The Aftermath

"The Aftermath"

My late father grew up in the Great Depression.  We used to joke about it, but I believe it shaped him forever.  He couldn't by a can of tuna, he'd buy a lot of cans of tuna.  Our refrigerator and cabinets and closets were stocked as though there would be no more food to buy in the future.  He sweated over saving pennies and clipped coupons.

Significant, Stressful Events Change Us.

So: What happens when COVID is a manageable disease, and the lockdowns are history? 

Some of us will simply forget.  Others of us will take this experience and leverage a much more potent and positive future.  And then, there are the ones who will experience backlash. 

As healthcare providers, we are trained to be calm in an emergency and compassionate in the midst of horror.  All of you, my colleagues, do this surpassingly well.  Some of us, however, will be left with pain and lingering distress.  Goldmann and Galea (2014) note that, while most people bounce back from disasters (a property we call "Resilience"), this is different from remaining in good mental health.  A percentage of us will develop PTSD (including 10-20% of rescue workers).  Another percentage will develop depression.  Still others of our professional family will have anxiety, increases in substance use disorders, and other changes that impair quality of life. 

How Might It Affect You?

There are some patterns that may reflect your experience, and how you may express your experience of the aftermath of disasters like the pandemic:

·       Already have a psychiatric or substance use challenge? In psychiatry, we know that PTSD is most prevalent in people who already live with a psychiatric disturbance, such as existing Major Depressive Disorder.  The same is true of substance use disorders (e.g. co-morbid with Bipolar disorder.) 

·       In the thick of it? The amount of exposure to the disaster is also directly correlated with the development of PTSD. 

·       Identify as female? Women tend to develop more PTSD, depression and anxiety after a disaster.

·       Identify as male? Men tend to be more associated with alcohol and substance use increases.

·       Seen a good bit of life already? Older age tends to be protective. 

·       Living on the fringes? Low social support, low SES and minority ethnic status tend to increase risk. 

·       Anxious and negative? Such personalities tend to more sequelae.

·       Normal stressors seem exacerbated? Sometimes people come through the disaster, and the straw that breaks the camel's back is life stressors, especially with poor family and social support afterwards (Goldmann and Galea, 2014).

It Ain’t Over ‘til It’s Over. (And It’s Not Over….)

Next time you are at work, look around you.  Listen in the break room.  And look in the mirror.  Do you see or hear anyone at risk?  Commonly, people come through the disaster and assume that because things are getting better, they will too.  They don't seek help.  They may be busy rebuilding externally without realizing that internal "infrastructure" is just as important.  Reach out, offer support.  Suggest that they get wellness help.  Make sure they get the tools they need to ensure they heal and thrive in the aftermath.

Please, if you feel you need help, are stuck or don’t know how to get help, talk to your manager, use the Employee Assistance Plan (EAP) or if you need a private conversation or help getting a NM psychiatry appointment, feel free to email me at aamberg@nm.org. For any thoughts of suicide, please go immediately to the ER for evaluation, call 911 or the national suicide hotline at 800-273-TALK or -8255