Uttarakhand tunnel rescue: What kind of trauma could the trapped be going through?

1. Being overwhelmed by the lack of control and uncertainty, the mind reacts with a fight-or-flight response, leading to heightened anxiety, persistent worry, restlessness, panic attacks and feelings of impending doom.

2. The stress of confinement can manifest as increased irritability where individuals may become easily frustrated, short-tempered, agitated and have difficulty managing their emotions.

3. Sleep disturbances are common and include difficulty in falling asleep, frequent awakenings during the night, or nightmares related to traumatic experiences.

4. Individuals may show signs of Acute Stress Disorder or Post-traumatic stress disorder (PTSD) becoming hypervigilant and constantly scanning their surroundings for potential threats. This state of heightened alertness is a result of the dangerous experience the people have had. They may also have flashbacks and intrusive thoughts related to the confinement experience, causing distressing memories to resurface unexpectedly and repeatedly. There could also be avoidance behaviour where people steer clear of reminders or situations that trigger distressing memories associated with the confinement, or social withdrawal where individuals have difficulty relating to others who may not fully understand the depth of their experiences. Some individuals may experience emotional numbness which can be evidenced as a detachment from emotions and a diminished ability to experience pleasurable occurrences.

5. Deprived of external stimuli, the person may experience cognitive impairment and dissociative symptoms which can manifest as difficulty concentrating, memory lapses, impaired decision-making ability, or an altered sense of reality. Persons may find it difficult to focus on elementary tasks or make simple decisions.

6. The prolonged isolation may lead to depressive symptoms like a feeling of persistent sadness, and a loss of interest in daily activities with a profound sense of helplessness, hopelessness, and despair. There could be physical symptoms such as headaches, muscle tension, gastrointestinal issues, and changes in appetite.

How to deal with confinement trauma

After the confinement trauma experience is over, the following behavioural patterns are needed to mainstream survivors.

1. Building a support system: Share your experiences with trusted friends, family members, or online support groups. Connecting with others can combat feelings of isolation. But identify and communicate your boundaries to others. Establishing healthy boundaries is crucial for managing stress and avoiding situations that may trigger distressing memories.

2. Practising self-care: Consistent sleep patterns, healthy meals, and regular exercise contribute to well-being. Avoid using addictive substances as a way of coping with distressing symptoms. These exacerbate mental health issues and interfere with the recovery process. Spending time in nature, engaging in outdoor activities, and creative outlets such as drawing, writing, or music, provide an excellent way to express emotions and process traumatic experiences. Practice self-compassion and acknowledge your efforts. Understand that recovery takes time, and setbacks are a normal part of the journey.

8. Seeking professional help: If symptoms worsen, consult a mental health professional. Cognitive-behavioural therapy (CBT), eye movement desensitization and reprocessing (EMDR), exposure therapy and hypnotherapy are some evidence-based approaches used to treat PTSD. In some cases, medications may be necessary.