Natural disasters

Whether hurricanes, earthquakes, floods or heat waves, natural disasters are set to multiply and intensify over the coming years and decades. Today, 1 in 4 French people live in flood-prone areas. The material consequences are well known, as is the impact on the physical health of those who survive these events.

What about the consequences for mental health, and more specifically for the development of post-traumatic stress disorder (PTSD)?

In this dossier, we will try to better understand the link between these two types of events, and also to provide concrete solutions for living better with, and preventing, post-traumatic stress disorder. You can read the chapters independently of each other, or in sequence, at your convenience.

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What is PTSD?

Post-traumatic stress disorder, sometimes referred to by its abbreviation PTSD, is a disorder that occurs following a traumatic event in which one is or feels confronted with death (an armed conflict, an attack, a car accident, etc.) or one's physical integrity is attacked (a physical and/or sexual assault, rape, etc.).

It's a reaction to intense stress, usually occurring within a month of the event, but can also manifest itself months or even years after the trauma. It affects more women than men, and children too.

The diagnosis of post-traumatic stress disorder is quite complex and can only be made by a medical professional. If in doubt, consult your GP, who will refer you to a psychiatrist or psychologist. In all cases, there are ways of getting better.

> Learn more about PTSD

Recognizing the symptoms of PTSD

There are four main types of symptoms that must persist for at least a month and cause discomfort:

- Avoidance: when we avoid going down a particular street, doing a particular activity, etc. In short, we avoid anything that might remind us of the traumatic event. In short, we avoid anything that might remind us of the traumatic event.

- Reliving: in spite of ourselves, we will "relive" the traumatic event and the emotions we felt at the time. These are particularly violent moments that can paralyze the person experiencing them. They can take the form of flashbacks, nightmares...

- Hypervigilance: you'll jump at the slightest noise, be on the alert all the time, turn around all the time in the street to see if anyone's following you, and so on.

- Negative emotions or ideas about oneself: one will feel anger, fear, guilt or shame in connection with the event. It can also be an inability to remember important elements of one's life from the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head trauma, alcohol or drug use).

Risk factors for PTSD

Not everyone develops PTSD after a traumatic event, but there are factors that increase the risk. These factors include:

- The severity of the event ;

- The person's proximity to the event;

- Lack of social support;

- Past trauma history;

- A history of other mental disorders.

It's important to understand that PTSD is not a weakness. PTSD is a psychological disorder that can occur in anyone who has been exposed to extraordinary and threatening events. In the next chapters, we'll look at how to identify, manage and overcome PTSD, whether after a natural disaster or any other traumatic experience.

Disasters

Before talking about natural disasters, let's review the term "disaster"in its broadest sense. In this dossier, we'll be talking about disasters in the sense of emergency plans, as the sudden occurrence of an unusual event, resulting in significant damage, both human (numerous victims) and material (destruction of the environment).

These disasters can be natural (such as Storm Alex in 2020), industrial (such as the explosion at the AZF factory in 2011) or man-made. When one of these disasters occurs, and a large number of emergency services need to be coordinated to provide assistance to a large number of victims, an emergency plan, such as the ORSEC plan, is triggered under the authority of the prefect.

What is a natural disaster?

A natural disaster is anevent that occurs naturally, without human intervention, and can causesignificant damage to human life, property and the environment.

The term "natural disaster" is also used when the damage caused by these events is significant. The French government may declare a state of natural disaster to speed up reimbursements to disaster victims. Between 1982 and 2021, some 7,000 communes were recognized as natural disasters each year.

Types of natural disasters

Natural disasters take many forms. They can be sudden and violent, like an earthquake shaking the ground beneath our feet, or gradual, like a drought that slowly takes hold and depletes water resources. Among the most common are hurricanes, floods, forest fires, tsunamis, avalanches, tornadoes, volcanic eruptions, landslides... the list goes on!

More and more disasters?

According to the 20224 report by the United Nations Office for Disaster Risk Reduction, the number of natural disasters is increasing every year, and not just a little. Between 1970 and 2000, between 90 and 100 disasters were recorded worldwide each year. Between 2001 and 2020, there were between 350 and 500 disasters a year! According to the report, if current trends continue, the number of natural disasters could rise from 400 in 2015 to 560 a year by 2030.

Evolution of number of natural natural disasters per year since 1970

To find out more: the 2022 report "Our world in danger" (available to download in French).

The consequences of climate change

Increasing concentrations of greenhouse gases in the atmosphere thus lead to climatic upheavals, which in turn accentuate large-scale climatic events, for example :

Temperature rise: climate change is causing a global rise in surface temperatures. This can lead to more frequent and intense heat waves, with serious consequences for human health, wildlife and agriculture.

Rising sea levels: as global temperatures rise, glaciers and ice caps melt, and seawater expands due to heat. This causes sea levels to rise, which can lead to more frequent and severe coastal flooding.

Through changes in precipitation: climate disruption can lead to changes in precipitation levels, resulting in prolonged droughts, more frequent forest fires and water shortages.

This list is not exhaustive, but the key point is that climate disruption is worsening weather and climate conditions, which can increase the probability and intensity of natural disasters.

How natural disasters affect us

When disaster strikes, it can leave a trail of chaos in its wake. The material consequences, sometimes spectacular, are often shown in the newspapers and on television. But in reality, the impact of these disasters is also invisible, over the long term, particularly on the mental health of disaster victims and their families.

First and foremost, natural disasters kill. According to the European Environment Agency, natural disasters have caused the deaths of almost 195,000 people in Europe since 1980.

Natural disasters can affect vast geographical areas, potentially affecting thousands of people at the same time. Survivors of natural disasters may face traumatic events such as loss of property, separation from family, physical injury, loss of loved ones or even loss of life. All these factors increase the risk of developing PTSD.

Natural disasters can also trigger a chain reaction of potentially traumatic events. For example, an earthquake can trigger fires, floods or landslides, leading to a series of additional traumas for those affected.

Property damage

One of the first obvious impacts of a natural disaster is material damage. This includes everything that can be damaged or destroyed: homes, buildings, roads, bridges, vehicles, electrical infrastructure, and much more. Material damage can be immense, often leaving entire communities without shelter or resources.

Floods, for example, can submerge entire neighborhoods, destroying everything in their path. Earthquakes can crack buildings and cause collapses. Forest fires can reduce hectares of forest to ashes, threatening homes and lives.

The cost of disasters

The costs associated with property damage caused by natural disasters vary considerably from year to year, depending on the scale of the event.

In 2018, major floods in certain French regions resulted in costs estimated at over 1.4 billion euros, according to the Fédération Française de l'Assurance (FFA). Moreover, according to the FFA, the cost of natural disasters and other compensated climatic events will double in 30 years. Between 1989 and 2019, cumulative damage caused by natural hazards amounted to €74.1 billion. For the period 2020 - 2050, this is expected to rise to 143 billion euros, an increase of 93%.

Storm damage can also be significant. For example, storm Xynthia in 2010 caused material damage estimated at around 1.5 billion euros.

Social and economic disruption

The consequences of natural disasters go beyond material loss. They can also cause massive social and economic disruption.

Communities can be torn apart, families separated, and social support networks severed. Economic disruption is often felt for years after the disaster, as reconstruction and restoration take time and considerable resources.

Consequences for mental and physical health

In addition to material damage, natural disasters can also have a major impact on the mental and physical health of those affected.

Physical health can be put at risk. Injuries, sometimes serious, are common in disasters, whether due to flying debris, falls, floods or other emergencies. In addition, post-disaster conditions, such as loss of access to drinking water, food and medical care, can lead to further health problems.

Some people experience event-related grief. These are difficult bereavements, because they are sudden and unexpected. They can lead to specific disorders such as prolonged grief disorder.

Compared to other traumatic events, people affected by a natural disaster may be confronted with the destruction of their home, possessions and environment, which can provoke a sense of loss, powerlessness and despair. It's harder to rebuild when your entire environment - your home, your neighborhood, your neighbors and sometimes even your health care facilities - are gone.

This is where post-traumatic stress disorder comes in. As natural disasters are very often potentially traumatic events, it's not uncommon to show signs of PTSD after your house burns down, the water rises in your village, or a hurricane destroys everything in its path. Solutions exist to help you get better. That's why it's so important to know how to spot the first signs of post-traumatic stress disorder, so that we can be directed to a health professional as quickly as possible if necessary.

Identifying the signs of PTSD

Post-traumatic stress disorder is a disorder that can develop after experiencing or witnessing a traumatic event, such as a natural disaster. This doesn't mean that everyone who has experienced a natural disaster, such as a flood, earthquake or forest fire, will necessarily develop this disorder.

After the earthquake that devastated Haiti in 2010, researchers determined that almost 1 in 4 of those affected showed signs of post-traumatic stress disorder.

It's perfectly normal to experience some form of acute stress in the days and weeks following a dramatic event such as a natural disaster. Disturbing symptoms must have been present for at least a month before a diagnosis of PTSD can be made. Only a health professional can make a diagnosis.

A climatic trauma?

A study recently highlighted the long-term effects of "climate trauma" caused by natural disasters8. In the aftermath of the massive California wildfire of 2018, many survivors continue to suffer from cognitive dysfunction, including intrusive thoughts and persistent distractions. According to psychiatrist Jyoti Mishra, who led this research, "it's very important to better understand climate trauma, as it can affect millions of people, with climate change occurring at an accelerating pace."

The term "climate trauma" is distinct here from post-traumatic stress disorder (PTSD) because of its recurrence and impact on so many people. As Jyoti Mishra explains, "the experience of climate-related stress or trauma is different from PTSD, which was created in the context of war." What's more, the health consequences are slightly different, with a higher prevalence of depression and anxiety associated with climate trauma, sometimes in conjunction with PTSD.

Identifying signs in a loved one

As loved ones, we can also recognize some of the signs of post-traumatic stress disorder. For example:

- Changes in behavior: if we observe marked changes in a loved one's behavior after the disaster, such as social isolation or avoidance of activities they once enjoyed, we need to pay close attention.

- Nightmares and sleep problems: if someone tells us about frequent nightmares or sleep problems since the disaster, they may be suffering from PTSD.

- Unexplained physical symptoms: people with PTSD may also experience headaches, body aches or other physical symptoms with no apparent cause.

Natural disasters, how to rebuild, mental health

Who to ask for help?

One of the major protective factors against PTSD is social support. So it's imperative not to isolate yourself after a traumatic event, and to dare to ask for help.

In the event of a natural disaster, you can ask several people for help, depending on what you're going through.

In an emergency, you can call 15 at any time.

In addition, if you or your loved one develops suicidal thoughts, call 3114, the national suicide prevention number.

After a natural disaster, local support groups can also be set up. These groups can help you deal with the aftermath of the disaster, and can be a great help in: discussing the disaster, dealing with administrative formalities, mourning in connection with the disaster, etc.

At the time of the disaster / in the days that follow

Ask loved ones for help with everyday tasks. Don't be afraid to ask for help with everyday tasks, such as running errands, looking after the children for a few hours, etc., if you're feeling overwhelmed. You can also take advantage of your loved ones to talk about what you've been through, and put the catastrophe into words.

Call the hotline set up by the CUMP (Cellule d'Urgence Médico Psychologique). The health professionals on the line will be able to provide you with psychological first aid and then refer you to other health professionals depending on your situation.

In the months that follow

If you think you're suffering from post-traumatic stress disorder more than a month after the natural disaster you experienced/witnessed, you can contact your local Centre Régional du Psychotraumatisme (CRP ).

You can also seek help from a psychiatrist or psychologist specializing in psychotrauma > Find out more about the different therapies for PTSD.

Your loved ones and your GP are always good people to turn to. Don't be alone, talk about it!

Years later

It's never too late to seek help. For one thing, because sometimes the signs of PTSD aren't recognized right away, or the disorder doesn't develop until well after the disaster. If you feel unwell, talk to your GP.

The aftermath for my child

Being a child, even a very young one, doesn 't make you immune to trauma or prevent you from developing post-traumatic stress disorder. The same goes for teenagers.

The only difference lies in the way PTSD is expressed in children.

In the aftermath of a natural disaster, children and teenagers can experience intense fear, anxiety and horror. They may be particularly frightened at the thought of losing their parents, their own safety and the destruction of their environment. Children and teenagers may relive the traumatic event through flashbacks (intrusive memories) and nightmares. They may have difficulty distinguishing between the past and the present.

How can I help my child?

If your child or a child you know has been the victim of a natural disaster, it's normal for him or her to react more or less strongly to the event. In any case, you can help them through this difficult period.

- By being attentive and reassuring: listening attentively to what your child has experienced will always be reassuring for him, especially as you will be showing that you understand his fears and worries. Reassure him that you are there to protect and support him.

- By creating a safe environment: if you have been able to return to your home or take shelter elsewhere, make sure that the house is secure and that potentially dangerous objects are out of reach. Attention should also be paid to the digital environment. Avoid exposing your child to shocking images or reports on the disaster.

- Maintaining a routine: for your own well-being, as well as that of your child, try to return to a daily routine as quickly as possible. Stability and predictability can help your child feel secure.

- Encouraging emotional expression: it's essential to let your child talk about his feelings. Encourage him or her to express anger, fear, sadness or confusion. You can use drawings, games or conversations to help your child express his emotions. To do this, parents must also allow themselves to express their own emotions.

As with adults, relaxation techniques such as deep breathing and meditation can help children manage anxiety and stress. If you can, get your child back into activities he or she enjoys (games, sports, creative arts...) to help take his or her mind off things and relax.

In fact, the best way to help your child is first and foremost to take care of yourself. Paying attention to your own well-being will enable you to be more available to support your child.

Recovery from trauma can take time. Be patient with your child and respect his or her pace.

If you find that your child continues to struggle with symptoms of trauma, it may be helpful to consult a mental health professional who specializes in trauma treatment.

Who to ask for help?

Every child reacts differently to trauma, and it's essential to tailor your approach to their individual needs. Family and professional support can play a crucial role in a child's recovery from a natural disaster.

For children directly affected by a natural disaster:

- If you notice any changes in your child's behavior, your pediatrician or general practitioner is the right person to talk to. He or she will be able to refer you to a healthcare professional specializing in psychotrauma, if necessary.

- A medical-psychological emergency unit (CUMP) was probably activated after the traumatic event. If you have not yet been in contact with the CUMP, don't hesitate to call 15 in an emergency.

- Regional psychotrauma centers also provide support for children suffering from post-traumatic stress disorder. If you think you see signs of PTSD in your child, don't hesitate to contact your local CRP. Please note, however, that waiting times can be long. In an emergency, dial 15.

For children indirectly exposed to natural disasters:

Without having been directly confronted with the natural disaster, your child may have lost a loved one or been exposed to the event via the news, television or a smartphone. It's important not to minimize what he or she has experienced, and to be attentive to his or her speech and behavior following this exposure. Follow this link for a fact sheet on what to do if your child has been exposed to violent and/or traumatic content.

Being confronted with traumatic images can activate or reactivate old trauma, at any age.

Natural disasters: how to help a child migration consequence, exile

How do you prepare for a natural disaster?

Preparing for natural disasters can make all the difference when an emergency situation arises. Here are some important steps you can take to prepare yourself and your family:

- Establish a family plan: discuss as a family what you will do in the event of an emergency. Identify a safe meeting place (or a second one further away if the first is inaccessible) and emergency contacts.

- Build an emergency kit: assemble essential supplies, such as water, food, medicine, flashlights and important documents, in an easily accessible kit.

- Stay informed: follow local weather warnings and alerts. A battery-powered portable radio can be a valuable tool for this.

- Know how to evacuate: familiarize yourself with local evacuation routes and keep your vehicle in good working order.

- Protect your home: reinforce your home against the specific risks of your region (for example, by using flood barriers or reinforcing structures against earthquakes).

Did you know? By entering your postal address on the georisques.gouv.fr website, you can access the various risks that your area faces or has faced in the past. It's the perfect way to anticipate and prepare for potential disasters in your area.

What to do during a disaster

During a natural disaster, it's essential to follow safety measures to protect our lives and those of our family. Obviously, recommendations will depend on the type of natural disaster we're facing.

In the event of flooding, evacuate immediately if the local authorities recommend it, and stay out of flooded areas. If evacuation is impossible, climb to the top floor or roof of your house if it's not too risky. Avoid walking or swimming in floodwaters at all costs, as they can be extremely dangerous.

In the event of a hurricane or storm, it is advisable to follow weather reports and evacuation recommendations (e.g. on the radio). After closing the shutters in your home, the authorities generally recommend staying indoors, as far away from windows as possible. After the storm, beware of downed power lines and stagnant water, which can represent a danger.

In the event of aforest fire, again, follow evacuation orders if they are issued. If you have to stay at home, it's advisable to close windows, doors and shutters to prevent ashes from entering your home, and to breathe through a damp cloth.

In all cases, listen to the instructions of the local authorities and follow the family emergency plan you have prepared in advance.

Recovery, reconstruction and resilience

Once the peak of the disaster has passed, it's time to rebuild your environment and yourself. Depending on the material damage and the situation, this reconstruction will take more or less time.

From a purely material point of view, it is advisable not to sign the documents presented to you by the insurance experts too quickly. If you enlist the help of associations, social workers, etc., you may be able to get better compensation than you're being offered right now.

Cultural recommendations

Les émotions du dérèglement climatique, by Célie Massini and Antoine Pelissolo (2021), Flammarion.

Comment rester écolo sans finir dépressif - eco-anxiety, solastalgia, green depression - practical solutions for reconciling with the beauty of the world, by Laure Noualhat (2020), Tana.

Une autre fin du monde est possible: Vivre l'effondrement (et pas seulement survivre y), by Pablo Servigne, Raphaël Stevens & Gauthier Chapelle (2018), Seuil.