Thankfully many people can go through their entire life never experiencing a natural disaster. However, for some, it can be a constant fear and threat to their life. For others, it can be a case of wrong time, wrong place – and a complete freak experience that determines their life going forward.

Those who experience natural disasters – for example, floods, earthquakes, tsunamis, hurricanes, fires, etc – are at risk of developing post-traumatic stress disorder. This can manifest itself as recurring flashbacks or nightmares, social anxiety, depression, feeling constantly on edge, mood swings, avoidance, tension headaches, nausea or trembling, sleep difficulties or eating issues, irritability, chest pain, withdrawal, difficulty making decisions or fear that the event will be repeated, among other symptoms.

Natural disasters and suicide rates

As an article in the Psychiatric Times comments, after Hurricane Maria in Puerto Rico during September 2017 (the largest-scale natural disaster to occur in the United States during our lifetime), there were 25 suicides per month in the immediate three months following the event, versus an average of 19 suicides per month in the 8 months before Hurricane Maria. It seems that although suicide rates vary depending on the location and population, typically suicidal behaviour increases following a natural disaster.

This is because the psychosocial stressors associated with the natural disaster are all present both immediately after the event, but also as time progresses, intensifying when appropriate help isn’t available. While many may initially disassociate themselves from what is happening and provide heroic efforts, both of which can serve as protective factors against suicide, eventually the grim reality of the destruction and its aftermath set in and create feelings of hopelessness, helplessness and disillusionment.

Prevalence of PTSD from natural disaster survivors

Additionally, research that looked at PTSD survivors between 1980 and 2007 found that those who were the direct victims of disasters were 30% to 40% more likely to have post-traumatic stress disorder, compared with the average of 5% to 19% in the general population.

Why do natural disasters cause PTSD?

Various factors affected how likely it was that an individual would get PTSD, including the degree of physical injury they incurred, the immediate risk it posed to their life, the severity of destruction to their property, their distance from epicenter, and whether they experienced loss of family members. It was found that those who suffered property loss or were forced to relocate were also at a higher risk of developing PTSD.

As Dr. Octavio N. Martinez Jr., the executive director of the Hogg Foundation for Mental Health at the University of Texas at Austin, told CNN in relation to the aftermath of Hurricanes Harvey and Irma in Texas, Florida and the Caribbean, “Unlike the physical damage, which is all too obvious, the psychological toll will have effects that cascade over time.” He notes, “It is when these symptoms affect the person’s ability to function, when it becomes crucial to reach out for assistance.” Otherwise, issues such as increased smoking, alcohol use and behavioural changes can slip under the radar, often assumed to just be a natural response to the experience.

He notes that after Hurricane Katrina, the prevalence of PTSD in Alabama, Louisiana and Mississippi rose from 15% a few months after the natural disaster to 21% a year later. He also noted that the number of people who were experiencing suicidal thoughts more than doubled from 2.8 percent to 6.4 percent. It is especially problematic to children and youth, who can be impacted for their entire lifetime after experiencing traumatic events.

How can you help someone affected by PTSD following a natural disaster?

Although natural disasters cannot be avoided, there are ways to help heal from the experience of them. Speaking out and getting counselling can be crucial, rather than bottling everything up. Vocalising things that have been of concern or causing fear can ensure they are addressed, and also put them into perspective. Early intervention is particularly important, so waiting until the problem manifests itself in symptoms can often mean recovery will take longer. Post-traumatic stress disorder is nothing to feel ashamed about and admitting you might need help means you’ll be able to address your health as a priority. In doing so, this can keep any further trauma at bay.

NICE guidance from 2005 and 2011 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).

REFERENCES: NHS, Psychiatric Times, Psychology Today, CNN