A Guide to Managing Stress in Crisis Response Professions

A Guide to Managing Stress in Crisis Response Profession

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CHAPTER I. Understanding the Stress Cycle
Common Stress Reactions
Extreme Stress Reactions
Stress is an elevation in a person's state of arousal or readiness, caused by some stimulus or demand. As stress arousal increases, health and performance actually improve. Within manageable levels, stress can help sharpen our attention and mobilize our bodies to cope with threatening situations.

At some point, stress arousal reaches maximum effect. Once it does, all that was gained by stress arousal is then lost and deterioration of health and performance begins (Luxart Communications, 2004).

Whether a stressor is a slight change in posture or a lifethreatening assault, the brain determines when the body's inner equilibrium is disturbed; the brain initiates the actions that restore the balance. The brain decides what is threatening and what is not. When we face challenging situations, the brain does a quick search. Have we been here before? If so, how did we feel? What was the outcome? Can we cope with the situation now? If there's doubt as to any of these questions, the stress response goes into high gear (McEwen & Lasley, 2002).

The following provides workers and managers with a list of common stress reactions. Most people are resilient and experience mild or transient psychological disturbances from which they readily bounce back. The stress response becomes problematic when it does not or cannot turn off; that is, when symptoms last too long or interfere with daily life.

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Common Stress Reactions
Behavioral

Increase or decrease in activity level
Substance use or abuse (alcohol or drugs)
Difficulty communicating or listening
Irritability, outbursts of anger, frequent arguments
Inability to rest or relax
Decline in job performance; absenteeism
Frequent crying
Hyper-vigilance or excessive worry
Avoidance of activities or places that trigger memories
Becoming accident prone

Physical

Gastrointestinal problems
Headaches, other aches and pains
Visual disturbances
Weight loss or gain
Sweating or chills
Tremors or muscle twitching
Being easily startled
Chronic fatigue or sleep disturbances
Immune system disorders

Psychological/Emotional

Feeling heroic, euphoric, or invulnerable
Denial
Anxiety or fear
Depression
Guilt
Apathy
Grief

Thinking

Memory problems
Disorientation and confusion
Slow thought processes; lack of concentration
Difficulty setting priorities or making decisions
Loss of objectivity

Social

Isolation
Blaming
Difficulty in giving or accepting support or help
Inability to experience pleasure or have fun

(Adapted from CMHS, 2004)

First the brain sounds an alert to the adrenal glands. The adrenals answer by pouring out the first of the major stress hormones—adrenaline—for the classic fight-orflight response.

The fight-or-flight response evolved with the prime directive of ensuring our safety and survival. The pulse begins to race as the adrenaline steps up the heart rate, sending extra blood to the muscles and organs. Oxygen rushes in as the bronchial tubes in the lungs dilate; extra oxygen also reaches the brain, which helps keep us alert. During this stage of the fight-or-flight response, the brain releases natural painkillers called endorphins. This phase, in which adrenaline plays a leading role, is the immediate response to stress (McEwen & Lasley, 2002).

When the stress response is active for a long period of time, it can damage the cardiovascular, immune, and nervous systems. People develop patterns of response to stress that are as varied as the individuals (Selye, 1984). These responses simply suggest a need for corrective action to limit their impact (Mitchell & Bray, 1990; Selye, 1984).







Acknowledgments
This publication was produced by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), U.S. Department of Health and Human Services (DHHS) and was reviewed by a group of experts. Ms. Maria Baldi served as the Government project officer. The SAMHSA Disaster Technical Assistance Center (operated by ESI under contract with CMHS), researched, compiled, and edited the information, and designed the cover and layout for this publication. SAMHSA gratefully acknowledges the contributions of Nancy C. Carter, M.S.W.

Public Domain Notice
All material appearing in this document is in the public domain and may be reproduced or copied without permission from SAMHSA or CMHS. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, DHHS.

Electronic Access and Copies of Publication
This publication may be accessed electronically through the following Internet connection: www.samhsa.gov. For additional free copies of this document, please contact SAMHSA's National Mental Health Information Center at 1-800-789-2647 or 1-866-889-2647 (TDD).

Citation
U.S. Department of Health and Human Services. A Guide to Managing Stress in Crisis Response Professions. DHHS Pub. No. SMA 4113. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.

Originating Office
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road, Rockville, Maryland 20857
DHHS Publication No. SMA 4113
Printed 2005