Gini McIntosh and Caroline Bell, a clinical psychologist and a psychiatrist respectively, say it is important to focus on the things that promote wellbeing as people cope with the effects of the earthquakes.
OPINION: Much has been said in recent weeks about the mental health and wellbeing of Canterbury residents in this post- earthquake world we are living in. Our experience, like many others living and working here, is that this matter is complex.
We have all been affected in different ways and recent surveys show this. Some people are doing very well; others are coping and managing with all they now have to juggle and sort; and others have significant difficulties with anxiety and depression.
Professor Rob Gordon, of Australia, an expert in post-disaster psychology, was in Canterbury recently and spoke about the difficulties communities and individuals are likely to face three years after a disaster.
Most people who attended these meetings would have been struck by his wise words describing how we are likely to be feeling, having had to deal with all that has and continues to happen in our lives.
His messages were to keep track of the effects, to pace ourselves and not try to do everything, to keep at the forefront of our minds what is really important - relationships, family, goals - to do things that make us feel good and not be consumed by trying to sort out everything, which often leaves us feeling powerless and that we lack any control over the processes.
This is, of course, not that easy to do. The All Right? campaign that you may have seen around the city is based on this approach, reminding us of things we can do that will help.
None of this minimises the huge pressures many people are under day to day. The recently published surveys and research from other communities after disasters indicate that secondary stressors - such as dealing with EQC and insurance problems and delays in the rebuilding process - have a huge negative effect on people's wellbeing. Most in Canterbury would agree wholeheartedly.
This is the "double blow" - the impact of the earthquakes, followed by perceived mismanagement of the recovery. These issues need to be dealt with to allow the community to move forward.
A common response to reports in the media of post-earthquake mental ill-health and struggles is that it is depressing to read about Cantabrians being depressed, when this does not reflect the experience of many in the community.
Some of the findings from the All Right? survey are that despite the very real difficulties many are experiencing, the majority of the community are coping well with day-to-day events. They are happy with their lives, appreciate small things that give joy, and find humour, exercise, being connected with family, friends and neighbours, and engaging in hobbies and interests all have a positive impact on their wellbeing.
At the same time, the survey also reports that most people in the community have endured damaged homes and contents, are often dealing with protracted processes related to this, and are grieving for what has been lost both personally and in the city. This is not easy and is a continuing stress for many.
Often people have never felt like this before and do not know what to do with these feelings.
Although much of this is understandable when we think about what we have been through and continue to battle, it is still unpleasant.
If these feelings persist, however, it is important to be aware that help is available, even though it may feel uncomfortable to ask for it.
Many things may help, depending on what a person needs. The simple-sounding things described above, such as putting joy or fun back in your life, meeting up with friends again, taking up an interest or hobby, taking a walk regularly, or doing things with the family, really do help.
They don't take the EQC/ insurance/rebuild problem away, but they can help it not consume you. Further help is also available through the Canterbury support line (0800 777 846) or by visiting your GP.
It is important to remember that it is not abnormal to be adversely affected by the earthquake- related experiences of the past 30-plus months.
But if you need it, help is available. And remember that people get better when they have help.
At the other end of the spectrum of responses, the All Right? survey also identified a group of people whose lives have been positively impacted by the earthquakes.
This is an interesting group, from whom we also want to learn, as they remind us that adversity does not invariably result in difficulties.
We are involved with research that involves talking to residents of Canterbury who are coping well, in spite of having difficult experiences during or since the earthquakes.
We hope to understand more about what makes these people different from others who are still experiencing adverse effects from the quakes, and we are interested in the psychological and biological factors that relate to good coping responses.
Some of the most interesting perspectives for us as researchers come from hearing people tell their stories about their personal experiences.
The participant group we work with is diverse and includes people who were rescued after being trapped in buildings, rescuers, hospital workers, people who lost friends or family members, and those who lost their homes or work.
We have talked to some people who have been very contemplative in their approach to processing their experiences. They might go for walks in the vicinity or meditate. Others might dance nearly every night or eat a steak after years of being vegetarian.
A common theme for this group is a tendency to re- evaluate what is important in their lives.
Often people identify material possessions as having less importance than before the quakes, and clearly prioritise relationships, community and connectedness.
We are very grateful to those who have volunteered to participate in this research with earthquake "copers".
If you are interested in participating in this study because you are coping well despite having had a substantial degree of earthquake-related exposure, either at the time of the earthquakes or subsequently, please contact us at: earthquake.coping @otago.ac.nz or 03 372 0400.
Overall, Cantabrians have coped remarkably, but it is still not an easy time. We need to continue to look after ourselves and each other.
We need to focus on the things that promote wellbeing - things such as connectedness with family, friends, neighbours, our community; routines - eating, sleeping, physical activity; participation - in recreation, activities, sport, trying new things; resuming the things we used to do, but have stopped; and focusing on the things we can control, and moving forward with those.
Gini McIntosh is a clinical psychologist with the Canterbury District Health Board Earthquake Treatment Team and a research fellow at the University of Otago's Christchurch campus. Caroline Bell is a psychiatrist with the CDHB Earthquake Treatment Team and a senior lecturer at the University of Otago, Christchurch.
- The Press