More than a month has now passed since the Christchurch earthquake. In some respects that seems like a long time, but it really isn’t.

You can still be experiencing stress, anxiety, or depression directly related to the trauma of February 22nd, even if you were not physically in Christchurch yourself. I’m seeing evidence of that among colleagues here in my own workplace. I’m also seeing evidence that some folks think everyone should just be “over it” by now.

The psychological dimension of post-tragedy recovery is too often minimized, overlooked, or repressed. It shouldn’t be. Post-trauma stress is to be expected, and it takes time – sometimes significant time – to recover. Psychological impact is as real – and as important to address directly – as a broken leg.

Dr Marcia Meckler

Dr Marcia Meckler.

That’s why one of the things I did the day after the quake was contact our regional US Department of State psychiatrist, Dr Marcia Meckler, to ask her to come to New Zealand. I knew that Dr Meckler had served in a variety of posts where she had direct, significant experience with earthquakes and other natural disasters. She knew what was “normal” after such events, as well as what steps could be taken to mitigate post-quake problems.

Dr Meckler immediately agreed to come, and she flew in from Bangkok the next week. She spent two days at the Embassy in Wellington, a day with Antarctic program folks in Christchurch, and a day at the Consulate General in Auckland.

She held town hall sessions to discuss the usual post-quake trajectory of emotional and physical responses, and met individually with colleagues and family members who wished to talk. I attended the group meeting at the Embassy and was impressed with both the Doctor’s practical approach and the open, productive give-and-take during the question period.

Prior to Dr Meckler’s arrival my spouse Dr McWaine circulated his own notes and suggestions to the extended Embassy family, which were very helpful.

Dr McWaine is an accomplished psychiatrist who simultaneously maintained a private practice, served as the medical director of several community mental health centers, and taught clinical psychiatry (at UCLA Medical School) when we were living in Los Angeles. Although he is unfortunately unable to work here, he certainly knows his stuff.

I did not think to record Dr Meckler’s presentations when she visited, but I do have ready access to Dr McWaine’s material.  So, I thought that it might be useful to share the notes he circulated within the Embassy immediately after the quake.

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From Dr. McWaine:

Dr Duane McWaine.

Dr Duane McWaine.

The Christchurch Earthquake was a disturbing event for all of us and a traumatic event for many. There are things we may be noticing and should understand.

Sleep problems are common after a disturbing event. There may be difficulty falling asleep in the evening … difficulty maintaining sleep, e.g., waking up through the night, having unusually rousing dreams or nightmares, or difficulty falling back asleep … and/or unusually early morning awakening.

Anxious or sad moods often accompany stressful events. Irritability (perhaps as a consequence of disturbed sleep) is another change some of us notice. We may also notice being more “emotional,” for example crying more easily, having exaggerated startle reactions, feeling more easily offended, etc.

Strangely enough, we can notice physical sensations as part of the post-earthquake experience. Similar to keeping your “sea legs” after disembarking a sea voyage, those who experienced the earthquake first hand may have episodes that feel like that earthquake is still rocking their world.

All of these phenomena, and others I haven’t mentioned, fit within the spectrum of normal responses to disturbing, distressing, or traumatic events. The frequency and intensity of these experiences, much like the aftershocks Cantabrians are experiencing, normally decrease significantly as time goes by.

We each have our own way of dealing with such events. A good way to tell how we are doing is to look back at how we’ve done with similar situations in the past. How long did I feel upset? When did I get back to normal sleep or appetite? What did I do to try to help with the situation? How effective were those measures?

The good news:  things that helped us through tough times in the past are likely to be helpful again.

Consider limiting exposure to news reports, for two reasons. First, if we’re already having difficulty, watching the news or reading the newspaper can cause us to re-experience the upset again and again. It’s as if the event never stopped – which is certainly not helpful. Second, the endless loop of images of damaged buildings and lives upset can be disturbing all by itself. How long can anyone stand such a constant barrage of “bad” and not be affected? Again, not helpful!

Be particularly sensitive to the reactions and needs of children. They take their signals from how you act. Young children might become quite clingy. Intermediate-age children might exhibit persistent worry about who will take care of them if something happens to you. Teenagers might exhibit a strong need to help in tangible ways or to find other means to reassert control over their environment. Understand that such reactions are common and natural at their respective stages of development.

For our own health and the health of those who may depend on us, it is important to take care of “us.” Maintaining “islands of normal” is a good thing – not just for youngsters, but for all of us. Finding ways to contribute to or support others in need can be a wonderful salve. Keeping up physical activity and social interactions, creating adventures, and generally making sure to provide for moments of respectful fun are all health-promoting.

A special note for supervisors – be aware that events like earthquakes affect people’s ability to function at their best. Also be aware that you yourself are likely to be affected and might be unusually irritable or short-fused. Be sensitive to your own reactions, and allow your colleagues time and space to regroup and recover.

Most importantly, if you need help, get help.

Help is available in many forms. Friends, neighbors, coworkers, and colleagues all stand ready to lend an ear or a hand. Counselors are available in many communities to listen with a more professional ear. If you are unsure how to find a counselor, you can always ask your doctor for suggestions.

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Dr D, thanks for the good advice. And Dr Meckler, thanks for parachuting in so quickly after the event.