Occupational Safety and Health Administration OSHA

Returning Home After Disaster Relief Work

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Substance Abuse and Mental Health Services Administration

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Disaster relief work can be a once-in-a-lifetime opportunity to help people in need of your expertise and assistance. It is a uniquely rewarding way to use the skills you have developed as a medical worker, soldier, aid worker, or trained volunteer. However, disaster relief work also can cause stress, which may not end when you complete your assignment. You can reduce this stress by taking care of yourself after your return home and by seeking help if you have trouble readjusting to your usual routine.

What to expect

Disasters are difficult to understand. When they occur, people often ask: Why did this happen? This question can be especially unsettling for disaster relief workers who have seen the effects and been involved with the catastrophe firsthand. After returning home, it may help to keep in mind the following tips from SAMHSA's National Mental Health Information Center on understanding the effects of a disaster:

  • No one who sees a disaster is untouched by it.
  • It is normal to feel sadness, grief, and anger about what happened and what you saw.
  • It is also natural to feel anxious about your safety and the safety of your family.
  • Acknowledging your feelings will help you move forward more quickly.
  • Focusing on your contributions, strengths, and abilities can help you heal if you are troubled by what you experienced.
  • Everyone has different needs and different ways of coping. This is normal.
  • It is healthy to reach out for and accept help if you need it.

Your physical and emotional health

SAMHSA's National Mental Health Information Center recommends seeking professional
help if you have any of the following ongoing symptoms upon your return home:

  • Physical aches and pains
  • Cold or flu-like symptoms
  • Changes in your vision or hearing
  • Insomnia, sleeping too little or too much
  • Increased use of alcohol or drugs
  • Limited attention span or decreased concentration
  • Poor work performance
  • Confusion or disorientation
  • Reluctance to leave home or be alone
  • Feelings of hopelessness or helplessness
  • Mood swings or elevated anger
  • Crying easily, prolonged sadness, or depression
  • Overwhelming guilt or self-doubt

Disaster work is challenging physically, mentally, emotionally, and spiritually. You may have worked for long hours in areas that were overcrowded or had poor sanitation or other health risks. You may have witnessed scenes of great pain and loss of human life. You may have had to cope with shortages of basic supplies or resources that most people take for granted. All of these experiences may have had a cumulative effect on your physical and emotional health that can continue after you return home.

Some of the above symptoms may be signs of ongoing stress. They also may be signs of an illness or serious physical condition. For example, flu-like symptoms can be a sign of meningitis, a potentially fatal disease that can spread quickly in crowded areas such as refugee camps. Don't take chances with your health. Call a doctor if you develop unexplained physical symptoms after returning from a place where you faced an increased risk of illness.

Taking care of yourself

After being away and taking care of others, you probably will need to spend some time focusing on and taking care of yourself.

  • Pay attention to your health. Make the extra effort to get enough sleep and eat balanced meals. Keep up any other habits that you normally practice to maintain good health, such as getting regular exercise and taking vitamins or medications prescribed by your doctor.
  • Maintain normal household routines. You may find household projects or invitations from friends waiting for you after you return. Some people need time to readjust before they jump back into their usual routines and relationships. Others find it helpful to resume their activities and connect with family and friends right away. Think about what you need to do for yourself, and do what is best for you.
  • Spend time with supportive family and friends. Doing disaster relief work can be emotionally overwhelming and isolating. Spend time with people who will understand if you don't want to talk about your experiences right away. Alternatively, if you do need to talk about some events, choose to be with someone you feel is able to be supportive, understanding, and patient.
  • Build "down time" into your schedule. After working long hours in a stressful setting, you need time to unwind. Scheduling a specific time or day to relax can help you keep the commitment you made to take care of yourself.
  • Avoid using alcohol or drugs to ease stress. Alcohol can act as a depressant and make you feel worse instead of better. It also can disrupt your sleep. You may experience problems with sleeping or working if you overuse sugar, coffee, tea, caffeinated sodas, or nicotine. These products can have an overstimulating effect.
  • Look for healthy ways to ease tension. You may want to learn a few meditation or deep-breathing techniques. Set aside time to walk, exercise, write in a journal, listen to soothing music, or engage in any activity that has helped you relieve stress in the past.
  • Focus on the tasks and goals you have now. While you were doing disaster work, you may have had to focus all of your energies on the task at hand, and it may be hard to shift your focus after returning home. It is important to be able to give your best efforts to work, people, and the things that need your attention now. Doing this will help you better manage any stress that you feel. It also will help you feel that you are making a contribution through your work and in your relationships.
  • Expect the unexpected. You may have certain expectations of how things went while you were away or how things should be now that you've returned. Your loved ones may have different expectations. Keeping the lines of communication open will help make the transition smoother for everyone.
  • Realize that some experiences may now seem mundane, routine, or even boring. Once you return home to your typical routines, job, and relationships, you may feel let down or feel that what you are doing now is not as meaningful or fulfilling. There is a necessary and typical period of adjustment before you can fully make the transition back to finding the rewards in your everyday life.
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Talking about your experience

Returning home will be easier if you can talk with people you trust about your feelings and experiences. It is important to share not just difficult emotions-such as grief, disbelief, or frustration-but also the joy you felt when helping those in need.

  • Share your feelings with the people closest to you. Some experiences will be easiest to share with people who know you well. You may want to talk to them before you try to describe your experiences to more distant friends or loved ones. If certain things are hard to describe or to begin talking about, you might start the conversation by bringing out photographs or talking about a particular news report related to your disaster work.
  • Allow others to talk about their experiences at home while you were away. Everyone you interact with regularly may need a chance to express their feelings and share their experiences with you about what it was like for them while you were away. Listening is important, even if you feel a little disconnected to what your loved ones are saying or do not know how to respond to them.
  • Stay in touch with disaster relief coworkers. The people you worked with on disaster relief efforts understand your experiences better than anybody else. Stay in touch with them through calls or e-mails. These coworkers may be especially helpful if your family and friends don't seem to understand what you went through. Staying in touch with coworkers will also allow you to support them if they are under stress.
  • Be aware that members of the media may try to contact you. Reporters are often interested in the stories of people who have returned from disaster relief work. Make sure you know your organization's policies about talking to the media and what, if any, clearances you need.

Finding support

Most people are able to adjust to returning home after disaster relief work, though the time required can vary greatly from person to person. If stress reactions persist, or interfere with your personal or work life following your relief assignment, it is important to seek professional help.

The following ongoing signs and symptoms may be an indication of post-traumatic stress disorder (PTSD):

  • Flashbacks (e.g., recurring scenes, pictures, and conversations)
  • Nightmares and/or other sleep problems
  • Difficulty concentrating or communicating
  • Feelings of anger, anxiety, sadness, depression, or crying a lot
  • Fear of being alone or only wanting to be alone
  • Frightening or recurring thoughts
  • Feeling numb or as though you're on "automatic pilot"

A person experiencing post-traumatic stress disorder may experience a few or many of the above symptoms. If responses and reactions like these continue for months, or if they interfere in your daily life to any extent, it is important to seek professional help immediately. Talking with a trained professional can help you recover from trauma and feel better faster. Your employee assistance program (EAP) or employee resource program can help you get the confidential, professional assistance you need.

Even if you don't have signs of PTSD, it is important to get help if you are having trouble with your work or relationships, or if you are still feeling low after your disaster relief coworkers have moved on. You might begin by talking to a professional you trust, such as your doctor or a chaplain or other clergy member. Again, your EAP or employee resource program can help you get professional assistance.

After returning, take some time to think about the valuable contribution you have made to many who needed your help. The American Red Cross encourages disaster workers to remember that they have given a gift of themselves - their time and caring - to those who have experienced a catastrophe. Eventually, you may do more disaster relief work, or you may move on to completely different tasks. Either way, if you take good care of yourself and get help when you need it, you will continue to keep making valuable and much needed contributions to others.

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Written with the help of Marjorie Dyan Hirsch, D.C.S.W., C.E.A.P., C.A.S.A.C., B.C.E.T.S. Ms. Hirsch is an organizational crisis management specialist, corporate consultant, executive coach, and trainer. Ms. Hirsch provided debriefings for the Federal Emergency Management Agency (FEMA) during the Oklahoma City bombing and for many major corporations after both World Trade Center crises. She is CEO of The Full Spectrum in New York City. Parts of this article were adapted from After a Disaster: Self-Care Tips for Dealing with Stress, a publication of SAMHSA's National Mental Health Information Center.


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