When natural disaster gets in our heads
Oh no, not Christchurch again.
The region that has already had every shred of its mental fortitude tested - and retested - is now being asked to dip into its resilience bucket all over again.
The Port Hills fires that have scorched land, homes and treasured possessions have also had a spiteful lash at the psyche of Cantabrians, many of who are still struggling with six-year-old earthquake trauma.
A natural disaster is any situation, which poses a threat to life, health, property or environment — and negatively affects society or the environment.
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While any such event can play havoc with a person's emotional state, it's particularly tough on those who have been there before, setting alight lingering depressions, anxieties and trauma symptoms that have been parked, but not eradicated.
Psychologically, natural disaster is less about the event than people's emotional reactions to it, and this is fuelled by what the fallout means for their lives.
So the loss of personal items is about the losing the link to precious memories and family history.
Natural disaster can be particularly damaging when it affects populations and communities because of the insidious spread of anxiety as people share their stories, their distress.
The larger the affected population, the more far-reaching the mental fallout.
On a large scale, it can lead to epidemics of trauma symptoms, some of which don't make an appearance for months.
Like a virus, fear can grow exponentially — and with force.
Research indicates a region already hurt by natural disaster will find it harder to deal with difficulties because it is already nursing old mental wounds. But, equally, Canterbury has a proven ability to cope; the people know how to pull together, they know about sharing resources and supporting each other. There is mental power in having banked evidence for your resilience — and knowing you can call on those qualities again.
All the same, disaster-related trauma is painful, especially when it's a re-run.
Symptoms can include:
* Intense and unpredictable feelings. Mood swings, irritability, anxiety and depression.
* Flashbacks: repeated and vivid memories (images, sounds, smells) of the event that lead to physical reactions such as racing heartbeat, shaking or sweating.
* Confusion, concentration problems and/or difficulty making decisions
* Sleep issues, including nightmares; eating issues
* Restlessness, inability to relax or sit still
* Extreme fear of a repeat event and obsessive efforts to prepare for this.
* Conflict in relationships or social withdrawal.
* Physical symptoms such as headaches, nausea, chest pain, unexplained aches and pains.
* Chronic insecurity and intense anxiety around reminders of the event and important anniversaries.
In the early stages, psychological needs are, out of necessity, put on hold.
Priorities must be practical: save what you can, do what you can to secure the safety of your family and others around you.
There may be dislocation from homes, worries about finding somewhere to live. Mentally, there is shock, tears, denial, numbness, the reality of loss and knowing life has inexplicably changed.
After the initial shock has subsided, we often see the best of people; the caring, the altruism, the offers of support.
This is when people feel hopeful, experiencing the goodness of others is nurturing for emotional struggles.
But, down the track, more challenges await.
Mental health can suffer most as people's resources are stretched and worn down.
The more obvious psychological fallout occurs as people lose homes and possessions, but the more subtle damage can be profound.
This includes people's incapacity to work, loss of income, housing problems, building delays, reduced productivity and more financial pressure on a fragile economy.
The effects on first responders to the scene — fire fighters, police, helicopter pilots, civil defence workers, and journalists — can also be significant.
They can be haunted by images of devastation or by the scale of the destruction.
Witnesses may feel guilt that someone else's home or life was destroyed but theirs wasn't.
The symptoms for witnesses and first responders are often the same, including post traumatic stress disorder, depression, and other mental health conditions; people who are present in the aftermath of a firestorm may need as much help and support as the victims.
The Port Hills fires will eventually be put out. But the psychological grind will remain. Earthquake-hardy Cantabrians have already shown us their resilience. It seems particularly tough they're being called on to do it again.
There are various Disaster Models designed to help people understand their reactions.
Phases of disaster response:
Below is a summary of the basic phases people experience, although it doesn't account for individual differences (strengths and vulnerabilities) and there can be a significant amount of overlap between phases.
Threat phase — This can be very short, as in the case of an earthquake or tsunami, or longer if people have time to salvage possessions. Whether they have this opportunity can make a difference to emotional coping and framing of the event.
Impact phase — the immediate aftermath of the event. Practical skills and solutions required. People experience the shock of loss
Hope phase — Communities pull together and we often see the best of people which can be nurturing and helpful for people who are struggling.
Disillusionment phase — Ongoing difficulties with finances, insurance, work, housing, uncertainty about the future can wear at even the most resilient person. More chronic mental health difficulties can set in, such as depression and Post-Traumatic Stress Disorder.
Rebuild phase — Putting lives back together, often while still bearing the mental scars of trauma.
- Karen Nimmo is a clinical psychologist who specialises in relationships, anxiety, trauma, body image issues and sport. Read her at https://medium.com/@karennimmo or visit https://www.facebook.com/KarenNimmoPsychology/?fref=ts