(This is an edited version of the advice I put together from Dr Rob Gordon and Professor Sandy McFarlane and sent to Mallacoota straight after the fires. But it can be applied to any experience of disaster. Dr Jonica Newby, science reporter)
Adrenaline? Jumping at noises? Hyper busy? A wind phobia? Kids with nightmares? Disaster experts on some of the things to expect if you or your kids went through the monster fires – and how to handle them.
This is how our brains are altered as we enter the ‘survival mode’ of an emergency – and why we can carry the after-effects for weeks, even years to come.
Adrenaline rises – it’s impossible for it not to when skies turn from red to black, the fire’s roar fills our ears, and smoke fills eyes and lungs. The sympathetic nervous system sparks: noradrenaline, cortisol, join the emergency cascade. Our muscles and body are pumped for action and we are jittery, awake.
Meanwhile, parts of the brain progressively shut down. As the threat escalates, our language centres and ability to speak are greatly reduced. Brain imaging studies of people with PTSD, who are in some ways ‘stuck’ in survival mode, show reduced activation of the Broca’s area – crucial to language. (I experienced this graphically myself once when, immediately after a parachute jump, I was asked to describe it and couldn’t remember the word for ‘door’.)
Executive brain function – planning, creative problem solving – also suffers. That’s why people can do bizarre things, like dropping jewellery to pick up a husband’s t-shirt as they race to evacuate their home. It’s also why emergency training is protective – it keeps arousal lower and allows us to focus on a practised task.
Our attention is narrowing to what’s immediately relevant to the threat. At the same time, our brain’s sensory systems are ramping up – vision, hearing, smell are all heightened and vulnerable to sensory overload. That’s why after the fire has passed, images of what happened are so vivid and intense. You can see it when people describe what they’ve been through – they look up and around – their hands pointing wordlessly at things they can see in their head. This isn’t a regular memory – this is reliving. It’s like you are back there. It’s the same thing that happens to people who’ve been in active service.
Once the threat passes, the brain has to turn that experience into a regular memory – but the sheer system-overwhelm of a natural disaster disrupts the normal process. It’s partly because of the overload itself, partly because our subconscious worldview that nature is a safe place has been shattered – and we’re usually still in adrenaline mode. Our brains can get stuck, replaying the most frightening or helpless bits. To prevent this getting worse, experts recommend going back over the narrative so we also remember the bits we did well and how we became safe.
The sensory overload can also create phobias. Dr Rob Gordon told me of a Black Saturday survivor who, months later, drove into fog and had to pull over to have a little panic attack. The fog triggered reliving the smoke. I personally know a family whose young son started wearing earmuffs to bed because he couldn’t stand the sound of wind. He’d developed a wind phobia; wind noise triggered reliving the trauma. Once recognised, it was easily resolved with professional help.
You don’t think of wind phobias, but they are surprisingly common after major fires according to Professor Sandy McFarlane, who’s done long-term studies of people who went through Ash Wednesday in Adelaide. If you do start developing a trigger-type phobia – wind, noise, smoke, for example – he recommends you tell yourself the difference between what’s making you anxious now and what happened in the dis- aster. It can help prevent the phobia worsening.
Trouble sleeping, intrusive visualisations, feeling jittery; everyone is different but most people who’ve been through an emergency will experience something. For kids, it often shows up as trouble concentrating at school.
Over days and weeks, reactions should gradually settle. Those of us most impacted then often hit a slump, where we feel exhausted, depressed and have trouble making plans or concentrating. We are emotionally labile. Quick to anger – especially men – or to seek blame. Yet emotional withdrawal from loved ones is also common. This chronic stress phase is what Black Saturday survivors dubbed ‘bushfire brain’, what Lockyer Valley flood survivors called ‘flood brain’, what Christchurch earthquake survivors called ‘earthquake brain’. They are all beautiful new terms Dr Gordon has heard over the years to describe the altered brain state you enter when your world is suddenly, unrecognisably changed.
Post-traumatic stress disorder (PTSD) is diagnosed only if more than a month has gone by and multiple symptoms are not settling and may even be increasing. Studies show that after a disaster, 10 to 20 per cent of the community will get PTSD. But Dr Rob Gordon estimates it’s two to three times that rate for anyone who had a life-threatening fire situation. That’s a lot of our fellow Australians, given the scale of this disaster.
Please watch out for friends and family whose stress symptoms are getting worse (repeated intrusive recollections, continued high adrenaline, hypervigilance and trouble sleeping, numbing or dissociation and shutting down emotionally, disruption of family life, phobias). The earlier this is dealt with professionally, the easier it is to resolve.
Practical recovery advice after living through a disaster
1. Focus on how you feel safe now
One of the most useful things you can do is remember when you first felt like you were going to survive, says Professor McFarlane. This is especially important for kids. Focus regularly on feeling safe.
2. There is no rush! ‘A slow recovery is a good recovery’
It’s common in the aftermath of a disastrous fire, especially for men, to run around trying to ‘fix’ everything as fast as they can. But being too ‘busy busy’ can actually disrupt the brain’s ability to process the sensory overload it just experienced and heal healthily, says psychologist Dr Rob Gordon. It can also lead to damaging anger and frustration when, inevitably, bureaucracy doesn’t move as fast as you’d like. In this state, you won’t make good decisions.
‘Don’t make a culture of 20 hours a day action,’ says Dr Gordon. ‘Do what needs to be done to ensure your family is safe and has a place to live and then prioritise re-consolidating family life. There’s time.’
Dr Gordon observes that people who dive into the ‘busy busy’ often neglect other important areas of their lives – to their cost later. Relationships and emotional balance need to be maintained.
3. Prioritise spending time with family and social networks
Re-establishing enjoyable family and social routines is the biggest priority, according to Dr Gordon. ‘Think about the things that were important to you that you did regularly before the fire, and start doing them,’ he advises. ‘Continue to enjoy recreation, leisure. Don’t forget to have fun. The whole family needs to get out of their high arousal, high adrenaline state.’
A strong predictor of whether children develop difficulties after a disaster is how well their parents adapt. Dr Gordon recommends parents just give their family their full attention regularly.
Socialising with people who’ve had the same experience, joking around with ‘black’ humour, hanging out with the community; all help our brains reduce their adrenaline load and process the experience.
4. Reconstruct the story of what happened – especially for children
After the emotional intensity of a fire, what will be held in memory are the most frightening bits at the expense of the reassuring bits. Sit down and go through the full story of what happened, especially if you have children, advises Dr Gordon. Sure, there were some scary moments, but make sure you fill in the full narrative leading up to those, and what you did to get through it, and what you achieved. Lots of good things happened.
‘What they need to remember is that they did get through it,’ says Dr Gordon, ‘and also to remember all the wonderful help they got.’
5. Manage exposure to media – especially for children
No need to have the same frightening images recycled on the 24-hour news channels. Check in regularly with the news, but balance it out with leisure activities that reduce stress.
6. Recognise when you are anxious, and have a strategy
Continuing heightened adrenaline and anxiety are common after living through a disaster. The adrenaline converts to anxiety when there is nothing we can do to solve the problem now. But the adrenaline makes us want to do things before we can. It helps to have strategies ready when this kind of anxiety flares. Anything that reduces arousal will do.
Deep breaths, going for a walk, exercising and burning off excess energy. Dr Gordon also recommends cutting down on the stimulants – caffeine, alcohol.
7. Have confidence in your future – you are not alone
It may not be obvious now, but even if you have lost your home, be confident in your future. You will grieve. But you will not be homeless – something will come through. In a disaster of this scale, there will be support and resources down the track – from agencies, and from your community and social networks.
‘Call to mind that even though you can’t see it now, many people have been through the exact same experience in previous fires,’ says Dr Gordon, ‘and they have homes and good lives again. You will not be in this alone.’
8. Professional emotional help is available
Just knowing that these stresses and symptoms are normal may be enough for many people, says Dr Gordon. ‘If the symptoms are too intense, or over the next few weeks are not getting better, seek advice on recovery from your GP or a mental health professional. The earlier these feelings are addressed, the more likely they are to be resolved.’
And watch out for friends or family members who have been in the frontline – firefighters, people who stayed to defend in an intense fire. Their residual stress may not become evident until more time has passed.
Stay safe, everyone.