After the heavy rain in Henan, psychological problems cannot be ignored

Produced by: Science Popularization China

Produced by: Zhiyao Science

Producer: Computer Network Information Center, Chinese Academy of Sciences

In July this year, Henan Province suffered extremely heavy rainfall, which damaged thousands of hectares of crops, destroyed hundreds of thousands of houses, and affected the lives of tens of millions of people.

Now, the flood has receded, but the psychological trauma it brought to people has not subsided.

Heavy rain in Henan (Photo source: Weibo @平安中原)

After a major natural disaster, psychological problems cannot be ignored.

Only by knowing more about mental health knowledge can we better help ourselves and even others after a traumatic event.

It should be emphasized that after a disaster, some individuals' psychological problems are delayed and difficult to detect in the early stages, so it is particularly important to continue to pay attention to mental health after a disaster.

Houses collapsed after heavy rain (Photo source: National Disaster Reduction Office)

After experiencing a traumatic event, it is easy to have these emotions

After a major natural disaster, we experience many emotional reactions:

When we see news about heavy rain, we are in disbelief and extremely worried, but we still can't stop refreshing the page;

Our family members were hurt in the rainstorm, and we were heartbroken, worried, and felt so much sadness that we couldn’t sleep at all;

After tossing and turning all night, I finally fell asleep. The huge rain net and the fierce rain sound were still spreading in my dream, accompanied by the roar of collapsed buildings and the cries of the old, young women and children. We couldn't tell in the nightmare whether the disaster had really left.

It needs to be emphasized that it is normal for us to experience emotions such as nervousness, fear, panic, anxiety and depression - most of them are normal emotional and behavioral responses to stress, which can usually be gradually relieved through self-regulation.

In addition, we may also experience physical discomfort symptoms such as increased heart rate, increased blood pressure, weakened appetite and digestion, dulled senses, and pain in various parts of the body.

These physical and emotional reactions are actually a set of instinctive survival warning and protection mechanisms that humans have established after a long period of evolution. When we feel that our life and health are threatened by the outside world, the individual's body and mind will make a series of reactions to remind us to take measures in time to avoid harm and fight against threats. This instinct once helped humans react quickly and successfully escape from lions on the savannah, but it also makes us now physically and mentally stressed after heavy rains.

Therefore, if we experience the above-mentioned "stress" symptoms after experiencing a major natural disaster, we should not panic too much and tell ourselves not to worry too much.

After experiencing a traumatic event, these situations need to be watched out for

Although the body's protection and regulatory mechanisms can help us withstand and overcome this tremendous stimulation, we should also be aware that not everyone can recover naturally.

After experiencing a major disaster, it is easy to develop post-traumatic stress disorder (PTSD). PTSD symptoms often do not exist alone, and they may be accompanied by other psychological diseases, such as anxiety, depression, sleep disorders, schizophrenia, personality disorders, etc., and may even coexist with physical diseases such as high blood pressure, heart disease and bronchial asthma. It is a trauma "from the inside out."

According to a survey by the World Health Organization, 30%-50% of people will experience moderate to severe psychological disorders after a major disaster, and when this happens, timely psychological assistance can alleviate the symptoms. The survey also shows that within one year of a disaster, 20% of people may develop serious mental illnesses.

Therefore, after a disaster occurs, everyone should continue to pay attention to the mental state of themselves and their relatives and friends. If there are strong or persistent psychological reactions, the possibility of mental illnesses such as post-traumatic stress disorder (PTSD) should be considered.

After experiencing major disasters such as rainstorms and floods, as well as traumatic events, if PTSD occurs, the following four hallmark symptom groups may appear:

1) Re-experiencing the symptom cluster.

Re-experiencing symptoms is the first core feature of PTSD. The person will repeatedly experientially experience the disaster, as if they were back to the time when the disaster occurred. The patient will repeat all the heart-wrenching pain when the incident occurred.

Patients who have experienced heavy rain or flooding may have the following experience: when they see water drops falling in the shower, their memories will "flash back" to the time when the rain was pouring down, and they will re-experience the panic, helplessness, and great sadness of being trapped in the heavy rain.

For more serious patients, even seeing or hearing the sound of water can trigger memory recall, which can be repeated many times a day.

Image source: Veer Gallery

The patient's life is like a black hole, and you never know when you will be sucked in. There are only two states left in a day: struggling with painful memories, and worrying about the painful memories that will suddenly appear again at any time.

Sometimes the person will even use illusions and hallucinations to construct a new experience of trauma, such as entering a painful scene in a nightmare that they have not actually experienced. Repeatedly reliving the traumatic experience will cause torture to the patient.

2) Persistent avoidance symptom cluster.

After a traumatic event, the person may not want to talk about the disaster and insist on avoiding anything related to the trauma. In the investigation of some violent cases, some victims "know nothing about anything". Even though they know that these details are very important to catch the murderer, the great pain in their hearts makes the patients continue to avoid relevant details and are unwilling to discuss the specific time, place, conversation, objects and content, or abstract feelings related to the incident.

In severe cases, patients may even experience "selective amnesia" and forget memories related to traumatic events. Although persistent avoidance seems to temporarily relieve patients from pain, traumatic events are like a serious scar in the patient's heart. If left unchecked, the scar will become more serious.

Therefore, persistent avoidance is a futile escape for the patient and cannot fundamentally alleviate the patient's pain.

3) Symptom cluster of negative changes in cognition and mood.

Due to the traumatic event, the client has experienced negative changes in cognition or mood. The traumatic event is like a huge reef on the patient's life journey. After hitting the reef, some patients' ships continue to sink like the Titanic, as if they are sinking from the bright sunshine into the deep sea, and the patient's life becomes cold, depressed, and dim.

On the external level, the patient appears numb, cold, and alienated, and is unwilling to have close emotional exchanges with others. On the mental level, the patient is indifferent to everything, has no interest in any activities, loses confidence in future life, and may even have suicidal tendencies.

Image source: Veer Gallery

4) Symptom cluster of increased alertness or significant changes in reactions.

The person may be easily irritated, easily frightened, and have difficulty concentrating, just like a frightened rabbit, and sometimes may experience physical symptoms such as palpitations and shortness of breath. Some patients may also have the urge to attack others or even engage in self-harm.

Image source: www.truspinesf.com/acupuncture-and-ptsd/

How do our hearts heal after the rainstorm?

If we feel that we have the above symptoms, we should not judge ourselves rashly, but seek help from professionals in time. A psychologist will draw conclusions based on clinical diagnostic standards and actively treat the disease.

Generally speaking, after being exposed to a traumatic event, at least one of the above symptoms appears and lasts for more than one month, and only then can it be diagnosed as PTSD by professionals.

Currently, the widely accepted clinical diagnostic criteria for PTSD are the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychological Association in 2013 and the 11th edition of the International Classification of Diseases (ICD-11) released by the World Health Organization in 2018.

For ordinary people who can recover on their own, how should they rebuild psychologically after experiencing a major natural disaster?

First, take care of yourself. Try to eat healthy, have a regular schedule, and do some aerobic exercise to help you recover. You can also do things that calm you down and relax you, such as reading, listening to music, doing yoga, or meditating.

Secondly, we need to stay connected with our family, friends and social groups. When you are in a bad mood, the company of your family and friends may be more helpful than you think. If you feel too uncomfortable, call your good friend and talk about your worries.

Companionship (Photo source: Veer Gallery)

Third, we can shift our focus to returning to normal life. Major natural disasters can make us feel that the rhythm of life has been disrupted, and we feel out of control and cannot live according to the pace. We can set a small goal to return to normal life, and move forward step by step, so that we can regain a sense of peace of mind, stability and control.

Finally, don’t be afraid to ask for help. After a disaster, many social groups will provide psychological assistance through various channels, such as opening a psychological rescue hotline. If you feel you need help, you can pay attention to relevant resources and seek guidance from professionals.

If you are a confirmed PTSD patient, don't worry too much. It can be relieved through psychotherapy and drug therapy.

Prolonged exposure (PE) is a commonly used psychotherapy for PTSD. During PE, patients are exposed to safe situations that evoke their fears.

The core of this therapy is to eliminate or replace the feeling of fear. Through relaxation techniques and the guidance of the therapist, the patient's fear level is controlled within a controllable range, so that the patient understands that they can tolerate this anxious situation; and when they recall the traumatic memory, nothing terrible happens. In this way, the patient's excessive fear and anxiety are reduced.

Before treatment, patients may believe that they are completely powerless in the face of trauma; after treatment, patients are able to view the traumatic event as a very, very special event, an accident rather than the norm, thereby regaining a sense of control and self-confidence.

This healing process is like when we were kids, we might not like eating fish because we had fish bones stuck in our throats. Until our mother put the delicious braised Spanish mackerel with few bones in front of us and showed us how to pick out the fish bones ourselves, we realized that eating fish is safe, not all fish will get stuck in our throats, and picking out fish bones is very simple. After going through this healing process, we can love eating fish again.

With the development of computer technology, virtual reality technology has also been applied to exposure therapy. Virtual reality exposure therapy (VRET) provides patients with a sense of psychological participation through a computer-generated virtual environment, and to a certain extent overcomes the practical difficulties of traditional exposure therapy.

During the rainstorm in Henan, we can see the tenacity and bravery in the blood of the Chinese people, and we can also feel the softness and kindness rooted in their souls.

The rainstorm is ruthless, but people are kind. No matter what kind of disaster we face, we will stand up in the sorrow of the whole city and not let each other break through the tears and floods. After the rainstorm, the sky in Henan will always be bluer and clearer, the grass will be greener and more lush, and our hearts will be more determined and resolute.

Image source: Veer Gallery

References:

1. http://m.news.cctv.com/2021/07/28/ARTIFshlq3OWp8MP6GyfuTmO210728.shtml

2. Ursano RJ, Zhang L, Li H, et al. PTSD and Traumatic Stress From Gene to Community and Bench to Bedside [J]. Brain Res, 2009, 1293: 2-12.

3. Luo Shan, Hou Lijuan, et al. Preliminary analysis of traumatic events and post-traumatic stress symptoms in patients with depression[J]. Journal of North Sichuan Medical College. 2008.23(6):587

4. Chen Zheng. Epidemiological investigation and analysis of traumatic events and post-traumatic stress disorder in community population in Tianjin[D]. Tianjin Medical University, 2018.

5. Deng Mingyu. New progress in clinical research on post-traumatic stress disorder (new DSM-5 standard) [J]. Chinese Journal of Health Psychology, 2016, 24(05): 641-650.

6. Huang Ruiwen, Wu Shiyu. Research progress in clinical diagnosis and psychological intervention of post-traumatic stress disorder[J]. Chinese Journal of Clinical Medicine, 2021, 28(02): 316-322.