Handling Critical Incident Stress

You have experienced a traumatic event or a critical incident (any event that causes powerful emotional reactions that have the potential to interfere with the ability to function normally.) Even though the event is over, you may now be experiencing or may experience later some strong emotional or physical reactions. It is very common, in fact quite normal, for people to experience emotional aftershocks when they have passed through a horrible event.

Sometimes, the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. But, sometimes, they may appear a few hours or a few days later. And in some cases, weeks or months may pass before the stress reactions occur.

The signs and symptoms of a stress reaction may last a few days, a few weeks, a few months, or longer, depending on the severity of the traumatic event. The understanding and the support of loved ones usually cause the stress reactions to pass more quickly. Occasionally, the traumatic event is so painful that professional assistance may be necessary. This does not imply craziness or weakness. It simply indicates that the particular event was just too powerful for the person to manage by himself.

Common signs and signals of stress reaction

Physical stress reactions include: Chills; thirst; fatigue; nausea; fainting; twitches; vomiting; dizziness; weakness; chest pain; headaches; elevated blood pressure; rapid heart rate; muscle tremors; shock symptoms; grinding of teeth; visual difficulties and profuse sweating.

Cognitive stress reactions include: Confusion; nightmares; uncertainty; hypervigilance; suspiciousness; intrusive images; blaming someone; poor problem solving; poor abstract thinking; poor attention and decisions; poor concentration or memory; disorientation of time, place, or person; difficulty identifying objects or people; heightened or lowered alertness and increases or decreased awareness of surroundings.

Emotional stress reactions include: Fear; guilt; grief; panic; denial; anxiety; agitation; irritability; depression; intense anger; apprehension; emotional shock; emotional outbursts; feeling overwhelmed; loss of emotional control and inappropriate emotional responses.

Behavioral stress reactions include: Withdrawal; antisocial acts; inability to rest; intensified pacing; erratic movements; change in social activity; change in speech patterns; loss or increase of appetite; hyperalert to the environment; increased alcohol consumption and changes in usual communication patterns.

Things to Try

• Within the first 24 hours, periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical reactions.
• Structure your time; keep busy.
• You're normal and having normal reactions; don't label yourself crazy.
• Talk to people; talk is the most healing medicine.
• Be aware of numbing the pain with the overuse of drugs or alcohol. You don't need to complicate this.
• Reach out; people do care.
• Maintain as normal a schedule as possible.
• Spend time with others.
• Help your co-workers as much as possible by sharing your feelings and checking out how they are doing.
• Give yourself permission to feel rotten and share your feelings with others. 
• Keep a journal; write your way through those sleepless hours.
• Do things that feel good to you.
• Realize those around you are under stress.
• Don't make any big life changes.
• Do make as many daily decisions as possible that will give you a feeling of control over your life, i.e. if someone asks you what you want to to each, answer them even if you aren't sure.
• Get plenty of rest.
• Don't try to fight reoccurring thoughts, dreams or flashbacks - they are normal and will decrease over time and become less painful.
• Eat well-balanced and regular meals (even if you don't feel like it).

For Family Members and Friends

• Listen carefully.
• Spend time with your traumatized person.
• Offer your assistance and a listening ear if they have not asked for help.
• Reassure them they are safe.
• Help them with everyday tasks like cleaning, cooking, caring for the family and minding the children.
• Give them some private time.
• Don't take their anger or feelings personally.
• Don't tell them that they are "lucky it wasn't worse; "those statements do not console a traumatized person. Instead, tell them that you are sorry for such an event and you want to understand and assist them.