Stress response

Emergencies (ES) from both the social and biological points of view represent a disruption of stability and integrity of the individual-macro- and microsocial environment system. Whether a particular event will become an ES and how severe its consequences will be depends on many factors. The most important of them is the strength of the stressor. Genetic predisposition plays a significant role in the individual's response to ES. Age is also considered a significant factor influencing the ability to withstand stress. It is believed that only a small proportion of children (10%) have a low level of CNS reactivity, while the rest, on the contrary, are distinguished by high reactivity, so the reaction to stress will be different for each individual. Premorbidity also affects the occurrence of mental disorders. Previous trauma plays a special role.

Whether a real emergency situation will become a stress factor (stressor) depends on various reasons: the factor of suddenness or expected occurrence of an emergency situation is of great importance. An unexpected emergency situation leads to significant losses, while an expected emergency situation makes it possible to reduce human losses and material damage to a minimum.

It should be emphasized that the primary role in the occurrence of mental disorders is played not by the emergency itself (the degree of real threat), but by how the individual perceives it. Sometimes the reaction to stress can be unfounded (for example, the "shaking" on an airplane), but despite this, it has an extremely strong impact.

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How does acute stress reaction manifest itself?

As a rule, a person responds to the occurrence of a particular situation, familiar or predictable to some extent, with a holistic reaction to stress - consistent actions that ultimately form behavior. This reaction to stress is a complex combination of phylogenetic and ontogenetic patterns that are based on the instincts of self-preservation, reproduction, mental and physical personality traits, the individual's idea of his own (desired and real) standard of behavior, the ideas of the microsocial environment about the standards of behavior of an individual in a particular situation and the foundations of society.

In a life-threatening event, the immediate reaction to stress is primarily determined by instincts (preservation, procreation) and personality traits (mental and physical). The idea of the real and desired standard of behavior, taking into account the microsocial environment, begins to be taken into account at later stages of emergency response.

Mental disorders, which most often occur immediately after an emergency, form an acute reaction to stress. There are two possible variants of such a reaction.

Most often, the reaction to stress is acute psychomotor agitation, manifested by unnecessary, rapid, sometimes purposeless movements. The facial expressions and gestures of the victim become excessively lively. There is a narrowing of the attention span, manifested by difficulty in maintaining a large number of ideas in the circle of voluntary purposeful activity and the ability to operate with them. Difficulty in concentrating (selective) attention is detected: patients are very easily distracted and cannot help but pay attention to various (especially sound) interference, and have difficulty perceiving explanations. In addition, there are difficulties in reproducing information received in the post-stress period, which is most likely associated with a violation of short-term (intermediate, buffer) memory. The rate of speech accelerates, the voice becomes loud, poorly modulated; it seems that the victims are constantly speaking in a raised voice. The same phrases are often repeated, sometimes the speech begins to take on the character of a monologue. Judgments are superficial, sometimes devoid of semantic meaning.

For victims with acute psychomotor agitation, it is difficult to remain in one position: they lie down, then stand up, then move aimlessly. Tachycardia is observed, there is an increase in blood pressure, not accompanied by a deterioration in the condition or headache, facial flushing, excessive sweating, and sometimes feelings of thirst and hunger appear. At the same time, polyuria and increased frequency of bowel movements may be detected.

The extreme expression of this variant is when a person quickly leaves the scene of the incident, without taking into account the situation that has arisen. There are cases when during an earthquake people jumped out of the windows of upper floors of buildings and crashed to their deaths, when parents first of all saved themselves and forgot about their children (fathers). All these actions were caused by the instinct of self-preservation.

In the second type of acute stress reaction, there is a sharp slowdown in mental and motor activity. At the same time, derealization disorders occur, manifested in a feeling of alienation from the real world. Surrounding objects begin to be perceived as changed, unnatural, and in some cases - as unreal, "lifeless". A change in the perception of sound signals is also likely: people's voices and other sounds lose their characteristics (individuality, specificity, "juiciness"). There are also sensations of an altered distance between various surrounding objects (objects located at a closer distance are perceived as larger than they actually are) - metamorphopsia.

Typically, victims with this type of acute stress reaction sit for a long time in the same position (after an earthquake near their destroyed home) and do not react to anything. Sometimes their attention is completely absorbed by unnecessary or completely unusable things, i.e. hyperprosexia occurs, which is outwardly manifested by absent-mindedness and seeming ignorance of important external stimuli. People do not seek help, do not actively express complaints during conversation, speak in a quiet, poorly modulated voice and, in general, give the impression of being devastated, emotionally emasculated. Blood pressure is rarely elevated, the feelings of thirst and hunger are dulled.

In severe cases, psychogenic stupor develops: the person lies with closed eyes, does not react to the surroundings. All reactions to stress of the body are slowed down, the pupil sluggishly reacts to light. Breathing slows down, becomes silent, shallow. The body seems to try to protect itself from reality as much as possible.

An acute reaction to stress is primarily determined by the instinct of self-preservation, and in women, in some cases, the instinct of procreation comes to the fore (i.e., a woman first seeks to save her helpless children).

It should be noted that immediately after a person has experienced a threat to their own safety or the safety of their loved ones, in some cases they begin to consume large amounts of food and water. Increased physiological needs (urination, defecation) are noted. The need for intimacy (solitude) when performing physiological acts disappears. In addition, immediately after the emergency (in the so-called isolation phase), the "right of the strong" begins to operate in the relationships between the victims, i.e. a change in the morality of the microsocial environment begins (moral deprivation).