PTSD: National Center for PTSD
What to Expect in the Wake of Recent Hurricanes: Harvey, Irma, and Maria
What to Expect in the Wake of Recent Hurricanes: Harvey, Irma, and Maria
On average, the Atlantic Basin is hit by 6 hurricanes a year. As of early October 2017, there have been 8 hurricanes and the season is not over. Hurricanes Harvey, Irma, and Maria received significant attention in the U.S. for their size, strength, and destructiveness. Hurricanes can cause life threat, bereavement, loss of physical property, financial hardship, and ongoing stressors as people work to put their lives back together.
Because hurricanes typically affect a large region there is also social and community disruption. Transportation, food and water supplies, and communications can be affected. It can be difficult to purchase materials needed for repairs, and skilled workers may have long waiting lists for their services. But there is also support that comes from going through a shared event.
Hurricanes are experienced collectively and therefore people are connected and can help each other cope. During the event itself we often hear stories of heroes who put their lives at risk to help strangers. Following the event, hurricane survivors are surrounded by others who can understand what they experienced as everyone is moving through the event at the same time. Support can also come from the public through fundraising efforts, outsiders volunteering to find ways to help, and FEMA’s practical assistance.
Given the damage and disruption that can occur after a major hurricane, it is not surprising that almost everyone has symptoms in the immediate aftermath. The initial relief to be alive may be followed by distress, fear, and anger.
Disaster survivors may find it hard to stop thinking about what happened, have trouble sleeping, or feel keyed up or on edge. For most people those reactions will lessen over the first few weeks after the hurricane. For those who lost a loved one, were injured, or were forced to relocate, those reactions may be more intense and longer-lasting.
In addition to the immediate problems hurricanes cause, there are additional stressors that can make it difficult to get on with life:
- Days or weeks may pass before evacuees can get back to their homes to even assess the damage.
- Rebuilding takes money, time, materials, and workers---all of which can be in short supply.
- Families may take in relatives while they look for other housing, which can be stressful for everyone.
- People may be out of work if their employers are rebuilding or if they cannot make it to their jobs.
- Parents may have to enroll children in new schools if the family was forced to relocate.
- New physical health problems may need attention and pre-existing health problems can be made worse by stress.
Coping after a Hurricane: Immediate Needs
After a severe hurricane, people's reactions, needs, and priorities will vary depending on many factors. A hurricane may cause injury, threat to life, evacuation or displacement, large-scale flooding and damage, separation from loved ones, extreme loss, or perception of ongoing health risks. People who experience these effects may require more psychosocial support because they are more likely to be significantly distressed.
In the immediate aftermath of any disaster, most people have a core set of priorities that are related to five key needs:
- Reestablishing a sense of safety
- Regaining control and calm
- Connecting with loved ones and others
- Getting through the crisis
- Feeling hope, optimism, faith, or the belief that things will work out
In general, anything you can do to help yourself or others move towards reestablishing a sense of safety, calm, connectedness, and hope can support recovery. Keep in mind that feelings of distress in the aftermath of disasters cannot be resolved by a single act or a simple fix. But there are some important principles to remember:
- There’s no “right way” to deal with these things. We each need to find the way that works for us, and be patient in applying simple, ongoing strategies.
- Talk when you need to; listen when you can. It sometimes helps to hear the perspectives of other people who share your values and experiences. Take what helps and leave the rest.
- You don’t have to talk when you don’t feel like it. Survivors sometimes do better when they are given space. If you are the loved one of a survivor, respect the survivor’s desire not to talk if that is what they want. Give them space, and check back later.
- Resilience often means rolling with the punches. Disasters highlight the forces in life that are much bigger than we are, and remind us that there’s only so much we can do.
- Social support is key. Positive social support plays a crucial role in helping people recover from threat, trauma, and adversity. Reconnect with those you feel closest to, or reach out to others who have had similar experiences or who are caring and wise.
- Give it time. Resilience means that you bounce back in the time; it doesn’t mean that you never feel the impact of traumatic events. Learning to accommodate the things you experience is a continual process.
Coping after a Hurricane: Long-Term Needs
Most people who experience hurricanes will recover. Having symptoms in the immediate aftermath does not mean that you will have symptoms forever. People who lost a loved one, were injured, or were forced to relocate are more likely to have longer-term reactions.
Recovering can take time, and it may require you to learn how to adapt in new ways. What you need in the long term may be different from what helped you immediately after the event. Here are some strategies to help you continue to recover over time.
Strategies for Managing Ongoing Distress
As time moves on, if you still feel distressed or have trouble functioning, it is important to continue with general self-care activities. But you may also want include some of the following strategies:
- Safety. To lessen worries, it can help to stay focused on specific routines of day-to-day living.
- Media Viewing. Turn off the television if watching coverage of the event is increasing your distress.
- Problem-Solving. Take an active, problem-solving approach to ongoing challenges by breaking problems into smaller chunks, brainstorming solutions, and planning for simple, achievable steps towards solutions.
- Positive Activities Scheduling. Try to engage in positive, healthy, or meaningful activities. Doing things that are enjoyable, even if you don’t feel like it, can make you feel better.
- Volunteering. Volunteer work may also be a way to find meaning in helping others and building relationships with people who share your interests and values.
- Managing Emotions. Look for positive coping strategies that help you manage your emotions. Listening to music, exercising, practicing breathing routines, talking with others, spending time in nature or with animals, journaling, or reading inspirational texts are some simple ways to help manage overwhelming or distressing emotions.
- Social Support. Spend time with people who give you a sense of security, calm, or happiness, or those who you feel you can support.
- Helpful Thinking. Reframe or divert your attention by practicing acceptance, prayer, or mindfulness. You can also use humor, or try to think through the costs and benefits of holding onto negative thoughts or behaviors and then practice more helpful ways of thinking or acting.
- Meaning Making. Reflect positively on people or aspects of life that you may have lost. Try to find meaningful ways to honor that loss, either on your own or through contact with others. You can also shift your expectations about what is considered a "good day," and reconfirm the people, values, and goals in your life that you realize are most important to you.
There is no standard timeline for recovering from a hurricane. Depending on how much the hurricane impacted you, it may take a long time to feel better. If you can develop your own ways of adapting to ongoing events and situations, you may gain a stronger sense of being able to deal with challenges, a greater sense of meaning or purpose, or an ability mentor and support others in similar situations.
When to Consider Professional Help
If you are distressed, or unable to function well, consider seeking help.
There are competent and caring professionals available who can effectively treat the most common responses to hurricanes, like depression, anxiety, PTSD, and complicated grief. The most effective treatments give you tools to problem-solve, mourn and make sense of what happened, deal with numbness or intense emotions, and foster resilience. It is a good idea to try meeting with a mental health professional at least once. The sooner you get help, the sooner you will feel better.
For those in need of more intensive services, research supports trauma-focused psychotherapy for PTSD as an effective treatment following disaster. Trauma-focused psychotherapy is a broad term that refers to several specific psychotherapies for PTSD.
“Trauma-focused” means that the treatment focuses on the memory of the traumatic event and its meaning. Trauma-focused psychotherapies use different techniques to help you process your traumatic experience. For example, some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.
Tools and Resources to Help
This mobile app has tools that can help you deal with common reactions after mass violence, like, stress, sadness, and anxiety. You can also track your symptoms over time.
Disasters and mass violence may lead to injury, death, and psychological distress. This page links to information to help affected individuals and loved ones deal with distress that may result from these events.
For Immediate Help
Are you are in crisis? You have options:
- Call 911
- Go to the nearest Emergency Room
- Call the National Suicide Prevention Lifeline
Calls are answered 24/7: 1-800-273-8255
- Veterans Crisis Line
Receive free, confidential support 24/7: 1-800-273-8255, press 1 or text 838255.