The horrifying earthquake and tsunami in Japan, will haunt not only survivors for years, but also rescue workers. Doctors, nurses, paramedics and other aid workers are streaming to Japan in an effort to assist in whatever way they can.
Trauma such as this carries a considerable risk of causing post-traumatic stress disorder (PTSD) in some individuals - a disorder that may occur after a person has experienced or witnessed a traumatic or terrifying event, or been exposed to horror after the event.
Previous large-scale disasters seem to point out that a disaster of this kind can have significant emotional consequences. It is normal to react to an event of this magnitude with symptoms of depression and anxiety.
How the disorder arises
This disorder arises as a delayed response to a traumatic or stressful event of an exceptionally threatening or catastrophic nature. These include natural disasters, acts of terrorism such as bomb blasts, hijackings and physical assault such as rape. Many people in Japan will be confronted with scenes of death and destruction for days on end.
However, people are incredibly resilient, and in most cases, symptoms will gradually subside over time. In a smaller group of people, symptoms persist.
A diagnosis of PTSD is likely if they also suffer from symptoms such as shock, anger, fear, sleeplessness, repeated unwanted memories, dreams and flashbacks, alternating between being overwhelmed and numbed, and being in a constant state of hyper-alertness and avoidance of anything that reminds them of the trauma.
Risk factors include personal history, poor coping skills, and lack of social support after the trauma. Repetitious exposure to traumatic events increases the risk for PTSD as seen in rescue workers, as does the development of survivor guilt in family members of victims.
Apart from PTSD, other disorders may develop such as depression, severe anxiety and substance abuse.
How is it diagnosed?
According to the Diagnostic and Statistical Manual of Mental Disorders, people who have PTSD are those who:
- Have experienced, witnessed or were confronted with a traumatic event that involved the threat of death or serious injury to themselves or others, causing them to respond with intense fear, helplessness or horror.
- Persistently re-experience the event through intrusive thoughts, dreams, acting or feeling as if the event were reoccurring, and/or intense distress and emotion when exposed to cues that symbolise or resemble the event.
- Avoid stimuli associated with the event and attempt to numb their general responsiveness by avoiding thoughts, feelings, conversation, activities, places or people associated with the trauma.
- Are unable to recall important aspects of the trauma and loss of interest in participating in activities.
- Feel detached from others, have a restricted range of emotions and are often unable to have loving relationships.
- Feel little hope for their future.
- Experience symptoms of increased emotional stimulation such as difficulty sleeping, irritability or angry outbursts, difficulty concentrating and exaggerated or startled responses.
- (Health24, updated March 2011)
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