Tips for Helping You and Your Family Cope with Disaster by the North Carolina Psychological Foundation Disaster Response Network

Based on information compiled from the American Psychological Association and other disaster mental health websites

WHAT TO EXPECT AFTER A DISASTER OR OTHER TRAUMATIC EVENT

Shock and denial are typical responses. Shock is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned, numb or dazed. Denial involves your not acknowledging that something very stressful has happened, or not experiencing fully the intensity of the event.

After shock subsides, reactions vary from one person to another. Normal responses include:

• Feelings become intense and sometimes are unpredictable. You may become more irritable than usual, and your mood may change back and forth dramatically. You might be especially anxious or nervous, or even become depressed.
• Thoughts and behavior patterns are affected by the trauma. You might have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions or become more easily confused. Sleep and eating patterns also may be disrupted.
• Interpersonal relationships often become strained. Greater conflict, such as more frequent arguments with family members and coworkers, is common. On the other hand, you might become withdrawn and isolated and avoid your usual activities.
• Physical symptoms may accompany the extreme stress. For example, headaches, nausea and chest pain may result and may require medical attention. Pre-existing medical conditions may worsen due to the stress.

HOW SHOULD I HELP MYSELF AND MY FAMILY?

There are a number of steps you can take to help restore emotional well-being and a sense of control following a disaster or other traumatic experience, including the following:

• Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced.
• Try to be patient with changes in your emotional state.
• Ask for support from people who care about you and who will listen and empathize with your situation. Recovery is quicker with support.
• Communicate your experience in whatever ways feel comfortable to you - such as by talking with family or close friends or keeping a diary.
• Engage in healthy behaviors to enhance your ability to cope with excessive stress.
• Eat well-balanced meals and get plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through relaxation techniques. · Avoid alcohol and drugs.
• Establish or reestablish routines such as eating meals at regular times and following an exercise program.
• Take some time off from the demands of daily life by pursuing hobbies or other enjoyable activities.
• Avoid major life decisions such as switching careers or jobs if possible because these activities tend to be highly stressful.

HOW MIGHT CHILDREN REACT?

The intense anxiety and fear that often follow a disaster or other traumatic event can be especially troubling for children. Reactions may include:

• Extreme feelings such as sadness, worry, irritability, fear, or guilt.
• Regression or younger behaviors such as thumb sucking or bed-wetting.
• Children may be more prone to nightmares and fear of sleeping alone.
• Performance in school, memory, or concentration skills may suffer.
• Changes in eating.
• Other changes in behavior patterns may include throwing tantrums more frequently, withdrawing or becoming more solitary.

HOW TO HELP CHILDREN COPE

There are several things parents and others who care for children can do to help alleviate the emotional consequences of trauma, including the following:

• Give age-appropriate information about the disaster. Limit exposure to news coverage, esp. with younger children.
• Children are often most interested in knowing about any impending changes in their lives. Be honest and optimistic.
• Remember that children watch their parents closely for reaction; parents in a state of anxiety only intensifies a child's own vulnerable feelings. Parents can admit concerns but also emphasize their healthy skills in coping.
• Normalize symptoms.
• Encourage children to speak with you, and with one another, about their thoughts and feelings. This helps reduce their confusion and anxiety related to the trauma. Allow them to ask questions.
• Spend more time with children and let them be more dependent on you during the months following the trauma. More reassurance and physical affection is very comforting to children who have experienced trauma.
• Provide play experiences to help relieve tension. Younger children in particular may find it easier to share their ideas and feelings about the event through non-verbal activities such as drawing.
• Develop an atmosphere of mastery by recalling times when he family has dealt with adversity in the past and reassurance about dealing with adversity in the future. Involve them in recovery activities where appropriate.
• Respond to questions in terms they can comprehend.
• Reassure them repeatedly that you care about them and that you understand their fears and concerns.
• Keep regular schedules for activities such as eating, playing and going to bed to help restore a sense of security and normalcy.

WHEN SHOULD I SEEK PROFESSIONAL HELP?

Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. It is not unusual to find that serious problems sometimes persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.

With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal, and other signs of intense anxiety or emotional difficulties all point to the need for professional assistance.

Psychologists and other mental health providers help educate people about normal responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact. A qualified mental health professional can also help children and their parents understand and deal with thoughts, feelings and behaviors that result from trauma.

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