Stress management guidance for WTC workers, Sept 2001

NYC 9/11 Public Portal Document

Managing Traumatic Stress: Tips for Recovering http://www.cdphp.coin/main/ManagmgTraumaticStress.shtml

Managing Traumatic Stress: Tips for Recovering From Disasters and Other Traumatic Events Posted with permission from the American Psychological Association Tuesday's terrorist attacks on the United States were the type of events we thought could never happen. Like other types of disasters they were unexpected, sudden and overwhelming. In some cases, there are no outwardly visible signs of physical injury, but there is nonetheless a serious emotional toll. It is common for people who have experienced traumatic situations to have very strong emotional reactions. Understanding normal responses to these abnormal events can aid you in coping effectively with your feelings, thoughts, and behaviors, and help you along the path to recovery.

What happens to people after a disaster or other traumatic event? Shock and denial are typical responses to terrorism, disasters and other kinds of trauma, especially shortly after the event. Both shock and denial are normal protective reactions. Shock is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned or dazed. Denial involves your not acknowledging that something very stressful has happened, or not experiencing fully the intensity of the event. You may temporarily feel numb or disconnected from life. As the initial shock subsides, reactions vary from one person to another. The following, however, are normal responses to a traumatic event: • Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed. • Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heart beat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns also may be disrupted. • Recurring emotional reactions are common. Anniversaries of the event, such as at one month or one year, as well as reminders such as aftershocks from earthquakes or the sounds of sirens, can trigger upsetting memories of the traumatic experience. These 'triggers' may be accompanied by fears that the stressful event will be repeated. • Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you naight become Withdrawn and isolated and avoid your usual activities. • Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress.

How do people respond differently over time? It is important for you to realize that there is not one 'standard' of reaction to the extreme stress of traumatic experiences. Some people respond immediately, while others have delayed reactions - sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather quickly. And reactions can change over time. Some who have suffered from trauma are energized initially by the event to help them with the challenge of coping, only to later become discouraged or depressed.

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