Thursday, August 11, 2005

Hurricane Stress: Before, During, and After

While tracking the storm can be an exhilarating pastime, enduring the storm, and it’s aftermath, can be something else entirely. I suspect that long-term, the stress of these storms claim more lives than the winds do.

BEFORE:

The buildup to the arrival of a Hurricane is probably more stressful today than ever before. Why? Because we know it’s out there. Often for days or weeks in advance. We can track these storms, watch them grow, and we then look around and envision the damage and disruption to our lives that is advancing towards us from just over the horizon.

Those of us who live in the path have more at stake financially than ever before. Homes are more expensive, as is the cost of insurance. We depend on our infrastructure more today than at any time in the past. Cable, Internet, phones, electronic banking . . . things that didn’t exist 40 years ago, and are integral to our lives, can be disrupted.

We also know, deep in our hearts, that we all live a little closer to the edge financially than our parents. How many people are just one paycheck away from being homeless? A Hurricane, and the disruption to their lives and employment, is an ominous threat to their lives.

And of course, for the survivors of previous storms, the specter of going through it again is paramount. If it was bad the last time, will it be as bad this time? If they were lucky the last time, will their luck hold? The mind reels and the stomach turns.

Putting up plywood, filling the bathtub with water, and checking evacuation plans are not just mechanical steps taken by those familiar with storms. They are stress-producing reenactments of the last time their lives were altered. And as the stress, and anticipation builds, the body begins to generate adrenalin. Cortisol levels may drop. Emotions may run high. Depression and despair, along with a sense of fatalism, may prevent some from taking appropriate action.

DURING:

For some, a Hurricane is a grand adventure. A near miss, or a low cat storm can be very exciting, and may not produce an inordinate amount of stress. At least not in everybody. But a big storm, one that forces you onto the road in an attempt to flee to safety, or one that locks you into an interior closet with six relatives for 12 hours, will produce enormous amounts of stress.

During a crisis, some people cave, while others rise to the occasion. But make no mistake; even those who act valiantly during a crisis do not go unaffected. They simply delay the effects, suppress the emotions, and will pay, one way or another, at a later date.

Cops, firefighters, paramedics, doctors and nurses are often exposed to extreme stress, and most of the time they react admirably during the crisis. They rely on training and the appropriate directing of the adrenalin in their systems. Afterward, what most people rarely see, are the shakes, tears, and vomiting that sometimes comes when the adrenalin bleeds off after a particularly bad call.

It isn’t a weakness, or a failure on their part. It is a natural reaction to the chemicals released into the body. Epinephrine and norepinephrine are powerful drugs.

The psychological effects last long after the physical ones. Most responders won’t talk about their dreams, but I can assure you, they are not pleasant. And they never go away.

The longer a crisis lasts, the harder it is to deal with. And the longer the effects will last. A car accident may only last a few seconds, but can change a person forever. Imagine the effects of lying in debris, your house collapse around your, perhaps with loved ones unaccounted for, for hours. Some people have endured this sort of thing for days.

No matter what, no one walks away from a major Hurricane unscathed.


AFTER:

During WWI and WWII it was called shell shock. Today, we call it PTSD. Post Traumatic Stress Disorder. It doesn’t require being hunkered down in a foxhole during a mortar barrage to get it. Hurricanes, car wrecks, and even long term financial or medical problems can precipitate it. It’s very real, and it produces distinct physical changes in the body.

The stress of living in third world conditions for days or weeks, looking for lost friends and relatives, rebuilding, finding a new job, or recovering from injuries is enormous and should not be underestimated.

Hormone levels, and naturally occurring opiates released in the brain, along with thyroid levels are all significantly altered by PTSD. Corticotropin releasing factor, CRF, which serves to jumpstart people into acting during a crisis often remains elevated in these people, for months and sometimes for years. They may appear `jumpy’ or `nervous’ to others.

It happens more often, and to more people, than you can imagine. And no, you can’t just tell someone to snap out of it.

The long-term effects of these storms is poorly understood. How many heart attacks, suicides, or psychiatric disturbances they inspire is unknown. But you can be sure, they are not insignificant. And with the portent of an active season, these costs could be enormous.

A great link on PTSD, and the effects of stress is provided at the bottom.

Link: http://www.nmha.org/camh/anxiety/ptsd.cfm

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