Easing the Trauma After the Storm
By PAULINE W. CHEN, M.D.
Craig Ruttle/Associated PressIn the small Connecticut town where I grew up, the tornado of 1979 remains the storm, a freak tornado packing 86-mile-per-hour winds that churned through the streets, killing three people, injuring hundreds and destroying several hundred homes and businesses, including many in my neighborhood.
I was 15 at the time, at home alone looking after my 10-year-old sister and 5-year-old brother. For months afterward, like others caught in the surprise storm, we struggled with memories of that afternoon. During the first few days, I kept reliving the moments huddled with my siblings in the corner; later, I had recurring nightmares and became paralyzed with fear whenever I heard a clap of thunder.
Even today, I tend to worry more than most whenever the sky looks odd or when the weather suddenly turns muggy and dark, the slightest hint of what my sister and I have come to call “tornado weather.”
For almost three decades now, health care experts have been studying the psychological effects of natural disasters and have found that disasters as varied as the 1994 earthquake in Northridge, Calif., and Hurricanes Katrina (2005), Andrew (1992) and Hugo (1989) left significant, disabling and lasting psychological scars in their wake. While individuals with pre-existing mental health issues were at particular risk, everyone was vulnerable. In New Orleans a month after Hurricane Katrina, for example, 17 percent of residents reported symptoms consistent with serious mental illness, compared with 10 percent of those who lived in surrounding areas and only 1 to 3 percent in the general population.
Most commonly and most immediately, the survivors suffered post-traumatic stress symptoms like recurrent nightmares, flashbacks, a hair-trigger temper and an emotional “numbing,” much of which could be considered normal in the first couple of months after a disaster. “It’s a pretty natural thing to have nightmares after living through a natural disaster,” said Ronald C. Kessler, a professor of health care policy at Harvard Medical School who has studied the effect of natural disasters on the mental health of survivors. “It would almost be abnormal if you didn’t.”
Over time, when those symptoms abated, survivors were able to move on. When they didn’t, or when other mood disorders like anxiety and depression appeared, mental health issues quickly became a leading cause of disability for survivors, further hampering other efforts at recovery.
But the research has also revealed that we can mitigate the psychological fallout, even after the disaster has occurred. Studies from Hurricanes Katrina and Rita have shown that what communities, governments and even elected officials do in the weeks, months and years that follow can have a significant effect on how individuals fare psychologically.
For example, among Hurricane Katrina survivors, there were striking differences in the rates of mental health disorders, depending on how people felt about the difficulties they had finding food and shelter. Survivors who continued to face such adversity because of the government’s slow response had significantly higher rates of mental health problems.
“There’s no question that the best thing the federal, state and municipal governments can do to protect against psychopathology in these kinds of situations is to restore the day-to-day functioning that keeps everyone healthy,” said Dr. Sandro Galea, lead author of the study and chairman of epidemiology at the Columbia University Mailman School of Public Health.
For now, experts are predicting that the psychological fallout from Hurricane Sandy will be less severe than that from Hurricane Katrina. But their optimistic predictions rest in part on the response thus far of government officials and the larger community.
“People pull together at times like this,” Dr. Kessler noted. “To the extent that those affected by Sandy can build on this sense of community and get back to normal, it could be an opportunity for people to grow and even develop a sense of accomplishment because of what they’ve been through.”
What I remember today as clearly as the blinding whiteness of the tornado winds that enveloped our house and the terror that gripped my siblings and me back in 1979 are the state and local officials and rescue workers who appeared almost immediately, the churches and community organizations that organized shelters and fund-raisers, and the neighbors, sleeves rolled up, who cleared debris and cooked for one another.
When the new homes finally began to emerge from the rubble the following spring, it wasn’t the cookie-cutter skyline of raised ranches and colonials that was restored. Instead, the neighborhood became a showplace of modest but quirky family abodes — a brown, modern geometric house on one corner, a yellow, partly subterranean one a few doors down.
From a devastating storm, my neighbors had managed to build new dreams.