Disaster Mental Health

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February 12, 2007 at 4:53 pm  •  Posted in Anxiety by  •  0 Comments

By John D. Weaver, MSW, LCSW, BCD, ACSW, CBHE
 

Introduction
Typical Reactions to Disaster
Recovery

 

People are always changed by disasters and other traumatic
life events, but they need not be damaged by them.

Introduction

Tropical storms, tornadoes, fires, floods, earthquakes, transportation accidents, mass murders, hazardous material spills, building collapses, nuclear plant malfunctions, terrorist bombings, and many other disasters occur throughout our country each year. In the wake of these events lies a wide path of catastrophic physical and emotional destruction. Many seriously traumatized people can be found there, struggling to recover from their losses and rebuild their lives.

Once a disaster occurs, folks look at a lot of things in a different way than they did before. Prior to the event, people have an order to their lives and they feel like they are in command. In the days and weeks following the disaster, they often feel they no longer have control over anything – the event has caused unexpected losses and has taken away their normal routines. They will find themselves awash in a sea of paperwork and bureaucracy (relief agencies and services, insurance claims, etc.) that many refer to as the second disaster. They soon begin to realize it will be some time before they will regain their former sense of stability and control. Faced with so many changes, people begin to react with fear, anger, anxiety, and depression – all normal stress reactions under the circumstances. Victims will expect themselves to “get over it” and to feel better quickly. When they don’t, they suddenly begin to fear they’re weak or they’re going crazy.

Typical Reactions to Disasters

These are the common feelings and reactions that most victims will express and/or display: basic survival concerns; grief over loss of loved ones and/or prized possessions; separation anxiety and fears for safety of significant others; regressive behavior (e.g., thumb sucking in children); relocation and isolation anxieties; need to express thoughts/feelings about experiencing the disaster; need to feel one is part of the community and rebuilding efforts; altruism and the desire to help others cope and rebuild.

Disasters often cause behavioral changes and regression in children. Many react with fear and show clear signs of anxiety about recurrence of the disaster event(s). Sleep disturbances are very common among children (and adults) and can best be handled by quickly returning to (or establishing) a familiar bedtime routine. Inability to do this often proves to be a major problem following major earthquakes, as frequent aftershocks and displaced residences make it difficult for anyone to return to regular sleep routines. Many families end up sleeping together in the same bed long after the main quake.

Similarly, school avoidance may occur and it can lead to development of school phobias, if children are not quickly returned to their normal routine of school attendance. In some disasters, the schools may be flooded (or damaged in another way), making them inoperable. This, and the need to be bused to other, unfamiliar buildings, will further add to the stresses on the children, who may prefer staying home due to fears of leaving their parents’ sides for the length of a school day.

Adults often report mild symptoms of depression and anxiety. They can feel haunted by visual memories of the event. Pre-existing physical problems such as heart trouble, diabetes, and ulcers, may worsen in response to the increased level of stress. They may show anger, mood swings, suspicion, irritability, and/or apathy. Changes in appetite and sleep patterns are quite common. Adults, too, may have a period of poor performance at work or school and they may undergo some social withdrawal.

Middle-aged adults, in particular, may experience additional stress, if they lose the security of their planned (and possibly paid-off) retirement home (or their financial nest egg), and if they are forced to pay for extensive rebuilding costs. Older adults will greatly miss their daily routines and will suffer strong feelings of loss from missing friends and loved ones. They may also suffer feelings of significant loss from the absence of their home or apartment or its sentimental objects (especially items like paintings, antiques, family Bibles, photo albums, and films or videotapes), which tied them to their past.

Timing of onset of these changes varies with each person, as does duration. Some symptoms occur immediately, while others may not show until weeks later. Just about all of these things are considered normal reactions, as long as they do not last for more than several weeks (to a few months). Unfortunately, victims and relief workers who are unfamiliar with these normal feelings/emotions/reactions will often begin to fear they are losing it or going crazy from the disaster related stress.

Recovery

Full recovery takes far longer to achieve than most people assume it will take. One simple way to explain it to others is to draw a parallel to the death of a close family member or friend. Most realize the recovery period will require at least one year (to pass each holiday, birthday, anniversary, change of weather and season, etc.) and the one-year anniversary of the loss (or the disaster event). It then can take several more years (some estimate 2 – 7 years) of repeating that cycle before folks have fully adjusted to their losses and the resulting changes in their lives.

Bear in mind that the personal impact of disasters tends to be much worse whenever the disaster events are caused by intentionally destructive human acts than by natural causes (or pure accidents). Whenever inhumanity plays a major role in causality, survivors seem to need extra time to resolve their losses and move forward with their lives. This relates directly to the greater amount of anger involved, overexposure from repetitive media coverage, and the fact that any true sense of closure may not come until the perpetrator(s) are found and prosecuted.

People who have survived disasters tend to mark time differently, referencing things as being before or after the event, even when things appear to have been successfully resolved. Most trauma victims are amazingly resilient. Disaster survivors often report being stronger or more mature afterwards. Many have taken steps for future personal preparedness, to be ready for the next time something like that happens. They are often more sensitive to future disasters; many donate money and/or volunteer to help others who must now go through the same pain they experienced.

The basic tenets of disaster mental health begin with the central principle that the target population primarily consists of people who are having normal (and fully expected) reactions to the abnormally stressful disaster/emergency situation. Victims generally will not stop functioning, but they will react in fairly predictable ways (with some differences due to age/maturity). By using psychological first aid, various crisis intervention techniques, outreach services, and psychoeducational approaches, the victims and relief workers can be quickly triaged and briefly counseled (or referred for formal services), so as to return them do pre-disaster levels of functioning as quickly as possible. The goal of disaster mental health is to help assure that the victims become survivors, by doing whatever can be done to prevent long-term, negative consequences of the psychological trauma.

If you or someone you know is struggling with mental health problems in the aftermath of a disaster (or any other traumatic event), please seek professional help. Call your local mental health crisis intervention hotline for additional support, information and referral.

For more information about disaster mental health, please visit this website:
http://www.eyeofthestorminc.com

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