Stress in Adults after a Disaster:

Warning Signs and Management

The Texas A&M University System

A disaster can be stressful for many people and can lead to mental and emotional disruption. This disruption is commonly referred to as post-disaster stress.

An adult's emotional reactions after a trauma can vary greatly, ranging from very little distress to extreme stress reactions. Although a person's reaction to post-disaster stress may be troubling, remember that these are normal reactions to abnormal situations .

Below are potential symptoms you might encounter in your interactions with adults after a disaster or terrorism event.

Erratic behavior: Some people engage in risky behaviors or even criminal activity to try to solve financial problems or deal with other matters. Anger is common after a terrorist attack or other human-made disaster.

Changes in mood: After a disaster, many people feel nervous, anxious, depressed and other emotions. Also common are irritability and rapid mood swings, which often result in outbursts toward family, friends and coworkers. Guilt feelings are also possible, especially if a person lost a loved one in the disaster. Some people may wish they had taken the place of their loved one or been there with that person.

Increased substance use: In stressful situations, some adults abuse alcohol or other substances. Substance abuse may lead to further problems at home and at work.

Physical symptoms: Adults may report physical symptoms such as headaches, fatigue and pains, and they may request more sick leave from work.

Some of these symptoms may be related to increased anxiety. High levels of stress can weaken the immune system, which can lead to increases in illness.

Recurrent thoughts: Adults may think about the disaster constantly and find it difficult to think about anything else. Dreams and daydreams about the event are also common. Some people may have flashbacks of the event or feel that they are reliving it. Recurrent thoughts or flashbacks can interfere with concentration and work performance.

A voidance: Adults may want to avoid places or things that remind them of the event. Such reminders bring back the strong emotions they experienced during the disaster. Depending on the nature of the disaster, victims have commonly avoided airplanes, bodies of water, cars and tall buildings.

Shaken belief systems: After a disaster, adults may question their religious or spiritual beliefs. They may question their assumptions about the safety of their community or country or question their trust in government officials. Such questioning and soul-searching is common after a disaster as people search for meaning and resolution.

For example, after terrorist attacks, people may question whether the world can be safe or wonder why people commit such violent acts against innocent citizens. After a toxic waste disaster, citizens may question their faith in government and industry officials, especially if there is some concern that early information may have been held back from the public. Natural disasters may lead people to question why a supreme being would allow such devastation, especially to those they view as being faithful.

Strained relationships: Adults may withdraw from their families or friends when they feel distressed. Or they may avoid leaving home for fear that something terrible will happen again, or they may feel shame over their emotional reactions.

Many victims describe their self-isolation as a product of feeling helpless and without energy. Others indicate that they simply want to avoid troubling others with the burden of their distress.

Some people may not want to leave their family members alone because they want to protect them from another possible disaster. Also, marital stress may increase because of disaster-related stressors.

Cognitive problems: People may have difficulty concentrating, paying attention and remembering things. Concentration and focus may be impaired by fatigue, recurrent thoughts of the disaster and worry about the future.

Impaired work performance: It is common for work performance and productivity to drop after a disaster. Occupational achievement may seem less important after a tragedy. Relationships and work performance may suffer because of impaired concentration, memory and attention, along with increased irritability and mood swings.

Changes in sleeping, eating, and daily routines: People commonly have trouble sleeping, and adults might have nightmares about the disaster. They might also experience daydreams that make them feel they are reliving the event. Dramatic changes in appetite-especially a drop in appetite-are common.

Managing stress

Practicing good stress management after a disaster can lessen your feelings of distress. Below are actions that can help you relieve stress.

Take care of yourself: Taking care of yourself will help you cope with the stressors after a disaster. Eat healthful foods; get plenty of rest; take some time to relax each day; and know your personal limits. You also may find it helpful to learn relaxation techniques, meditation or yoga.

Many people want to help their families and friends after a disaster. However, you will be less helpful to others if you are tired and stressed.

Seek support: Reaching out to other people allows you to talk with others about the experience. Seek out people you trust, and spend time with family and friends.

When seeking support, remember that your friends and family also may be distressed about the disaster. Because of this, some of your normal sources of support may be unable to provide the help you need. If this is the case, seek out other sources of support.

Maintain routines: If possible, stick with your normal routine. Routines can help provide a sense of normalcy as well as help you maintain normal social contacts at school, work or other places you usually go every day.

Following your regular routine can also help you take your mind off the disaster, even just for a little while. Distracting yourself from thoughts about the disaster is a critical component for successful coping for many people.

If you cannot attend your regular activities because of the disaster, try to maintain as many of your home routines as possible (such as mealtimes, family time, etc.) and engage in hobbies or activities that you enjoy.

Engage in physical activity: Physical activity can be an excellent stress reliever for many people. Taking a walk, going for a run or playing basketball can reduce stress.

Some people may prefer to engage in activities such as cleaning the garage, working in the yard or helping rebuild the community (such as cleaning up debris from the storm). This will not only help manage your stress, but also reduce the sources of stress, the problems that the disaster created.

Limit exposure to news coverage of the event: Some people find that watching too much media coverage of an event can increase their feelings of distress. This occurred after the September 11, 2001, terrorist attacks.

It is normal to want to stay updated on the events surrounding the disaster. However, you may be able to lessen your feelings of distress by limiting the amount of time you spend watching or listening to media coverage of the event.

Seek trusted sources of information: During any disaster, but especially during disasters involving chemicals or biological agents you are unfamiliar with, seek out accurate sources of information. These sources may include information from the Centers for Disease Control, from your local government officials or from your family doctor. By educating yourself, you may feel some control over the situation.

As is the case with media exposure, spending too much time seeking out information could increase feelings of distress for some people. Remember that there will probably be more sources of misinformation than sources of accurate information. For example, many Internet sites contain inaccurate information. For the most accurate information in a disaster, search sites maintained by local, state or federal governmental agencies.

Avoid using drugs and alcohol: Avoid using drugs or alcohol to cope with stress. Such substances only provide a temporary "numbing" for feelings of distress and can lead to additional problems. Using them as a coping mechanism can lead to difficulties in family relationships, job performance and recovery from the disaster.

Consider participating in recovery efforts: Helping others can be a great source of stress relief for some people. You can help by volunteering in recovery efforts, such as cleaning up debris, delivering food to families who are struggling or raising disaster recovery funds. You may want to support friends, family members and neighbors by listening to their experiences.

However, it is common for people involved in disaster recovery efforts to feel "burned out" from time to time. It is important to recognize your own limits and seek adequate time and support for yourself if you wish to help others.

Participating in recovery efforts is not suited for everyone; you may find that this increases your stress. If so, do not be afraid to decrease your participation.

Be understanding of yourself and others: Remember that others around you may be feeling distressed. It is normal for people to be more irritable in the initial period after a disaster. Keep this in mind when you are interacting with others.

You may need to be more patient than usual with coworkers, family members or children. Give them opportunities to talk about their experiences and encourage them to take extra time for themselves.

You also may need to have more patience with yourself. Do not be too hard on yourself if it takes you longer than others to recover from the disaster. Disaster recovery is an individual process. If you feel strained, try to avoid taking on extra responsibilities.

Seek extra help: It is normal to experience feelings of distress after a disaster. However, you may benefit from seeking additional help if these feelings persist for more than a month and if they seem to interfere with your daily activities such as work, school or family responsibilities.

You may wish to seek help from a clergy member, mental health professional or your doctor. All of these people can refer you to an appropriate source of help.

Other sources of help might include support groups at work or in the community. Some people are surprised to learn about how many of their fellow community members participate in support groups or otherwise seek help after a disaster. They should not be. Most disasters are big events that have significant impacts on many people. Coming together is an important part of rebuilding a community. Remember, you need to help and support yourself to be able to help and support others around you.

Where to go for help:

1. Family and friends
2. Support groups
3. Pastor or clergy member
4. Community mental health center and local mental health professionals
5. Family physician