Dr. Rijusmita Sarma, BAMS, MSc in Psychology, CCS

Counselling Psychologist and Psychotherapist,

Editorial Assistant of the Open Journal of Psychiatry & Allied Sciences (OJPAS®)

It was a typical May evening of 2009. I was in my reading room with book in my hand and the reading lamp on. I was in the second year of medical school. Out of the blue, I found that it was difficult for me to breathe, there was palpitation, and sweating and I was terror-struck. It was overwhelming and the symptoms reached its peak within seconds. I sat down on the floor feeling helpless. I wasn’t even able to call out for help. Fortunately, my sister came in but she was perplexed to see me that way. She called our parents and as it seemed apparently, they felt I was going through something fatal. Medical help was sought for immediately and I dozed off after I was given a sedative. I was checked for every possible organic cause but everything was normal. These episodes became recurrent and it was very baffling and obscure for me and my family.

A flashback…

30th Oct 2008, a day very well etched in the minds of people of Assam. As high as 18 blasts ripped apart Guwahati, Barpeta Road, Bongaigaon and Kokrajhar. It was extremely intimidating as news of one blast after another was flashed in the state and national electronic media. For some time it seemed difficult to understand what was going on, but it was evident that Assam was going through something very dreadful.

Not realising the harm I was doing to myself I kept on watching the television for hours together. In the evening when I was going to Panbazar, while I crossed CJM court I got a glimpse of the burnt vehicles which exhibited the devastation the place witnessed on that unfortunate noon. A tempest of thoughts, questions and emotions raged in the then teenaged mind. But I could barely share those things with anybody, as I was not very expressive back then. I started having nightmares and flashbacks of those horrendous images but I ignored my poor quality of sleep (also not knowing how debilitating it can be). But the anxiety attack on 9th May 2009 was something neither my family nor me could turn a blind eye to. As it was difficult for me to unveil what I was going through it was tough for everybody else to understand what was bothering me. But one day after a severe attack, in a heavy-eyed stage I spoke out everything inside me and I was diagnosed with stress disorder.

Direct exposure can lead to stress disorders like PTSD (Post Traumatic Stress disorder). PTSD is a condition that “arises as a delayed or protracted response to a stressful event or situation (either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone”. The symptoms of PTSD can include some or many of the following:

1. The traumatic event is persistently re-experienced by the person through intrusive, recurring thoughts or nightmares.
2. The person avoids stimuli associated with the trauma.
3. The person may experience chronic tension and irritability, often accompanied by insomnia and inability to tolerate noise.
4. The person may have impaired concentration and memory.
5. Feelings of depression may take over and the individuals may avoid social situations or environments where he/she would be exposed to excitable stimuli.

PTSD can persist for life and can trigger after many years of witnessing the trauma.

Indirect or media exposure can also trigger symptoms encompassing a wide range of disorders like Acute Stress Disorder (ASD) and depression.

The blast took away many lives and hundreds of innocent people were maimed for their entire lives, affecting countless families. Besides these there were many people who neither died nor bled but still went through inexplicable pain. These were the people who suffered or may be is still suffering from psychological trauma, primary (individuals who witnessed, experienced or confronted with the trauma) or secondary (individuals who were indirectly exposed to the trauma e.g. through a narrative of a traumatic incident). They may still be burdened with unanswered questions, anger, fear, guilt, grief etc.

I was a young adult of 19 years then, not equipped enough to handle the overwhelming emotions. But I was fortunate enough and will always remain thankful for the timely intervention by mental health professionals like Dr. Mythili Hazarika and others. And I was also blessed with immense support from my family. Because of which I not only recovered from the secondary trauma I went through but I myself am a practicing psychologist today (taking a major drift after my medical education).

But I still have two questions (regarding any such untoward incident) for the readers to reflect on:

1. Can casualties be measured only in terms of deaths and non-fatal injuries? Is the loss even countable?
2. Is there adequate awareness and help for the survivors who suffer psychological wounds with or without physical injuries?

Bibliography

World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.

World Health Organization. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organization; 1993.

Sampath H, Soohinda G, Sharma A, Dutta S. Media exposure to earthquake-related content in its aftermath as a risk factor for acute stress disorder. Open J Psychiatry Allied Sci [serial online]. 2018;9:152-6. doi: 10.5958/2394-2061.2018.00032.0. Epub 2018 Feb 28 [cited 2018 Oct 29]. Available from: https://www.ojpas.com/ojpas-20180228/fulltext.html

Das S. Media exposure and PTSD. In Horizon: the supplement with The Assam Tribune [Internet]. 2018 Oct 26 [cited 2018 Oct 29]. Available from: http://www.assamtribune.com/scripts/spat.asp?id=2018/oct2618/BigPage19.jpg

Program and collection as well as preliminary program of the National Congress of Hospital Psychiatry with international participation that will be held in Belgrade from October 10 to 12, 2018, organized by the Association for Emergency Psychiatry of Serbia, Clinic for Psychiatric Diseases, “Dr Laza Lazarević” and the Clinic for psychiatry at the Clinical Center Kragujevac are made available online. They include the abstracts of the invited lecturers: “Using antipsychotic pharmacodynamics and pharmacokinetics to choose a medication and to dose long acting injectables” by Stephen M. Stahl and “Global psychiatry: a LAMIC perspective” by Shyamanta Das, the Editor-in-Chief of the Open Journal of Psychiatry & Allied Sciences (OJPAS®).