The Psychological Impact of DisasterNEW YORK CITYVOICES: November/December 2001
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By Kelsey Batchelder
Dr. Anand Pandya, co-founder of Disaster Recovery Outreach and a staff psychiatrist at Bellevue Hospital spoke to the general monthly meeting of the National Alliance for the Mentally Ill (NAMI) New York City-Metro affiliate on October 9th about coping with disaster. Those attending the meeting included consumers and family members. Dr. Pandya has worked with victims of several disasters including the Egypt Air crash in 1999 and the Swiss Air crash in 1998, the El Salvador earthquake and most recently the disaster and tragedy of the World Trade Center. Dr. Pandya spent considerable time working with people who came for help to the family center at Pier 94 for help following the attack on September 11.
In speaking about how people react to disaster Dr. Pandya said we all tend to go back to coping skills we developed and used in childhood. We see life, people and events as either black or white, as all bad or all good, and we have trouble seeing subtle differences.
In response to disaster most of us, including those who are mentally ill, have a strong urge to help. Dr. Pandya suggested that we should not tell those who are ill that they cannot help because of their illness. Instead we should suggest numerous ways they can be helpful. They might be encouraged to make small donations of money even if they have limited incomes. To be of help to others, people must first take care of themselves; this is a way to be patriotic and helpful.
Within the first month following a disaster people may suffer from Acute Stress Disorder (ASD). Those who are mentally ill are especially vulnerable to ASD. Some of the symptoms of ASD are:
Dr. Pandya suggested several kinds of treatment, which might be helpful in dealing with these reactions including cognitive behavioral therapy, and antidepressant medications such as Prozac and Zoloft.
- Numbness and Avoidance — Avoiding reminders of the disaster by not going downtown, into tall buildings or on airplanes. Avoiding talking about the disaster — People may lack interest in anything and may have a blank, flat look.
- Flashback and Re-experiencing — This may occur in the form of nightmares or continuing to talk about the disaster over and over.
- Hyper vigilance — A person may be “jumpy” or easily upset.
- Dissociative Experiences — We may find ourselves looking at ourselves from outside ourselves, or may have trouble remembering what happened. At times, things don't seem real.
In addition to Acute Stress Disorder Dr. Pandya also discussed Post Traumatic Stress Disorder (PTSD), which occurs later, a delayed reaction to disaster. PTSD can be similar to major depression. The symptoms of depression being a sense of hopelessness, difficulty experiencing any kind of pleasure, a foreshortened future, insomnia, lack of interest, losing or gaining weight, difficulty concentrating and feeling worthless and guilty.
Effective treatment for major depression is similar to that for Acute Stress Disorder — cognitive therapy and medications. Additional problems which may arise in response to disaster are acute anxiety, panic, and if one hears voices, they could get worse and more troublesome.
In his presentation Dr. Pandya noted that everyone may experience some of these reactions but they may be more serious for those who suffer from mental illness. Therefore, it is important for all of us to be alert and aware of the reactions and symptoms and to do whatever we can to help our loved ones and ourselves cope with the effects of the disaster.
Opinions expressed are those of the author and not necessarily those of New York City Voices. Kelsey Batchelder has a family member with mental illness and is a member of the National Alliance for the Mentally Ill.
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