Navigating the Storm: Understanding and Managing Post-Traumatic Distress Amidst Cyclone Threats

As Townsville braces for the impending cyclone and potential flooding, many of us are reminded of the traumatic experiences from the Townsville Floods that occurred a few years back. For children, adolescents, and even adults, the looming threat can stir up a whirlwind of emotions, from acute stress to deep-seated anxiety. As a psychologist, I aim to shed light on these emotional responses in an accessible, evidence-based manner. This blog will explore the concepts of posttraumatic distress, acute stress, fear, and anxiety, focusing on their manifestation in children and teens, as well as signs to be mindful of in adults.

Posttraumatic distress:

Definition:

Posttraumatic distress refers to the emotional, cognitive, and behavioural responses individuals may experience following a traumatic event, like the Townsville Floods. It involves a range of feelings, thoughts, and behaviours that arise as an individual tries to process and cope with the impact of the traumatic experience.

Key Characteristics:

This can include recurring memories of the event, avoidance of reminders, negative changes in thoughts and mood, and heightened reactions.

Posttraumatic distress in children: 

Children, particularly younger ones, may not have the words to express their feelings adequately. Their responses to trauma are often expressed through behaviour and play. Here are key signs of posttraumatic distress in children:

1.    Regressive Behaviours:
Younger children might revert to behaviours they had outgrown, such as bedwetting, thumb-sucking, or fear of the dark.

2.    Play and Re-enactment:
Children may repeatedly play out parts of the traumatic event in their games or drawings. This can be their way of trying to understand and process the event.

3.    Physical Complaints:
Complaints about stomach aches, headaches, or other physical pains without a clear physical cause can be common.

4.    Changes in Sleep and Eating Habits:
Difficulty falling or staying asleep, nightmares, and changes in appetite are common.

5.    Clinginess or Separation Anxiety:
Increased attachment to parents or caregivers, fear of being alone, or anxiety when separated from primary caregivers.

6.    Mood Swings and Emotional Responses:
Unpredictable emotional responses, such as increased irritability, sadness, or bursts of anger, are common. Some children may also become unusually quiet or withdrawn. 

7.    School and Social Changes:
A decline in school performance, loss of interest in previously enjoyed activities, or changes in relationships with peers.

Posttraumatic distress in teens: 

Teenagers might display different or more subtle signs of posttraumatic stress. Their responses can often mimic adult reactions but can also be influenced by their developmental stage. Key signs include:

1.    Withdrawal from Family and Friends:
Teens may withdraw from family or show a lack of interest in social activities they used to enjoy.

2.    Changes in Behaviour:
Risk-taking behaviours, such as substance abuse or reckless driving, can be a sign of trying to cope with distressing feelings.

3.    Mood Disturbances:
Increased irritability, mood swings, feelings of hopelessness, or frequent bouts of anger or sadness.

4.    Academic Issues:
A noticeable drop in grades, lack of concentration, or frequent absences from school.

5.    Sleep and Appetite Changes:
Similar to children, changes in sleep patterns and eating habits can occur. Insomnia or excessive sleeping, changes in appetite, or weight loss/gain might be evident.

6.    Physical Complaints:
Complaints of chronic pain, such as headaches or stomach aches, without a clear physical cause.

7.    Avoidance Behaviour:
Actively avoiding reminders of the traumatic event, which can include places, people, activities, or thoughts related to the trauma. 

8.    Emotional Numbness:
Teens might seem emotionally 'numb' or detached, showing less interest in activities they used to enjoy.

How can parents help?

For Children:

1.    Open Communication:
Create a safe space for children to express their emotions. Encourage them to talk about their feelings and fears, and listen attentively without judgment.

2.    Routine and Structure:
Maintain a regular schedule as much as possible. Consistent routines provide a sense of normalcy and security for children.

3.    Reassurance:
Regularly reassure children about their safety. Explain the steps being taken to keep them safe in a manner they can understand.

4.    Play and Creative Expression:
Encourage play and creative activities, particularly drawing/painting. These can be therapeutic, helping children to express and process their feelings. Asking kids to choose colours to represent their feelings can often be a great place to start. 

5.    Physical Comfort and Affection:
Provide physical comfort through hugs or holding hands, as appropriate. Physical reassurance can help children feel safe and loved. 

6.    Limit Exposure to Media:
Shield children from distressing news or social media that may depict the traumatic event or current threats. Repetitive exposure to the event can be particularly problematic.

7.    Creating a Supportive Home Environment:

• Unified Front: Present a calm and controlled front as parents or caregivers. Children often take cues from adult reactions.

• Family Activities: Engage in comforting family activities. This can foster a sense of togetherness and security.

• Preparing Together: Involve children in preparation plans for the cyclone in age-appropriate ways. This can help them feel more in control.

For Teens:

1.    Encourage Open Dialogue:
Foster an environment where teens feel comfortable sharing their thoughts and feelings. Be a patient and non-judgmental listener.

2.    Promote Independence and Control:
Involve teens in planning and decision-making, especially in matters affecting their lives. This helps them feel a sense of control.

3.    Healthy Coping Mechanisms:
Encourage and model healthy coping strategies, such as exercise, journaling, or engaging in hobbies.

4.    Limit Media Exposure:
Advise teens on the importance of balancing their intake of news and social media to avoid being overwhelmed.

5.    Creating a Supportive Home Environment:

• Unified Front: Present a calm and controlled front as parents or caregivers. This helps to contain emotions in others and reduces confusion.

• Family Activities: Engage in comforting family activities. This can foster a sense of togetherness and security.

• Preparing Together: Involve your teens in preparation plans for the cyclone in age-appropriate ways. This can help them feel more in control and allows them to feel as though they’re contributing to something bigger than them.

6.    Peer Support:
Encourage teens to stay connected with friends and peers. Peer support can be a significant source of comfort and understanding.

7.    Professional Help if Needed:
Be open to seeking professional help if you notice signs of severe or persistent distress. A psychologist or therapist with a thorough understanding of adolescent mental health can provide valuable support.

For Adults:

1.    Self-Care:

• Prioritise your own wellbeing. This includes adequate sleep, healthy eating, and physical activity.

2.    Social Support:

• Ensure you people in your social network (family, friends, other parents, work colleagues) you can talk to about your worries and apprehensions. It’s ok to talk to adult children about this too, but limit how much you offload onto your teen.

3.    Mindfulness and Relaxation:

• Techniques such as deep breathing, meditation, mindfulness or yoga can help manage stress and anxiety.

4.    Stay Informed, But Not Overwhelmed:

• Stay updated with reliable information about the cyclone but avoid overexposure to distressing news or social media.

• In Townsville, the Emergency Management and Disaster Dashboard run by the Townsville City Council and Townsville Disaster Management Group is recommended: https://disaster.townsville.qld.gov.au

 5.    Neighbourly Care:
Check in on neighbours, especially those who may be vulnerable, to foster a sense of community resilience.

Why do we experience this anyway?

Understanding the brain's response to trauma helps explain why posttraumatic distress occurs. It's a complex interplay of emotional, cognitive, and physiological responses, deeply embedded in our brain's mechanism to protect us from harm. Recognizing this can be crucial in empathizing with those experiencing posttraumatic distress and highlights the importance of seeking professional help when needed.

The Brain's Response to Trauma:

1.    Activation of the Amygdala:

• The amygdala is a part of the brain that plays a key role in processing emotions, especially fear and threat-related stimuli.

• During a traumatic event like a natural disaster, the amygdala is hyperactivated. It senses danger and triggers a fear response, which is crucial for survival.

2.    The Role of the Hippocampus:

• The hippocampus is involved in forming and retrieving memories, particularly those related to personal experiences.

• Trauma can impact how the hippocampus processes and stores memories. Instead of storing a coherent narrative of the event, the memories can be fragmented and disorganized, leading to intrusive and distressing recollections.

3.    Hypothalamic-Pituitary-Adrenal (HPA) Axis and Stress Hormones:

The HPA axis is a complex network that regulates the body's stress response.

In response to a threat, this system releases stress hormones like cortisol and adrenaline, preparing the body for a 'fight-or-flight' response.

This hormonal surge increases heart rate, blood pressure, and energy levels, enabling an immediate reaction to the threat.

Why Emotional Responses Occur:

1.    Survival Mechanism:

• The emotional responses triggered by the brain during and after a traumatic event are part of an evolved survival mechanism.

• Fear and anxiety heighten awareness and readiness for action, which is crucial in dangerous situations.

2.    Dysregulation After Trauma:

• In the aftermath of trauma, the brain's normal stress response can become dysregulated.

• The amygdala may remain hyper-vigilant, leading to heightened emotional responses to triggers that remind the individual of the trauma.

• The HPA axis might also remain in a state of heightened reactivity, causing prolonged stress hormone release and contributing to symptoms like anxiety and hyperarousal.

 3.    Impact on Mental Health:

• Prolonged exposure to stress hormones and the ongoing activation of the amygdala can lead to various mental health issues, including anxiety disorders, depression, and PTSD.

• The brain may continue to respond as if the individual is still in danger, even when the threat has passed.

Recognising when professional help is needed:

While many will cope with support from family and community, some may need professional help. Signs that an individual, whether child, teen, or adult, may need professional intervention include:

1.    Persistent and Severe Symptoms:
Symptoms that persist for more than a month and significantly impair day-to-day functioning.

2.    Harmful Behaviours:
Any behaviours that pose a risk to themselves or others, such as self-harm or aggressive behaviour.

3.    Deterioration in Daily Functioning:
Marked decline in performance at school or work, withdrawal from social activities, or difficulties in family relationships.

Where to go for support:

1.    Psychological Services:
Consulting a psychologist can be beneficial. Therapies like CBT, EMDR and psychoeducation are effective for trauma and anxiety-related symptoms. 

2.    GP and Referrals:
A general practitioner can provide initial advice and referrals to mental health professionals.

3.    Community Resources:
Local mental health services, helplines, and support groups can be valuable resources.

4.    School counsellor or psychologist:
Talk to your child’s school counsellor (guidance office) or school psychologist. They may be able to provide some additional support for your child or young person.

Click here to download a PDF version of this resource.