The following article was included in an e- newsletter from the Mental Health Association in North Carolina

North Carolina is no stranger to hurricanes and the devastation they can cause, but Hurricane Katrina has proven to be one of the largest humanitarian tragedies the U.S. has ever seen. Communities have been destroyed and many citizens have lost everything, including the lives of loved ones. As this crisis continues to unfold, it is important that we recognize the mental health needs of those on the Gulf Coast, as well as of ourselves and our children who are being exposed to the events of Katrina through the media and are therefore experiencing the emotions, anxieties, and fears associated with disasters. MHA/NC would like to express our support in this time of tragedy. Please read below for articles on Dealing with Stress, Surviving Sudden Loss, and Helping Children Cope.

For more information or resources, please visit us online at www.mha-nc.org, or contact our Information & Referral line at 1-800-897-7494 or callctr@mha-nc.org

Dealing with Stress

Whether you have family and loved ones in the Gulf community or whether you just engaged through devastating images brought to us by the media, we are all trying to make sense of what has happened during and in the aftermath of Hurricane Katrina. Of course none of us are affected the way those community members who were hot directly and have lost everything. An event such as this creates a tremendous amount of stress, anxiety, and emotional and physical exhaustion for those both directly and indirectly affected. In the days and weeks to come, you may begin having some of these common reactions:

  • Disbelief and shock
  • Fear and anxiety about the future
  • Disorientation; difficulty making decisions or concentrating
  • Apathy and emotional numbing
  • Nightmares and reoccurring thoughts about the event
  • Irritability and anger
  • Sadness and depression
  • Feeling powerless
  • Changes in eating patterns; loss of appetite or overeating
  • Excessive crying
  • Headaches, back pains and stomach problems
  • Difficulty sleeping or falling asleep
  • Increased use of alcohol and drugs

Tips for Coping

It’s normal to have difficulty managing your feelings after major traumatic events. Because everyone experiences stress differently, don’t compare your progress with others around you or judge other people’s reactions and emotions. Here are some tips for coping with stress:

Talk about it. By talking with others about the event, you can relieve stress and realize that others share your experience and feelings.

Spend time with friends and family. They can help you through this tough time. If your family lives outside the area, stay in touch by phone. If you have children, encourage them to share their feelings and concerns with you.

Take care of yourself. Get as much rest and exercise as possible, and eat properly. If you smoke or drink coffee, try to limit your intake, since nicotine and caffeine can add to your stress.

Take one thing at a time. Pick one urgent task and work on it. Once you accomplish that task, choose the next one. Completing each task will give you a sense of accomplishment and make things feel less overwhelming.

If you can, help. Give blood, prepare “care packages” for people who have lost relatives or their homes or jobs. Volunteer in a rebuilding effort. Helping others can give you a sense of purpose in a situation that feels beyond control.

Avoid drugs and excessive drinking. Drugs and alcohol may seem to help you feel better, but in the long run they generally create additional problems that compound the stress you’re already feeling.

Ask for help if you need it. If your stress doesn’t begin to subside or is so strong it interferes with your ability to function in daily life, talk with a trusted relative, friend, doctor or spiritual advisor. You may want to make an appointment with a mental health professional to discuss how well you are coping with recent events. This could be especially important for people who had existing mental health problems or those who’ve survived past trauma. You could also join a support group. Don’t try to go it alone. Asking for help is not a sign of weakness.

Surviving Sudden Loss

The death of a loved one is painful enough but sudden loss is shocking. When death is sudden, as during a natural disaster like Hurricane Katrina, it doubles our pain and intensifies the grief. Mourning and recovery are more difficult for surviving family members, regardless of their age. Many, if not most, survivors will be in denial of the tragedy, some for a very long time.

Children’s Response to Loss

In general, the loss of a parent, sibling, relative or friend will mean a loss of sense of security for a child. Also, while pre-schoolers have difficulty understanding that death is not temporary, older children, between the ages of five and nine, begin to experience grief more like adults.

Children express grief in a variety of ways, including appearing to be unaffected. But, no matter how a child appears on the outside, there may be grief beneath the surface. Here are some common ways children respond to a death:

  • Anxiety or panic
  • Unexplained anger
  • Boisterous play
  • Crying often and easily
  • Difficulty concentrating
  • Sleeplessness
  • Loss of appetite or other eating disruption
  • Increased physical complaints or illnesses
  • Acting younger, possibly reverting to bed wetting, thumb sucking or baby talk
  • Fear of being alone
  • Sharp drop in school performance or refusal to attend school

Helping Children Cope with a Loss

  • Respond patiently to children’s concerns.
  • It can take them a long time to recover from a loss.
  • Expect their grief to revisit in cycles as strong reminders, such as the anniversary of a death, reawaken grief. Keep children’s routines as regular as possible.
  • Children grieve not only for the person but also for changes in the household and environment of family and friends.
  • Whenever possible, offer children choices in what they do or don’t do to memorialize the deceased and ways to express their feelings about the death.
  • Help the child plant a tree or dedicate a place in memory of the person who died.
  • Give children a chance to talk about their feelings. But don’t push them to talk.
  • Children, like adults, need time to grieve and be upset. Let them know you are ready to listen and provide reassurance when they express their feelings.
  • To lessen confusion, avoid expressions such as “passed on” or “went to sleep.”
  • Answer their questions about death simply and honestly. But, only offer details they can absorb.
  • Don’t overload them with information.

Adults’ Response to Loss

Some common ways that adults respond to a death include:

  • Feeling numb, emotionless or lost
  • Feeling cheated
  • Guilt over failure to protect their loved one
  • Frustration, anger, fear or uncertainty
  • Difficulty concentrating and making decisions
  • Overworking
  • Forgetting things
  • Difficulty with changes in routine
  • Calling in sick frequently

Helping Yourself and Others with Loss

The more sudden and unexpected the death, the harder it is for people to express support. Often, the fear of saying or doing something “wrong” keeps people from offering support. Remember, the more tragic and unexpected the event, the greater the need for support.

Here are some ways to help yourself:

  • Do your mourning now. Being brave is important but don’t miss an opportunity to cry. It’s not self indulgent, but a sensible and honest way to deal with your emotions.
  • Repressed feelings don’t go away. Express your feelings. Remember that people do recover from sudden loss and that you too can move through this terrible pain and begin to heal.
  • Bear in mind that emotional pain isn’t constant. We will love forever but we don’t need to grieve forever to honor that love.
  •  Get support from others – counselors, support groups, bereavement groups, compassionate friends, or other sudden loss survivors. You may find them through a hospice, place of worship, or community or social agency.

Here are ways to help others:

  • Acknowledge the loss in some way.
  • Send a card. Help to plan a memorial service. Observe a moment of silence at a community event.
  • Offer help to the family by making a meal, providing transportation or babysitting a child.
  • Offer words of sympathy. Speak from the heart, but be mindful of the different ways in which people mourn.

If your stress doesn’t begin to subside or is so strong it interferes with your ability to function in daily life, talk with a trusted relative, friend, doctor or spiritual advisor. You may want to make an appointment with a mental health professional. This could be especially important for people who had existing mental health problems or those who’ve survived past trauma. Don’t try to go it alone. Asking for help is not a sign of weakness.

Helping Children Cope

Children respond differently to disaster, depending on their understanding and maturity, but it’s easy to see how an event like Hurricane Katrina could leave a child feeling a good deal of anxiety. Kids who live in the track of the hurricane felt firsthand the threat of danger to themselves and those they care about. However, children in North Carolina may be re-living the fears from previous hurricanes such as Floyd or Fran. Or they may be experiencing fears of “Could this happen to us?” It’s important to comfort your children and reassure them that they’re safe. It’s also important to be open and honest with them in discussing unforeseen consequences of Hurricane Katrina.

Pre-School Age Children

Such behaviors as bed-wetting, thumb sucking, baby talk, or fear of sleeping alone may worsen in young children or reappear in others. Children may complain of stomach cramps or headaches and be reluctant to go to school. It’s important to remember that these children are not being bad. They are afraid and their feelings are real.

Here are some ways to help preschoolers cope with their fears:

  • Reassure them that they’re safe.
  • Provide extra comfort and contact by discussing the child’s fears at bedtime, telephoning them during the day, and giving them plenty of hugs.
  • Get a better understanding of their feelings about the entire event.
  • Talk with them and find out each child’s particular fears and concerns.
  • Answer all their questions, responding with respect and comfort.
  • Structure children’s play so that it serves as a constructive outlet for expressing fear or anger.
  • Limit their media exposure to the event

Grade School-Aged Children

Children this age ask many questions and it’s important that you try to answer them in clear and simple language. If a child is concerned about a parent who is distressed, don’t tell a child not to worry—that will just make him or her worry more.

Here are several other things to remember with this age group:

  • Be realistic in your reassurances.
  • Don’t say disasters will never affect your family again.
  • Children will know this isn’t true.
  • Instead, say, “You’re safe now and I’ll always try to protect you.”
  • Remind children that disasters are very rare.
  • Monitor children’s media viewing.
  • Seeing replayed images of the hurricane and its damage can be frightening to children, especially if they think the event is happening all over again.
  • Limit the amount of media coverage they see.
  • Schedule activities—dinner, a walk, story reading, drawing, or a movie – during the evening news hours.
  • Encourage expression through play or drawing.
  • As with younger children, school-aged children sometimes find comfort in expressing themselves through playing games or drawing scenes of the disaster.
  • Encourage them to do so and then talk about it.
  • Don’t be afraid to say, “I don’t know.”
  • Part of keeping discussions open and honest is not being afraid to say you don’t have all the answers.
  • Explain that disasters of this kind cause troublesome feelings even in adults.

Adolescents

Adolescents often try to downplay their worries. It’s generally a good idea to talk about them anyway, keeping the lines of communication open and honest about the emotional, physical, and financial impact of the hurricane on your family. When adolescents are frightened, they may express their fear through acting out or regressing to younger behavior.

When dealing with teens, remember to:

  • Provide careful supervision and additional support, especially for those teenagers with pre-existing emotional problems such as depression.
  • Ask, as part of dinner conversation, how or if the hurricane was discussed at school.
  • Monitor their media exposure to the event, including information received on the Internet.