PHYSICAL SIGNS OF ACUTE STRESS

Mental slowness or confusion Inability to make decisions Loss of ability to conceptualize thoughts or prioritize tasks Loss of objectivity in evaluating own functioning Decreased computational skills Decreased memory and attention span

Hyperactivity Excessive fatigue Inability to express self verbally or in writing

Workers may experience post-traumatic stress syndrome days or weeks after the incident, or at the time of a similar incident.

There are many ways to deal with stress response syndrome, either during the disaster response or afterward. It is very important that workers and debriefers realize and communicate to the people they are working with that all of these signs and symptoms are normal reactions.

Remember, the majority of workers and victims will have only temporary problems associated with the stress they experience. They are normal people having normal reactions to an abnormal situation. These are understandable, warranted, and necessary feelings to recover. It is important to stress this to victims and workers who may otherwise see themselves as sick.

Everyone has experienced stress at one time or another. Pushing oneself for weeks to meet a deadline at work or school; going through a long divorce; caring for a sick relative or friend; over-exertion in too much physical training - these push the body too much and often result in getting sick.

Professionals in every field - executives, doctors, lawyers, people in positions where they must make frequent rapid decisions - learn how to take advantage of their stress response. They use it to bring their performance to a peak (consider athletes in competitive sports). However, these people also learn how to lower their stress response. This can be accom plished subconsciously or it can be trained. Anyone who has successfully learned how to juggle many tasks simultaneously has also learned to assess situations quickly, break them down into their most manageable parts, prioritizing components, and dealing with them in order of urgency. Examples include airplane pilots, stockbrokers, homemakers, secretaries, business executives, doctors in emergency rooms, etc. Whether learned by trial and error or through training, such a pattern of behavior minimizes stress responses, resulting in feeling more in control.

Stress can occur also over longer periods. There may be weeks, months or even years which are more turbulent than usual. This can be related to the stage of life or just with chance. For example, as the parent of an adolescent, you may experience difficulties letting go as your child grows. Your own aging parents may be ill at the same time. As a result, you find yourself constantly on call for unexpected responsibilities and difficult decisions. Another scenarior related to phase of life might find you as the parent of a young child, your first, and simultaneously juggling a career with the attendant pressures to succeed. If, at such times, you experience another unexpected stress such as the loss of a loved one, you may not be able to cope.

If between stressful events your life settles down to a quiet baseline, your system will have a chance to recover and be ready for the next event. However, without a safety net, a chronic load of stress accumulates. This eventually takes a toll on your health because, unless the body has a chance to recuperate, the effects of stress accumulate and build up.

Inescapable exposure to many different stressors simultaneously (e.g. a move, caring for children and home, full-time work) over a period of time (usually months) can lead to a type of exhaustion known as burnout. Some professions tend to be more prone to burnout than others. These include teachers, emergency workers and others. They are faced with daily situations in their work lives that require important decisions and responses on their part. They often receive inadequate pay, inadequate assistance in their jobs, and too many patients, students or incidents on the job.

Stress can deplete the body's will to fight. Chronic illness is an example. Psychological stress is another. Additionally, strenuous, unaccustomed and prolonged physical stress (e.g. running to your max on a treadmill) lasting for days; or chronic physiological stresses (e.g. lack of sleep and food) all deplete the body's reserves. Initially, these chronic stresses keep the body's response switched on, working at its maximum as long as the stress remains. If these extremes persist, however, the response can fail, exhaustion is reached and burn-out results.

Chronic unrelenting stress can change the stress response itself. However, with sufficient rest, persons suffering from burnout can recover.

War is an experience in which all possible stresses combine in the extreme. They continue for prolonged periods and are unrelenting. These stressors include: physical stress; continuing strenuous exercise in harsh environments of extreme heat or cold; threat of unpredictable life-threatening attacks; lack of sleep (3 or 4 hours or less a night for days at a time); lack of food (one meal or less for days); and the psychological stress of life-depending need for peak performance. Many recover from these with minimal effect on their stress responses. However, some do not recover. They continue to suffer hormonal, physical and psychological effects long after peace has returned and they have gone home. Soldiers from all wars have experienced some for of this syndrome. It has been given different names at different times. In the Civil War it was called Da Costa's syndrome; in World War I, Shell Shock; in World War II, Battle Fatigue or "disordered action of the heart"; and Viet Nam and the Gulf War, Post-traumatic Stress Syndrome (PTSD).

This syndrome does not just occur with soldiers. It is also seen in Holocaust survivors, those exposed to traumas resulting from bombs, fires, rape, natural and man-made disasters and other traumatic events and losses. For every individual who is exposed to a traumatic event, there is a different interpretation of its stressfulness.

There is another form of work stress - the demand for rapid-fire decision making - involving frequent, short but high intensity bursts of stress.

For example, consider a job in which you must be constantly vigilant. One second of inattention might result in the death of hundreds of people whose lives depend on your moment to moment judgments. Now, consider that you are working on this job at a small workstation surrounded by dozens of other co-workers, all trying to concentrate on their mission. All around you there is constant movement and distracting noise which you must ignore or lose your concentration. Your job requires lightning quick eye-hand coordination as well as an ability to react and give commands and directions in response to shifts in the tiny blips you see on the screen in front of you. Your job requires perfect performance for hours at a time - sometimes late into the night or in the early dawn. The job is that of an air traffic controller. It is a profession which places the worker under high stress and high pressure on a constant basis. Members of this profession are at risk for high blood pressure, stroke, heart disease, accidents and depression.

In 1983, air traffic controllers went on strike and thousands were laid off. A large percentage of controllers suddenly found themselves out of work. These were men in the prime of their lives, highly trained, heads of households, and skilled in a very specialized profession. They suddenly, and without warning, lost their jobs without any recourse or possibility of returning to their profession. As a result, many experienced clinical depressions during the first year following their lay-off. Others turned to drinking to mask their problems. Most found new and productive jobs and put the strike and depression behind them. Others did not.