A primer for mental health professionals

The immediate response to events such as disasters is stress, about which we have prepared information for the public, for health care professionals, and for public safety workers.  This fact sheet is an overview of stress-related disaster as it relates to health care and mental health care.

Stress is an elevation in a person's state of arousal or readiness, caused by some stimulus or demand. As stress arousal increases, health and performance actually improve. Within manageable levels, stress can help sharpen our attention and mobilize our bodies to cope with threatening situations.  As the following graph illustrates, “optimal” stress involving functional amounts of arousal contributes to effective task performance, including response to disaster.

But beyond that optimal level there is deterioration of health and performance begins to lessen, so it is important to manage stress in order to keep it in the “good” range.

Stress is mediated by appraisal, a cognitive “story” that we tell ourselves about the disaster circumstances and our response to them: Have we had this experience before? If so, how did we respond? What was the outcome? Can we cope with the situation now? If there's doubt as to any of these questions, the stress response elevates.

Here are some common stress reactions in response to disasters, experienced to varying degrees by everyone involved with them, and which you will experience as well.

Symptoms of stress that may be experienced during or after a traumatic incident

Physical*

Cognitive

Emotional**

Behavioral

 Chest pain*
 Difficulty breathing*
 Shock symptoms*
 Fatigue
 Nausea/vomiting
 Dizziness
 Profuse sweating
 Rapid heart rate
 Thirst
 Headaches
 Visual difficulties
 Clenching of jaw
 Nonspecific aches and pains

 Confusion
 Nightmares
 Disorientation
 Heightened or lowered alertness
 Poor concentration
 Memory problems
 Poor problem solving
 Difficulty identifying familiar objects or people

 Anxiety
 Guilt
 Grief
 Denial
 Severe panic (rare)
 Fear
 Irritability
 Loss of emotional control
 Depression
 Sense of failure
 Feeling overwhelmed
 Blaming others or self

 Intense anger
 Withdrawal
 Emotional outburst
 Temporary loss or increase of appetite
 Excessive alcohol consumption
 Inability to rest, pacing
 Change in sexual functioning

*Seek medical attention immediately if you experience chest pain, difficulty breathing, severe pain, or symptoms of shock (shallow breathing, rapid or weak pulse, nausea, shivering, pale and moist skin, mental confusion, and dilated pupils).

**Seek mental health support if your symptoms or distress continue for several weeks or interfere with your daily activities.