A regular word in Nepali which means “It’s arrived!” is enough to scare anybody out of their wits these days. “Aayo” has, over the past three weeks, become synonymous with the Great Quake of April 25 and its consecutive aftershocks.

Life has come to an unnatural standstill after the quake hit the country last month. Most people have lost their focus, confidence and energy to the tremors that killed thousands and injured even more.  A flying plane, a barking dog or a crowing bird is enough to make people tremble in fear. Mundane things like enjoying one’s food, taking a nice long shower or locking the door while using the restroom seem like luxuries now. Most people admit that they feel safer out in the open than inside their houses, which used to be their sanctuaries in the past.

Niva Nakarmi, a preschool teacher from Otu, has been living in a tent in Tundikhel for the past 12 days. She and her family wake up early in the morning and go home to cook, eat and use the restroom on the ground floor. After that, they go back to their tent, which they share with three other families.

“The moment I enter the house, I am flooded with the memories of the big quake. I immediately start feeling dizzy and scared,” says Niva, who was on the terrace when the main quake hit more than three weeks ago.

The feeling of insecurity and fear has taken deep root in the general psyche.  And the situation is even worse in the case of those who are in a vulnerable state, physically or mentally. For instance, pregnant women who fear a miscarriage and those who are old, sick and already suffering from some sort of psychosocial disorders are finding it even more difficult to cope with these adverse circumstances.

Mallika Khadgi, a beautician from Bagbazaar, has been living with her family in the premises of the Nepal Academy Hall in Kamaladi. She is extremely worried about her mother-in-law, who suffers from anxiety disorder. The earthquake has increased her blood pressure and even the smallest of aftershocks sends her into full panic mode. As a result, the rest of the family has stopped discussing the earthquake altogether in her presence.

“She is really stressed out regarding our neighbour’s house, which has been badly damaged by the quake. She feels like it’s going to fall down and crush us all,” says Mallika, who is trying her best to convince the older lady to return home since she is in danger of catching a cold from sleeping outdoors.

After going through any great disaster, it’s only natural for the survivors to suffer from acute stress reaction. But a majority of them are able to handle it pretty well. However, in some cases, symptoms like flashbacks, palpitation, anxiety, panic attacks and insomnia tend to continue for several weeks. And this is when a psychological expert needs to intervene.

According to Sushil Acharya, a post-graduate psychology student who is voluntarily offering psychosocial counseling to earthquake survivors in Kathmandu and Bhaktapur, stress is directly proportional to the personal and professional responsibilities that a person was shouldering at the time of the calamity. He gives the example of a woman who was already under a lot of stress brought about by financial problems.  She was so miserable due to the added trauma of the earthquake that she was unable to control her urine for the first few days following the main shock.

“We have been able to help such people through psychological counseling, breathing therapy, relaxation and entertainment methods and meditation,” says Acharya, who also mentions that psychological counseling is itself a form of stress reliever. “It is, actually, the best kind of therapy,” he adds.

Merely surviving a catastrophe is never the end of the story. In fact, it’s just the beginning of so many different challenges that need to be dealt with post-disaster.

Stress induced by disasters can, for example, escalate the levels of conflicts and violence in the community. Panic makes people tense, short-tempered and aggressive, in what is called maladaptive coping behaviour. This kind of coping mechanism may also induce or intensify self-destructive behaviours like alcoholism, smoking and substance abuse. In extreme cases, it may even heighten suicidal tendencies.

Similarly, many survivors are haunted by the sense of survivor’s guilt, which may eventually result in psychosis or depression. Narayan Maharjan is a local businessman from Harisiddhhi, where 16 people died in the Great Quake. He talks about his 70-year-old uncle who is extremely distressed regarding his neighbour’s death. The two men were together when the earthquake struck. But unfortunately, only one of them was able to survive.

“My uncle has not been the same ever since the incident. He has been put under medical care since his physical and psychological condition has been deteriorating with each passing day,” he says.

Dr Sagun Pant, a resident psychiatrist at TUTH, suggests that the best way to deal with stress is to talk it out with somebody you trust. More often than not, the head of the household is compelled to hide their fears and maintain a façade of composure for their family’s sake. But this may prove to be hazardous for their mental health in the long run.

He further adds that unlike many who respond to a crisis immediately, some show delayed reactions. For instance, in some people, symptoms like recurring dreams, hyper arousals and flashbacks could start only a few months or years later. This, he explains, is known as Post Traumatic Stress Disorder.

“Every individual is different. But there is one thing in common among all people—the desire for support and togetherness,” he says. According to him, it’s very important that you don’t feel alone and helpless during a problematic situation and that you try to maintain a positive outlook and believe that things will get better.

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