When Crisis Becomes Chronic

As floodwaters recede, some North Dakotans continue to experience the daily stress of evacuation from homes, loss of farm crops and business income, and uncertainty. Because of the continual "not knowing what's next," some people are unsure of their futures. Natural disasters often lead to prolonged emotional and physical stress. Disasters can also lead to "lessons learned" as communities rebuild.

The Downhill Slope: Prolonged Stress

During times of extreme stress, people experience varying stages of emotion. Alarm or shock is often the first stage, followed by resistance or denial then exhaustion.

"As the crisis continues for some or as clean-up begins for others, physical and emotional stress continues," said DonnaRae Jacobson, a family science specialist with the North Dakota State University Extension Service. "Exhaustion, fear, anger, disillusionment, cynicism and depression are common. These responses are normal and appropriate for something which is lost (a home, a farm, a business, a dream)."

Negative results of prolonged stress include:

• difficulty falling or staying asleep
• nightmares for children and adults
• irritability; outbursts of anger
• excessive drinking/drug use
• difficulty concentrating
• excessive worry or extreme concern
• re-experiencing the traumatic event
• incapacitating guilt and self-doubt
• withdrawal and suspicion
• frequent loss of self-control
• sudden painful emotions
• apathy; avoidance of emotions, activities and situations associated with the event
• feelings of detachment from others, from the future or from life.

If these symptoms continue to persist well after the crisis is over or surface several months or even years later, then the person might be experiencing Post-Traumatic Stress Disorder (PTSD).

Sometimes called shell shock or battle fatigue, Post-Traumatic Stress Disorder can affect people who have survived the trauma of a natural disaster, such as flood. Mental health professionals are understanding more about prevalence of PTSD in adults, children and communities.

The natural disaster might also become a turning point in people's lives which leads to insecurity, lack of confidence and fear. People might lose sight of their lifetime goals. They may become helpless and hopeless.

Jacobson says there is no right or wrong way to experience loss associated with crisis. "Everybody has their own individual timetable for grief. Some people may go through the rest of their lives angry with the unfairness of the flood. Fortunately, grief can be one of the most healing things we can do."

The Uphill Climb: Recovery

Feelings of detachment, avoidance and apathy might be an effective way of conserving emotional energy and re-grouping. If people don't get stuck in anger, grief, denial or depression then the healing cycle can continue.

"Crisis has equal opportunity outcomes," Jacobson says. "People can learn valuable lessons by adversity."

Lessons to be learned might include:

• reframing the meaning of life and setting priorities; finding larger purposes, value and meaning to life
• realizing the importance of relationships and that helping others may be a way to repay the help received during the disaster
• the positive power of connection to our neighbors and communities
• the qualities of strong families which include commitment, appreciation, communication, time, coping and spiritual wellness
• the need to say thanks and the benefits of celebration

"When the volunteers have gone, the flood survivors will be left to clean up the mud in their basements. We must be sure we haven't abandoned them in their grief," Jacobson says. "People shouldn't isolate themselves. By getting out, talking with community support groups and getting guidance from mental health professionals, ministers and other caregivers, recovery and growth are possible."

How can the community counteract isolation and withdrawal and provide support?

1. Emphasize the importance of community.
2. Help people be aware of the factors which work against community when experiencing a disaster.
3. Help people devise ways to deal with their distancing of other people's emotions.
4. Emphasize that often people can be helped by small deeds.
5. Encourage people to find support when they need it and accept help.
6. Use widespread support and knowledge of available resources to help a community effectively grow, develop and maintain itself.
7. Emphasize that the people in our lives are resources.
8. Create a structure which provides for long-term needs in the community.
9. Encourage a focus on the practical future.