Brief presentations of information on
aspects of PTSD:
- Warning
Signs
Warning signs of trauma-related stress,
from Los Angeles County Department of Mental Health.
- Warning
Signs from APA
Warning signs of trauma-related stress,
from the American Psychological Assn.
- Normalizing
Emotions
You are not alone! description of normal emotions following a disaster,
from the American Red Cross.
The
Peniston Protocol
PTSD Treatment
Dendrite
Forest Home
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VA NATIONAL
CENTER FOR PTSD
Research and Education on Post-Traumatic
Stress Disorder
DISASTER
RESCUE AND RESPONSE WORKERS
A National Center
Fact Sheet
Every year, millions
of Americans are affected by earthquakes, floods, hurricanes,
tornados, wildfires, and other natural disasters. Survivors face
the danger of death or physical injury, and the loss of their
homes possessions, and communities. Rescue workers -- police and
fire fighters, National Guard members, emergency medical technicians,
and volunteers -- are also at risk for behavioral and emotional
re-adjustment problems as well as physical danger.
The psychological
problems that may result from disaster experiences include:
- Emotional
reactions: temporary feelings (i.e., for several days
to a couple of weeks) of shock, fear, grief, anger, resentment,
guilt, shame, helplessness, hopelessness, emotional numbness
(difficulty feeling love and intimacy, or in taking interest
interest and pleasure ion day-to-day activities )
- Cognitive
reactions: confusion, disorientation, indecisiveness,
worry, shortened attention span, difficulty concentrating,
memory loss, unwanted memories, self-blame
- Physical
reactions: tension, fatigue, edginess, difficulty sleeping,
bodily aches or pain, being startled easily, racing heartbeat,
nausea, change in appetite, change in sex drive
- Interpersonal
reactions in relationships at school, work, in friendships,
in marriage, or as a parent, such as: distrust, irritability,
conflict, withdrawal, isolation, feeling rejected or abandoned,
being distant, judgmental, or overcontrolling
Most disaster
rescue workers only experience mild normal stress reactions, and
disaster experiences may even promote personal growth and strengthen
relationships. However, as many as one in three rescue
workers experience some or all of the following severe stress
symptoms, which may lead to lasting post-traumatic stress disorder
(PTSD), anxiety disorders, or depression:
- Dissociation
(feeling completely unreal or outside yourself, like in a
dream; having "blank" periods of time you cannot
remember)
- Intrusive
reexperiencing (terrifying memories, nightmares, or flashbacks)
- Extreme
attempts to avoid disturbing memories (such as through substance
use)
- Extreme
emotional numbing (completely unable to feel emotion, as if
utterly empty)
- Hyperarousal
(panic attacks; rage; extreme irritability; intense agitation)
- Severe
anxiety (paralyzing worry, extreme helplessness, compulsions
or obsessions)
- Severe
depression (complete loss of hope, self-worth, motivation,
or purpose in life)
Rescue workers
who directly experience or witness any of the following during
or after the disaster are at greatest risk for severe stress symptoms
and lasting readjustment problems:
- Life threatening
danger or physical harm (especially to children)
- Exposure
to gruesome death, bodily injury, or bodies
- Extreme
environmental or human violence or destruction
- Loss of
home, valued possessions, neighborhood, or community
- Loss of
communication with/support from close relationships
- Intense
emotional demands (such as searching for possibly dying survivors,
or interacting with bereaved family members)
- Extreme
fatigue, weather exposure, hunger, or sleep deprivation
- Extended
exposure to danger, loss, emotional/physical strain
- Exposure
to toxic contamination (such as gas or fumes, chemicals, radioactivity)
Studies also
show that some individuals have a higher than typical risk for
severe stress symptoms and lasting PTSD, including those with
a history of:
- Exposure
to other traumas (such as severe accidents, abuse, assault,
combat, rescue work)
- Chronic
medical illness or psychological disorders
- Chronic
poverty, homelessness, unemployment, or discrimination
- Recent
or subsequent major life stressors or emotional strain (such
as single parenting)
Disaster stress
may revive memories of prior trauma, as well as possibly intensifying
pre-existing social, economic, spiritual, psychological, or medical
problems.
Here are some
ways to manage stress during a disaster operation:
- Develop
a "buddy" system with a co-worker
- Encourage
and support your co-workers
- Take care
of yourself physically, with regular exercise and eating frequently
in small quantities
- Take a
break when you feel your stamina, coordination, or tolerance
for irritation diminishing
- Stay in
touch with family and friends
- Defuse
briefly whenever you experience troubling incidents, and after
each work shift
After the disaster:
- Attend
a debriefing if one is offered, or try to get one organized,
2 to 5 days after leaving the scene
- Talk about
feelings as they arise, and be a good listener to your co-workers
- Don't
take anger too personally -- it's often an expression of frustration,
guilt, or worry
- Give your
co-workers recognition and appreciation for a job well done
- Eat well
and try to get adequate sleep in the days following the event
- Maintain
as normal a routine as possible, but take several days to
"decompress" gradually
After returning
home:
- Catch
up on your rest (this may take several days)
- Slow down
-- get back to a normal pace in your daily life
- Understand
that it's perfectly normal to want to talk about the disaster,
and equally normal not to want to talk about it; but
remember that those who haven't been through it might not
be interested in hearing all about it -- they might find it
frightening, or simply be satisfied that you're back safely
- Expect
disappointment, frustration, and conflict -- sometimes coming
home doesn't live up to what you imagined it would be -- but
keep recalling what's really important in your life and relationships
so that small stressors don't lead to major conflicts
- Don't
be surprised if you experience mood swings; they will diminish
with time
- Don't
overwhelm children with your experiences; be sure to talk
about what happened in their lives while you were gone
Taking every
day one-at-a-time is essential in disaster's wake. Each day is
a new opportunity to FILL-UP:
- Focus
Inwardly on what's most important to you and your family
today;
- Look
and Listen to learn what you and your signficant others
are experiencing, so you'll remember what is important and
let go of what's not;
- Understand
Personally what these experiences mean to you as a
part of your life, so that you will feel able to go on with
your life and even grow personally.
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