Life after disaster strikes

For many of us, the morning of September 26, 2009 started like any other day. Yes, it was raining, but isn’t that the norm for that time of the year? I had to be at work that morning, but it was a bed-weather day. And since I was not rushing, I decided to snuggle in bed for an extra hour or so, and leave for work an hour later than I was supposed to. I woke from my sleep with a flood of text messages (pardon the pun). Typhoon Ketsana, locally known as Ondoy, hit the country. I knew then that it was not like any other day.

Over the next few hours, I found myself glued to my television and on the Internet as I watched - initially in amazement, later in shock and fear - the flood waters rise. In the days and weeks that followed, the damage that the typhoon had brought was still evident all over.

While the physical damage was obvious and fixable, the emotional and psychological trauma the disaster brought is another story.

For weeks after the incident, I would catch myself panicking at the sound of raindrops. The song lyric, “pumapatak na naman ang ulan sa bubong ng bahay”, that used to play automatically in my head when I would hear the pitter-patter of rain on the roof was replaced with flashbacks of the images I had seen during the flood. Tears would spring to my eyes and my chest would tighten as soon as I notice the rains getting stronger and water starting to pool on the ground, even if it was just as high as the sidewalk.

Ten months since the typhoons, I still feel my heart jump to my throat whenever I am driving home and there is a sudden downpour.

All these, despite the fact that, at the height of these typhoons, I was safe at home, warm and dry in a place that was virtually unaffected by the raging storm because I decided to go back to sleep instead of going to work.

During the time I was having those reactions, I would feel guilty because I felt I had no right to feel that way. If someone should be experiencing post-traumatic stress, I thought, it should be those who bore the brunt of disaster head-on: those who were trapped in their attics or had lost their homes, families and belongings during the flood, not me. After all, I lost nothing, not even electricity during the hours that followed.

What I was feeling were symptoms of post-traumatic stress.

The emotional aftermath of disaster

While I may have been lucky enough to not have had a full-blown Post-traumatic Stress Disorder or PTSD, some people were not. Maria*, for example, would have panic attacks and needed medication to help her deal with the trauma of the disaster. Even local celebrities such as Carmina Villaroel and K Brosas were “deeply affected” by the tragedy, as reported in an article. Villaroel even had to take time off from work because she was having difficulty coping with what had happened to her family and their home.

PTSD is defined by the National Institute of Mental Health (NIMH) as “an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat”. Essentially, it is a condition that some people get after witnessing, living through or experiencing a traumatic event.

People with PTSD may experience intense fear, anxiety, and feelings of helplessness or horror after the trauma. They may have flashbacks of the event and some may even go to great lengths to avoid being exposed to stimuli they associate with the incident.

The NIMH identifies three clusters of symptoms associated with PTSD. These are:

Re-experiencing symptoms. These include flashbacks wherein the individual relives the trauma repeatedly, nightmares and intrusive thoughts. A person with PTSD may also feel distressed when he or she is reminded of the trauma. At times, merely talking about the trauma may elicit intense physical reactions such as nausea, muscle tension, dry mouth, palpitations and muscle tension.
Avoidance symptoms. After the trauma, one may go through great lengths to avoid being exposed to stimuli associated with the incident, such as places, objects or people, even those that were previously enjoyed. They may feel emotionally numb and detached, as well as may avoid talking about what had happened. For some, they may actually be unable to recall the event. Other symptoms may include feelings of depression, worry and guilt.
Hyperarousal Symptoms. People with PTSD may be hyper sensitive to stimuli around them. They are easily startled or jumpy and may feel “on edge”. They are also hypervigilant or are on guard in case of anything. Sleep disturbances, irritability and anger outbursts are also common.

While we may often use the word “traumatized” loosely to refer to our response to difficulties and tragedies, the Diagnostic and Statistical Manual for Mental Disorders – 4^th Edition (DSM-IV) outlines a specific criteria for diagnosing PTSD which include the following:

Exposure to a traumatic event
Persistent re-experience, avoidance, and increased arousal
Experience of symptoms is more than 30 days
These symptoms cause the individual significant impairment and distress

I survived

While surviving a disaster or tragedy is often seen as a second birth or a second chance at life, for some, they come out of it with Survivor’s Guilt. They may ask themselves, “why did I survive when so many others did not?” Some may even feel besieged by thoughts of “if only I tried harder” and “what if I did this instead?”

Donna Marzo, Psy.D defines this as “a phenomenon often experienced by those who escape from a disaster that seriously injures and kills others. An individual dealing with this particular type of guilt may believe that they experienced a good fortune at the expense of others and that by attempting to save their own lives, they intentionally harmed others”.

While for some, the guilt feelings may exacerbate symptoms of trauma, others use this guilt as a motivator to help in relief efforts. In my case, this spurred me on to write a blog post about the different ways we can help after the disaster. For others, they are inspired to live better lives as a testament to those who did not survive.

The rainbow after the storm

PTSD can, at times, be like a thief in the night. Survivors of war or natural disaster, for example, may think they are fine and may not immediately feel anxious or stressed because of their experience. Months later, or in some cases even years later, they come across an event that may trigger their repressed trauma. What allows us, particularly Filipinos, to rise above such disaster is our innate sense of optimism and resiliency.

Treating PTSD and its symptoms is important in order to help the one experiencing make their way back to life as they knew it, or for some, create a “new normal”. Debriefing, psychotherapy and counseling are some ways of dealing with PTSD. Medication may also be prescribed by a physician to help a PTSD patients address their condition.

If you have friends or family who are experiencing post-traumatic stress, you can be a great help by simply being there and letting them talk about their experience. It is important, however, not to belittle their experience or ridicule them with statements like “OA na yan, ha” (you’re overreacting to nothing). For children, story books, art activities and other expressive exercises can help relieve their stress and anxiety.

Disasters do not end when the debris is cleaned up and swept away. It changes us in countless ways.

*Not her real name.

Photos: “Fear's Feelings !!!” by ŇÄĵŵÅ Ă. Мǻŗǻƒįę, c/o Flickr. Some Rights Reserved / “Fear” by , c/o Flickr. Some Rights Reserved / “190/365: Instead of watchin' rainbows I'm gonna make me some” by Janine, c/o Flickr. Some Rights Reserved.

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Maria Andrea (Ria) S. Tirazona, M.S. (cand.), popularly known as Yapatoots in the online blogging and social networking community, is a preschool teacher at Playschool International and part-time lecturer at the Psychology Department of De La Salle University. She is also an Associate Psychologist atPsychConsult, Inc, where she specializes in Psychological Assessment. She holds a Bachelor's Degree in Family Life and Child Development from the University of the Philippines and is currently working on her thesis for her Master's Degree in Clinical Psychology at the De La Salle University. In her spare time she maintains several blogs, including www.theaccidentalteacher.com, www.fatgirlnomore.com andwww.yapatoots.com.