Mental health in emergencies

Physical symptoms

• Rapid heartbeat: pounding heart, palpitations
• Trembling: shaking hands or body
• Nausea: upset stomach, loss of appetite
• Headaches: tension, pressure in the head
• Extreme fatigue: exhaustion even without physical effort
• Insomnia: difficulty falling asleep or waking during the night
• Muscle tension: stiffness in the neck, shoulders, and back

Emotional symptoms

• Anxiety: constant worry, sense of danger
• Fear: fear of it happening again, hypervigilance
• Anger: irritability, frustration over small things
• Guilt: feeling you could have done more
• Sadness: crying, sense of loss or emptiness
• Difficulty concentrating: forgetfulness, mental fog
• Helplessness: feeling nothing is within your control

4-7-8 breathing

A simple technique that activates the parasympathetic nervous system and helps you calm down:

1. Breathe in through your nose for 4 seconds
2. Hold your breath for 7 seconds
3. Exhale through your mouth for 8 seconds
4. Repeat 4 times

You can do this exercise anywhere. It is particularly useful before sleep or during moments of panic.

5-4-3-2-1 grounding

This technique uses your senses to anchor you to the present moment, reducing anxiety:

1. 5 things you can see (describe them mentally)
2. 4 things you can touch (feel their texture)
3. 3 things you can hear (identify the sounds)
4. 2 things you can smell (focus on the scents)
5. 1 thing you can taste (notice the flavour in your mouth)

Maintain a routine

After an emergency, routines provide a sense of control and normality:

• Mealtimes: eat at regular times, even without an appetite
• Sleep schedule: go to bed and wake up at the same time
• Physical activity: even a short walk helps reduce stress
• Social contact: talk to family and friends every day
• Simple tasks: small actions like tidying up or cooking restore a sense of control

Limit news exposure

Constant information about the emergency can worsen anxiety:

• Limit to twice a day: morning and evening
• Official sources: IPMA (Portuguese weather agency), ANEPC (Civil Protection), SNS 24 (Portuguese health line). Avoid unverified social media
• Turn off notifications: constant alerts keep the brain in alarm mode
• Repetitive conversations: it is natural to want to talk about what happened, but constantly reliving the details can be harmful

Ages 3 to 6

• Simple, honest language: "There was a big storm and it damaged some things, but we are safe"
• Reassure them: emphasise that the adults are taking care of everything
• Allow regression: thumb-sucking, bedwetting, or nightmares are temporary normal reactions
• Maintain routines: mealtimes, playtime, and bedtime
• Play: play is how young children process their emotions

Ages 7 to 12

• Answer questions honestly: do not make things up or play them down, but adapt to their level of understanding
• Involve them in tasks: tidying up, packing bags. Feeling useful reduces anxiety
• Validate feelings: "It's OK to feel scared. I felt scared too"
• Limit news exposure: repeated images can be traumatic
• Watch for changes: drop in school performance, withdrawing from friends, aggression

Teenagers (13+)

• Treat as near-adults: share facts, involve them in family decisions
• Encourage peer support: being with friends helps recovery
• Watch for risky behaviour: isolation, alcohol or drug use, reckless behaviour
• Normalise emotions: anger, frustration, and sadness are valid reactions
• Offer autonomy: let them actively contribute to the family's recovery

Post-Traumatic Stress Disorder (PTSD)

Some symptoms may persist or worsen weeks after the emergency:

• Flashbacks: reliving the event as if it were happening again
• Nightmares: recurring dreams about the event
• Avoidance: avoiding places, people, or conversations that recall the event
• Hypervigilance: constant state of alertness, startling easily
• Emotional numbness: feeling disconnected from others or from yourself

When to seek professional help

Seek support if:

• Symptoms persist for more than 1 month without improvement
• Daily functioning is affected (work, relationships, self-care)
• Alcohol or substance use has increased
• You have thoughts of self-harm or suicide
• You feel you cannot cope alone

Seeking professional help is a sign of strength, not weakness. Recovery takes time and everyone has their own pace.