The emotional aftershocks of Haiti's earthquake

Eulalee Thompson - BE WELL

Long after the wounds have healed, bodies buried and buildings in Port-au-Prince reconstructed, it is the mental-health issues that will linger among the people of Haiti. These are invisible wounds of trauma and grief that will affect their lives and relationships.

When the search and rescue teams complete their work, the psycho-social team should be included in efforts to reconstruct the lives of people exposed to mind-boggling traumatic events such as an earthquake or hurricane.

Recognise when someone is grieving

Significant life events involving loss, such as the death of someone close, divorce/break-ups or terminal illness can trigger stages of grief reaction extending up to two years for most, and a lifetime for some. Grief has stages:

1. Shock and denial: The loss is received with numbed disbelief. However, denial plays the important function of emotional protection from being overwhelmed by the event all at once. This stage may continue for weeks.

2. Anger and pain: Shock and denial gives way to anger and pain. The individual keeps wondering, "How can this be happening to me?" or "Why me?" or "This just isn't fair."

The grieving individual will experience excruciating, almost unbearable emotional pain. He or she may try to self-medicate with alcohol and drugs. But this stage, where life feels chaotic and scary, is a normal part of grieving.

3. Bargaining: Wishing and begging for the impossible, such as for the lost one to come back.

4. Depression: The grieving individual begins to think: "I miss my loved one, why go on?" or "I am feeling so sad, why bother myself about anything?" Well-intentioned friends and relatives may try "to talk the grieving person out of it", however, the grieving person is isolating himself/herself and reflecting on the magnitude of the loss.

5. Acceptance and hope: The individual will eventually adjust to the loss and accept the reality of the situation.

Post-traumatic stress disorder

Even more important in the Haitian earthquake situation is the condition, post-traumatic stress disorder (PTSD). As many as 30 per cent of people exposed to frightening and traumatic events will experience PTSD indicators.

This condition can occur after experiencing or witnessing serious road accidents, being held hostage, violent deaths, violent personal assaults such as sexual assault or robbery, and natural or man-made disasters, such as earthquakes and hurricanes.

A local study conducted in Kingston after Hurricane Ivan in 2004 (Thompson & Abel, West Indian Medical J 2009: 58 (2): 174) found that a significant number of persons who were anxious or fearful in the hurricane or suffered loss of property or death of someone close were at risk of developing PTSD symptoms.

The condition causes severe distress as the individual with PTSD continues to re-experience the trauma in nightmares and intrusive recollections over which he or she feels that he or she has no control. He or she also tries to avoid memories of the events and often becomes detached from people close to him or her. Persons with PTSD (including children), also become irritable, with frequent angry outbursts, and have difficulty sleeping and concentrating.

Eulalee Thompson is health editor and a professional counsellor. Email: eulalee.thompson@gleanerjm.com.