Managing Traumatic Stress: Guidelines for Individuals

Traumatic events, sometimes referred to as critical incidents, tend to be sudden and unexpected by the individuals involved. Such events may include natural disaster (eg. earthquakes and floods), combat, vehicle accidents, or physical assault. While many of the people involved in these events may escape physical injury, there is often 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 behaviours, and help you along the path to recovery.

What happens to people after a disaster or other traumatic event?

Initially, people exposed to trauma may go into a state of shock and denial. This is a typical response to trauma, especially shortly after the event. Both shock and denial are normal protective reactions and serve to protect the individual from the “reality” of the event.

Shock is a sudden and intense disturbance of your emotional state that may leave you feeling stunned or dazed. People in shock often have trouble taking in information and responding to the environment. Denial involves difficulty acknowledging that something very stressful has happened, or not completely understanding the intensity of the event.

As shock subsides, reactions vary from one person to another. The following, however, are normal responses to a traumatic event:

• Feelings become intense or unpredictable. You may become irritable, and you may experience mood swings. You might be especially anxious or nervous, or even become depressed.
• Thoughts and behaviour patterns may be affected. For example, repeated vivid memories of the event (or “flashbacks”) may occur for no apparent reason and can lead to physical reactions such as rapid heart beat or sweating. You may find it difficult to concentrate or make decisions, and you may become more easily confused. Sleep and eating patterns can also be disrupted.
• Recurring emotional reactions are common. Anniversaries of the event, such as at one month or one year, can lead to feelings of depression, anxiety, or guilt. Other reminders such as dealing with people involved in the incident or returning to a similar environment may also trigger upsetting memories. These “triggers” may be accompanied by fears that the stressful event will be repeated.
• Interpersonal relationships often become strained. You may experience greater conflict with family members and coworkers, or you might become withdrawn and isolated.
• 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.

How do people respond differently over time?

Different people respond to trauma in different ways. While some will go into shock almost immediately, others may not appear to go into shock at all. Others may have delayed reactions. Some people may experience adverse effects for a long period of time, while others recover very quickly.

A number of different factors affect each individual’s recovery, including:

• The extent of the trauma. Highly threatening and long lasting events, or those involving loss of life and substantial property loss, often take longer to resolve.
• The person's general ability to sustain stress and cope with emotional challenges. People who have coped with other difficult and stressful circumstances may find it easier to cope with trauma.
• Other stressful events preceding the traumatic experience. The more stress the individual is living with prior to the traumatic event (eg. personal or health problems), the more difficult he/she is likely to find it to cope with the trauma.

How should I help myself and my family?

A number of things can be done to help restore emotional and psychological well-being following a traumatic experience, including the following:

• Communicate your experiences in a way that is comfortable for you. Talking to family and close friends often helps, or you may wish to keep a diary.
• Give yourself time to heal. Anticipate that this will be a difficult time and allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.
• Ask for support when needed. You may like to approach family, friends, or external support agencies. Often trauma survivors find it beneficial to speak to other people exposed to the trauma.
• Find out about support groups and other health providers. These may include chaplains, psychologists, social workers, or community groups.
• Engage in healthy behaviours. Eating healthy food, avoiding stimulants (eg. caffeine and nicotine), and getting plenty of rest should help reduce trauma symptoms. If you have ongoing sleeping difficulties, you may find relaxation techniques useful. Avoid alcohol and drugs.
• Establish or reestablish routines such as eating meals at regular times and following an exercise program. Returning to work is also a good idea, as long as you return to a manageable workload.
• Avoid major life decisions such as switching careers or jobs if possible. It is difficult to make a well considered decision while under stress, and you may regret these decisions later on.

When should I seek professional help?

In the vast majority of cases, trauma symptoms such as those described above recede reasonably quickly following the event (ie. days or weeks). However, some people find that serious problems continue to interfere with daily living. Common examples include continuing to feel overwhelming anxiety or sadness, which in turn may impact upon job performance and interpersonal relationships.

Individuals with prolonged reactions should consult with an appropriately trained and experienced mental health professional. Psychologists and other mental health providers work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.

1st Psychology Unit contact details

1st Psychology Unit
Randwick Barracks
Avoca St.
RANDWICK NSW 2031
tel: (02) 9349 0599; mob: 0412 825 642