Stress in emergencies: what happens in body and mind

As soon as the brain recognises a threat, the body releases stress hormones such as adrenaline and cortisol. They make energy available quickly: the heart pumps harder, breathing speeds up, blood flows more strongly to the large muscles. At the same time, everything not needed for survival in that moment is turned down – digestion, for example. That is why your stomach often feels queasy when you are afraid and your mouth goes dry.

Perception changes too. Attention locks onto the danger and your view narrows as if through a tube – this is called tunnel vision. Sounds at the edges go unheard, time seems to race or stand still. Later, memories of parts of the event are sometimes missing. This is not a memory defect but a result of the brain processing only what matters most.

This reaction is very old and made for physical dangers: running away, holding on, fighting. It fits poorly with modern emergencies, in which you are more likely to have to give an address, read a map or put on a bandage. Exactly those tasks need steady hands and an overview – and exactly that is what the alarm response makes difficult.

In the body: a pounding heart, fast breathing, trembling, sweating, weak knees, nausea, a dry mouth. People who breathe very fast sometimes get tingling in their hands or around their lips. It is unpleasant, but often simply comes from the hurried breathing – breathing out slowly then helps many people.

In your thinking: you cling stubbornly to the first plan, find it hard to weigh up options, or forget very simple things such as your own address during an emergency call. Some people talk and act very fast, others go quiet and hardly respond. Someone who freezes is not indifferent – their brain is simply overloaded.

After the event, further reactions often follow: exhaustion, crying, trembling, irritability, poor sleep or images that keep coming back. These reactions are common after extraordinary events and become weaker with time for many people. Important: someone who seems calm is not automatically unaffected. Feel free to ask how they are doing.

You cannot simply switch the alarm off, but you can work against it. The simplest way is a short, deliberate pause with slow breathing out. After that it helps to do just one task after another and to say aloud what you are doing (“I am calling now”). Speaking puts your thoughts in order.

What helps most, though, is preparation. Routines you have practised many times work almost by themselves under stress – just as you tie your shoes without thinking. That is why checklists, a family plan agreed in advance, a list of important numbers and practised skills are so valuable. They take work off the overloaded mind.

Involve others. With two people it is easier to keep an overview: one makes the call, the other takes care of things. And if you know that trembling, a pounding heart and chaotic thoughts are normal reactions, you are less shocked by yourself – that alone takes off some of the pressure.

Not every racing heart is stress. Chest pain, severe breathlessness, numbness, sudden weakness or confusion can also have physical causes that need quick treatment. When in doubt: better to call the emergency number (112 in the EU) once too often than to dismiss a serious illness as “just panic”. This applies to you and to others.

Stress reactions in the days after an event are common. But if they last for weeks, get stronger or clearly restrict daily life – for example because someone hardly sleeps, can no longer work or withdraws completely – professional help makes sense. A family doctor or a local counselling service is a good first point of contact.

Immediate help is needed by anyone who is thinking of harming themselves, endangering others or losing control completely. Then call the local emergency number (112 in the EU) or a local crisis line or helpline and do not leave the person alone. This text does not replace a diagnosis or treatment.

People react very differently. Whether someone reacts strongly or mildly depends on many things: previous experiences, tiredness and hunger, whether they are responsible for others – children, for example – and the type of event. So there is no “right” amount of fear.

A common misconception is that people in disasters typically fall into wild mass panic. Guides and experience from many emergencies rather show that most people behave helpfully and sensibly. Stress does not make you lose your head; it just makes thinking narrower and slower.

Survival manuals such as the US Army's (FM 3-05.70) and psychological first-aid guides describe stress as a normal reaction that can even be useful: it makes you alert and gives you strength. What matters is recognising it and meeting it with simple routines instead of being ashamed of it.