• Anxiety, fear, guilt, anger.

  • depression, sadness, irritability.

  • Feeling lost, feeling isolated.

  • worried about others, sense of shock.

  • feeling numb or abandoned.

  • exaggerated startle response.


*indicates need for medical attention

  • Chest pain, difficulty breathing.*

  • Rapid heart rate, rapid breathing.

  • increased blood pressure.

  • dizziness, profuse Sweating.*

  • upset stomach, diarrhea.

  •  feeling uncoordinated.

  • sleep disturbances, headaches.

  • tremors (lips, hands).*


  • Slow thinking, confusion.

  • memory problems.

  • re-living the event (flasbacks).

  • Distressing dreams.

  • Difficulty making decisions or problem solving.

  • difficulty focusing or concentrating.

  • disorientation (place/time).

International Association of Fire Fighters Local 18   /   Vancouver Fire Rescue Services 
Information Email: vancouvercism@gmail.com

this list includes more common symptoms of a stress reaction, but does not detail all cis indicators, if you are concerned about the way you are feeling, speak in confidence to a CISM team peer or professional.

Recognize the signs of stress

Our bodies often react to cis before we're aware of it. here are some common signs and symptons of stress reactions


  • wanting to limit contact with others.

  • substance abuse, increased smoking.

  • vacant stare.

  • Acting out anger (hitting/kicking the wall).

  • Change in appetite.