Psychological Impact Of Boston Terror Likely To Continue For Residents

By Amir Khan

While helicopters flew overhead early this morning, Cathy Olofson and her daughters huddled in the basement of their home near the Boston community of Watertown. Olofson's 13-year-old daughter had heard an explosion and her mother thought it would be safest for the family to move to the basement while police widened their search for the suspects thought to be responsible for Monday's Boston Marathon bombing.

Olofson, 50, said she was asleep when her younger daughter woke her up after hearing an explosion.

"We immediately assumed it was related to the bombing," she said. "We all went into the basement because we didn't know what was going on and it sounded really close. We came back up after 10 minutes and heard another explosion. It was clear that something was unfolding close by."

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Olofson said she heard helicopters throughout the night -- most likely related to police efforts to capture two bombing suspects about a mile from the Olofson's home."We were scared, but once I realized it was a little ways away, we just sort of took it in stride," she said. "You feel safe being in the house. I don't think we panicked."

Police have killed one of two bombing suspects, according to numerous reports, and continue to search for the other, believed to be Dzhokhar Tsarnaev, a Chechnyan national living legally in the United States. But experts say that for those like the Olofson's, the ordeal is likely to continue to resonate and -- potentially -- pose emotional health concerns.

"It's one thing when something happens across the country, but when it has a personal connection, it looks much different," said Jeffrey Magill, project coordinator for behavioral health emergency management at Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center. "We empathize with other places, but when the people have names and faces and are from our community it's much different."

"All of a sudden, we realize we could be next," he added.

For some, the images and sounds of the Marathon bombing, which killed three and left 170 injured, can cause problems typically seen in soldiers returning from war, according to Rachel Yehuda, PhD, director of the traumatic stress studies division at the Icahn School of Medicine at Mount Sinai.

"Post-traumatic stress disorder may occur in those who were directly affected by the event," she said in an email. "The injuries appear similar to what soldiers experience on the battlefield—head trauma, physical damage such as loss of limbs or shrapnel wounds, combined with the emotional trauma, the unexpected nature of the event, and the knowledge that someone has had an intent to harm, can be a devastating combination."

Olofson said that while she was scared by last night's helicopters and explosions, she and others in the Boston area have been waiting for something like this to happen ever since the Marathon.

"You never expect this to happen so close," she said, "but since Monday, people have been prepared for something like this and ready to go into some kind of protection mode."

That protection mode, said Diane Poole Heller, Ph.D., a trauma resolution expert, is a normal response to trauma, but can cause serious health problems. Once we begin to feel that our lives are in danger, it can cause us to see danger everywhere, which has not only psychological effects, but physiological effects as well.

“When people perceive that they're in a life threating situation, it's normal for them to go into a shutdown mode,” she said. "Over a long period of time, it can affect their digestion, they can become hyper-vigilant and lose sleep. It can lead to panic, anxiety and perceiving threat everywhere."

Being on lockdown in their own community, Magill said, will only serve to exacerbate those problems.

“If a lockdown in a community goes on for hours, that fear and anxiety that comes from not knowing what is going on has a greater impact,” he said. “It can exacerbate previous trauma."

But even once the lockdown is lifted, people begin resuming their daily activities,and the trauma begins to subside, it's important to remain on the lookout for signs of depression, anger and flashbacks up to a year later, Heller said.

“Whenever something really traumatic happens, there's a very strong incidence of anniversary trauma,” she said. “On the year anniversary of the event, the trauma surfaces again, and if people don't plan to take care of themselves around that time, it's almost like it's happening again.”

How To Cope With A Disaster
When a disaster affects you so personally, Heller said, it is imperative to lean on other people in the community in order to foster a sense of safety. Talking to a friend or family member can help you work through any issues that arise once the ordeal is over.

“One of things that is really important is having a strong support system,” she said. “Isolation is a fallout of trauma that's very damaging. It's hard to deal with a tragedy if you are by yourself.”

Olofson said that while the streets in Belmont are eerily quiet, she cannot wait for people to start leaving their homes so they can talk about it in person, rather than over the phone.

“I think human contact and talking about it, reassuring yourself and each other will help a lot,” she said.

And while having a support network can help you overcome feelings of grief, shock, or horror during times like this, Heller added, if you begin to experience flashbacks or have angry outbursts, you should seek professional help.

For children, it's important to sit down and explain to them what is going on, Magill said, as they are not able to express themselves as well as adults.

“Adults have life experience and coping mechanisms, but kids may not have the same level of ability to communicate their fears or concerns, so they often do so through their actions,” he said. “You may see some acting out, some regression in behavior or destructive behaviors.”

Allowing them to express themselves is important, he added, but if the behavior begins to interfere with their lives or schoolwork, you may want to consider bringing in a professional.

In the end, Dr. Yehuda said it's important to be prepared for emergencies, because as this week's events show, they can happen in the blink of an eye.

“Knowing emergency plans – for example, where to meet up with family and loved ones, or knowing with whom to stay following a catastrophic event – can help minimize some of the stress brought on in times of disaster,” she said. “In addition to preparing for trauma, people can alleviate their own feelings of anxiety or helplessness by volunteering in some way, particularly if they are in the Boston area.”

But for Olofson, who said she's relieved that the whole thing is over now, she's just hoping that they never hear those sounds again.

“The ordeal was unnerving, but it's no longer scary,” she said. “We're just hoping no one else gets hurt.”

"Psychological Impact Of Boston Terror Likely To Continue For Residents" originally appeared on Everyday Health