Everybody Has Issues:
The impact of hurricanes on mental health, part one


The devastation from recent hurricanes made me think about a premise in psychology known as “Hierarchy of Needs.” Psychologist Abraham Maslow proposed that all of us have certain needs, and that those needs have an order of importance. Imagine a drawing of a pyramid divided into five levels to show how the needs build on each other.


The broad base reflects all humans have basic needs; the smallest reflects few accomplish all steps. The levels (by importance) are: physiological needs (food, water, rest); safety needs (security, safety); belongingness and love needs (intimate relationships, friends); esteem needs (prestige, feeling of accomplishment); and self-actualization (achieving one’s potential, including creative activities). Perpetually hungry or unsafe people are unlikely to reach the next level.

Even before the hurricanes hit, the needs of those in harm’s way dropped immediately to the bottom two levels. Nothing compared in importance to figuring out how to stay alive! Next, finding shelter and attaining food and drinkable water became the primary focus. Some had additional basic needs like securing prescribed medications or getting treatment for physical injuries.

Fortunately, organizations and governmental agencies were already prepared for rapid response with coordinated plans to provide shelter, food, and water. The Red Cross also sent an alert to mental health professionals soliciting volunteers certified in disaster response, crisis management, or anyone willing to take a crash course so they could provide on-site assessments, referrals, and counseling services.

Many flood victims will meet the criteria for Acute Stress Disorder, as will first responders and volunteers. The symptoms are:

– directly experiencing a traumatic event

– witnessing a traumatic event happen to someone else

– hearing about a loved one’s experience of a traumatic event

– experiencing repeated or extreme exposure to aversive details of the event (e.g., first responders collecting human remains; victims witnessing someone drown or viewing the obliteration of their home)

– the presence of nine or more symptoms from five categories of:

– intrusion (distressing thoughts, memories, nightmares)

– negative mood (depression, hopelessness, anxiety)

– dissociation (experience of unreality, feeling detached as if in a dream)

– avoidance (of people, places, conversations)

– arousal (hypervigilance, angry outbursts, poor concentration, exaggerated startle response)

If these symptoms persist for more than one month, the diagnosis changes to Posttraumatic Stress Disorder (PTSD).

Next week, I will address treatment approaches and write about how people navigate this and other stressful life transitions successfully.

Stockton is a Licensed Professional Clinical Counselor and owner of Inner Peace Coaching & Counseling located at 4030 Mount Carmel Tobasco Road in Cincinnati, OH. For more information, call 513.201.5949 or visit www.lindastockton.com.