Mental Health Zone | Introduction
What is a crisis (traumatic) event?
A crisis (traumatic) event is a sudden or rare event that has an extremely disturbing effect on most people who were present at the event. It involves the potential or actual loss of persons, things, or values important to an individual or group, and it causes suffering to almost everyone who experiences it, regardless of how mentally and physically strong and healthy someone was before such an event. Affected persons usually cannot prevent, avoid, or overcome a crisis event alone with the knowledge and skills they use in solving other stressful situations and life problems.
Crisis events are events that can affect individuals (for example, kidnapping, rape, traffic accident) and events that can affect groups or communities (for example, armed robbery, natural disasters, refugee crisis, war, terrorist attacks, pandemics).
What is a psychological crisis?
A psychological crisis is a condition caused by a crisis event and can be seen through reactions that can occur during or immediately afther the event itself, but also through delayed reactions to that event.
A psychological crisis can be recognized by these signs:
- feeling of loss of control
- feeling distracted and confused
- emotional overwhelm
- a feeling of agitation and interruption of the person’s usual way of functioning
- a strong feeling of vulnerability
Crisis situations can also strongly and suddenly affect our core beliefs about:
- Safety of the world, ourselves and people close to us
- Trust in other people and society, especially if the crisis event occurred as a result of human action
- Control over what happens in our life
- Self-worth in terms of a damaged self-image, feelings of helplessness, and sometimes guilt and shame felt by survivors
- Intimacy in terms of feeling that other people do not understand us, feeling alienated from others and reduced trust towards people
People can react very differently to the same crisis event, but in the days and weeks after the traumatic event, most people experience different stress and trauma reactions. Stress and traumatic reactions usually appear immediately after the event, but delayed traumatic reactions can also occur. Delayed traumatic reactions can sometimes be caused by an event that reminds a person of the original traumatic event.
In many cases, the psychological state of crisis disappears with a restored sense of security, reestablishment of routine and community support. However, for some of us, due to being unable to continue the life we are used to, previous life experiences or the absence of necessary support, the state of crisis can be prolonged, and sometimes it can even result in serious consequences for our physical and mental health.
Most people experience at least one crisis (traumatic) event during their life, many of us even more. Therefore, this platform was developed with the intention of providing you with necessary information, encouragement, and support on your road to recovery.
IMPORTANT TO KNOW!
Reactions to traumatic events are:
- extremely unpleasant
- characteristic of almost all people who have lived through a traumatic experience
- are not a sign of weakness or a sign that something is wrong with you
- they can last for weeks, but also for several months
- they can appear immediately after a traumatic experience, but also months (sometimes even years) later
They are all normal reactions to abnormal circumstances that have happened to you.
When to seek for professional help?
In dealing with different reactions to traumatic stress, almost all of us can benefit from the support of a mental health specialist (psychologist or psychotherapist), and some of us may also need additional support in the form of taking special medications for easier recovery that can be prescribed by a doctor, a specialist in psychiatry. When we have a health problem, we will usually seek the help of a doctor. When we have a toothache, we will visit the dentist. However, some people may hold back from seeking support of a mental health professional because they fear that such help may imply that they are weak, mentally ill (“crazy”) or that other people will judge them for it. Overcoming the embarrassment of asking for support when we are struggling is a characteristic of courageous, self-aware, and independent people who have a healthy capacity to care for themselves and the people they care about.
It is also important to know that most people who seek the support of a mental health professional are not mentally ill, and that contacting a mental health professional implies confidentiality, so it is up to you to decide whether you want to share the information that you have sought help with anyone.
Below is a table of common reactions to traumatic stress and reactions that indicate a possible need for the support of a mental health professional.
Common reactions to traumatic stress
- Difficulties in concentration, recall and memory
- Difficulties in making decisions
- Confusion
- Too many thoughts at once
- Frequent thinking about the event, recalling images and sounds related to the event without being able to control it
- Impossibility of objectively looking at the situation
- Distorted perception of time
- The experience of a lack of meaning
- Loss of interest
- Blaming yourself
- Nightmares
When to ask for professional help?
- Suicidal thoughts and ideas
- Thoughts and plans to hurt someone else
- Disorientation (lost in time and space)
- Uncontrollable images of the traumatic event that make it feel like it’s happening again
- Frequent nightmares
- Hallucinations (e.g. we see or hear things that other people cannot see or hear)
- Delusions (we believe in something that is objectively not true, e.g. we think that someone is persecuting us, that we have special powers…)
- Paranoia (for example, we have ideas that someone wants to harm us, but it is not realistic)
- Inability to make simple decisions
Common reactions to traumatic stress
- Shock, we can’t believe what happened
- Feeling of emptiness, “dullness“
- Absence of mind (our thoughts are somewhere else, not in the present)
- Freeze response
- A feeling of alienation and isolation from others
- Guilt, shame, self-doubt
- Anxiety
- Not feeling safe
- A feeling of powerlessness, hopelessness and helplessness
- Restlessness
- Irritability, anger
- Mood swings
- Sadness, crying
- A sense of exhilaration as a result of surviving
When to ask for professional help?
- Panic attacks
- Frequent repetition of emotional reactions that are not usual in the situation we are in (e.g. hysterical laughter)
- A strong and persistent feeling of guilt or shame
- Extremely intense and overwhelming emotions (too many strong emotions at once)
- A long-lasting feeling of emotional emptiness (“dullness”)
- Persistent and strong feelings of despair, hopelessness and/or helplessness
Common reactions to traumatic stress
- Communication problems with other people
- Reduced activity and productivity
- Outbursts of anger, frequent conflicts with others
- Hyperactivity (excessive activity, with a lot of energy)
- Sleep problems
- Being easily startled or frightened
- Extreme fatigue
- Family conflicts
- Crying
- Withdrawal or complete isolation from others
- Abuse of alcohol, cigarettes, drugs
- Strong fear of loneliness and fear of separation from close people
- Inability to perform daily tasks that we used to do without difficulties
When to ask for professional help?
- Inability to take care of yourself and carry out daily activities
- Reactions that endanger your safety and/or safety of other people
- High level of hyperactivity (excessive activity, with a lot of energy)
- Physical immobility
- Muteness
- Repetitive behaviors that are characteristic of a younger age (for example “swaying”)
- Inappropriate anger
- Violence and serious threats
- Loss of control
- Uncontrollable and repetitive prolonged crying
- Engaging in high-risk activities (which can harm us and others)
- Self-destructive and antisocial behaviors (harming oneself or other people)
- Frequent accidents / accidental injuries
- Signs of addiction to psychoactive substances
Common reactions to traumatic stress
- Rapid pulse rate
- Headache, neck and back pain, dizziness, feeling weak, trembling, difficulties in breathing, tightness and suffocation in the throat and lungs, chest pressure
- Lump-in-throat feeling
- Extremely strong reactions to sudden stimuli
- Changes in appetite
- Muscle pain, muscle tension
- Abdominal pain and digestive problems
- Disturbed appetite, nausea, diarrhea, stomach pains
- Exhaustion, sleep disorders
- Night sweats
- Agitation
- Aggravation of already existing health problems
- Menstrual cycle disorders
- Changes in sexual desire and behavior
When to ask for professional help?
- Breathing difficulties
- Hiperventilation
- Irregular pulse or chest pain
- Dizziness
- Sudden weakness or stiffness
- Speech or comprehension difficulties
- Thunderclap headaches
- Loss of consciousness
- Prolonged vomiting or diarrhea
Common reactions to traumatic stress
- Anger towards God
- Stronger faith
- Newfound faith
- Withdrawal from religious communities
- Superstition
When to ask for professional help?
- A crisis of faith with strong reactions
- Loss of faith (for people for whom faith was previously very important)
- Obsessive religious thoughts (occurring against our will)
- Compulsive practice of religion (for example, praying and performing religious rituals to the extent that it interferes with other daily activities)
- Religious-themed hallucinations or delusions
If you recognize the difficulties marked in red, we strongly advise you to contact a mental health specialist in order to get necessary support for finding ways to cope easier with the difficulties you are facing. Contact psychologists, psychotherapists, your doctor or staff from organizations that are active in your community to provide you with support or refer you to a professional who can provide it.
IMPORTANT!
If you notice that you are feeling so overwhelmed that you are thinking about harming yourself or someone else, it is important that you seek help without delay. If you do not have access to a mental health specialist or a doctor who can refer you, you can seek help by visiting the nearest emergency medical service.
Panic attacks
Panic attacks are experiences of intense fear or/and anxiety, usually with a strong physical reaction (where there is no real danger around).
Some typical symptoms are rapid heartbeat, shaking, difficulties with breathing and dizziness.
Panic attacks can last for 5-20 minutes.
Here are some tips to help you cope:
Breathing:
We know it is hard, but it helps to calm your nervous system down.
Put one hand on your stomach and inhale slowly through your nose and exhale through your mouth at least 10 times.
Remind yourself that:
‘’Even though this is not pleasant, it will not kill me and I will not go crazy.’’
‘’The feeling that I am in danger is just one of the symptoms of a panic attack.”
‘’Panic attacks are here now, but they will go away, I just have to be patient.’’
‘’This too will pass – as it always does.’’
Stimulate your senses:
It can be helpful to stay in the present moment and calm down.
For example, you can touch some objects, listen to the noises around you, drink a glass of water, take a short walk…
Acknowledge what is happening:
Tell yourself you are having a panic attack. Acknowledging that you are having a panic attack and that you can go through it will calm you down.
Do not fight it:
It may seem counterintuitive, but one of the most effective ways to react to a panic attack is to ride it out instead of resisting. It is like a wave that comes and goes on its own.
References
Pregrad, J. (1996). Stres, trauma, oporavak. Zagreb: Društvo za psihološku pomoć
https://dpp.hr/wp-content/uploads/2020/07/Stres_Trauma_Oporavak-min.pdf
WHO (2011) Psychological first aid: Guide for field workers https://www.who.int/publications/i/item/9789241548205
Médecins du Monde Belgique (2016). Psihološka prva pomoć.
Heath, A., Mashuga, H. & Arens, A. (2015). Effects of a Conscious Breathing Intervention on Emotion and Energy Flow: https://sophia.stkate.edu/ma_
Walker, M. (2018). Why we sleep. Penguin Books.
https://www.webmd.com/balance/what-is-box-breathing
https://caps.arizona.edu/grounding#senses
https://blissfulkids.com/mindfulness-exercises-for-kids-teddy-bear-belly-breathing/
https://au.reachout.com/articles/how-to-challenge-negative-thoughts
https://www.getselfhelp.co.uk/docs/SafePlace.pdf
