There is no way to make sense of this act of violence. Your courage over the past days has been immense.

Remember that grief for our friends, our colleagues and our community is natural. If you would like to talk with someone about your experience, there are a number of resources available to you:

A 24-hour free community hotline for those in need of counseling
1-866-342-6892

A link to a list of Pima County community mental health resources

A guide to critical incident stress: symptoms, treatment and coping with crisis induced Stress.

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Critical Incident Stress

Tragedies, traumatic deaths, serious injuries, life-threatening situations — these events are known as critical incidents. Stress is the natural and normal physical reaction we experience in response to the demands placed upon the body by an emotional or mental stimulus — what is often referred to as a stressor. Many of us deal with the day-to-day stressors in our life without much difficulty and without experiencing any extreme physical or emotional reactions.

Occasionally, however, a critical incident impacts us to the point that we feel overwhelmed by the situation or the event. During such periods of intense, traumatic stress there is a wide range of emotional and physical reactions which we may experience as part of the normal stress response of adjusting to the intense feelings and other reactions in the aftermath of the event.

The list below details some of those signs and symptoms. As you read through the remainder of this information, please remember that these stress reactions are normal responses to abnormal situations and, while more intense initially, they tend to lessen over time. In addition to the information on these “Common Reactions to Critical Incidents,” we are also providing you with a list of “Things to Try” as well as some tips “For Family and Friends” that may help you through the process.

COMMON REACTIONS TO A CRITICAL INCIDENT

PHYSICAL* COGNITIVE/THOUGHTS

*any of these symptoms may indicate the need for medical evaluation. When in doubt, contact a physician.

• Nausea/Diarrhea
• Shallow breathing
• Twitches/Tremors
• Dizziness/Faintness
• Chills/Sweating
• Easily startled/Jittery
• Fatigue
• Changes in appetite
• Sleep disturbances and nightmares
• Headaches
• Grinding teeth
• Feeling uncoordinated
• Weakness/Chest pain
• Elevated BP
• Visual difficulties
• Confusion
• Nightmares
• Uncertainty
• Suspiciousness
• Intrusive images
• Blaming someone
• Flashbacks
• Preoccupation with the event
• Overly sensitive/critical
• Difficulty concentrating or making decisions
• Short attention span
• Memory problems
• Disorientation of time, place or person
• Difficulty identifying objects or people
• Increased or decreased awareness of surroundings

EMOTIONAL BEHAVIORAL

• Fear
• Anxiety
• Guilt
• Panic
• Denial
• Agitation
• Irritability
• Depression
• Intense anger
• Apprehension
• Self-doubt
• Feeling overwhelmed
• Emotional outbursts, loss of control
• Inappropriate emotional responses
• Social withdrawal/Silence
• Inability to rest
• Hyper-alert to environment, hypervigilence
• Suspiciousness
• Intensified pacing
• Loss of emotional control
• Changes in typical behavior
• Avoiding thoughts, feelings or situations related to the event
• Change in speech patterns
• Loss or increase of appetite
• Change in usual communication
• Change in sexual function
• Increased consumption of alcohol

THINGS TO TRY

• Schedule physical exercise, alternated with relaxation. This will help alleviate some of the physical reactions.
• Structure your time — keep busy.
• Know you are normal and having normal reactions – don’t label yourself crazy or weak.
• Be aware of numbing the pain with overuse of alcohol or other drugs
• Talk with people you trust. Reach out — people do care and talk is the most healing medicine.
• Don’t be afraid to set limits with others when you don’t feel like talking. You don’t have to discuss the incident or your feelings when you don’t want to.
• Maintain as normal a schedule as possible.
• Spend time with others.
• Help your co-workers as much as possible by sharing feelings and checking out how they are doing.
• Give yourself permission to feel rotten and share your feelings with others.
• Keep a journal; write down your thoughts and reactions
• Do things that feel good to you (take a mini-break, garden, go to the movies, read, take a long, hot shower, etc.).
• Realize those around you are under stress.
• Don’t make any big life changes or major life decisions at this time.
• Do make as many daily decisions as possible which will give you a feeling of control over your life, i.e., if someone asks you what you want to eat, answer them even if  you’re not sure.
• Get plenty of rest.
• Recurring thoughts, dreams or flashbacks are normal — don’t try to fight them — they’ll decrease over time and become less painful.
• Eat well-balanced and regular meals.
• Ask for help if you need it. If you are having trouble coping on your own, help is available from many sources — co-workers, church, friends, family, and other community resources can be valuable sources of support.

FOR FAMILY AND FRIENDS

• Listen carefully.
• Spend time with the traumatized person.
• Offer your assistance and a listening ear, even if they have not asked for help.
• Reassure them that they are safe.
• Help them with everyday tasks like cleaning, cooking, caring for the family, minding the children.
• Give them some private time.
• Don’t take their anger or other feelings personally.
• Don’t tell them that they are “lucky it wasn’t worse” — traumatized people are not consoled by those statements. Instead, tell them that you are sorry such an event has occurred and you want to understand and assist them.
• Remember that everyone deals with grief, trauma, and stress in their own way.

(Materials adapted from the International Critical Incident Stress Foundation sources: www.icisf.org)