The National Police Agency reported June 11 that more than 90,000 people remain displaced by the country’s earthquake, tsunami and nuclear crisis. The government aims to build 52,000 temporary homes for the evacuees, but only about 28,000 of the homes have been completed. Many evacuees have rejected moving into temporary housing, saying there are insufficient support services compared to those at shelters. Additionally, the slow progress continues due to the massive amount of debris that needs to be cleared in the disaster-hit areas.
The possibility of PTSD (Post Traumatic Stress Disorder) rises about three months after the crisis as reality and the isolation of living in temporary housing sets in, especially for those who lost family members, noted Dr. Kazunori Matsumoto
The victims go through four stages, he added. The first one is the initial shock period these people suffered immediately after the earthquake and tsunami. The second stage is the honeymoon period where the victims are connected with others in solidarity, which helps them cope.
The third phase is realizing the reality of their situation and their endurance reaches the critical limit, especially for those who lost their family members. It becomes easier for fights and trouble to occur. Depression and alcoholism also increase and this is the time that doctors need to watch victims.
The last stage is the rebuilding period. Even if daily life returns to the stricken area, flashbacks occur, but they gradually recover. However, it is still difficult and many need support to help them cope with stress.
“I basically agree with this four-stage psychological way of thinking,” says Nobuhara Harada, a medical doctor who treated Japan’s earthquake and tsunami victims at shelters. “But this fourth stage is also called ‘normal stress reaction after natural disaster’ and it is not specific to tsunamis or nuclear disasters. The speed of recovery is different for each individual and normally people recover in one month.”
He said that those who don’t recover within one month usually end up suffering from PTSD. However, because of the huge disaster in northeastern Japan, it is extremely difficult to determine the diagnostic cut-off, as it could be longer than one month. He noted in the United States, physicians usually wait three months before diagnosing PTSD.
“There were also a lot of strong aftershocks after the March 11 earthquake and continuous exposure to radiation which re-traumatized people,” Harada said. Alcoholism is a major problem in a situation like this as well. “A lot of people drink to self-medicate themselves from afflictions such as anxiety, depression, nervous breakdown. As alcohol has a relaxation effect for most people, it helps to alleviate these symptoms.”
He added that a malignant cycle starts and pushes a lot of people into alcoholism. There was a report of a man in his fifties who got drunk in a shelter in Iwate prefecture and started screaming at others around him. He had hidden his alcohol inside a water bottle so no one knew he had been drinking.
However, in treating alcoholism physicians usually only accept patients who are willing to discontinue drinking. Treatment never helps unless the alcoholic wants to stop drinking. “As far as I know, AA (Alcoholics Anonymous) is a group to help and support each other but all of them must be willing to quit drinking,” Harada said.
According to Dr. Ekihiro Ueno, a professor at Kobe University who studied the aftermath of the 1995 Great Hanshin Earthquake in Kobe, of the 253 residents of temporary shelters in Hyogo prefecture who died from 1995-1999, more that 70 percent passed away from liver failure as a result of drinking alcohol.
He noted that a housing salon helped people during this period because it provided a place for people to get help and support.
A similar salon was completed June 10, 2011, in a junior high school in Iwate Prefecture to prevent suicide and mental problems. Ueno said these people will need help for a long time and treating them could take between 10 to 20 years.
Harada says the salon should target these people in the affected areas if one expects to have a therapeutic effect on alcoholism.