Prolonged Stress

Prolonged Stress Reactions: Tips on Coping

After a traumatic event, you expect that, over time, life will get back to some sort of normal routine. You will get back to work, back to sleep, back to feeling safe and comfortable in your community. However, when an event occurs which is unresolved for many months or even years, you may find that your ‘normal’ routine keeps getting upset. You may find that you can’t settle into a ‘new normal’ way of being. When this happens, you may find that many areas of your life can be disrupted when memories of the trauma are triggered. Thinking about the traumatic event can affect eating, sleeping, health, relationships and work. Most of all, this continuation of the event can disrupt your usual feelings of safety and security. You may experience a heightened sense of anxiety and concern for yourself, your co-workers, and your friends and family members. You may notice being on edge, fearing every small event that reminds you of what happened, and feeling a sense of dread which you can’t explain.

These can be symptoms of ‘anticipatory anxiety’. Anxiety is defined as the ‘subjective state of apprehension and uneasiness.’ Anticipatory anxiety is worry and nervousness about future events which may or may not occur, and which may or may not be negative. We anticipate that we will not be able to control a situation or ourselves. These thoughts and feelings affect people differently, but in general, when we are anxious, we tend to think about the worst possible outcomes, we feel a sense of fear, and our hearts race. The following are some reactions you may have when anxious:

• BODY – headaches, nausea, diarrhea, body temperature changes, sweating, rapid breathing, light headed or dizzy feeling, rapid heartbeat, dry mouth, and fatigue.
• BEHAVIORS – fidgeting, pacing, yelling, rapid speech, increased aggression, road rage, eating more or less, change in sleep pattern, avoidance, and substance abuse
• EMOTIONS – fear, excessive worry, anger, rage, depression, irritability, agitation, and crying
• THOUGHTS – racing thoughts, difficulty concentrating, negative thoughts, catastrophizing, hopelessness, and helplessness.

Usually, the symptoms of anticipatory anxiety build in intensity gradually and decrease quickly after the anxiety-provoking situation is over. One of the many difficulties when there isn’t a clear ‘end’ to a traumatic situation is that you can have a harder time telling yourself that you don’t have to worry anymore.

In addition to the anticipatory anxiety, you may experience some of the prolonged stress reactions. These can include:

• Feeling preoccupied with the incident: feeling like you can’t get it out of your mind
• Having trouble sleeping, or experiencing nightmares about the traumatic event
• Feeling anxious or fearful
• Feeling unusually irritable or angry
• Feeling depressed or low, with unexpected crying bouts
• Feeling helpless or guilty: unrealistically thinking that you should have done something to prevent this event from happening
• Feeling fearful at work
• Feeling the need to reassure family members about your day-to-day safety

The following are some strategies you can use to decrease your own level of reaction.

• Recognize how far you have come. People often feel stuck and don’t realize that they have survived this traumatic event and possibly even thrived in some areas. Even though things aren’t exactly where you want them recognize that your resilience has allowed you to bounce back in most areas of your life.
• Identify what you are grateful for on a daily basis. Consider starting a gratitude journal.
• Focus on what you do have control over – your thoughts, your feelings, your physical activity, your interpersonal interactions…yourself.
• Reach out and connect with friends and family. A sense of community is very healing. This is one of the most important things that you can do.
• Be alert, but not so alert that you become paranoid.
• Act upon what you do have control over: your work, redirecting negative thoughts, your health, taking care of yourself and your family, and continuing on with your daily routines and schedule.
• Be prepared, as recommended by your managers.
• Challenge catastrophic and irrational thoughts: Stay focused on the present. Do not make assumptions about the future or think about “what if’s.” Redirect your thoughts from these fears by using positive affirmations.
• At work, respect everyone’s differences. Some people may want to talk a lot about their concerns. Others may want to be silent.
• Try deep breathing. Practice diaphragmatic breathing by slowly inhaling through the nose allowing your diaphragm to expand and then exhaling even more slowly through your mouth.
• Try some ‘soft’ stress management activities: exercise, play or watch sports, engage in your hobbies.
• Use positive images to form a private sanctuary, a safe place to retreat to for quick “mini-stress breaks”. Repeat a short phrase, prayer, or mantra while you are there. 
• Express your feelings. 
• Discuss your concerns with your manager and/or Human Resources. 
• Keep your usual routines. 
• Monitor how much you expose yourself to news/weather updates. It’s okay to turn off the radio/tv and social media, and just keep up-to-date without having a minute to minute update

If you feel you are having difficulty managing your anxiety or depression, it’s important to seek support. Consider contacting your EAP for help. The EAP has counselors that can speak to you 24/7 and set you up to see a counselor face to face in your area.

Suggested Reading: I Can’t Get Over It: A Handbook for Trauma Survivors, 2nd Edition, by Aphrodite Matsakis.(New Harbinger Publications, 1996)