Monday Medical: Critical Incident Stress

Editor’s Note: This story is Part 1 of a two-part series on the impact of crisis events on physical, mental and emotional health. Part 2 focuses on first responders.

Whether you’re first on the scene of a car accident or a bystander when someone is seriously injured, responding to an unexpected crisis situation can take a toll on your physical, mental and emotional health.

Molly Lotz, a licensed clinical social worker and crisis counselor at UCHealth Yampa Valley Medical Center, explains what you should know about the impact of crisis incidents.

Effects on the body

During a crisis, the sympathetic nervous system takes control and prepares the body for a fight, flight, or freeze response.

“When we are in the middle of a crisis and we are expected to respond, such as calling 911 or providing care, our bodies change,” Lotz said.

In a fight-or-flight response, these changes can include increased heart rate and breathing, increased blood pressure, and increased concentration. During a freeze reaction, someone may feel stiff, cold, numb, and experience a decreased heart rate.

After the event, this physical stress can persist and manifest itself in a range of symptoms such as increased heart rate, fatigue, chills, headache and chest pain.

Effects on the mind

The brain is powerful and has adapted to healing, but sometimes after a crisis situation, people find that their thoughts are reeling from the event and they may become stuck in a state of hypervigilance. Signs that you are stressed by a critical incident may include feelings of insecurity and confusion, constant searching for threats, withdrawal from others, lack of attention, inability to calm down, changes in appetite, feelings such as sadness, fear and intense anger, etc. an increased Sensitivity to other stressors.

“This can be a pretty difficult place to live for a while,” Lotz said. “It can also bring up old unresolved traumas, as the brain can group together things that have something vague in common. If we can distinguish between the traumas, old traumas will not be triggered as easily.”

Coping with the impacts

After the incident, it is important to address the activated stress response.

“We want to allow ourselves to return to a regulated state, but that portion of the time while we were in response mode continues to exist in our bodies and brains,” Lotz said.

Participating in a critical incident debriefing can allow people to process the event in a healthy way. It is best to do this 24-72 hours after the event when you are safe and calm.

“The human brain is always trying to make sense of things,” Lotz said. “If we can put the pieces together after the incident, like, ‘Oh, you came in and called 911,’ the brain can incorporate that information into the action rather than searching for it.

“When the brain is in a calmer state, it can perceive this as an incident that has a beginning, a middle and an end, rather than a loop that just continues. It mitigates the impact of the incident on our thinking and functioning.”

Additional actions

Steps such as contacting a friend or loved one, drinking a cold glass of water, squeezing the neck, spending time outdoors, and practicing deep breathing can also help regulate the nervous system after an acute incident.

“When we fight, flee or freeze, our bodies don’t allow us to take deep breaths,” Lotz said. “If we can get the brain to take deep breaths, it helps us feel safe.”

Be aware of what you need and don’t hesitate to seek additional help if symptoms begin to interfere with your normal life.

“There are therapeutic modalities that can really help – it’s not just about talking,” Lotz said.

Different reactions

Don’t be surprised if a particular incident seems to affect you more or less than others.

“Something that might be a traumatic incident for you might feel different to me,” Lotz said. “I bring my entire history as a human being into an incident. It might be more traumatic, maybe less.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at [email protected].