Managing Traumatic Stress: After Hurricane Katrina

Managing Traumatic Stress: After Hurricane Katrina

The effects of a hurricane like Katrina will be long-lasting and the resulting trauma can reverberate even with those not directly affected by the disaster.

It is common for people who have experienced traumatic situations to have very strong emotional reactions. Understanding normal responses to these abnormal events can aid you in coping effectively with your feelings, thoughts, and behaviors, and help you along the path to recovery.

What happens to people immediately after a disaster or other traumatic event?

Shock and denial are typical responses to large-scale natural disasters, especially shortly after the event. Those who were in close proximity to danger or who lost family members or even pets may be particularly affected. Both shock and denial are normal protective reactions.

Shock is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned or dazed. Many of those affected by Hurricane Katrina may be feeling shock as well because they thought the hurricane had missed them, but the devastating flooding added an element of surprise. Denial involves your not acknowledging that something very stressful has happened, or not experiencing fully the intensity of the event. You may temporarily feel numb or disconnected from life.

What emotions may people feel after Hurricane Katrina?

Once the initial shock subsides, those affected by Hurricane Katrina will have to face other hardships. Many will be without electricity or basic supplies; some will still face uncertainty about family members’ whereabouts; and some will have been displaced because their homes are unsafe to return to. Others will be fearful about the health hazards from the flooding, or from the lawlessness represented by the looters. Reactions to these hardships will vary from one person to another. The following, however, are normal responses to a traumatic event:

- Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed.

- Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns also may be disrupted.

- Recurring emotional reactions are common. Anniversaries of the event, such as at one month or one year, as well as reminders such wind or rain, can trigger upsetting memories of the traumatic experience. These 'triggers' may be accompanied by fears that the stressful event will be repeated.

- Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you might become withdrawn and isolated and avoid your usual activities.

- Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress.

How do people respond differently over time?

It is important for you to realize that there is not one 'standard' pattern of reaction to the extreme stress of traumatic experiences. Some people respond immediately, while others have delayed reactions - sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather quickly. The reactions over time may be complicated by the fact that it could take a long time to rebuild after Katrina and hardship conditions can persist for quite some time.

Reactions can change over time. Some who have suffered from trauma are energized initially by the event to help them with the challenge of coping, only to later become discouraged or depressed.

A number of factors tend to affect the length of time required for emotional recovery, including:

- The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life or substantial loss of property is involved, often take longer to resolve.

- A person's general ability to cope with emotionally challenging situations. Individuals who have handled other difficult, stressful circumstances well may find it easier to cope with the trauma.

- Other stressful events preceding the traumatic experience. Individuals faced with other emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the new stressful event and need more time to recover.

How should I help myself and my family?

Many people already possess the skills of resilience and will bounce back on their own, given time. There also are a number of steps you can take to help restore emotional well being and a sense of control following a natural disaster, including the following:

- Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state.

- Ask for support from people who care about you and who will listen and empathize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma.

- Communicate your experience in whatever ways feel comfortable to you - such as by talking with family or close friends, or keeping a diary.

- Find out about local support groups that often are available such as for those who have suffered from natural disasters. These can be especially helpful for people with limited personal support systems.

- Try to find groups led by appropriately trained and experienced professionals such as psychologists. Group discussion can help people realize that other individuals in the same circumstances often have similar reactions and emotions.

- Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. Avoid alcohol and drugs.

- Establish or reestablish routines such as eating meals at regular times and following an exercise program. This can be especially important when the normal routines of daily life are disrupted. Even if you are in a shelter and unable to return home, establish routines that can bring comfort. Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.

- Avoid major life decisions such as switching careers or jobs if possible because these activities tend to be highly stressful.

How do I take care of children's special needs?

The intense anxiety and fear that often follow a disaster can be especially troubling for surviving children, especially if children were victims of the disaster or were separated from their families. Some may regress and demonstrate younger behaviors such as thumb sucking or bed wetting. Children may be more prone to nightmares and fear of sleeping alone. Performance in school may suffer. Other changes in behavior patterns may include throwing tantrums more frequently, or withdrawing and becoming more solitary.
There are several things parents and others who care for children can do to help alleviate the emotional consequences of trauma, including the following:

- Spend more time with children and let them be more dependent on you during the months following the trauma - for example, allowing your child to cling to you more often than usual. Physical affection is very comforting to children who have experienced trauma.

- Provide play experiences to help relieve tension. Younger children in particular may find it easier to share their ideas and feelings about the event through non-verbal activities such as drawing.

- Be available and encourage older children to ask questions they may have, as well as sharing their thoughts and feelings with you and with one another. This helps reduce their confusion and anxiety related to the trauma. Respond to questions in terms they can comprehend. Reassure them repeatedly that you care about them and that you understand their fears and concerns.

- Keep regular schedules for activities such as eating, playing and going to bed to help restore a sense of security and normalcy, even if your family has been relocated to a shelter or other temporary housing.

- Reduce the number of times children see the trauma on the news. Repeatedly watching broadcasts of the disaster can re-traumatize children.

For those struggling to cope from afar

Even if you were not in the actual disaster, you may experience a sense of vulnerability from witnessing the results of the disaster.

This can be especially acute if a relative or friend was affected by the disaster, particularly if you have been unable to get news on their welfare.

- Take a news break. Watching endless replays of footage from the disaster can make your stress even greater. Although you'll want to keep informed - especially if you have loved ones affected by the disaster - take a break from watching the news.

- Be kind to yourself. Some feelings when witnessing a disaster may be difficult for you to accept. You may feel relief that the disaster did not touch you, or you may feel guilt that you were left untouched when so many were affected. Both feelings are common.

- Keep things in perspective. Although a disaster often is horrifying, you should focus as well on the things that are good in your life.

- Find a productive way to help if you can. Many organizations are set up to provide financial or other aid to victims of natural disasters. Contributing can be a way to gain some “control” over the event.

- Control what you can. There are routines in your life that you can continue and sometimes you need to do those and take a break from even thinking about the disaster.

- Look for opportunities for self-discovery and recognize your strengths. People often learn something about themselves and may find that they have grown in some respect as a result of persevering through hardship. Many people who have experienced tragedy and adversity have reported better relationships, greater sense of personal strength even while feeling vulnerable, increased sense of self-worth, deeper spirituality, and heightened appreciation for life.

When should I seek professional help?

Many people are able to cope effectively with the emotional and physical demands brought about by a natural disaster by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers help educate people about common responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.

With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance. A qualified mental health professional such as a psychologist can help such children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.