Two groups of people are likely to develop symptoms of Post-Traumatic Stress Disorder (PTSD) from the June 17 tornado: directly affected Wadena area residents and the indirectly affected volunteers and workers helping them, according to Jim Kraemer of the Neighborhood Counseling Center and Dr. Dan Casey of Green Cross Academy of Traumatology.
"[PTSD] can be caused by anything that would be traumatic in a person's life," said Kraemer.
Casey and Kraemer said symptoms of PTSD include difficulty sleeping, changes in appetite (hardly eating, not eating at all or overeating), anxiety and flashbacks replaying the traumatic event in one's mind.
The multiple July storms have not helped.
Casey also said that people living with or without PTSD may overreact to severe weather -- for example, taking shelter in the basement without an actual tornado warning.
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Acute Distress Response occurs immediately after an event. After 30 days, it can be diagnosed as PTSD, according to Casey.
"Too often people look at Post Traumatic as this huge kind of situation that doesn't happen to very many people," Kraemer said.
The rate for developing PTSD is "well over 50 percent for the victims," Casey said. "For the workers it will be somewhere between 10 and 30 percent."
Kraemer indicated that the line between clinically diagnosed PTSD and slightly milder symptoms should not be over-emphasized.
"It's just that, it's just a clinical diagnosis," he said. The functional aspects, the symptoms themselves, are the most important.
"So I don't want people to think that just because they have some symptoms means that they have to be hospitalized," Kraemer said. "But I also don't want people to avoid getting support if they start to have some symptoms."
Kraemer said people should not minimize their own emotional responses or compare themselves to others who are worse off.
"Just because your loss is worse than my loss, doesn't mean that I don't still have to go through that process," he said.
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Losing one's own house is an obvious traumatic event. For others, "Some of the trauma can be driving by and seeing the destruction. For a high school student, it might be just driving by and seeing the high school crumbling a little more each day. For somebody else, it might be driving through their neighborhood and seeing their neighbor's house is gone. So because we are such individuals, things affect us differently," Kraemer said.
Kraemer suggested that people with PTSD symptoms should talk to their minister, family physician or mental health professional.
Casey said that for people living with PTSD, "the best way to help them is through the counseling center." Several types of professional therapy are available.
Kraemer said prevention is important. Good diet, sleep, exercise, taking time to laugh and talking with someone about thoughts and feelings can help to deal with traumatic situations and may hold off more severe symptoms.
Relief workers and others helping to rebuild are vulnerable to experience what Casey and Kraemer call compassion fatigue.
"It is the cost of caring," Casey said.
Because of this phenomenon, Green Cross has an agreement with the Salvation Army. Green Cross members arrived in Wadena seven days after the tornado hit and stayed for 10 days. Earlier this week, they were on standby and will return if the Salvation Army asks them.
During their stay in Wadena, Green Cross members mostly helped Salvation Army workers, but also offered assistance to local residents who were directly affected by the disaster.
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"We're not an on the ground right away entity because people are doing their job," Casey said. "But after a few days of building up that's where the strength of what we provide comes in."
According to www.greencross.org,The Green Cross is an international humanitarian organization based in Becker, Minn. It was founded in 1995 after the Oklahoma City bombing and earlier this year was also involved in the Haiti earthquake relief work.
The Neighborhood Counseling Center has been in contact with Green Cross and other organizations and has positioned itself to help with the mental health aspects of tornado relief. Kraemer said the counseling center has an on-call person every day.
The Neighborhood Counseling Center is located on 11 Second St. SW in Wadena. It may be contacted at (218) 631-1714.