The most commonly reported reactions after a critical incident include:
- Anxiety about being involved in a similar event
- Fear for the safety of yourself or loved ones
- Preoccupation about the stressful event
- Avoidance of situations or thoughts that remind you of the incident
- Flashbacks where you mentally re-experience the event
- Physical symptoms: muscle tension, fatigue, headaches, nausea, bowel problems
- Decreased interest in usual activities, including sex and appetite
- Feelings of sad or loneliness
- Disbelief at what has happened; feeling numb, unreal, isolated, or detached from other people
- Insomnia, frequent awakening, disturbing dreams or nightmares
- Increased startle response
- Problems with concentration, or memory (especially aspects of the traumatic event)
- A misperception of time
- Guilt and/or self-doubt related to the traumatic event
- Anger or irritability at what has happened; at the senselessness of it all
What to do after experiencing critical incident stress
Immediately after the event:
- Make sure you are with people. Don't go home to an empty house.
- Talk about the incident with others. Discuss your feelings and reactions
- Remind yourself that the event is over and that you are now safe.
- If possible, get some physical exercise to burn off some of your tension and anxiety.
- Restrict caffeine and other stimulants.
- Try to eat something, even if you do not feel like eating.
- Avoid alcohol, other CNS depressants, and sleeping pills
- If you cannot sleep, get up and do something until you are tired, and then try again.
How to handle the next few days:
- Do not be afraid of your feelings.
- Remind yourself that your reactions are a normal result of trauma and will pass in time.
- Try to get back into your normal routine as soon as possible; you may need to gradually introduce yourself to tasks that seem difficult.
- If you feel uncomfortable, scared or anxious, take some deep breaths and remind yourself that you are safe.
- Be kind and patient with yourself; engage in enjoyable and relaxing activities.
- Continue to talk to your family, friends and colleagues about the trauma.
- Even if you feel a bit distant from other people, do not reject genuine support.
- Work on your general stress levels; make sure that you have adequate sleep, a good diet and regular exercise.
- Practice relaxation techniques to help reduce nervous tension and insomnia.
- Remember that accidents are more common after severe stress; be more cautious in your activities.
- Allow yourself time to deal with the memories. There may be some aspects of the experience that will be difficult, if not impossible, to forget.
- If your reaction(s) continues to seriously disrupt your life, seek appropriate help.
Many law enforcement agencies have established peer support programs to assist officers with critical incident stress. Peer support officers can be extremely helpful, especially as sounding boards. Appropriately trained officers can also offer support, empathy and concern, recognize acute problems, and make appropriate referrals.
Critical incident stress and the department
After any major critical incident your department may compel or strongly encourage you to have a physical exam, be evaluated by a psychiatric clinician, or both. These are excellent ideas. This will allow you a chance to ask questions and to learn more about what is happening to you, what to expect, and what you can do to help yourself cope and reduce your symptoms. If your symptoms are acute you will be given referrals for treatment. You may be placed on routine administrative leave, depending on the incident. Use the time off productively. If you are under too much stress to return to work right away, request some time off.