What are possible responses to trauma events?
Potentially traumatic events can affect emergency service professionals in diverse physical, mental, and emotional ways. While the initial instinct is to automatically equate a trauma event to the development of PTSD, this is not always the case.
Some emotional distress following a traumatic event or critical incident is a normal reaction to an experience that is abnormal (at least for most people), and is not indicative of the development of a mental health diagnosis/disorder. Typically, following a traumatic event, one would expect to experience a range of reactions, which could include anxiety, arousal caused by adrenaline, fatigue, irritability, hypervigilance, increased emotionality, problems sleeping, bad dreams, exaggerated startle response, change in appetite, feeling overwhelmed, impatience, and/or withdrawing from family and friends.
Signs or indicators of a more potentially concerning response occur when physiological, emotional, cognitive and/or behavioral changes persist for longer than four weeks, cause unmanageable levels of distress (including depression, anxiety, or suicidal thoughts), or have a significant negative impact on important areas of functioning (i.e. work, school, family, relationships). If months have passed since a particular critical incident or traumatic event and an individual is still experiencing significant distress, a more chronic or potentially serious stress reaction may be the reason. It is important to watch for red flags of more serious problems such as significant changes in family, work, or school patterns, persistent sadness, ongoing sleep disturbance, persistent and/or increasing irritability, or ongoing increase in the use of alcohol or other addictive substances.
Not all symptoms of distress that occurs in individuals exposed to an extreme stressor should necessarily be attributed to PTSD. There are a variety of other outcomes that could arise that do not get mentioned or discussed as often.
Each of these responses, as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are introduced here: