and you need to execute your plan responsibly. 

John McAdams: 

So, scheduling. This is one way to work with it. Actually schedule your sleep. 

Annette Zapp: 

Absolutely. And I say treat yourself like a toddler. Have a bedtime routine, whatever that looks  like. Mine looks like get a glass of water, take my magnesium supplement, go upstairs, brush  my teeth, read a few pages, go to bed. 

The other thing that I didn't mention is we're inundated by this blue light from our  computers, from our iPads, from our phones, and so we really need to minimize that exposure  to blue light for a couple of hours before bed to get optimal sleep.  

And the other big mistake people make is they equate having a nightcap, so an  alcoholic beverage, with helping them sleep. Again, it's very clear. It might help you fall asleep  initially, but your sleep isn't going to be good quality, and more than likely you're going to  wake up at some point during the night and good luck getting back to sleep. So, alcohol is not  a good strategy for good sleep. 

John McAdams: 

That brings up two things in my mind. One is you talk about good quality sleep. So, there's  quantity of sleep and there's quality of sleep. And there are a lot of ways to track that. I track  my sleep every night, and I check it first thing in the morning. What's your take on the efficacy of actually tracking sleep and having a tracker, and what can we learn from that? 

Annette Zapp: 

I truly believe that the trackers are great for habit formation. So, the Ōura Ring, and I have a  polar watch that I wear. It's great for habit formation, and they're pretty good at telling you  quantity of sleep. But some of them dive into the you got this much REM sleep, you got this  much deep sleep, and that's where they become a lot less accurate. 

And so, if you're looking for real accurate sleep data in terms of cycles, there are a  couple of products on the market. One of them is called the Enchanted Wave. It's like a  headband that you wear, and it's an actual EEG of the brain, and that's going to be a lot more  accurate. 

The other thing that I caution my firefighters with the sleep trackers is they'll come and  they’ll say, "Oh, my watch says I got rotten sleep." And I'll say, "How do you feel?" And they'll  say, "Oh, I feel pretty good." So that's a classic case of 'treat the patient' and not the 'monitor.'  Yes, your tracker may say you didn't sleep well, but if you feel great, let's take that as a win.  

And then the final thing that I would say about sleep is that my friend, Dr. Jen  Goldschmied, who is a sleep researcher, has a real simple answer to ‘did I get enough sleep?’ And that is, do you feel tired? Because if you feel tired, you didn't get enough sleep. End of  story. 

John McAdams: 

The BioTracker and how do I feel? And you mentioned that people can wake up in the middle  of the night. I think that is pretty standard that people wake up in the middle of the night. Any  tips on getting back to sleep? 

Annette Zapp: 

Well, the first thing you do not want to do is grab your phone and start surfing. Put an X on  that one. Don't do that one. What you can do is definitely do some deep breathing, you can do  some mindfulness meditation type things. Just try to relax and then get out of your head  because the more you get frustrated about not being able to sleep, the less you're going to be  able to sleep.  

But truly, if you do eliminate that alcohol, many times that helps with that waking up in  the middle of the night. That said, the older I get, the more difficult it is to go back to sleep at  work. I used to be able to go out on a medic call when I was 35 years old, be out for an hour  and 30 minutes, come back to the station, plot, and I was sleeping. I can go on a 10 minute call  now and come back and lay awake for four hours and never get back to sleep. So age-related  sleep challenges are a real thing. 

John McAdams: 

Do you want to share a particular deep breathing exercise or skill that you would use or you're  using at night?

Annette Zapp: 

Yeah. I'm a real big fan of just the box breathing, so taking a nice, big inhale for four through  the nose and then just hold it 1, 2, 3, 4, a nice deep exhale through the mouth for four, and  hold it for four. So, you're actually making a little box.  

Another one that I've used that's really, really effective, and I don't know if it actually  has a name, but to take that nice, deep inhale through your nose, and then you exhale, exhale.  You just keep excelling until you feel like it doesn't get out any more. And then you take a tiny  sip of air, and then you breathe normally. That for me kind of resets my sympathetic nerves,  the nervous system, down-regulates me, and kind of snaps out of it. That said, I still have  trouble getting back to sleep, so I'm working on strategies for that. 

John McAdams: 

Great. That's great. As far as the strawberry thing which is a skill that we utilize a lot in our  training, there's a similarity because that exhale is connected with activating the  parasympathetic, right? So, we're going to down regulate with that extended exhale, so that's  really helpful. 

Annette Zapp: 

Yes, for sure. But again, the biggest take away for sleep is optimize your sleep off duty. Your  life literally depends on it. So, do everything you can to get good sleep off duty. 

John McAdams: 

Okay, great. Great. Okay. Nutrition. How can I eat better? How can I eat more responsibly for  this body? 

Annette Zapp: 

I think the first thing is being aware. We have to keep in mind that there's a lot of different  ways our body is regulated. One of the really micro ways that it's regulated is at the epigenetic  level. 

The way I explain it is the CliffNotes version of epigenetics is that everything you do  affects how your genes are expressed to some extent. So, if you really drill down to it, every  meal you eat, every night of sleep deprivation, every whatever, every time you almost get run  over by a car and you freak out and your sympathetic nervous system goes in overdrive, they  have tiny effects on your epigenetic expression.

And so, what I tell people is every meal matters. You just need to do your best. Your  best may look different than someone else's best. But the principles that I try to teach are  when you're trying to eat better and get better nutritional habits going, trying to add things is a  lot easier than trying to subtract things. When you're trying to subtract things, that sounds  painful. I can't have donuts, I can't have this, I can't do that. That's a pain point for most people.  But if they're adding habits like, “I can still have pizza but I have to have a big side salad first.”,  it doesn't feel so painful. So, adding things rather than subtracting things to start out with.  

And then, fruits and vegetables are super powerful. I encourage people to eat them at  every single meal, including breakfast. When you're planning your plate, it's a great idea to  start with your fruits and vegetables. I try to fill up half of my plate with fruits and vegetables  at every meal.  

Especially in this population, quality protein is important. I shouldn't say ‘especially in  this population’ because it's important for everyone. The US RDA for protein is 0.8 grams per  kilogram, which is just not very much protein. That's really low. The RDA, as we know, is that  to keep you from dying. So, all of the vitamins and minerals, all of those things are the  minimum amount you need so that you don't die or get a really bad disease, but it's not  necessarily optimal.  

And especially as we age, we need more protein. You would think maybe we need less,  but we actually need more protein to still get the same results in our bodies. And so, there's  different schools of thought on how much protein, but if someone can aim for roughly three  quarters to a gram of protein per pound of their body weight, it's going to do a lot of great  things. It's going to help them build and maintain muscle, which is a glucose disposal system,  so that's great. It's going to help them with their satiety so they're not going to be as hungry. And back to that muscle, people that eat more protein are generally stronger and have better  body composition. 

All things being equal, if I compare one person and the other person, everything's equal  but this person eats more protein, they generally have better body composition, and they're  stronger. So that's great.  

So far, we covered fruits and vegetables. We covered protein. Hydration, super  important, getting in adequate water and other hydration for your body and your brain. Even just the little bit of dehydration in that brain can cause cognitive disruption. So, that is not  great.  

And then, the last thing is just quality fats. People are afraid of fats. We need to  remember that fats are the precursors for a lot of things in our body, and also, they help form  the membranes of our cells. So, if we're not taking in adequate fats, we're not able to  adequately manufacture our hormones, and we just don't have good cell membranes.  

When you take that macro or 10,000 foot look at it and just think, "Oh, you know what?  I need to eat some fruit and vegetables, I need to focus on a good amount of protein, I need to  look at healthy fats and be careful of what I drink," it doesn't become so difficult. It doesn't  come down to I need to worry about how many grams of this, that, and the other thing that I'm  eating. I just need to eat food that looks more like it looks in its original format, rather than  food that looks like a box with a cartoon picture on it. That's my take on nutrition. 

John McAdams: 

One point I'd like to just dig a little bit into is protein. A lot of folks love to work out, a lot of  ways to get protein, a lot of different types of protein. There's whey protein in powder. There's  good old chunk of steak. There are nuts. There's really lean chicken. What about the whole  world of protein? 

Annette Zapp: 

That's a really great question, and it's interesting. I'll give you the same answer I give everyone  which is frustrating. It kind of depends. Meaning, first of all, if you are intolerant of dairy  products, whey protein isn't going to be a good idea for you. Or if you're a vegetarian or a  vegan, whey protein isn't going to work.

You don't necessarily need to supplement with whey protein or any type of protein. You  can get all of the protein you need from foods. Sometimes that's just a little tough. You're on  the go, meals aren't falling together as you would like them to fall together, so a protein  supplement is something that works great. And again, it's nothing that you have to take. 

What we need to remember too, and I say this in all my podcasts and all of my talks,  every high school boy in the world thinks peanut butter is a good source of protein. And those  high school boys grow up to be firefighters. And so, firefighters think that peanut butter has an  abundance of protein. And unfortunately, it does contain protein, but it's a very heavy fat  source.When you're looking in terms of what is a good source of protein, peanut butter - not so much, nuts - not so much, beans - even though they do have protein in them, not a lot of  protein. 

I look at things, lean proteins, chicken, fish, turkey, lean cuts of beef. Salmon is a great  source of protein. It also contains a lot of healthy fats in it. So, I look at more of those pure, if  you want to say that, more pure proteins as opposed to the other things that we could be  putting in our body like sausages. Things like that. 

John McAdams: 

Okay. The last thing under nutrition, because you mentioned fat twice and I just want to make  sure that you can help us to understand what are good fats. When you mentioned peanut  butter, I always use peanut butter. I eat peanut butter. But you said it's a large fat load for the  amount of protein load that you're going to get out of it. I also eat avocados. I'm in California, I  grew there, I got them all the time. So, tell us a bit about good fats. 

Annette Zapp: 

Well, it's easier to work from let's talk about fats that aren't so great. So, any time you super  heat a fat, so when you're deep frying something, that's going to make some molecular  changes that are going to make those fats less good for your body. I always say really  minimize that deep frying aspect of nutrition.  

But in terms of good sources of fat, dairy has wonderful sources of fat. Avocados, as  you mentioned, you're so lucky you live in the avocado state. I just paid $4 for an avocado that  was terrible. Olive oil is a great source. There are other wonderful oil sources. Egg yolks is a  good source of fat. I mentioned dairy. So, we don't need to fear the fats. Of course, it's  calorically dense and so we don't want to eat a diet heavy in fat unless we're trying to gain  weight, but fats are super important. 

And a lot of times when people are cutting calories, they start cutting out a lot of fat  and they get mood disturbances. So, we want to make sure we're eating adequate fats. And  again, the bottom line on nutrition is if you can do the right thing or eat well 80% of the time,  the other 20% of the time probably doesn't matter as much.  

One of my good friends says, "You know what? Firefighters are probably going to eat a  donut.” If we can increase the quality of that donut by making sure they have a side of fruit with it or something, a Greek yogurt. Something to make the quality of that meal just a little bit  better, that's a good move too. 

John McAdams: 

Great. Thank you so much. That's great. Let's move on to pillar number three. I've seen it  written as mindfulness, but you opened up a whole big world there. I'd love to hear your take  on our third pillar. 

Annette Zapp: 

Absolutely. So that was the aspect that was missing in my life before. It's one of the aspects  that I really, really think is positive for me now. My ability to just take a breath to just recenter.  But there's, like you said, many aspects to it.  

The first thing I recommend to people is before they even start in fire and law  enforcement, make a relationship with a mental health professional, with a counselor. I call it  the checkup from the neck up. You just go in, have a conversation, drop your baggage off, and  say, "I'm starting a career that's going to be challenging for me, and I want to have a  relationship so that when I come to obstacles, I have someone to come and relate to." 

You may just want to make an appointment quarterly, semi-annually, once a year,  whether you need to or not, go in for your checkup from the neck up. Because when you truly  do have something that gets to be more of a crisis level, you've already got a relationship. This  person already knows you. And so, that's one great tool that I try to give people on their first  day. I make that recommendation.  

But there's a lot of different ways that I practice mindfulness and I suggest it to people.  And you just have to try it on like jeans and see which one fits for you. But journaling, just  simply writing down your thoughts, your feelings, how things are going for you can be  cathartic. 

There's a lot of different apps out there now, the Calm app. I can't remember what  they're all called, but available on your smartphone. And those can be great because they're  anywhere from a couple of minutes up to 20 minutes. Something like yoga, which where you're  going, you're focusing on your breath, you're focusing on the postures, you're focusing on  something other than the things that are going on outside of your world. 

All of those things are super, super important and super valuable. So, try on those jeans and figure out which pair fits you, and then do it. That's the key. It's one thing to know about it,  it's another thing to practice it. So, find what works for you and do it regularly. 

John McAdams: 

Great. I love your idea of even before you launch into the career to start to establish a  relationship with a counselor. One of our colleagues, Lieutenant Richard Goerling, he talks  about his counselor and his approach as my mental health coach. "This is my mental health  coach. This is part of my team. This is part of my wellness team." 

Annette Zapp: 

I love that. And what we have to remember is first responders are not hired from some  subpopulation of superheroes. They're not. They're the general population. And the general  population, depending upon what study you read, has a lifetime prevalence of a serious mental  health challenge of somewhere between 20% and 40%.  

And then, we take these general population people, and we put them in a high stress  job, and we sleep deprive them, and then we wonder why they're having problems. The  general population also has about a 10% occurrence of alcoholism. So, that's going to spill  over into the fire service too. And so, we have to remember that these people are people, and  they are stressed more than the general population. 

The other thing that I might mention is that many of our fire service community and law  enforcement community are coming into this career with adverse childhood experiences that  may be not just one, maybe 2, 3, 4, 5 adverse childhood experiences which we know affects both your physical and your mental health, and adulthood. And so, put those things in a pot,  turn it on simmer, and pretty soon it's going to boil. We just don't know how long that's going  to take. That's why I think it's so critical to have that. I love that mental health team aspect. I  love that. I'm going to steal it. 

John McAdams: 

Well, I think we're coming close to the end. I know that our fourth pillar is movement and  you're a strength and conditioning coach. I'm just going to ask you just a sentence or two  because I want us to wrap this up and really give you an opportunity to tell us about the  future.

Annette Zapp: 

Absolutely. And here's the thing. Because I'm a strength and conditioning coach, that scares  people because they think that means super vigorous, super hard, super maximal training. I  just want you to move enough to be healthy. So, find something that you enjoy doing. Whether  it's skateboarding, whatever. I don't care. Find something you enjoy doing, and then spend at  least 15 minutes a day doing it because health takes 15 minutes a day. If we want  performance, yeah, you got to work a lot harder to get performance increases. But health, we  can get health increases in 15 minutes a day. 

John McAdams: 

Gardening, is that on the list? 

Annette Zapp: 

Absolutely. Just move. The average American watches four hours of television per day. Usually, two hours at a time without moving. So, yes. Everything counts. Get moving. 

John McAdams: 

Great. This has just been great. I think you've given our audience a lot of points of departure  where they can start to experiment and try on the jeans and see what's going to work for them  and understand that we can build resilience. We can train before, during, and after, and I think  that's all great. So, I'm going to ask you your sense of the future of your training as a trainer for  first responders, and what really is your greatest hope for the future of First Responder  Resilience and Wellness? 

Annette Zapp: 

My hope is that I am able to help educate people on that front end, so upstream, so that they  never have to get to that critical crisis point because the resources are there. They are. And the  stigma of raising your hand and saying, "I need help. I'm feeling suicidal. I'm feeling hopeless."  The resources are there.  

Wouldn't it be wonderful if our first responders never had to get that far in the river or  the stream? And so, I hope that just by having them be aware that this is coming, but there are  tools on the front end to help mute the effect of this trauma and sleep deprivation. That's my  hope, that people will have solutions upstream so that they never have to go downstream. 

John McAdams: 

Well, I'm just really glad that you're out there making that happen.

Annette Zapp: 

Well, thank you. This has been a great opportunity, and I really appreciate having the  conversation with you today. 

John McAdams: 

It's just been fantastic, Annette. Thank you so much for joining us on the summit here, and I  wish you a good rest of the year. 

Annette Zapp: 

Thank you, and you too. 

John McAdams: 

Thank you.