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Coping After Disaster

 See APA blog - Coronavirus and Mental Health: Taking Care of Ourselves

If you are experiencing a crisis, the resources below are available to help now:

       Disaster Distress Helpline           
           1-800-985-5990                       National Suicide Prevention Lifeline
                                                                               1-800-273-8255
            Crisis Textline                                    Chat online with Lifeline
      Text TALK to 741741

Following a disaster, most people will ultimately do well and return to their previous level of functioning. However, many people will initially experience distressing thoughts, feelings, and physical symptoms and may engage in risky behaviors to help cope. 

There are steps that individuals can take for themselves and their families to reduce negative effects and improve their ability to function at home, work, and school. This page features resources that can assist in coping with disasters and other traumatic events.              

            
•       Helping Adults                  

  Helping Adults Cope after a Disaster

  Following a disaster, most people will ultimately do well and return to their previous level of functioning.

  However, many people will initially experience distressing thoughts, feelings, and physical symptoms and may engage in risky behaviors to help cope. Some may develop psychiatric disorders, like depression, anxiety and posttraumatic stress disorder. The impacts and reactions can happen immediately or may appear after some time.

  There are steps that individuals can take for themselves and their families to reduce negative effects and improve their ability to function at home, work, and school.

  Common reactions in adults after a disaster:

  • Trouble falling asleep or staying asleep
  • Sadness, depression, hyperactivity, irritability or anger
  • Having no feelings at all or feeling numb
  • A lack of energy or feeling exhausted all the time
  • Lack of appetite or, the opposite, eating all the time
  • Trouble concentrating or feeling confused
  • Social isolation, reduced or restricted activities
  • Thinking no one else is haviang the same reactions as you
  • Headaches, stomachaches or other body pains
  • Misusing alcohol, tobacco, drugs or prescription medications to cope

  Helpful steps for adults after a disaster

  • Eat, hydrate, exercise, and get rest on a regular basis; taking care of your body reduces the negative effects of stress.
  • Avoid using alcohol, tobacco and other drugs to manage distressing emotions; these substances often make things harder in the long-run and can cause problems.
  • Find healthy ways to relax, such as breathing exercises, meditation, mindfulness, calming self-talk, soothing music.
  • Engage in fun and restoring activities, including exercise, hobbies and social activities.
  • Keep informed about new information and developments. Use credible sources of information to avoid speculation and rumors.
  • Limit exposure to television and social media content about the disaster; overexposure can increase distress.
  • Stay connected with friends, family, neighbors and colleagues to give and receive support. Helping one another aids in healing.
  • Learn what local health care and other resources are available; use and share this information to help yourself and others.
  • Remind yourself and others that its normal to have many different feelings as well as “good days” and “bad days” as a natural part of recovery.
  • Seek assistance from a health care professional if your distress remains high after several weeks, you are having persistent trouble functioning at work or home, or thinking about hurting yourself or someone else.
•       Helping Children      

  See also: Supporting Homebound Children During COVID-19 from the Center for the Study of Traumatic Stress

  Helping Children Cope with Traumatic Events

  Traumatic events are not easy for anyone to comprehend or accept. Understandably, many children feel frightened and confused. Fortunately, most children, even those exposed to trauma, are quite resilient. Parents, teachers and caring adults can help by listening and responding in an honest, consistent and supportive manner.

  By creating a supportive environment where children feel safe asking questions and believe their concerns are being heard, we can help them cope with stressful events and experiences and reduce the risk of lasting emotional difficulties. Although these may be difficult conversations, they are important. There is no "right" or "wrong" way to talk with children about these events.

  Below is information on common reactions and how to help children and adolescents after disasters.

  Common reactions in children and teens after a disaster

  • Trouble falling asleep or staying asleep
  • Sadness, depression, hyperactivity
  • Irritability or anger
  • Having no feelings at all or feeling numb
  • A lack of energy or feeling exhausted all the time
  • Lack of appetite or, the opposite, eating all the time
  • Trouble concentrating or feeling confused
  • Thinking no one else is having the same reactions as you
  • Headaches, stomachaches or other body pains
  • Very young children may become clingy, fearful, have tantrums, or resume behaviors such as bedwetting or thumb-sucking
  • School aged kids may get into fights, socially isolate, or have trouble with schoolwork
  • Adolescents and teens may use alcohol, tobacco, drugs or prescription medications to try to cope

  Steps to help children and adolescents after a disaster

  • Let children know there are people helping keep the community safe. It's a good opportunity to show children that when something scary happens, there are people to help.
  • Limit exposure to television and social media content about the disaster; repeated exposure to frightening or intense images increase distress.
  • Maintain routines at home and school as much as possible
  • Spend family time together; this can increase feelings of safety and provide helpful opportunities to talk and share.
  • Ensure they have regular meals and get good sleep every night.
  • Educate them to avoid using alcohol, tobacco and other drugs to manage distressing emotions.
  • Find healthy ways to relax, such as music, reading, sports, and other hobbies.
  • Stay connected with friends, family, classmates and neighbors to give and receive support. Helping one another aids in healing.
  • Use words and concepts children can understand. Gear your explanations to the child's age and understanding.
  • Make time and encourage kids to ask questions. Don’t force children to talk about things unless and until they're ready.
  • Give children honest answers and information. Children will usually learn if you’re making things up, which can diminish their trust in you.
  • Be prepared to repeat information and explanations several times. Some information may be hard to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
  • Acknowledge and validate the child's thoughts, feelings and reactions. Let them know that you think their questions and concerns are important and appropriate.
  • Remember that children tend to personalize situations. For example, they may worry about their own safety and the safety of immediate family members, friends and neighbors.
  • Be reassuring, but don't make unrealistic promises.
  • Help children find ways to express themselves. Some children may want to talk about their thoughts, feelings or fears. Others prefer to draw pictures, play with toys, or write stories or poems to help them cope.
  • Be aware of how you respond to the tragedy and talk about it with other adults. Children learn from watching parents and teachers.
  • Children who have experienced trauma or losses in the past may be more vulnerable to prolonged or intense reactions. These children may need extra support and attention.
  • Monitor for physical symptoms, including headaches and stomachaches. Many children express anxiety through physical aches and pains. An increase in such symptoms without apparent medical cause may be a sign that a child is feeling anxious or overwhelmed.
  • If the following are persistent or worsen over time, a child may need additional help: sleep disturbances, intrusive thoughts or worries, preoccupation with concerns about the event, recurring fears about death, diminished school performance, or aggression. If these or other concerning behaviors persist, seek help from your child's pediatrician, family physician or school counselor.

  Resources for helping children

  • A child’s reaction to disaster by age   (FEMA)
  • Helping Childrena nd Adolescents Cope with Violence and Disasters -- What parents Can Do (NIMH)
  • Tips for Talking with and Helping Children and Youth After a Disaster or Traumatic Event – A Guide for Parents, Caregivers, and Teachers (SMHSA)
  • Help Kids Cope – This app helps parents and caregivers talk with children about disasters; know what to do before, during, and after 10 disaster types; and know what to say “in the moment” to support your kids of all ages. (NCTSN)
  • Tips for College Students After a Disaster or Other Traumatic Event (Spanish) (SAMHSA)
  • Educational Fact Sheets for Helping Children and Families (CSTS)

Additional Resources

Reactions to Trauma; Recognizing Signs

• Mental Health: A Guide for Faith Leaders (APA) This Guide helps show faith leaders how they can support individuals with a mental illness, and where to direct them for treatment.
• Effects of Disasters: Risk and Resilience Factors   (NCPTSD)
• When Terrible Things Happen, What You May Experience   (NCTSN/NCPTSD-PFA)
• Community Violence: The Effects on Children and Teens   ;(NCPTSD)

Coping/Managing Stress 

• Tips for Survivors of a Disaster or Other Traumatic Event: Managing Stress (Spanish, Punjabi) (SAMHSA) 
• Asking for Help. Do you Know How? (CSTS)

Coping/Recovery – Specific Circumstances

• Recovery After Witnessing a Traumatic Event (CSTS)
• Coping with Stress Following a Mass Shooting (CSTS)
• Coping with Stress During Infectious Disease Outbreaks (Spanish) (SAMHSA)
• Alcohol, Medication, and Drug Use After Disaster    (NCTSN/NCPTSD - PFA)
• Helping Families Deal with the Stress of Relocation after a Disaster  (ATSDR)

Dealing with Grief

• Tips for Survivors: Coping With Grief After a Disaster or Traumatic Event (SAMHSA)
• Tips for Survivors: Coping with Grief After Community Violence     (SAMHSA)
• Children and Grief  (AACAP)

Apps for managing stress:

• Breath2Relax – Provides information on deep breathing exercises for calming and reducing anxiety and a tool for tracking your activity and progress. From the U.S. Department of Defense.
• Mindfulness Coach – Provides training in mindfulness to help with stress and relaxation as well as a variety of voice-guided practice sessions. It also has the ability for users to track their own progress. From the U.S. Department of Veterans Affairs.
• Virtual Hope Box – Provides guided relaxation techniques, tools for enhanced coping, games, and inspirational thoughts. From the U.S. Department of Defense.
• PTSD Coach - Provides users with information about post-traumatic stress disorder (PTSD), including educational resources, information about professional care, a self-assessment tool, opportunities to find support, and tools to help manage the stresses of daily life with PTSD. From the U.S. Department of Veterans Affairs.

Additional Information

• American Association of Child and Adolescent Psychiatry (AACAAP) Disaster Resource Center
• Centers for Disease Control and Prevention (CDC), Coping with a Disaster or Traumatic Event: Resources for Families
• Center for the Study of Traumatic Stress (CSTS)
• Federal Emergency Management Agency (FEMA), Coping with Disaster
• National Center for PTSD (NCPTSD)
• National Child Traumatic Stress Network (NCTSN)
• National Institute of Mental Health (NIMH), Coping with Traumatic Events
• Substance Abuse and Mental Health Services Administration (SAMHSA), Disaster Technical Assistance Center

Physician Review By:

Joshua C. Morganstein, M.D.
November 2019