Managing Traumatic Stress: Tips for Recovering From Disasters and Other
Traumatic Events
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:
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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.
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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.
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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.
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Interpersonal relationships often become strained. Greater conflict,
such as more frequent arguments with family members and coworkers,
is common. On the other hand, you might become withdrawn and
isolated and avoid your usual activities.
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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' pattern
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.
A number of factors tend to affect the length of time required for recovery,
including:
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The degree of intensity and loss. Events that last longer and pose
a greater threat, and where loss of life or substantial loss
of property is involved, often take longer to resolve.
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A person's general ability to cope with emotionally challenging situations.
Individuals who have handled other difficult, stressful circumstances
well may find it easier to cope with the trauma.
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Other stressful events preceding the traumatic experience. Individuals
faced with other emotionally challenging situations, such as
serious health problems or family-related difficulties, may have
more intense reactions to the new stressful event and need more
time to recover.
How should I help myself and my family?
There are a number of steps you can take to help restore emotional well
being and a sense of control following a terrorist act, a disaster or
other traumatic experience, including the following:
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Give yourself time to heal. Anticipate that this will be a difficult
time in your life. Allow yourself to mourn the losses you have
experienced. Try to be patient with changes in your emotional
state.
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Ask for support from people who care about you and who will listen
and empathize with your situation. But keep in mind that your
typical support system may be weakened if those who are close
to you also have experienced or witnessed the trauma.
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Communicate your experience in whatever ways feel comfortable to
you - such as by talking with family or close friends, or keeping
a diary.
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Find out about local support groups that often are available such
as for those who have suffered from natural disasters, or for
women who are victims of rape. These can be especially helpful
for people with limited personal support systems.
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Try to find groups led by appropriately trained and experienced professionals.
Group discussion can help people realize that other individuals
in the same circumstances often have similar reactions and emotions.
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Engage in healthy behaviors to enhance your ability to cope with
excessive stress. Eat well-balanced meals and get plenty of rest.
If you experience ongoing difficulties with sleep, you may be
able to find some relief through relaxation techniques. Avoid
alcohol and drugs.
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Establish or reestablish routines such as eating meals at regular
times and following an exercise program. Take some time off from
the demands of daily life by pursuing hobbies or other enjoyable
activities.
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Avoid major life decisions such as switching careers or jobs if possible
because these activities tend to be highly stressful.
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Become knowledgeable about what to expect as a result of trauma.
Some of the 'Additional Resources' listed at the end of this
fact sheet may help you with this learning process.
How do I take care of children's special needs?
The intense anxiety and fear that often follow a disaster or other traumatic
event can be especially troubling for children. Some may regress and
demonstrate younger behaviors such as thumb sucking or bed wetting. Children
may be more prone to nightmares and fear of sleeping alone. Performance
in school may suffer. Other changes in behavior patterns may include
throwing tantrums more frequently, or withdrawing and becoming more solitary.
There are several things parents and others who care for children can
do to help alleviate the emotional consequences of trauma, including
the following:
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Spend more time with children and let them be more dependent on you
during the months following the trauma - for example, allowing
your child to cling to you more often than usual. Physical affection
is very comforting to children who have experienced trauma.
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Provide play experiences to help relieve tension. Younger children
in particular may find it easier to share their ideas and feelings
about the event through non-verbal activities such as drawing.
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Encourage older children to speak with you, and with one another,
about their thoughts and feelings. This helps reduce their confusion
and anxiety related to the trauma. Respond to questions in terms
they can comprehend. Reassure them repeatedly that you care about
them and that you understand their fears and concerns.
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Keep regular schedules for activities such as eating, playing and
going to bed to help restore a sense of security and normalcy.
When should I seek professional help?
Some people are able to cope effectively with the emotional and physical
demands brought about by a natural disaster or other traumatic experience
by using their own support systems. It is not unusual, however, to find
that serious problems persist and continue to interfere with daily living.
For example, some may feel overwhelming nervousness or lingering sadness
that adversely affects job performance and interpersonal relationships.
Individuals with prolonged reactions that disrupt their daily functioning
should consult with a trained and experienced mental health professional.
Psychologists and other appropriate mental health providers help educate
people about normal responses to extreme stress. These professionals
work with individuals affected by trauma to help them find constructive
ways of dealing with the emotional impact.
With children, continual and aggressive emotional outbursts, serious
problems at school, preoccupation with the traumatic event, continued
and extreme withdrawal, and other signs of intense anxiety or emotional
difficulties all point to the need for professional assistance. A qualified
mental health professional can help such children and their parents understand
and deal with thoughts, feelings and behaviors that result from trauma.
How may I use APA as a resource?
'Talk to Someone Who Can Help,' brochure about psychotherapy and choosing
a psychologist from the American Psychological Association can be ordered
free of charge. Call 800-964-2000
You can also call 1-800-964-2000 to be connected with the state psychological
association referral network in your area.
Additional Resources
'A Terrible Thing Happened', a story for children who have witnessed
a violent or traumatic event.
Local chapters of the American Red Cross may be able to direct you to
additional resources. Check your local telephone directory for the chapter
nearest you.
National Organization for Victims Assistance, 1757 Park Rd., N.W., Washington,
D.C. 20010; toll-free, 1-800-TRY-NOVA; in D.C. metropolitan area, (202)
232-6682.
Other materials available via Internet offer additional information about
coping with traumatic events:
'Emotional Reactions to Disasters' University of Illinois Cooperative
Extension Service
September 2001