After the Storm: How to Deal with Mental Health Challenges

Hurricane Ian’s financial costs will run into the billions. But its emotional, mental, and physical costs are incalculable.

Mental health issues after a catastrophic event like Hurricane Ian don’t always appear right away, either. They can affect people for years. Studies show that survivors of life-changing natural disasters face increased risk of developing anxiety, depression and post-traumatic stress disorder (PTSD).

“Traumatic events like Hurricane Ian are marked by a sense of horror, helplessness, serious injury, or the threat of serious injury or death, “ says Dr. Ronald Smallwood, a psychiatrist with Lee Health/Lee Physician Group. “They affect survivors, rescue workers, and the friends and relatives of victims who have been involved.”

Dr. Smallwood offers expert insight into PTSD and how we can cope in the aftermath of Hurricane Ian. Board-certified in psychiatry and neurology, he’s also a Florida native.

Q: What kinds of emotions could people affected by the storm be feeling right now?

A: I imagine people are feeling a wide array of emotions, understandably. During the storm and the immediate events leading up to it, our “fight or flight” response was active as we all prepared and were on edge, waiting for the event. Now, afterward, there’s a feeling of exhaustion as we handle or are still enduring days of living without power and water.

Also, many of us may be feeling a sense of defeat and despair, seeing images of the devastated landscape, living in a town [that had a] curfew, and being unable to engage in simple activities such as enjoying our once beautiful local beaches. Our lives have been disrupted, and in many instances, permanently.

Q: What are the hallmarks of hurricane-specific PTSD?

A: Post-traumatic stress disorder (PTSD) is an intense physical and emotional response to thoughts and reminders of the event that last for many weeks or months after the traumatic event. For an actual PTSD diagnosis, there would need to be at least four weeks of symptoms. Acute stress disorder is a separate diagnosis like PTSD in terms of symptoms but can be diagnosed before the four-month mark.

The first important symptom of PTSD is exposure to a life-threatening event. For some people, that could occur from dealing with the aftermath of a traumatic event, like with first responders who are repeatedly exposed to dead bodies.

The other categories are intrusion symptoms, avoidance symptoms, and negative behavioral changes. Negative intrusion symptoms are  repeated memories or dreams related to the trauma. Avoidance symptoms are efforts we make to avoid things that remind us of the event. Negative behavioral changes are changes in thinking and mood that can include negative thoughts about yourself, other people or the world, feeling hopelessness about the future, and so on.

Q: Do PTSD symptoms differ depending on the trauma type?

A: The core symptoms are the same, but the presentation can be different and is largely influenced by the severity of the trauma and the background of the person going through it.

Q: What are the risks of leaving PTSD untreated?

Post traumatic stress disorder can disrupt a person’s life, job, relationships, health, and enjoyment of everyday activities. Leaving it untreated increases the risks for irritability, guilt, depression, and catastrophic thoughts (example: “everything is over”), all of which can lead to hopelessness and isolation, further worsening these symptoms.

Q: What can people affected by the hurricane do right now, at this moment, to ease their suffering?

Remember, your symptoms may be normal, especially right after the trauma. One suggestion is to continue to do the things that make you happy and healthy in life. Happiness often comes from the purpose gained from doing things we define as meaningful to ourselves. We can lose our sense of purpose if we stop doing these things.

Oftentimes, the first instinct of someone who’s undergone trauma is to withdraw. Isolating ourselves from the things that we love and that give us meaning only  worsens things in the long run. If the suffering continues to get worse and doesn’t start to resolve with time, then it may be a good idea to try and obtain professional help.

Other ways to help yourself, per the Centers for Disease Control and Prevention, are:

• Keep to your usual routine.
• Take the time to resolve day-to-day conflicts, so they don’t add to your stress.
• Don’t avoid the situations, people and places that remind you of the trauma. Avoiding fear only reinforces it.
• Find ways to relax and be kind to yourself.
• Turn to family, friends, and clergy person for support, and talk about your experiences and feelings with them.
• Recognize that you can’t control everything.
• Recognize the need for trained help, and call a local mental health center for support.

Q: How can people help their loved ones suffering from post-traumatic stress disorder or other anxiety-related issues because of the hurricane?

A: Validate, or acknowledge their feelings. Validating someone is exactly what it sounds like - listening to their feelings in a nonjudgmental way and showing that what they’re going through is important to you. It’s important to remember that we don’t always know what someone is going through. Nonjudgmental listening is always a great start to making that connection with someone.

I generally try to avoid putting a timeline of when most people expect to feel better, given that people may have had different experiences with different outcomes. Instead, I think it’s important to note that if the symptoms are worsening over time rather than improving, it may be a good idea to seek help.

If symptoms become so severe that they interfere with your ability to function, it would be ideal to seek help as soon as possible.

If you notice someone who appears to be getting worse with time instead of better, reach out to them. Try to connect them with resources in your area. We’re all in this together.

Do you need help?

Hope For Healing is an initiative started by First Lady Casey DeSantis - a partnership across state agencies for mental health substance abuse support.

The U.S. Substance Abuse and Mental Health Services Administration operates a free 24/7 crisis counseling helpline for people involved in disasters, including hurricanes and tropical storms.

• Call or text 1-800-985-5990. Spanish speakers can press 2 for help in that language. Third-party interpretation services are available in more than 100 other languages.
• Español: Llama o envía un mensaje de texto 1–800–985–5990 presiona “2”
• For Deaf and Hard of Hearing ASL Callers:  
  • To connect directly to an agent in American Sign Language, click the "ASL Now" button below or call 1-800-985-5990 from your videophone. ASL Support is available 24/7.

Post traumatic Stress Disorder (PTSD) Alliance is an alliance of professional and advocacy organizations that provide educational resources to individuals diagnosed with PTSD and their loved ones; those at risk for developing PTSD; and medical, healthcare and other professionals. Visit www.ptsdalliance.org or call 1-877-507-PTSD.

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).

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