We Live in Perilous Times

 

At any moment multiple small wars are raging all over the globe. Violence by and against civilians is epidemic in the Middle East, Latin America, Africa, the USA and elsewhere. Climate change has increased the incidence of dangerous weather conditions, and hurricanes and tornadoes are frighteningly more frequent. Soldiers, firemen, and peace officers return from duty psychologically crushed by the horrors they have seen and participated in.  

 

Recently, it has become clear that the psychological damage which follows exposure to life-threatening events also has a biological basis in physiological changes induced in the brain and central nervous system. The DSM-IV classifications for such disorders may be covered by the umbrella term: Post-Traumatic Stress Disorder or PTSD. In line with recent NIH classifications, clinical PTSD may develop after a terrifying ordeal involving either physical harm or the threat of physical harm and currently affects about 7.7 million American adults. Untreated and unrecognized, the impact of this condition on an individual’s personal and professional life can be profound, leading to depression, aggressive behavior, delusions, violence, and suicide. 

 

Early diagnosis and treatment of PTSD are critical and can improve long-term outcomes. However, both local healthcare teams and outside providers responding to disasters often have their hands full with immediate triage and acute care needs. Worse, once temporary healthcare teams have departed impacted populations the absence of resources is acutely felt. This often occurs at the same time the latent symptoms of PTSD become manifest. North et al (2011), strongly recommend long-term placement of mental health services in disaster recovery areas. Unfortunately, the personnel and on-the-ground infrastructure needed to address the surge of mental health needs among impacted populations is insufficient in the face of already overburdened mental health care systems.