Whether your disaster relief assignment took you to the front lines or behind
the scenes, you have made an
enormous contribution to our fellow Americans. You have faced difficult
challenges to help people in a time
of extraordinary need. You have experienced rare and rewarding opportunities
that have proven to be uniquely
stressful. The effects of that stress can cause difficulties as you reenter the
workplace. This brochure
contains useful information to ease your transition and enhance your return to
your usual work routine.
Before Returning to Work
During your disaster response and
recovery efforts, you most likely worked
under less than desirable conditions
while taking care of others. Before you
return to your normal duties, you will
want to take care of yourself by making
sure that all your basic needs are met.
These include the following:
- Maintaining a healthy diet, routine
exercise, adequate rest/sleep
- Spending time with family
and friends
- Paying attention to health concerns
- Meeting neglected daily personal
tasks (e.g., pay bills, mow lawn,
shop for groceries)
- Reflecting upon what the
experience has meant personally
and professionally
- Getting involved in personal and
family preparedness.
Signs of Stress
The following is a list that you may
find helpful in identifying signs of
stress in yourself or others who have
had experiences similar to yours:
- Anxiety, fear
- Grief, guilt, self-doubt, sadness
- Irritability, anger, resentment,
increased conflicts with
friends/family
- Increased use of alcohol or
other drugs
- Feeling overwhelmed, hopeless,
despair, depressed
- Anticipation of harm to self
or others; isolation or social
withdrawal
- Insomnia
- Gait change
- Hypervigilance; startle reactions
- Crying easily
- Gallows/morbid humor
- Ritualistic behavior
- Memory loss, anomia (i.e., difficulty
naming objects or people)
- Calculation difficulties;
decisionmaking difficulties
- Confusion in general and/or
confusing trivial with major issues
- Concentration problems/
distractibility
- Reduced attention span and/or
preoccupation with disaster
- Recurring dreams or nightmares
- Fatigue
- Nausea
- Fine motor tremors
- Tics or muscle twitches
- Paresthesia (e.g., numbness and
tingling in extremities)
- Profuse sweating
- Dizziness
- Stomach or gastrointestinal upset
- Heart Palpitations/fluttering
- Choking or smothering sensation
- Intrusive thoughts
- Relationship problems
- Job/school-related problems
- Decreased libido/sexual interest
- Appetite change
- Overly critical, blaming
- Decreased immune response.
Expecting the Unexpected
Upon returning to your routine
duties, you may notice changes in
yourself, your coworkers, or your
work environment. The following are
a few examples of potential diffi culties
you may face and some tips on how
to overcome them.
Pace change — The disaster
environment often moves at a pace
that is much faster than the normal
workplace. After working in a disaster
response environment, this begins
to feel normal. When returning to
normal work, it may appear that
people are moving at a much slower
pace than you remember. It is easy to
misinterpret this as laziness or lack of
caring or motivation. Remember that
it is probably you who has changed,
not them. Be slow to judge, criticize,
or make assumptions.
Unrelenting fatigue — Even with
what seems like sufficient sleep, you
may experience chronic fatigue. This
may be a result of several factors. You
may need more rest than you realize.
Sometimes chronic stress results in
never feeling rested. Chronic fatigue
may also be a result of a medical
condition. See a doctor if chronic
fatigue persists.
Cynicism — Typically, during disaster
work you see the best and the worst in
individuals and systems and it is easy
to become cynical. This is expected.
These feelings often diminish over
time once you are able to focus on the
positive results of your work.
Dissatisfaction with routine work — It
is very rewarding to be involved,
directly or indirectly, in saving lives
and protecting our fellow citizen’s
health and safety. Most work does
not provide such dramatic and
immediate reinforcement. You might
start seeing your daily work routine
as lacking meaning and satisfaction.
These feelings are normal. To counter
these feelings, incorporate the positive
things you have learned during disaster
response into your personal and
professional life.
Easily evoked emotions — Sometimes
the combination of intense
experiences, fatigue, and/or stress
leaves you especially vulnerable to
unexpected emotions. For example,
you may cry easily, be quick to anger,
or experience dramatic mood swings.
These are normal reactions that
typically subside over time. In the
meantime, be aware of your reactions,
discuss your experiences, and be
sensitive of comments that might be
hurtful or upsetting to others.
Relating your experiences — While you
may want to share your experiences
with others, you may be unsure if it is
appropriate. This is normal. Exercise
care when discussing your disaster
relief experiences, especially graphic
and disturbing topics while in the
presence of children or others who are
emotionally vulnerable.
Difficulties with colleagues and
supervisors— You may not experience
a welcome back from your colleagues
and supervisors that meets your
expectations. Coworkers may resent
having to assume additional workloads,
may not understand the difficulty of
the work you did, or may resent the
recognition that you are receiving as a
responder. In response to any negative
feelings, express appreciation for their
support during your deployment and
take care in relating your experiences.
Cultural issues — Culture affects how
an individual reacts to trauma. For
example, showing emotion, discussing
problems with others, or touching is
acceptable with some groups and
not with others. On the basis of this
understanding, it is important to
appreciate and respect these differences.
When to Seek Help
Remember, stress is a normal reaction
to abnormal situations like disasters.
If you experience the following signs
of persistent or severe stress, seek
help from a licensed mental health
professional.
- Disorientation (e.g., dazed,
memory loss, unable to give date/
time or recall recent events)
- Depression (e.g., pervasive feeling
of hopelessness and despair,
withdrawal from others)
- Anxiety (e.g., constantly on edge,
restless, obsessive fear of another
disaster)
- Acute psychiatric symptoms (e.g.,
hearing voices, seeing visions,
delusional thinking)
- Inability to care for self (e.g., not
eating, bathing, changing clothing,
or handling daily life)
- Suicidal or homicidal thoughts
or plans
- Problematic use of alcohol or drugs
- Domestic violence, child abuse, or
elder abuse
Sometimes it may be difficult to
determine if what you are experiencing
is a result of a physical illness or stress
(or both). In some disaster situations,
workers may have been exposed to
infectious disease and/or environmental
exposure that may result in signs and
symptoms similar to stress. When in
doubt, get an evaluation from a health
care professional.
Coping Suggestions
Find ways to use your disaster
experience to better understand
yourself—You have had an experience/
opportunity that not many people
have had. During that experience you
undoubtedly learned things about
yourself. What stresses you most?
What were you able to handle in
ways that surprised yourself? What
unrecognized skills/talents did
you discover? What did you learn
about how you function in extreme
environments? Use the experience to
better understand yourself.
Find ways to use disaster experience
to enhance your job function—Your
normal job role probably does not
involve disaster response. What skills/
knowledge did you bring from your
normal role that was helpful? What
skills/knowledge/perspective did you
gain from the disaster deployment that
can enhance your normal job function?
Did your experience point you in
directions in which you would like
to move professionally or make you
cognizant of assignments you would
like to seek or avoid?
Use the experience to change your
life in positive ways—Few of us get
the opportunity and privilege of
serving and being with individuals
and communities in the hours of
their greatest need. It is indeed
a privilege. With that privilege
comes responsibilities. One is the
responsibility to be as well prepared
as possible to be optimally helpful.
If there is the potential for being
deployed again, take all opportunities
available to become as prepared
as possible.
There is also a responsibility to use
this unique experience as a way of
honoring and bearing witness to
the loss and suffering of others,
to use the experience to positively
influence our lives. Are our priorities
and values what they should be? Are
we as prepared for adversity as we
should be? Do we value our family,
friends, and colleagues as we should?
When we see others whose lives
have been turned upside down, lives
prematurely ended, and lives forever
changed through loss, we are well
served by reassessing our own values
and priorities.
Getting Help
If you feel you need additional information, you may find this list of resources
to be helpful.
SAMHSA Resources
Information Clearinghouses
Disaster Technical Assistance Center (DTAC)
(800) 308-3515
National Mental Health Information Center (NMHIC)
P.O. Box 42557, Washington, DC 20015
(800) 789-2647 (English and Español)
(866) 889-2647 (TDD)
National Clearinghouse for Alcohol and Drug Information (NCADI)
P.O. Box 2345, Rockville, MD 20847-2345
(800)
729-6686 (English and Español)
(800)
487-4889 (TDD)
Treatment Locators
Mental Health Services Locator
(800) 789-2647 (English and Español)
(866) 889-2647 (TDD)
Substance Abuse Treatment Facility Locator
(800) 662-HELP (4357) (Toll-Free, 24-Hour English and Español Treatment Referral
Service)
(800)
487-4889 (TDD)
Hotlines
National Suicide Prevention Lifeline
(800)
273-TALK (8255)
(800)
799-4889 (TDD)
Other Federal Resources
Centers for Disease Control and Prevention — Mental Health
Center for the Study of Traumatic Stress at the Uniformed Services University of the Health Sciences
Federal Occupational Health Employee Assistance Program for Federal and Federalized Employees or
(800) 222-0364
(888) 262-7848 (TTY)
National Center for Post-Traumatic Stress Disorder (PTSD)
U.S. Department of Health and Human Services—Employee Assistance Program
(202) 690-8229
NMH05-0219
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