It is not unusual for soldiers who have fought in a war to suffer from post-traumatic stress after their missions. People who have experienced violence, who have been driven out of their homes or who have been forced to flee may also develop PTSD, as can emergency workers deployed to disaster zones to rescue the injured and recover the dead.
Such disasters might be caused by extreme weather events. People may have to fight for their survival, escape from floods or wildfires, and even witness others dying. If a person has been acutely and directly endangered by extreme weather conditions and has felt helpless in the face of disaster, they have an increased risk of developing PTSD.
"Hurricanes Katrina and Rita have been studied very closely," says the psychiatrist Andreas Meyer-Lindenberg. Back in 2005, the current president of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) worked to administer psychological first aide in the US, after Hurricane Katrina caused terrible destruction across several states and claimed the lives of more than 1,800 people.
"Basically, not every person who is exposed to extreme weather events has mental health problems as a result," Meyer-Lindenberg says. "But there is a significant increase in mental health problems and illnesses after extreme weather events."
He explains that almost half of those affected by the devastation of Katrina developed PTSD. While people may also suffer from depression, anxiety and even addiction after an extreme event, PTSD is a direct, causal result of what they have experienced.
PTSD as a direct result of extreme weather
"The definition of PTSD is that an extremely threatening event has been experienced by the person themselves or by someone close to them, and this event is at the center of their problems," Meyer-Lindenberg says. A typical symptom is that a disaster is relived over and over again in the form of flashbacks, dreams, and memories. People will therefore try to avoid anything that might trigger these flashbacks. For flood victims, this could be rain.
The psychiatrist explains that this avoidance strategy prevents victims from dealing with what they have experienced, and that consequently they are often unable to overcome their post-traumatic stress without therapy.
Little data is available on the impact of extreme weather events on the mental health of victims from developing countries — which are often among those worst affected by fire and flood. "Most of the research has been done in Europe, North America, and Australia," Meyer-Lindenberg says, adding that there is a particular lack of available data from Africa.
Yet the countries of the Global South have already been dealing with extreme weather events, exacerbated by ongoing climate change, more frequently and for longer than those in the north. "If countries have experience of extreme weather, and are better able to deal with the consequences as a result, this can, of course, cushion the impact of such events," Meyer-Lindenberg.
For example, stable dikes not only protect people's houses and possessions from floods, they also protect their mental health by providing a sense of security. But good protection against extreme weather events requires financial resources that in poorer countries are often lacking.
How does psychological first aid work?
Money is also needed to provide psychological first aid in the aftermath of a disaster. Meyer-Lindenberg lists five key points that are vital for the psychological stability of survivors.
First, they need a place to sleep, something to eat, and clean drinking water. "You don't need to think about anything else until this has been ensured," he says.
His second point is that it's important to reassure victims by listening to them if they want to talk. However, under no circumstances should they be forced to talk about what they have experienced.
Thirdly, people should be able to contact relatives as quickly as possible. "It's hugely important for children in particular to be able to be with someone familiar as soon as possible."
The psychiatrist's fourth point is that people are better able to cope with a disaster if they experience self-efficacy. This is a sense of active participation in helping to shape a situation, rather than simply feeling that you are at its mercy. "Helping others is one way of achieving this," Meyer-Lindenberg said.
Finally, it is essential to keep people's hope alive: "Not with platitudes, but with actions that give those affected the feeling that they can get through this difficult period together."
More extreme weather can retrigger PTSD
If a person develops symptoms of PTSD, they can be helped with a treatment called exposure therapy. This allows them to confront the trauma again in a safe, therapeutic space, and, in doing so, to overcome it. "It is possible for [it] to disappear completely," says Meyer-Lindenberg.
However, people with existing PTSD can be retraumatized if they are repeatedly exposed to extreme weather events. The symptoms of post-traumatic stress disorder are not reduced the more often a person experiences an extreme situation. On the contrary: "The more often such a person experiences helplessness, the worse their reaction to it will be."