Survivors of natural disasters often vulnerable to traumatic stress

Natural disasters represent a significant risk factor to the mental health of trauma survivors. These events are often followed by community devastations, destructions and displacements, loss of lives, homelessness, injuries, missing individuals and financial losses. The devastation in Haiti is one such example. The psychological distress associated with natural disasters is typically exacerbated by the stressors and losses that occur in the aftermath of the trauma such as the loss of loved ones, homes, jobs and the physical damages that surround them.

Research shows that in addition to adults, children and adolescents exposed to such natural disasters are vulnerable to mental health problems. Indirect exposure to trauma could as well lead to emotional distress among children. For instance, media exposure to a traumatic event and conversations among adults could induce traumatic images and thoughts in children, resulting in increased feelings of anxiety and fear for their safety.

Post Traumatic Stress Disorder (PTSD) is the most frequent and disabling psychological disorder that occurs following natural and human made disasters. PTSD is an anxiety disorder that develops when a person experiences, witnesses or is confronted with an extreme traumatic event that has threatened their safety. A traumatic event makes a person feel intensely fearful, helpless or horrified. The more unpredictable and uncontrollable the traumatic incident is perceived, the more the incident could trigger PTSD. Some might wonder whether living in hardship before a trauma helps to protect people against the development of PTSD. But studies have shown that pre-existing difficulties do not offer a protective effect; in fact, they represent a strong risk to developing PTSD.
PTSD symptoms include re-experiencing symptoms such as intrusive and upsetting memories of the traumatic event, bad dreams, flashbacks or a sense of reliving the event, feelings of intense psychological distress when reminded of the trauma intense physical reactions to reminders of the event. Avoidance symptoms such as avoiding thoughts, feelings, or conversations associated with the trauma; avoiding activities, places or people that are reminders of the trauma, feeling detached from other people or feeling emotionally numb. And increased arousal symptoms such as difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance, or being constantly “on guard”, feeling jumpy and easily startled.

Such reactions are typically seen shortly after a traumatic event – and are natural and expected. However, if the symptoms continue over a prolonged period of time and increase or become more distressing and begin to interfere with daily activities, then a person might be suffering from PTSD. Seeking help is essential in that case. According to the National Centre for PSTD, the condition includes several phases. Phase one is the impact phase where individuals who have survived the traumatic event try to protect their lives and the lives of others. People are often in panic, might be in shock, cry or run away. Phase two, post-disaster or rescue phase, survivors try to withdraw from the impact of the traumatic event; they might feel highly anxious or in shock, angry, sad and feel helpless or hopeless or feelings of guilt for having survived. Phase three is the recovery phase where survivors begin to readjust to their lives. The adjustment will depend of the severity of the traumatic event, the injuries and losses experienced. Phase four is the problematic stress response phase where PTSD might be diagnosed. During the latter phase, survivors often experience distressing thoughts, memories or flashbacks, nightmares, feelings of detachment, and will try to avoid any reminders of the trauma.

Disasters have been found to result in some positive experiences including personal growth, strengthen relationships, and learning. However, one out of three individuals who has experienced a devastating natural disaster is at risk for experiencing symptoms of PTSD according to the National Center for PTSD. The prevalence of PTSD is higher among the victims of a disaster who have been closest to the disaster. The prevalence is lower among those of rescue workers and even lower in the general population.

Close relationships among family members and parental warmth, love and care and parental support are very important and beneficial for children and adolescents who are victims of disasters. In addition to connectedness to family, connectedness with school and teachers has been found to provide a place of safety and stability after the upheaval caused by a natural disaster. These serve as protective factors against upsetting and tragic events and, in turn, could help decrease the risk for PTSD. Promoting a sense of safety, security and support and hope have been found to be helpful interventions for children.

Children need to be protected from re-exposures to trauma, reminders of trauma or frightening situations. Those who are at risk for prolonged distress should be closely monitored. Scientific based psychological interventions for trauma have been found to be effective and can be provided when symptoms continue to be very distressing weeks after the traumatic event.

Among adult victims of natural disasters, coping mechanisms including the support of social networks, collective mourning, cultural and spiritual practices, and community self help groups, have all been found to be effective in helping people  cope .  When the acute stress subsides, survivors who experience increasing and distressing symptoms of PTSD would most likely benefit from seeking mental health services.

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