The psychiatrist told how to save the psyche of children who survived an earthquake or an explosion at home

In recent days, anxiety and fear have been growing in society, firstly, because of the monstrous earthquakes in Turkey and Syria, which claimed a huge number of lives, and, secondly, because of successive gas explosions in houses in Efremov and Novosibirsk , also entailed victims, among whom there are very young children … Undoubtedly, for the psyche of children who witnessed such terrible events, for example, live in the neighboring entrance of a destroyed house, or they themselves were pulled out from under the ruins, such things cannot pass without a trace. What could be the consequences and how to alleviate the psychological state of the child in such a situation? About this, “MK” talked with a well-known psychiatrist, psychotherapist, doctor of medical sciences Lev Perezhogin.

To all such traumatic events, as Dr. Perezhogin says, both adults and children react in approximately the same way. The first two or three days there is a condition called “acute reaction to stress.” And this reaction can manifest itself in different people in completely different ways.

“The first option, which may be, is a state resembling a “motor stupor”: a person has stopped, barely moves in space, hardly understands what is happening around, reacts poorly to words or movement,” our interlocutor explains. – Or, on the contrary, it can be an acute mental excitement – when a person runs somewhere, tries to save everyone, grabs a shovel in his hands and begins to clear the rubble … And for someone it can be a reaction simply associated with a very high level of anxiety, with a sharp decrease in mood. But, as a rule, most people go from this state to a state of mental health within a maximum of three days. This applies to both children and adults.

The main help during these three days, as they say, “here and now”, according to the psychiatrist, is that such people need to be fed, watered, given any sedatives that are available (they are certainly available from emergency doctors ), put to sleep. If the mental state of a person noticeably worsens, he is hospitalized in a psychiatric clinic.

Most, as the expert noted, come to their senses in three days, but not all. In some people (about a tenth of the participants in such events), after some time this condition is transformed into a more severe one – the so-called “post-traumatic stress disorder” (PTSD).

“PTSD always develops delayed,” continues Lev Perezhogin. – Between the actual psychotrauma and the formation of PTSD, some time should pass, usually several months. These few months in an adult may not be noticeable at all. But in children, specific symptoms can be observed. They wake up at night, cannot sleep, start to write… They start to eat badly, interact badly with their peers. Boys often become aggressive, girls, on the contrary, are clamped, frightened. But no specific symptoms, by which one could say that this is a consequence of the same injury, are not visible.

And then, when the development of PTSD actually begins, two groups of symptoms appear – clear symptoms of PTSD and others, non-specific, but directly related to the trauma. The symptoms of PTSD in children, in principle, include three main things. The first and main one is the so-called flashbacks. They occur in both adults and children. These are haunting memories of extremely terrible events. That is, suddenly the whole dramatic story flashes before your eyes again, usually at an accelerated pace. Suddenly, sometimes in response to something remotely reminiscent of the events that took place, and sometimes out of the blue, a person plunges into what was – like a flash in the mind. It lasts for several minutes, but it is very difficult to bear. And this is an additional traumatic condition.

A lot of people are afraid of these flashbacks later – they are afraid that they will happen again. In children, they are no less bright than in adults.

Secondly, children always develop an avoidance reaction. That is, children understand that some events can form flashbacks, and they begin to consciously avoid them. Suppose a man with a beard was lying next to him, crushed by slabs. They start to fear the bearded ones. Or violence against them was committed by a man in a red cap. They begin to be afraid of people in a red cap.

Thirdly, their inner experiences begin to pour out in the form of dreams with a trauma plot. This plot can turn into some kind of fairy tale. That is, in reality, the ceilings of the house collapsed, and there the cave in the mountain will collapse, in which the child is looking for something … But, one way or another, slowly turning into a fairy tale, moving more and more away from real events, in its tension these plots are not inferior to the traumatic events that actually happened. And all these sleep disturbances, nightmares, aggression in boys, withdrawal in girls, eating disorders and recovering of natural needs – all this still remains. And now this condition in a child is already extremely severe, and it requires both medication and psychotherapy, in general, complex and, as a rule, long-term treatment – for a year or several years.

– What can alleviate the condition of the child, prevent the development of PTSD?

– First. The younger the child, the more important it is for mom and dad to be around. That is, for children 5-6 years old, the constant presence of a number of parents dramatically reduces the risk of developing post-traumatic disorder. This is known for sure: during all catastrophes, in all wars – there are dozens of works on this topic – the presence of significant adults, especially a mother or father, sharply reduces the development of PTSD.

The second thing that dramatically reduces risks is the level of education and awareness of the child. The more well-read the child is, the wider his horizons, the more he is familiar with various kinds of literature, the more often he went to museums and theaters, the lower the development of post-traumatic stress disorder will be. That is, if a child has accumulated some kind of spiritual resource.

The third, very important, factor is that if the event is single and short-term, then, as a rule, it rarely leads to PTSD. If there are many such events around the same child at the same time, then the chances increase dramatically. That is, suppose something exploded, a crowd of people died – this, of course, is scary. But these are other people. But when his loved ones die before the eyes of a child, or, excuse me, his beloved kitten, when the house in which he lived is destroyed, when he had to change his place of residence and he lost his usual environment in a kindergarten or at school, when you can’t go to your grandmother , because I had to evacuate to another city – when all this accumulates together, the risk increases significantly. Therefore, it is necessary to make sure that the familiar environment around the child remains as untouched as possible. The child must understand that yes, there was trouble, but most of his life is unchanged. Everything familiar that was around him, it is.