Dr Ubaldina Noronha
When we see images of the recent floods, be it Assam or Nepal, it is easy to reduce the severity of the crisis once the water recedes and relief arrives. But from a psychological standpoint, the disaster does not end when the headlines fade. For many survivors, the most enduring damage is invisible. The trauma experienced can reshape thoughts, emotions and behaviour long after the physical destruction has been cleared.
This is the reality of post-traumatic stress disorder (PTSD), a condition that can emerge in the wake of sudden, overwhelming natural disasters like floods and linger for months, years or even a lifetime. PTSD also occurs in distressed victims of wars, terrorism, extreme assaults of all types, accidents and even repeated exposure to another’s traumas.
PTSD is not simply being upset or remembering a bad event. It is a specific cluster of symptoms that include intrusive and distressful memories like flashbacks, nightmares, negative changes in thought and mood or a sense that the world is utterly unsafe. People with PTSD are easily startled, irritable, hypervigilant or unable to sleep.
Not everyone who lives through a negative event necessarily develops PTSD. Among those who do, the course of recovery differs dramatically. Some people experience acute distress in the immediate aftermath but gradually return to their old selves with time. Others find themselves trapped in a cycle that erodes their quality of life.
Vulnerability is higher among those who suffered severe personal loss, like a death of a loved one, had pre-existing mental health conditions or lacked supportive resources. Women, in particular, have been found to be at greater risk for PTSD in India. Conversely, resilience is bolstered by strong social support, access to mental health care, stable income and adaptive coping strategies.
The ecological model of disaster proposed by Norris and colleagues (2008) suggests that post-disaster adjustment depends on the balance between risk factors and protective resources. In this view, PTSD is the result of overwhelming risk in the absence of sufficient buffers. For example, a flood survivor who loses their home but has a supportive community, receives timely aid and has access to counselling may experience post-traumatic growth as a positive psychological change that includes greater appreciation for life or renewed spiritual faith. Another survivor, isolated and economically disadvantaged, may spiral into chronic PTSD, compounded by depression and substance use.
The question of why some people never fully recover from PTSD also touches on the nature of trauma. Unlike ordinary memories, traumatic memories are often integrated into the person’s life narrative. This can lead to a sense that the trauma is still happening, even years later. Cognitive theories of PTSD, such as Ehlers and Clark’s (2000) model, propose that the disorder persists when the trauma is seen as a constant threat. In flood-prone regions, this sense of threat is realistic. Without psychological intervention, the mind may remain stuck in survival mode, unable to distinguish between past danger and present safety.
So, what can be done to cope with PTSD? First, one needs to acknowledge that psychological recovery takes time. Seeking social connection can reduce isolation and provide emotional validation. One must consider professional help and, in some cases, medication, if symptoms persist beyond a month or interfere with daily life. In settings where psychological help is lacking, support groups and psychological first aid training for local volunteers can bridge the gap. Finally, practices that restore a sense of routine, mindfulness and physical activity can help. Where relevant, certain spiritual or cultural practices can foster meaning, hope and a sense of safety.
The recent floods remind us that disasters are not just events but processes, unfolding over time, leaving scars that are not always visible. PTSD is one such scar, but it is not a life sentence. We must acknowledge that recovery does not end when the water goes down. It begins there.
(The writer is Associate Professor, Department of Psychology, St Xavier’s College, Mapusa)
