Hurricane-Related Distress

Charles R. Figley, Ph.D.

FSU Traumatology Institute

Issues: Facing a third hurricane hit when recovering from another how to cope for yourself, your children, your elderly parents and grandparents, and how to defuse hurricane stress-related rage. Based on more than 50 years of research on hurricane-related human behavior:

A. Background

•  Four phases each with its own set of demands (or stressors):

•  Phase I: Anticipation and Preparation (A&P) Starts from warning to impact (if any)

•  Phase II: Disaster Impact (DI). Lasts as long as there is perceived immediate danger (shortest phase of the 4)

•  Phase III: Immediate Post-Disaster Impact (IPDI). Starts with return to a sense of safety and ends with a sense of normality (or new normality)

•  Phase IV: Long-term Post-Disaster Impact (LPDI). Starts after a sense of normality and never ends with elevations.

•  Phase I (A&P): Human reactions range from panic buying and preparing to hostile avoidance and denial. Best to attempt to gain as much control over stress as possible by making effective preparations. Do not forget to arrange for a contact person and point. Follow local law enforcement and disaster management authorities. In shelters volunteer and keep busy. Greatest interests are when will the storm hit, where, what happened to my stuff and loved ones.

•  Phase II (DI): Shortest phase is associated with seeking safety and making mental notes of what was done right to cope and stay safe. Keep mind occupied, especially if very fearful. Praying or some regularized, ritualized activity is useful. Greatest interest is staying alive.

•  Phase III (IPDI): Most dangerous phase because of efforts to return home is risky. There is a desperate need try to return to normal. Greatest interests are what happened to my stuff and loved ones, should we rebuild or vacate, what is best for my family.

•  Phase IV (LPDI): Longest phase is associated with creating a new normal, grieving the losses, thankful it was not worse and potential growth, efforts to recover by drawing upon own personal and social resources, some need help in doing so. Most recover completely unless there are other emotional issues or mental disorders (e.g., previous trauma, grief of loss, depression, storm-related phobia).

•  Phase II (DI) experience of stress include rushes of adrenalin, we have a heightened sensitivity, a hypersensitivity to whatever the stressor is and if that heightened sense of awareness isn't quelled in a reasonable sense of time, we can see decreases in immune system, feelings of getting sick, decrease in health in general,

B. Coping with Anxiety During Phase I

1. Prepare as best you can. Taking action to protect yourself or your family can help restore a sense of control.
2. Try some exercise. It'll help relieve stress build-up.
3. Realize nerves may be on edge. Be patient.
4. Accept that the storm will do what it wants.
5. Be safe, but don't feel as if you have to put everything in your life on hold. Go about your normal business as much as possible.
6. Keep kids busy with games, including those functional without electricity
7. Be aware kids know when you are scared.

C. Coping with Anxiety During Phase III

1. Parents must be on the same team and focus on the welfare of the children first.
2. Be patient and flexible with children's behavior and reactions (both physical and emotional).
3. Kid's reactions (like adults) vary greatly: they have suffered losses too, and it's natural for them to express disbelief, anger, sadness, anxiety and depression afterwards.
4. Emotions of hurricane survivors often follow a roller coaster pattern of changes in mood, emotion, energy --- can change unexpectedly.
5. Children, in particular, resent the shattering of their routine. That resentment may manifest itself in enormous guilt, nightmares, temper tantrums and problems at school.

D. Post-Hurricane Trauma Generally

1. Mental health experts say the unscathed often suffer "survivor's guilt.''
2. People suffering survivor's guilt often push themselves to the limit trying to help.
3. There is a natural grieving process -- denial, questioning, acceptance and recovery -- after the loss of normalcy, loved ones and property.

E. Signs of Stress in Adults

1. Fear, disbelief, suspicion, anger, anxiety or apathy.
2. Short temper, moodiness and irritability.
3. Reluctance to abandon property.
4. Guilt over having been unable to prevent the disaster.
5. Confusion, numbness and flashbacks.
6. Difficulty in making decisions.
7. Excessive helpfulness to other disaster victims.
8. Loss of appetite.
9. Crying for no apparent reason.
10. Increased effects from allergies, colds and flu.
11. Rejecting outside help or feeling disappointed with outside help.
12. Isolation from family, friends and social activities.
13. Domestic violence.

F. How to Cope with Adult Stress

1. Recognize and accept your feelings -- and realize you're not alone.
2. Talk to others, including family, friends or clergy, about your feelings.
3. Be patient -- accept that restoring your life to normalcy will take time.
4. Keep family meals as nourishing and on as much of a routine as possible.
5. Get as much sleep as possible.
6. Relax -- a deep breath and vigorous stretch helps reduce tension and stress.
7. Whenever possible, do something enjoyable -- read a book, go to the movies.
8. Walk or jog.
9. Hug your family and friends -- affection and touching can be soothing.
10. If your stress symptoms persist, seek professional help.

G. Signs of Stress in Children

1. Head and stomach aches.
2. Reluctance to go to bed.
3. Insomnia and recurring nightmares sparked by fear that the hurricane will return.
4. Regressive behavior such as bed-wetting, thumb-sucking and clinging to parents.
5. Fantasies that the hurricane never happened.
6. Withdrawal.
7. Temper tantrums, crying and screaming.
8. Shortened attention span, plummeting school performance or refusal to attend school.
9. Loss of appetite.
10. Loss of interest in playing.
11. Drug and alcohol use by older children.

H. How to Help Your Child Cope

1. Like you, children are scared. Understand their fears -- real or imagined -- and reassure them they are safe. Extra attention and hugs are important.
2. Allow children to express their feelings in conversations, drawings or activities. Children sometimes think scary things will go away if they block them out.
3. Share your feelings with your children; let them know their feelings are normal.
4. Answer questions thoughtfully. Take extra time to make sure the explanation is simple and open for discussion.
5. Be patient.
6. Let children know they are not responsible for the disaster. Tell them how being a prepared member of the family helped everyone feel safe.
7. Allow children to help in the cleanup. Children who feel they belong are likely to feel more self-assured.
8. Give extra doses of praise for good behavior.
9. Resume your normal routine as quickly as possible. Provide the same snacks you used to. Make time for family activities such as playing games.
10. Encourage children to help those less fortunate than themselves. Allow them to prepare food, clothing and other items for donations.
11. If your children continue to show stress signs, seek professional help. Your children's stress may be more than you can handle.

I. How to Help the Dependent Elderly or Others with Disabilities

1. Often overlooked and neglected.
2. Yet their fear and stress reactions are greater than any other group because they are so dependent upon others (others who now may be greatly affected by the storm).
3. Listen carefully to their needs.
4. Write it down like a check list so that they can see needs are being addressed.
5. Call on as many supporters outside the affected area as possible to do anything they can – even phone calls are useful.

J. Issues about Multiple Hurricane Adjustment

1. When there is an overlap in recovery phases (e.g., Phase IV of Charley, Phase III of Frances, and Phase I of Ivan) yields Hurricane Stress Fatigue for those most affected.
2. The best treatment (if possible) is complete removal from the area in order to regain stability).
3. Most people must draw upon what sustained them in earlier trying times, including the spirituality.

K. Useful Observations [New York Times (September 14, 2004)]:

[Florida Governor Jeb] Bush conceded that residents were worn thin. "I don't know if it's the five-day forecasts or the slowing down of the last two storms that's created a little bit of a challenge in terms of people's patience levels," the governor said.

He encouraged residents not to fixate on the day-to-day swings of the storm. Everyone in the danger zone, he said, should prepare and then focus on other thoughts, perhaps the outstanding high-school and college football teams in the state.

Thus,

1. Patience levels lowed when forecasts are extended.

2. Prepare then focus on other more pressing or enjoyable issues.