Hurricane Fatigue: The psychological impact of repeated battering from storms Charles R' Figley, Ph'

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Hurricane FatigueThe psychological impact of
repeated battering from storms Charles R.
Figley, Ph.D.FSU Traumatology Institute

• Sponsored by Hurricanes Charley, Frances, Ivan,
  and Jeanne at the

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Aim Boil down 50 years of research on human
reactions to hurricanes into useful
axiomsObjectives Discuss

• The four phases of disaster coping
• Reactions at each phase and how to cope
• how to defuse hurricane stress-related rage,
  especially
• Fatigue when FOUR HURRICANES HIT A SINGLE STATE
• the Implications for disaster workers and those
  who work in disasters

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Phase I Anticipation and Preparation (AP) From
warning to impact (if any)
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Phase II Disaster Impact (DI) Lasts as long as
there is perceived immediate danger (shortest of
the four phases)
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Phase III Immediate Post-Disaster Impact (IPDI)
Starts with return to a sense of safety and ends
with a sense of normality (or new normal)
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Phase IV Long-term Post-Disaster Impact (LPDI)
Starts after a sense of normality and never ends,
including frequent elevations in stress for a
long time.
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Human Reactions During Each Disaster Phases

• Phase I (AP)
• range from panic buying and preparing
• to hostile avoidance and denial.
• Best to attempt to gain as much control over
  stress as possible by making effective
  preparations

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Phase II (DI) Shortest phase is associated with

• seeking safety and making mental notes of what
  was done right to cope and stay safe.
• Keep mind occupied, especially if very fearful.
• Praying or some regularized, ritualized activity
  is useful.
• Greatest interest is staying alive.

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Phase III (IPDI) Most dangerous phase because

• Attempts to return home too early
• There is a desperate need try to return to
  normal.
• Greatest interests are what happened to my stuff
  and loved ones,
• should we rebuild or vacate,
• what is best for my family.

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Phase IV (LPDI) Longest phase is associated with

• creating a new normal,
• grieving the losses,
• thankful it was not worse and potential growth,
• efforts to recover by drawing upon own personal
  and social resources,
• some need help in doing so
• Depression, substance abuse common

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Most recover completely unless

• there are other emotional issues or
• mental disorders (e.g.,
• previous trauma,
• grief of loss,
• depression,
• storm-related phobia).

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Coping with Anxiety During Phase I

• Prepare as best you can.
• Take action to protect yourself or your family
  can help restore a sense of control.
• Try some exercise and keep busy
• Be patient.

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Accept that the storm will do what it wants

• Be safe, but don't feel as if you have to put
  everything in your life on hold.
• Go about your normal business as much as possible.

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Phase II (DI) Coping

• Recognizing it is similar to being in combat
• Anticipate rushes of adrenalin,
• heightened sensitivity, and
• hypersensitivity to whatever the stressor is and
• Recognize it wont last long

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Phase III (IPDI) Coping with the immediate
aftermath

• Take one task, minute, day, setback at a time
• Keep a diary (will be useful later)
• Use effective stress management
• Attend to priorities
• Draw from the strengths and
• Kindness of others
• Contribute to others

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Distress in Phase IV

• Anticipate and accept the
• Emotions follow a roller coaster pattern of
  changes
• mood, emotion, energy
• -- can change unexpectedly
• The very young and old are conservative
• Dont like change and uncertainty

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Post-Hurricane Stress Generally

• Mental health experts say the unscathed often
  suffer "survivor's guilt.''
• People suffering survivor's guilt often push
  themselves to the limit trying to help.
• There is a natural grieving process -- denial,
  questioning, acceptance and recovery -- after the
  loss of normalcy, loved ones and property.

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Hurricane Fatigue is

• A sense of hopelessness and frustration from
  dealing with the stress of multiple hurricanes

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New York Times (September 14, 2004)

• "I don't know if it's the five-day forecasts or
  the slowing down of the last two storms that's
  created a little bit of a challenge in terms of
  people's patience levels," the governor said.

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Wise advice from Gov. Bush

• He encouraged residents not to fixate on the
  day-to-day swings of the storm. Everyone in the
  danger zone, he said,
• should prepare and then focus on other thoughts,
  perhaps the outstanding high-school and college
  football teams in the state.

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Ivan Counties
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Charlie Counties
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Jeanne Counties
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Charley then Frances
Frances
Charley
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Charley then Frances then Ivan
Charley
Frances
Ivan
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Charley then Frances then Ivan then Jeanne
Charley
Frances
Jeanne
Ivan
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Signs of Hurricane Fatigue in Adults

• Fear, disbelief, suspicion, anger, anxiety or
  apathy.
• Short temper, moodiness and irritability.
• Reluctance to abandon property.
• Guilt over having been unable to prevent the
  disaster.

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Hurricane Fatigue

• Confusion, numbness and flashbacks.
• Difficulty in making decisions.
• Excessive helpfulness to other disaster victims.
• Loss of appetite.
• Crying for no apparent reason.
• Increased effects from allergies, colds and flu.

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And, less frequently.

• Rejecting outside help or feeling disappointed
  with outside help.
• Isolation from family, friends and social
  activities.
• Domestic violence.

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How to Cope with Hurricane Fatigue

• Recognize and accept your feelings -- and realize
  you're not alone.
• Talk to others, including family, friends or
  clergy, about your feelings
• Be patient -- accept that restoring your life to
  normalcy will take time.
• Keep family meals as nourishing and on
• as much of a routine as possible.
• Get enough sleep.

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Hurricane Fatigue Issues about Multiple
Hurricane Adjustment

• When there is an overlap in recovery phases
  (e.g., Phase IV of Charley, Phase III of Frances,
  and Phase I of Ivan) yields Hurricane Fatigue for
  those most affected.

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Professionals Are Affected too

• The Green Cross (www.Greencross.org) and the
  Academy of Traumatology (www.traumatologyacademy.o
  rg) have developed standards of self care that
  help prevent hurricane fatigue, burnout,
  compassion fatigue, and other work-related
  exhaustion

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Standards of Self Care include

• Assessment
• Rest and Relaxation requirements
• Mental health first aid
• Social support

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Conclusions

• Hurricane fatigue is
• Predictable
• Preventable
• And easily mitigated
• Much worse without proper attention it costs
  time, money, and mental health
• Practice wise self care as professionals