Critical Incidents - How can it effect you?

You may experience distress following a critical incident, some responses may be intense but are considered normal reactions to an abnormal event, such as:

Cognitive Distress

  • Sensory distortion
  • Inability to concentrate
  • Difficulty in decision making
  • Guilt
  • Preoccupation with event
  • Confusion
  • Inability to understand consequences of behavior

Emotional Distress

  • Anxiety
  • Fear
  • Sadness or grief
  • Guilt or regret
  • Anger
  • Irritability
  • Depression
  • Emotional numbness or detachment
  • Overwhelming helplessness
  • Mood swings

Behavioral Distress

  • Withdrawal from others
  • Increased use of alcohol, nicotine, or caffeine
  • Changes in appetite (overeating or loss of appetite)
  • Restlessness or pacing
  • Avoidance of people, places, or situations related to the incident
  • Increased startle response
  • Sleep disturbance
  • Impulsiveness
  • Risk taking
  • Compensatory sexuality
  • Crying spells

Physical Distress

  • Fatigue or exhaustion
  • Headaches or migraines
  • Gastrointestinal issues (nausea, diarrhea, upset stomach)
  • Muscle tension or body aches
  • Increased heart rate or palpitations
  • Sweating, chills, or dizziness
  • Hyperventilation

Spiritual Distress

  • Questioning faith or beliefs
  • Feeling abandoned by a higher power
  • Loss of sense of meaning or purpose
  • Doubting core moral values
  • Struggling with forgiveness (self or others)

You may however, experience more severe, prolonged, or maladaptive responses that indicate a need for professional intervention, such as:

Cognitive Dysfunction

  • Persistent intrusive thoughts interfering with daily life
  • Severe memory loss or dissociation
  • Persistent diminished problem solving
  • Dissociation
  • Disabling Guilt
  • Delusions
  • Persistent hopelessness and helplessness
  • Hallucinations
  • Paranoia
  • Suicidal /homicidal thoughts or persistent hopelessness
  • Loss of ability to perform routine tasks

Emotional Dysfunction

  • Debilitating depression or apathy
  • PTSD
  • Intense, uncontrolled anger or rage
  • Panic attacks
  • Prolonged, unresolved grief
  • Emotional detachment or inability to feel joy
  • Persistent feelings of worthlessness or self-loathing

Behavioral Dysfunction

  • Self-destructive behaviors (reckless driving, unsafe sex, criminal activity)
  • Substance abuse or dependence
  • Complete social withdrawal or isolation
  • Aggressive or violent outbursts
  • Chronic avoidance behaviors (refusing to work, severe phobias)
  • Persistent hypervigilance leading to paranoia

Physical Dysfunction

  • Chronic fatigue syndrome or severe sleep deprivation
  • Chest pain
  • Seizures
  • Headaches
  • Numbness/paralysis of arms, legs, face
  • Inability to speak or understand speech
  • Cardiovascular problems (hypertension, arrhythmias)
  • Immune system suppression (frequent illnesses)
  • Gastrointestinal disorders (chronic ulcers, IBS)
  • Persistent, unexplained pain or medical symptoms
  • Development of stress-related conditions (fibromyalgia, chronic migraines)

Spiritual Dysfunction

  • Complete loss of faith or extreme religious obsession
  • Feeling permanently forsaken or cursed
  • Deep existential crisis leading to nihilism
  • Self-hatred based on moral or ethical conflicts
  • Inability to reconcile personal beliefs with the incident
  • Suicidal ideation based on loss of purpose

Acute Stress Disorder (ASD) & Post-Traumatic Stress Disorder (PTSD)

If you recently witnessed a critical incident you may find that you have symptoms related to Acute Stress Disorder (ASD); these symptoms last 3 days to 1 month after trauma exposure.

What are the symptoms of ASD and how do I know if I have it? You are considered to have ASD if you have 9 or more of the following:

  • Intrusion Symptoms:
    • Recurrent, involuntary, intrusive and distressing memories of the event
    • Recurrent distressing dreams related to the event
    • Dissociative reactions (flashbacks) where the individual feels the event is reoccurring
    • Intense distress or physiological reactions to trauma cues
  • Negative Mood:
    • Persistent inability to feel positive emotions (happiness, satisfaction, or love)
  • Dissociative Symptoms:
    • Feeling detached from reality
    • Memory gaps related to the trauma (dissociative amnesia)
  • Avoidance Symptoms:
    • Avoiding distressing thoughts, memories, or feelings related to the trauma
    • Avoiding external reminders (people, places, conversations)
  • Arousal Symptoms:
    • Sleep disturbances (insomnia, nightmares)
    • Irritability of aggression
    • Hypervigilance (excessive alertness)
    • Exaggerated startle response
    • Difficulty concentrating

What if I have 9 or more of these symptoms and they last longer than a month?

If these symptoms last longer than a month, you may transition to Post-Traumatic Stress Disorder (PTSD). PTSD occurs after exposure to life-threatening trauma (direct, witnessed, or indirect). The symptoms are grouped into four main clusters:

  • Intrusion Symptoms (Re-experiencing):
    • Recurring distressing memories, distressing dreams, or flashbacks
    • Intense emotional or physical distress when exposed to trauma-related cues
  • Avoidance Symptoms:
    • Avoiding trauma-related thoughts, feelings, people, places, or conversations
  • Negative Alterations in Cognition & Mood:
    • Persistent negative beliefs about self, others, or the world ("I am bad," "The world is dangerous")
    • Distorted blame of self or others for the trauma
    • Diminished interest in activities
    • Persistent fear, guilt, shame, or detachment from others
    • Inability to experience positive emotions
    • Inability to experience positive emotions
  • Arousal & Reactivity Symptoms: 
    • Irritability, angry outbursts, or aggressive behavior
    • Hypervigilance
    • Exaggerated startle response
    • Difficulty concentrating
    • Sleep disturbances

What local resources are available:

  • NAMI Maine (National Alliance on Mental Illness – Maine Chapter):
    • Services: Offers support groups, educational programs, and advocacy for individuals affected by mental illness.
    • Contact: 800-464-5767
    • Website: https://namimaine.org/
  • Maine Department of Health and Human Services – Office of Behavioral Health:
    • Services: Provides a range of mental health services, including crisis intervention, early intervention, residential treatment, and recovery support.
  • 211 Maine:
    • Services: A free, confidential information and referral service available 24/7, connecting individuals to local mental health resources.
    • Contact: Dial 211 or text your ZIP code to 898-211
    • Website: https://211maine.org/mental-health
  • MaineHealth Behavioral Health Services:
  • Sweetser:
    • Services: Provides mental health services for adults and children, including peer support, counseling, and crisis intervention.
    • Website: https://www.sweetser.org/

What national resources are available: 

  • National Institute of Mental Health (NIMH):
    • Services: The lead federal agency for research on mental disorders, offering information on various mental health conditions and treatments.
    • Website: https://www.nimh.nih.gov/
  • Substance Abuse and Mental Health Services Administration (SAMHSA):
    • Services: Provides information on mental health and substance use disorders, and operates the National Helpline for treatment referrals.
    • Contact: 1-800-662-HELP (4357)
    • Website: https://www.samhsa.gov/
  • Mental Health America (MHA):
    • Services: Dedicated to addressing the needs of those living with mental illness and promoting overall mental health.
    • Website: https://mhanational.org/
  • National Alliance on Mental Illness (NAMI):
    • Services: Offers education, support, and advocacy for individuals and families affected by mental illness.
    • Website: https://www.nami.org/
    • National Suicide Prevention Lifeline:
    • Services: Provides 24/7, free, and confidential support for people in distress, as well as prevention and crisis resources.
    • Contact: 988
    • Website: https://suicidepreventionlifeline.org/

In Crisis?

If you or someone you know is experiencing a mental health crisis, these resources are available to provide immediate assistance. Remember, reaching out is a vital step toward getting the support you need.

Maine Mental Health Crisis Lines:

If you have a medical emergency call 9-1-1. 

  • Maine Crisis Line
    • Services: Provides 24/7 crisis support, including connections to local mobile crisis response teams and assistance for non-English speakers and those who are deaf or hard of hearing.
    • Contact: Call or text 988
    • Website: https://heretohelpmaine.com/
  • NAMI Maine Helpline
    • Services: Offers mental health resources, information, and support; not a crisis line but provides guidance during non-crisis situations.
    • Contact: 1-800-464-5767 (Press #1)
    • Website: https://namimaine.org/helplinemaine/

For local community information about resources to help families and individuals meet their needs contact 211 Maine, a free and confidential helpline:

National Mental Health Crisis Lines:

  • 988 Suicide & Crisis Lifeline
    • Services: Offers 24/7 access to trained crisis counselors for individuals experiencing mental health-related distress, including thoughts of suicide, mental health, or substance use crises.
    • Contact: Call or text 988
    • Website: https://988lifeline.org/
  • SAMHSA National Helpline
    • Services: Provides free, confidential, 24/7 treatment referral and information services for individuals facing mental health or substance use disorders.
    • Contact: 1-800-662-HELP (4357)
    • Website: https://www.samhsa.gov/
  • Veterans Crisis Line
    • Services: Offers 24/7 confidential crisis support specifically for veterans and their loved ones.
    • Contact: Dial 988, then press 1
    • Website: https://www.veteranscrisisline.net/
  • Crisis Text Line
    • Services: Provides free, 24/7 support via text messages for individuals in crisis.
    • Contact: Text HOME to 741741
    • Website: https://www.crisistextline.org/