Use the experience to change your 

life in positive ways—Few of us get 

the opportunity and privilege of 

serving and being with individuals 

and communities in the hours of 

their greatest need. It is indeed 

a privilege. With that privilege 

comes responsibilities. One is the 

responsibility to be as well prepared 

as possible to be optimally helpful. 

If there is the potential for being 

deployed again, take all opportunities 

available to become as prepared 

as possible. 

There is also a responsibility to use 

this unique experience as a way of 

honoring and bearing witness to 

the loss and suffering of others, 

to use the experience to positively 

influence our lives. Are our priorities 

and values what they should be? Are 

we as prepared for adversity as we 

should be? Do we value our family, 

friends, and colleagues as we should? 

When we see others whose lives 

have been turned upside down, lives 

prematurely ended, and lives forever 

changed through loss, we are well 

served by reassessing our own values 

and priorities.

NMH05-0219

Getting Help

If you feel you need additional information, you may find this list of 

resources to be helpful.

SAMHSA Resources

Information Clearinghouses

SAMHSA’s Health Information 

Network (SHIN)

P.O.Box 2345

Rockville, MD 20847-2345

Email: SHIN@samhsa.hhs.gov 

(877) SAMHSA-7 or (877) 726-4727 

(800) 487-4889 (TTY)

(240) 221-4292 (FAX)

www.samhsa.gov/shin

Disaster Technical Assistance 

Center (DTAC) 

www.mentalhealth.samhsa.gov/dtac

Treatment Locators

Mental Health Services Locator

(800) 789-2647 (English and Español)

(866) 889-2647 (TDD)

www.mentalhealth.samhsa.gov/databases

Substance Abuse Treatment 

Facility Locator

(800) 662-HELP (4357) (Toll-Free, 

24-Hour English and Español Treatment

Referral Service)

(800) 487-4889 (TDD)

www.findtreatment.samhsa.gov

Hotlines

National Suicide Prevention Lifeline

(800) 273-TALK (8255)

(800) 799-4889 (TDD)

SuicidePreventionLifeline.org

Other Federal Resources

Centers for Disease Control and 

Prevention—Mental Health

www.bt.cdc.gov/mentalhealth/

Federal Occupational Health 

Employee Assistance Program for 

Federal and Federalized Employees

http://www.foh4you.com or 

(800) 222-0364

(888) 262-7848 (TTY)

National Center for Post-Traumatic 

Stress Disorder (PTSD) 

www.ptsd.va.gov/

U.S. Department of Health and 

Human Services—Employee 

Assistance Program

(202) 690-8229 

HHSEAP@hhs.gov
·

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

www.samhsa.gov

A Post-Deployment

 Guide for 

Emergency and Disaster Response Workers

Returning Home After Disaster Relief Work
Before Returning to Work

During your disaster response and 

recovery efforts, you most likely worked 

under less than desirable conditions 

while taking care of others. Before you 

return to your normal duties, you will 

want to take care of yourself by making 

sure that all your basic needs are met. 

These include the following:

•	 Maintaining a healthy diet, routine

exercise, adequate rest/sleep 

•	 Spending time with family 

and friends

•	 Paying attention to health concerns

•	 Meeting neglected daily personal 

tasks (e.g., pay bills, mow lawn, 

shop for groceries)

•	 Reflecting upon what the 

experience has meant personally 

and professionally

•	 Getting involved in personal and 

family preparedness.

Signs of Stress

The following is a list that you may 

find helpful in identifying signs of 

stress in yourself or others who have 

had experiences similar to yours:

•	 Anxiety, fear

•	 Grief, guilt, self-doubt, sadness

•	 Irritability, anger, resentment, 

increased conflicts with 

friends/family

•	 Increased use of alcohol or 

other drugs

•	 Feeling overwhelmed, hopeless, 

despair, depressed

•	 Anticipation of harm to self 

or others; isolation or social 

withdrawal

•	 Insomnia

•	 Gait change

•	 Hyper-vigilance; startle reactions

•	 Crying easily

•	 Gallows/morbid humor

•	 Ritualistic behavior

•	 Memory loss, anomia (i.e., difficulty

naming objects or people)

•	 Calculation difficulties; 

decisionmaking difficulties

•	 Confusion in general and/or 

confusing trivial with major issues

•	 Concentration problems/

distractibility

•	 Reduced attention span and/or 

preoccupation with disaster

•	 Recurring dreams or nightmares

•	 Fatigue

•	 Nausea

•	 Fine motor tremors

•	 Tics or muscle twitches

•	 Paresthesia (e.g., numbness and 

tingling in extremities)

•	 Profuse sweating

•	 Dizziness

•	 Stomach or gastrointestinal upset

•	 Heart Palpitations/fluttering

•	 Choking or smothering sensation

•	 Intrusive thoughts

•	 Relationship problems

•	 Job/school-related problems

•	 Decreased libido/sexual interest

•	 Appetite change

•	 Overly critical, blaming

•	 Decreased immune response.

Expecting the Unexpected

Upon returning to your routine 

duties, you may notice changes in 

yourself, your coworkers, or your 

work environment. The following are 

a few examples of potential difficulties 

you may face and some tips on how 

to overcome them.

Pace change—The disaster 

environment often moves at a pace 

that is much faster than the normal 

workplace. After working in a disaster 

response environment, this begins 

to feel normal. When returning to 

normal work, it may appear that 

people are moving at a much slower 

pace than you remember. It is easy to 

misinterpret this as laziness or lack of 

caring or motivation. Remember that 

it is probably you who has changed, 

not them. Be slow to judge, criticize, 

or make assumptions.

Unrelenting fatigue—Even with 

what seems like sufficient sleep, you 

may experience chronic fatigue. This 

may be a result of several factors. You 

may need more rest than you realize. 

Whether your disaster relief assignment took you to the front lines or behind the scenes, you have made an

enormous contribution to our fellow Americans. You have faced difficult challenges to help people in a time

of extraordinary need. You have experienced rare and rewarding opportunities that have proven to be uniquely

stressful. The effects of that stress can cause difficulties as you reenter the workplace. This brochure contains 

useful information to ease your transition and enhance your return to your usual work routine.
Sometimes chronic stress results in 

never feeling rested. Chronic fatigue 

may also be a result of a medical 

condition. See a doctor if chronic 

fatigue persists.

Cynicism—Typically, during disaster 

work you see the best and the worst in 

individuals and systems and it is easy 

to become cynical. This is expected. 

These feelings often diminish over 

time once you are able to focus on the 

positive results of your work.

Dissatisfaction with routine work—

It is very rewarding to be involved, 

directly or indirectly, in saving lives 

and protecting our fellow citizen’s 

health and safety. Most work does 

not provide such dramatic and 

immediate reinforcement. You might 

start seeing your daily work routine 

as lacking meaning and satisfaction. 

These feelings are normal. To counter 

these feelings, incorporate the positive 

things you have learned during disaster 

response into your personal and 

professional life.

Easily evoked emotions—Sometimes 

the combination of intense 

experiences, fatigue, and/or stress 

leaves you especially vulnerable to 

unexpected emotions. For example, 

you may cry easily, be quick to anger, 

or experience dramatic mood swings. 

These are normal reactions that 

typically subside over time. In the 

meantime, be aware of your reactions, 

discuss your experiences, and be 

sensitive of comments that might be 

hurtful or upsetting to others.

Relating your experiences—While you 

may want to share your experiences 

with others, you may be unsure if it is 

appropriate. This is normal. Exercise 

care when discussing your disaster 

relief experiences, especially graphic 

and disturbing topics while in the 

presence of children or others who are 

emotionally vulnerable.

Difficulties with colleagues and 

supervisors—You may not experience 

a welcome back from your colleagues 

and supervisors that meets your 

expectations. Coworkers may resent 

having to assume additional workloads, 

may not understand the difficulty of 

the work you did, or may resent the 

recognition that you are receiving as a 

responder. In response to any negative 

feelings, express appreciation for their 

support during your deployment and 

take care in relating your experiences.

Cultural issues—Culture affects how 

an individual reacts to trauma. For 

example, showing emotion, discussing 

problems with others, or touching is 

acceptable with some groups and 

not with others. On the basis of this 

understanding, it is important to

appreciate and respect these differences.

When to Seek Help

Remember, stress is a normal reaction 

to abnormal situations like disasters. 

If you experience the following signs 

of persistent or severe stress, seek 

help from a licensed mental health 

professional.

•	 Disorientation (e.g., dazed, 

memory loss, unable to give date/

time or recall recent events)

•	 Depression (e.g., pervasive feeling 

of hopelessness and despair, 

withdrawal from others)

•	 Anxiety (e.g., constantly on edge, 

restless, obsessive fear of another 

disaster)

•	 Acute psychiatric symptoms (e.g., 

hearing voices, seeing visions, 

delusional thinking)

•	 Inability to care for self (e.g., not 

eating, bathing, changing clothing, 

or handling daily life)

•	 Suicidal or homicidal thoughts 

or plans

•	 Problematic use of alcohol or drugs

•	 Domestic violence, child abuse, or 

elder abuse

Sometimes it may be difficult to 

determine if what you are experiencing 

is a result of a physical illness or stress 

(or both). In some disaster situations, 

workers may have been exposed to 

infectious disease and/or environmental

exposure that may result in signs and 

symptoms similar to stress. When in 

doubt, get an evaluation from a health 

care professional.

Coping Suggestions

Find ways to use your disaster 

experience to better understand 

yourself—You have had an experience/

opportunity that not many people 

have had. During that experience you 

undoubtedly learned things about 

yourself. What stresses you most? 

What were you able to handle in 

ways that surprised yourself? What 

unrecognized skills/talents did 

you discover? What did you learn 

about how you function in extreme 

environments? Use the experience to 

better understand yourself.

Find ways to use disaster experience 

to enhance your job function—Your 

normal job role probably does not 

involve disaster response. What skills/

knowledge did you bring from your 

normal role that was helpful? What 

skills/knowledge/perspective did you 

gain from the disaster deployment that 

can enhance your normal job function? 

Did your experience point you in 

directions in which you would like 

to move professionally or make you 

cognizant of assignments you would 

like to seek or avoid?