“Ciolino knows firsthand: a tree crashed into his home during the storm, and he used his car to charge his cell phone for an interview this morning.” For Dr. Ciolino, the fury of Hurricane Sandy did not only crash his house and his power connection, but also the connection to his patients.
As the chair of the New Jersey Psychiatric Association’s Disaster Preparedness Committee, Charles Ciolino, M.D., is speaking for the silent victims of Hurricane Sandy; patients who depend on medications, patients who need psychotic drugs or psychiatric care, and patients who will suffer from ASD or PTSD in the aftermath of Hurricane Sandy.
According to the Psychiatric News Alert from November 1, 2012, the American Psychiatric Association and the Psychiatric Community, psychiatrists are having difficulties connecting with their patients in the aftermath of Hurricane Sandy.
The latest Reuters report on Nov. 1, 2012, summarizes Hurricane Sandy’s wrath:
- Hurricane Sandy is estimated with 20 or more billion dollars to be the fourth costliest U.S. catastrophe ever behind Hurricane Katrina in 2005 (100 billion), the 9/11 attack in 2001, and Hurricane Andrew in 1992.
- In New York, the U.N. headquarters suffered severe damage.
- Electricity power has been restored to 250,000 customers; however, 650,000 customers are still without power.
- Rescuers are searching flooded homes for survivors in Seaside Heights, NJ.
- Drivers are waiting in lines for hours to get scarce gasoline.
- Millions are without power on Thursday in New York City and nearby towns.
- The lower half of Manhattan is still without power.
- After being shut down since Sunday, New York subway trains crawled back to limited service.
- Areas such as Staten Island, the New Jersey shore and the city of Hoboken are still trying to recover from Hurricane Sandy’s record storm surge and flooding.
- So far at least 95 people died in the “superstorm” that ravaged the Northeastern United States on Monday; the number will most likely rise as rescuers continue to search house-by-house in coastal towns.
- In New York City neighborhoods, residents have to deal with an overwhelming increase in crime, diminished police presence, looting, and traffic safety. Despite the presence of “Guardian Angels”, a group of anti-crime volunteers, trying to enforce the law in the aftermath of any natural disaster is a daunting task.
According to the World Health Organization, disaster is defined as “a severe disruption, ecological and psychosocial, that greatly exceeds a community’s capacity to cope”.
Whether hurricanes, earthquakes, flooding, airplane crashes, acts of terrorism like 9/11, or school shootings, psychiatrists are among the first responders when disaster strikes.
“More than 800 psychiatrists are believed to have responded to the 9/11 attacks….Today, disaster psychiatry encompasses a wide spectrum of clinical interests, ranging from public health preparations and early psychological interventions to psychiatric consultation to surgical units and psychotherapeutic interventions.” (Disaster Psychiatry: Readiness, Evaluation, and Treatment)
In dealing with the aftermath of Hurricane Sandy, the APA (American Psychiatric Association) reports in its Nov. 1, 2012 article New York Psychiatrists Respond to Hurricane Sandy that according to Seeth Vivek, M.D. (chair of psychiatry at Jamaica Hospital Medical Center in New York’s borough of Queens and vice president of the New York State Psychiatric Association) among Hurricane Sandy’s fiery destruction of more than 100 houses in the beach side communities of the Rockaways were perhaps 40 to 50 group homes for chronic psychiatric patients.
“They all were evacuated to two local colleges. Most were stable, but others had to go to emergency rooms. Many had lost their medications, and many pharmacies lost power and so could not fill prescriptions.”
Under the guidance of the Red Cross, the Disaster Psychiatry Outreach (DPO) assisted with 100 volunteer psychiatrists in the Rockaways.
While the Disaster Psychiatry Outreach can provide temporary assistance for some of Dr. Ciolino’s existing patients during Hurricane Sandy’s aftermath, there will most likely be many more people showing symptoms of acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) as described by the National Institute of Mental Health:
- Flashbacks, or reliving the traumatic event for minutes or even days at a time
- Upsetting dreams about the traumatic event
- Trying to avoid thinking or talking about the traumatic event
- Feeling emotionally numb
- Avoiding activities you once enjoyed
- Hopelessness about the future
- Memory problems
- Trouble concentrating
- Difficulty maintaining close relationships
- Irritability or anger
- Overwhelming guilt or shame
- Self-destructive behavior, such as drinking too much
- Trouble sleeping
- Being easily startled or frightened
- Hearing or seeing things that aren’t there
After a traumatic event like Hurricane Sandy, many people have serious symptoms like the above. If the symptoms go away after a few weeks, this is called acute stress disorder (ASD). However, if the symptoms last more than a few weeks and become an ongoing problem, these might be symptoms of post-traumatic stress disorder (PTSD).
In contrast to ASD, some adults and children with PTSD do not show any symptoms for weeks or months.
Even though it is normal to have a wide range of feelings and emotions after a traumatic event, it is time to talk to someone if the fear, anxiety, lack of focus, sadness, nightmares, trouble sleeping, trouble eating, or crying spells persist for more than a month or if they are severe.
Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
“In some cases, post-traumatic stress disorder symptoms may be so severe that you need emergency help, especially if you’re thinking about harming yourself or someone else. If this happens, call 911 or other emergency medical service, or ask a supportive family member or friend for help.” (Mayo Clinic)
With his house crashed under a tree and without power, Dr. Ciolino is a doctor without patients and patients are without a doctor. However, there are many “Drs. Ciolinos” out there and no one is alone. Parents, teachers, neighbors, other citizens, and officials can be aware of and keep an eye out for symptoms of ASD or PTSD.
In Hurricane Sandy’s aftermath, Hurricane Sandy’s fury can only be as strong as everyone allows it to be.