Stress in Emergency Responders: Know the Warning Signs

Krystina C., Editor

Emergency responders are usually the first on the scene to face challenging and stressful situations. They are also the first to reach out to disaster survivors and provide them with emotional and physical support. These duties, although critically important during a disaster, can affect emergency responders in harmful ways.

Signs of Stress in Emergency Responders

After responding to a disaster, emergency responders may experience physical, cognitive, emotional or behavioral symptoms of stress. Some responders experience these reactions immediately at the scene while for others, symptoms may occur weeks or months later. Common signs of stress may include the following:

Physical Effects

  • Rapid heart rate, palpitations, muscle tensions, headaches, tremors, gastrointestinal distress, nausea, inability to relax when off duty, trouble falling asleep or staying asleep, nightmares or flashbacks

Negative Feelings

  • Excessive worry, fear or terror about something bad happening, anger, frustration, irritability, deep sadness, difficulty maintaining emotional balance

Difficulty Thinking Clearly

  • Disorientation or confusion, difficulty solving problems and making decisions, difficulty remembering instructions, inability to see situations clearly, distortion and misinterpretation of comments and events

Risky Behavior

  • Unnecessary risk-taking, failure to use personal protective equipment, refusal to follow orders or leave the scene, endangerment of team members

Social Conflicts

  • Hostility in social situations, blaming, failure to support team members

Most stress symptoms are temporary and will resolve on their own. However, if symptoms continue for several weeks or if they interfere with daily activities, professional help may be needed. Contact your health care provider or seek help from a trusted mental health professional.

What You Can Do

  • Use a buddy system to identify physical, emotional, cognitive and behavioral signs of stress in team members.
  • Enforce breaks.
  • Rescue and recovery efforts at the site may continue for days or weeks; practice self-care to remain focused and alert to hazards over the long term.

When to Seek Help

The following symptoms may be signs of severe stress or could indicate a medical emergency:

  • Disorientation (e.g., feeling dazed, not being able to recall events)
  • Significant depression (e.g., prolonged feelings of sadness)
  • Suicidal or homicidal thoughts or plans
  • Psychiatric symptoms (e.g., hearing voices)
  • Inability to care for self (e.g., not eating or bathing)
  • Problematic use of alcohol or drugs, or misuse of prescription medication

If you or someone you know is struggling after a disaster, you are not alone. The Substance Abuse and Mental Health Administration's Disaster Distress Helpline provides 24/7 crisis counseling and support to people experiencing emotional distress related to natural or manmade disasters. Call 800-985-5990 or text "TalkWithUs" to 66746.

For more information on various health and wellness topics, browse the QuickSeries® library of guides, including Mass Casualty Event Preparedness and Response.

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