UNHCR Handbook for Emergencies - UNHCR eCentre

iii. Intellectual
Concentration difficulties, memory difficulties,
problems with reasoning and verbal
expression.
8. The presence of several of these symptoms
may mean that a person’s coping ability
is diminishing and work performance is being
affected. However, the signs and the degree
of stress presented by a person in any given
situation will vary, depending on the level of
stress experienced, previous emotional experiences
and the personality of the individual.
9.
If the cyclic causes and resultant symptoms
of cumulative stress are not promptly addressed,
exhaustion sets in, leading eventually
to “burnout”. Should this happen one
needs rest and counselling.
Traumatic Stress
10. Traumatic stress is brought on by unexpected
and emotionally powerful events (“critical
incidents”) that overwhelm the individual’s
usual coping abilities. Critical incidents
may arise in the context of a major disaster
or emergency, and could be, for example,
injury or death of a colleague, hostage taking,
deaths of children, undergoing great personal
risk, being a powerless witness of violence,
or seeing or being associated with a tragic
event accompanied by intense media coverage
(especially if this is inaccurate).
11.
Staff might experience acute reactions during
a critical incident or a delayed stress
reaction minutes, hours or days after the
event. In rarer cases reactions may come
after a few months or years.
12. The reactions after a critical incident can
resemble those of cumulative stress but they
can be much more pronounced. Vomiting instead
of nausea as an example. The following
are mental survival mechanisms that allow us
to deal with the event:
Emotional numbing, changes in the perception
of time, along with a sense of ones live
flashing before ones eyes, highly focused attention
or tunnel vision, hyperarousal with
sharpened senses.
These initial responses can be replaced in the
period of time immediately after the incident
by:
Hyperactivity, exaggerated humour, argumentativeness,
social withdrawal, fear, anxiety,
sadness, grief, memory problems, poor concentration,
slow thinking and loss of perception
in addition to the physical symptoms
mentioned above.
13.
It should be emphasized that these symptoms
are normal reactions to abnormal
events and in most cases will disappear.
14. However, occasionally a serious condition
termed Post Traumatic Stress Disorder (PTSD)
can result from critical incidents. The risk of
PTSD can be considerably reduced by preparation,
on-site care, and post incident defusing
or debriefing.
15. The diagnosis of PTSD is made by a psychiatrist
or psychologist based on the presence
of various elements which include:
i. Invasive memories (flashback);
ii. Nightmares and sleep disturbance;
iii. Repeated reliving of the event;
iv. Detachment;
v. Avoidance of trigger persons or situations;
vi. Hyperarousal;
vii. Anxiety, depression, grief, anger;
viii. Suicidal thought;
ix. Reactions intensifying over time;
x. Clear alteration of personality;
xi. Withdrawal from others;
xii. Continued rumination about event;
xiii. Constant expectations of a new disaster;
xiv. Persistent sleep difficulties;
xv. Total absence of reactions;
xvi. Phobia formation;
xvii.Reactions continuing for 3 to 4 weeks.
Techniques for dealing with Stress
Preventing and Minimizing Harmful Stress
16.
It is important to recognize that it is impossible
to take care of others if you do not
take care of yourself.
17. Being well prepared, both physically
and psychologically, is an important way to
reduce the chances of harmful stress. This
Coping with Stress
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