Dealing with trauma such as a natural disaster

In recent years Australians have been affected by a number of natural disasters, both at home and overseas. Most recently, we have had terrible bushfires again in the Adelaide Hills, with many homes and property lost, animals killed and huge areas of bush and farmland destroyed. We are all familiar with Bushfire Survival Plans, but not so familiar with having a Mental Health Survival Plan. It is also important to be psychologically prepared.

At the time around the threat you will need follow to focus on the warning messages and what needs to be practically done. You need to listen to emergency advice on the radio or check online, and also check on others. Your plan may be to evacuate early. During this time be prepared that you may experience stress and anxiety, and may need to calm your breathing (take medium slow breaths) as well as your thoughts. Thoughts that minimise or catastrophize the threat can occur, so take stock of your thinking and focus on helpful realistic thoughts; such as, “We have a plan, and we are going to follow it through step by step”.

In other words, the three steps involved in being psychologically prepared are:
1. Anticipating that you will feel worried and anxious.
2. Identifying the specific feelings and thoughts you are having.
3. Managing them with breathing and calm self-talk.

As the disaster unfolds, humans tend to go into a survival mode, doing what need to be done. Once the threat has passed, we can remain in this mode for some time, and experience a range of physical symptoms, behaviours, thoughts and emotions. Here are some examples:
a. Being hyper-alert all the time, not sleeping, getting tired/exhausted.
b. Feeling numb, irritable, anxious or panicky, depressed.
c. Feeling disorientated or confused, having visual images of the event or nightmares.
d. Withdrawing from others, keeping overly busy.

It is important to remember that these responses, even though they can be very distressing, are normal, and they can last for days or weeks. Here are some tips to help coping:
1. Recognise that you have been through a very distressing experience, and focus on feeling safe and secure in the first instance.
2. Avoid overusing alcohol or other drugs to cope.
3. Don’t bottle up your feelings – share them with people close to you if you are able to or write them down. If you are a person who expresses yourself through action (e.g. gardening), then do these things.
4. Let key family and friends know about what you need, whether practical or emotional support.
5. Maintain a normal routine, and do some things you usually enjoy.
6. Rest when you can, and use relaxation techniques (e.g. relaxing each muscle group in the body, breathing effectively – you can download phone apps or borrow CDs from a library).
7. Eat well and do some exercise.
8. Problem-solve what you need to be doing – seek help with this from family and friends.
9. Be aware that a recent trauma may stir up memories from past traumas. Focus on keeping these memories separate in your mind – you can only process so much at one time.
10. Seek professional help if need be.

Here are some tips too for children and adolescents, as they will react differently to adults:
1. Help your child feel safe and secure – talk and play with them and reassure them.
2. Avoid watching and re-watching television reports about the disaster that can upset children and even adolescents.
3. Be mindful of what you are saying and doing around them in relation to the disaster, as they are observing and taking the lead from you.
4. Be aware that children sometimes don’t react for days or weeks. Sometimes trauma with children can come out again in dreams or play, or with adolescents as risk-taking. Watch out for this.
5. Listen to your child if they want to talk, and explain calmly how you feel.
6. Help them return to routine and normal activities. Encourage them to participate in things they enjoy.
7. Encourage your child/adolescent to help e.g. raising some money to donate, or volunteering.
8. Consider seeking professional help for your child or adolescent if you are concerned.

Trauma can involve a great deal of loss and grief, such as loss of loved ones, property or animals. Recovery from loss and grief takes time, and a roller-coaster range of emotions can be experienced. Many of the above tips will be useful and more information on grief can be found on the Grieflink website – www.grieflink.asn.au

Some individuals will have a severe and persisting reaction to stress/trauma and will need to seek help. If you are experiencing significant distress lasting more than a couple of weeks, then please seek help from your General Practitioner (GP) who can assess, monitor and advise you and organise appropriate assistance.

Following a trauma or disaster, others may go on to develop depression or post-traumatic stress disorder (PTSD). PTSD can occur after an individual or someone close to them is exposed to threatened serious injury or death. They may experience continued intrusive symptoms (images, dreams, flashback, distress), persistent emotions such as fear, anger, guilt, depression, persistent hyper-alertness, problems with sleep or memory/concentration, avoiding any reminders of the trauma, or feeling dissociated from self or surroundings. Remember too that some people will develop this at a much later time.

You can find out more information on PTSD on the Beyondblue website (www.beyondblue.org.au), or The Australian Centre for Posttraumatic Mental health (www.acpmh.unimelb.edu.au). Again, please seek help from your GP.

Useful resources:

Lifeline 131114
Mental Health Triage 131465
Beyondblue 1300224636
Australian Centre for Post-traumatic Mental health (www.acpmh.unimelb.edu.au).
Headspace (for young people) www.headspace.org.au
Australian Psychological Society www.psychology.org.au
Grieflink website – www.grieflink.asn.au

References:
• Australian Centre for Post-traumatic Mental health website (www.acpmh.unimelb.edu.au).
• Australian Psychological Society website (www.psychology.org.au)
• Managing emergencies and pandemics in general practice A guide for preparation and recovery. RACGP, 2013.
• DSM-V, American Psychiatric Association.