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Disaster Rescue and Response Workers
A National Center for PTSD Fact Sheet
The terrorist attacks on New York and Washington are, together, the greatest
man-made disaster in America since the Civil War. Lessons learned from natural
and human-caused disasters can help us understand the unique stressors faced by
rescue workers such as police and firefighters, National Guard members,
emergency medical technicians, and volunteers. Past experience may also help us
recognize how these stressors may affect response workers. Rescue
workers face the danger of death or physical injury, the potential loss of
their coworkers and friends, and devastating effects on their communities. In
addition to physical danger, rescue workers are at risk for behavioral and
emotional readjustment problems.
What psychological problems can result from disaster experiences?
The psychological problems that may result from disaster experiences
include:
- Emotional reactions: temporary (i.e., for several days
or a couple of weeks) feelings of shock, fear, grief, anger, resentment, guilt,
shame, helplessness, hopelessness, or emotional numbness (difficulty feeling
love and intimacy or difficulty taking interest and pleasure in 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, startling 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: distrust; irritability;
conflict; withdrawal; isolation; feeling rejected or abandoned; being distant,
judgmental, or over-controlling
What severe stress symptoms can result from disasters?
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 out of every three rescue workers
experience some or all of the following severe stress symptoms, which may lead
to lasting Posttraumatic 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 empty)
- Hyper-arousal (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)
Who is at greatest risk for severe stress symptoms?
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 dead or
maimed bodies
- Extreme environmental or human violence or destruction
- Loss of home, valued possessions, neighborhood, or
community
- Loss of communication with or support from close
relations
- 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 are at a higher than typical risk
for severe stress symptoms and lasting PTSD if they have 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 and may intensify
preexisting social, economic, spiritual, psychological, or medical problems.
How can you manage stress during a disaster operation?
Here are some ways to manage stress during a disaster operation:
Develop a "buddy" system with a coworker.
Encourage and support your coworkers.
Take care of yourself physically by exercising regularly and eating small
quantities of food frequently.
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.
How can you manage stress after the disaster?
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 coworkers.
- Don't take anger too personally - it's often an
expression of frustration, guilt, or worry.
- Give your coworkers 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.
How can you manage stress after returning home?
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 returned 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.
- If talking doesn't feel natural, other forms of
expression or stress relief such as journal writing, hobbies, and exercise are
recommended.
Taking each day one at a time is essential in disaster's wake. Each day
provides 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 significant 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, so that you will feel able to go on with your life and
even grow personally.
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The information on this Web site is presented for educational purposes only. It is not a substitute for informed medical advice or training. Do not use this information to diagnose or treat a mental health problem without consulting a qualified health or mental health care provider.
All information contained on these pages is in the public domain unless explicit notice is given to the contrary, and may be copied and distributed without restriction.
For more information call the PTSD Information Line at (802) 296-6300 or send email to ncptsd@ncptsd.org. This page was last updated on Wed May 14 15:15:46 2003.
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