Coping With Disaster

Manmade or natural disasters can have a lasting effect on those who witness or experience them. Many people find themselves sorting through a variety of emotions weeks, months, and even years after the traumatic event.

"Actually, as we get farther out, we may see more changes in ourselves, as the situation starts to become more entrenched and more real, rather than just images on TV," says Steven E. Shaw, MD, medical director of child psychiatry services at John Muir Health.

Dr. Shaw notes that experiencing serious, traumatic events — ones that people would not normally experience — affects people differently.

Post-Traumatic Stress Disorder

At the extreme end of the scale, Post-Traumatic Stress Disorder, or PTSD, can occur. An anxiety disorder marked by intense fear and helplessness, PTSD is a protective response of the brain.

Symptoms can manifest themselves immediately following the event or much later, and include:

• Reliving the event through vivid dreams
• Recalling painful memories
• Believing that the event is happening at the present time
• Emotional numbness
• Guilt
• Extreme anxiety or panic
• Intense fear
• Difficulty sleeping

A person's risk is determined by a number of factors, including:

• The response to the event at the time it occurs
• Intensity of the memory of the event
• Coping style, personality, past life experiences
• Feelings of safety and support

Anxiety and other concerns

Even without PTSD, people can have a variety of similar symptoms, usually to a lesser degree. Anyone can have strong reactions to what has happened.

Some of the changes Dr. Shaw has noted in patients facing trauma include more difficulty sleeping, or getting calmed down to go to sleep. Some are having a hard time with racing thoughts, not being able to stop going over information in their minds.

Typical symptoms for many other people, whether adults or children, include:

• A change in sleep patterns
• A change in appetite, decreased or increased
• Subtle changes in normal reactions, such as being more irritable, or more emotionally sensitive than before

Coping with children

When a traumatic event happens, young children may become aware that serious things are going on because they see changes in adult behavior. If you notice children becoming angry or tearful easily, it may be important to help them sort out and verbalize their thoughts.

"You might say, 'there's been a lot of bad stuff going on in the world, and it's making me feel strange and uncomfortable. Is it making you feel that way, too?' " suggests Dr. Shaw. "Give them the opportunity to feel better by talking about it."

He notes that shielding children from images is a natural reaction from parents. "Kids have wonderful imaginations, and they may build on what they see — it can become too intense… But they should understand the basics of what is going on."

Overall, he says, what children need to hear during this stressful period is that their parents are there and will keep them safe.

Getting help

Dr. Shaw offers these general tips:

• It's important to talk about what has happened. Network with family and friends.
• Stay away from extremes of reaction, such as hatefulness. And shield children from this type of reaction.
• Take care of your physical self. Stay with your usual routine, eat and rest at normal times, and don't let yourself get too overwhelmed.
• Some people turn to alcohol and other drugs as a means of dulling reality. This is not going to help, and may well make matters worse.

Coping with disaster is never easy. If you feel overwhelmed by symptoms of grief, depression, anger, or stress, reach out to your physician or other health professional without delay.