Coping with #NepalEarthquake- Part II
Disaster such as earthquake comes unannounced. Every individual who experience this, will go through some form of distress or trauma may it be physical, social or psychological or emotional. Different individuals cope with this in different ways. Some individuals get back to normal without external support, where as some require medical or psychological therapies. In this article, we will discuss about the various ways of coping the stress after disaster like this, as my personal experience and what evidences have to say on this. There are two forms of coping: (1) Approach Coping includes behavior such as seeking social support, whereas, (2) Avoidant Coping involves denial, or withdrawal from society. Available evidence shows that approach coping helps decrease stress (Zheng et al. 2012).
Disaster such as this brings sense of social integration as it is not only a problem of one person, as everyone is affected in some ways. People like to discuss the experiences with each other may it be with a stranger. “Misery really does love company”. The best thing anyone can do at times of disaster is to be with someone (Johal et al. 2014). Specifically #NepalEarthquake brought all the family members and neighbours together in the same open space and or under the same tents. People who hardly knew who lived in the next house have now become good friends. I personally talked to neighbors I had not spoken to in the last 5 years. “Talking to someone” helps a lot; even gets people to laugh. Social support is really important aspect of the biopsychosocial model (Bokszczanin 2012).
Psychology of a person is badly affected after a disaster like this. People have fear of another aftershock which is yet to come. This fear adds on to the existing stress. This in turn impairs sleep awakening cycle and disturbs sleep. As humans, we have a beautiful sentiment: “sympathy”. “Speaking of God”, or prayers help. Hope is the oxygen to our souls. As long as we have hope, we will fight. Evidence has shown that Post-traumatic Growth (which includes improved relation with others, appreciation of life, increased belief in god, etc) improves quality of life and this also alleviates depression (Kyutoku et al. 2012). Talking helps... But talking about the future predictions of the earthquake isn’t a good idea. Having someone in the family who can say “There won’t be anymore earthquake...we are safe. Just go to sleep!!!” can itself make so much difference. This will improve the psychological status by reducing the fear by beliefs of no more big aftershocks. Perpetuating the rumors about aftershocks that cannot be predicted and warning everyone else about it does not help. It only adds to the fear. All that can be done is to stay alert and safe.
Getting away for a little while can be a good idea if the stress is bothersome (Johal et al. 2014). People tend to perceive aftershocks in the location where they experienced the worst earthquake. Getting away could also mean, get away from home to the work place if you felt the big earthquake at home. For someone who experienced the event while at work, a few days off could help. Longer breaks from work may not be a wise idea. Going back to work also positively affects the family members and other people. Over working or exhausting ourselves at work may not help either. It could add to the sense of helplessness. So, self-care is important (Johal et al. 2014). Giving good time to ourselves, doing things what we love to do, eating food we like to eat, meeting people whom we like has positive psychological benefits. Apart from this, good sleep is really very important. Sleep deprivation can add to the emotional stress (Johal et al. 2014). Psychotherapeutic management and pharmacotherapy may help the problems associated with sleeping disorders(Brownlow et al. 2015). Post-disaster stress is higher in the primary affected areas so rescue and care should be intensively allocated to these sites targeting the population living there (Kyutoku et al. 2012). Post traumatic stress disorders most of the times require psychotherapy. Adolescent are more prone to develop mal-adaptive strategies such as substance abuse. Especially those that have an external locus of control i.e they believe that everything is out of their control and they are destined to suffer, are more prone to chronic post-traumatic stress disorders. Heath promotion support should be focused more for those with this trait (Zhang et al. 2014).
Tips for coping with disaster:
- Seeking social support from family, relatives and neighbours is one of the best ways to cope.
- Reducing the fear of future aftershocks, but staying safe and alert is desirable.
- Keep the emergency contact numbers accessible.
- Exchange your knowledge about disaster management with others. Make sure to acquire the right knowledge from trusted sources. Not everything in the internet is true!!!!
- Assurance can help cope the stress.
- Volunteer --- Make a contribution. Serve the people the best way you can with the best available resources in hand. There is no need to know drastic life changing measures for us to help others. Just simple help can be a life saver. Bringing a sense of ease in someone’s life would suffice.
Bokszczanin A (2012): Social support provided by adolescents following a disaster and perceived social support, sense of community at school, and proactive coping. Anxiety Stress Coping 25, 575-592.
Brownlow JA, Harb GC & Ross RJ (2015): Treatment of sleep disturbances in post-traumatic stress disorder: a review of the literature. Curr Psychiatry Rep 17, 587.
Johal S, Mounsey Z, Tuohy R & Johnston D (2014): Coping with disaster: general practitioners' perspectives on the impact of the canterbury earthquakes. PLoS Curr 6.
Kyutoku Y, Tada R, Umeyama T, Harada K, Kikuchi S, Watanabe E, Liegey-Dougall A & Dan I (2012): Cognitive and psychological reactions of the general population three months after the 2011 Tohoku earthquake and tsunami. PLoS One 7, e31014.
Zhang W, Liu H, Jiang X, Wu D & Tian Y (2014): A longitudinal study of posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control in adolescents after an earthquake in China. PLoS One 9, e88263.
Zheng Y, Fan F, Liu X & Mo L (2012): Life events, coping, and posttraumatic stress symptoms among Chinese adolescents exposed to 2008 Wenchuan Earthquake, China. PLoS One 7, e29404.
This post is written by Anupa Pathak. Anupa is a third year undergraduate physiotherapy student at Kathmandu University School of Medical Sciences, Dhulikhel Nepal.
Contact Anupa: firstname.lastname@example.org
Part of the article is written by Saurab Sharma.