Coping with trauma after a calamity

Trauma can change the brain’s architecture. If not prevented, it can cause lifetime psychiatric problems.

Trauma (from Greek word, "wound") also known as "injury", is a physiological wound caused by an external source, according to Wikipedia.

“Few weeks after the traumatic incident, if there is Post Traumatic Stress Disorder, there will be avoidance, hyperarousal and reexperiencing,” said Dr. Aimee Chua, a child and adolescent psychiatrist in Iloilo.

“There will be flashbacks, nightmares, numbness, body pains,muscle tension and other symptoms. It’s as if the incident is happening to you again. That’s why rape victims sometimes crawl as if escaping from a perpetrator; or soldiers have nightmares of being in battle,” she added.

Volunteers during a discussion. JAGAT RUBIO PHOTO

Activity for parents and children. JAGAT RUBIO PHOTO

Dr. Chua said the trauma caused by typhoon Yolanda manifests in the physical, psychological, cognitive, behavioural and spiritual levels.

Some manifestations are irritability, disobedience, hyperactivity, nervousness, clingy to parents/anxiety about separation from parents, shorter attention span, aggressive behaviour, repetitive talking about experiences, exaggeration or distortion of disaster experience, exaggeration of behavior problems, bedwetting, loss of appetite/overeating, sadness, fear of darkness, fear of animals, fear of “monsters”, fear of strangers, fear of rain, wind, storms, withdrawal from play groups, friends, family members; people may ask if indeed there is a God. If yes, why did God allow this to happen?

She said there is no medicine to manage trauma, especially the normal post-disaster reactions.
“But the coping style has to be positive and activities should be purposeful,” she said.

“There should be relaxation techniques such as deep breathing and imagining that you are in a safe place. This way, they can control their fear and have courage to start again. It’s important for parents to relax. Children see the world through their parents’ eyes,” she warned.

“It is also at this stage that victims feel numb. Guide them on what steps to take next,” she said.

Let children play. JAGAT RUBIO PHOTO

TIME WITH THE ADULTS.  She encourages other groups who want to engage in psycho education to gather small groups of adults together and not include the children in the conversations.
“It’s better if the children are not in the conversations so that they will not be exposed to the seriousness of the situation,” she said.

She narrated a case wherein a child’s grandfather died. Whenever people visit their home for the wake, the adults would call the child to be interviewed by the guests. “So, she cries everytime. This is not encouraged,” she said.

She added that parents should be made aware that children exposed to trauma may need their attention and presence more.

“Let the children eat properly, do not expose them to more trauma, keep them warm, keep them safe and do not shout at them, don’t promise what you can’t give and do not expose them to scenes of the disaster on the television and news,” she said.

“Encourage parents to do something and not depend on relief goods. For example, when there’s a feeding program, let them prepare the food. Let them work together. Rebuilding and rehabilitation should be a community effort. This will help them return to their routine,” she said.

“After 8 weeks, they’re supposed to return to their old routine. Schools should be open by then. Sadly, in Concepcion, parents said they don’t have anybody to leave their kids with, so they can’t go on with their livelihood.”

TIME WITH KIDS. Dr. Chua said all the activities for the children should have beauty, harmony and order. Her suggestions are:

* Let storytelling be descriptive and full of metaphor so that children will imagine rather than feel. Do not rouse strong emotions that they may not be able to handle.
* No lectures
* In the drawings and songs, let them see beauty again.
* Let them play to interact with one another and encourage more movement.

About 30 to 40% of victims may develop post traumatic stress disorder (PTSD), depending on the severity of the experience, age and past experiences. “Those who have a previous history of psychiatric disorders will have higher risk,” she said.

The child will need professional help when:
* If the child talks about suicide. Call Hopeline 24/7 Suicide Prevention and Emotional Crisis Lines: 02-8044673; 09175584673; 2919 (for Globe and TM)
* Manifests serious destructive acts towards people, animals, and property
* Has loss of appetite for more than a week
* Has difficulty sleeping for more than a week
* Has blank stares
* Develops any kind of extreme behavior
* Shows self-destructive behaviour

 “If a risk for PTSD is identified, immediately refer for evaluation and treatment. We have already seen two cases in the WVSUMC wherein the children could not sleep and with other anxiety symptoms. The parents were scared that it will worsen, so they sought treatment,” she said.
Psychiatric treatment and medications for PTSD may last 6 months or more../Marie Katherine Villalon/

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