Refugees will need help in coping

The folks who survived Katrina with front row seats, riding out the hurricane, are now in survival mode. And refugees arriving in Utah from the storm are apt to be in that mode for some time.

Later, on varied schedules depending on their individual emotional makeup and circumstances, they will begin to move through stages of grief, anger, frustration and fear as they begin to rebuild their lives, according to Utah crisis experts who are preparing to help with the recovery process.

Reactions — now and stretching into the future — are likely to include anxiety, irritability, depression, anger, "all the emotions, intensified," says Richard Hatch, director of adult services for Valley Mental Health, who is also a crisis counselor. "Maybe guilt. I survived and friends and family members haven't. Why did I survive and not others?"

Some victims of the hurricane are likely to deny all feelings, simply trying to block them off. Or have unpleasant flashbacks of things they endured. Sleep disturbances, poor concentration, loss of memory, confusion, inability to act and think may occur, he says. And there will be a host of physical symptoms, including nausea, headaches, numbness, chest pains and heart palpitations.

Some will have — likely are having — panic attacks. This level of stress can lead to increased colds and flu. "The body is dealing with so much stress, such pressure, it's susceptible to illness," Hatch said.

Most are likely fairly numb and shocked right now. Some are likely "hypervigilant," nervous about danger and fearful of more trauma to come. Mood swings are common, say Cathie Delewski, a crisis social worker at University Hospital, and Janina Chilton, spokeswoman for the state Division of Substance Abuse and Mental Health.

Some of the first steps are finding food, shelter, clothing and attending to the basics. That's where others can be most helpful to them right now, Hatch says. It's also important to allow people who have been through a cataclysmic event to express their feelings. That's a way to begin to regain a sense of control.

Part of being there for those who are traumatized is knowing what not to say — perhaps one of the most important ways people can help, Chilton says.

It's OK to tell someone you understand why they feel as they do but not to tell them how to feel. You can assure someone his reaction is normal: "It's normal be feel upset and confused." It's OK to say: "Things won't ever be the same, but they will get better."