Beirut Port Explosion

The August 4 Post-traumatic Stress Disorder: Emotional Anesthesia, Sadness, and Anxiety

Almost 20% of people, who experience a collective trauma, develop post-traumatic stress disorder (PTSD). Seeking professional help is recommended since PTSD can affect work, family, and social life.

The August 4 Post-traumatic Stress Disorder: Emotional Anesthesia, Sadness, and Anxiety

The port of Beirut devastated by a double explosion on August 4. Anwar Amro / AFP

More than forty days after the explosion that rocked Beirut on August 4, Roula * still experiences severe anxiety every time she visits Ashrafieh. That day, she had just arrived at her house in Accaoui neighborhood when the disaster struck. Her apartment was badly damaged, but she was “miraculously saved”, along with her husband and her mother-in-law. “I've never heard or seen anything like this,” she said. "In a few seconds, everything was shattered, it felt like a movie. My husband got shards of glass in his leg. I was scared, everyone in the building was screaming. It was a state of panic, I just couldn't speak. "

Ever since that day, Roula has been staying in Bickfaya. “The first three days, I felt like I wanted to cry, but I just couldn't,” she said. "I was functioning normally. It wasn't until three days later that I started to shed a few tears. For the first few weeks after the explosion, every time I arrived near Dora, my tears started to fall for no reason and my feelings usually worsened once I got home. To this day, my heart remains heavy and I feel like crying. I can't stay at the house for long, although the repairs are well in progress. I can't wait to get out from there. I no longer feel safe in there, even though it was my safe haven. "

Roula’s feelings are common after a disaster of this magnitude. Her case is not isolated, and there are many like her, who have not yet been able to "overcome" the shock. "In whatever trauma, the person who experiences it, witnesses it, or knows someone who has experienced it, may go through a state of acute stress with diverse symptoms," explained psychiatrist Wadih Naja. "These symptoms can range from emotional anesthesia to lack of concentration, sadness, lack of motivation and energy, feeling of withdrawal, fear, anxiety, recurring ideas about the disaster, or avoidance of some places. "

Emotional shock

This is the case of Omar. Severely injured on August 4, while alone in his home in Achrafieh, he spent six days in intensive care suffering from a large wound in the back and six broken ribs that caused him pneumothorax (a condition where the pleural cavity, the area between the lungs and the rib cage, is filled with air). “I still haven't visited Mar Mikhaël and Gemmayze,” he confided. "I fear I will have an emotional shock. I try to protect myself and focus on my recovery. But I will eventually go. I am itching to."

Since August 4, Omar often thinks about the explosion "without having nightmares."

“On the day of the explosion, I was in a state of physical and mental denial,” he said. I couldn't feel anything as I was bleeding and my ribs were broken. I was thinking about doing practical things, like getting our passports and my laptop, smoking a cigarette and seeing which of the neighbors needed help. Still, I think about the hole in my back all the time. "

“Symptoms caused by acute stress usually last between three and thirty days,” Dr. Naja explained. "In general, therapeutic interventions consist of cognitive and behavioral therapy, which may be accompanied, depending on the case, by the administration of antidepressants.

For some, there is no need for specialized intervention but they must be allowed the necessary time to absorb the trauma. This was the case of Mirna *. This 50-year-old woman has been living in Ashrafieh for almost two years. She had barely left her apartment building when the explosion happened. The windows in her bedroom were shattered. "In the car, I felt the ground shaking, then I heard the explosion," she recalled. I looked in the rearview mirror and saw the mushroom smoke. It was terrifying. "

Mirna did not return to her apartment for two weeks after the explosion. “Every time I got ready to go there, I felt like a lump in my stomach,” she said. "I was having trouble returning to the scene. I didn't want to hate this city that I love so much. Then over the days, the anxiety and fear slowly dissipated. It took me a month to make up my mind and return home. "

To calm down, Roula repeats to herself that "lightning does not strike twice in the same place". "I'm trying to come to terms with the idea that I'm going to go home and feel safe there again. I have to resume some sort of physical activity. It will help me move forward.”

Disabling Pathology

If the symptoms experienced in the state of acute stress persist beyond a month, it usually means that the individual is developing post-traumatic stress disorder.

"It is important to consult a psychologist to evaluate the situation and a psychiatrist for possible treatment with antidepressants, especially since PTSD is a very disabling pathology, with consequences on professional, family, and social life," warned Dr. Naja, saying it could also lead to slipping into alcohol or substance abuse. "Early intervention is therefore advisable at the stage of acute stress to prevent the transition to PTSD," he added.

According to global statistics, PTSD affects "up to 20% of a population that has experienced a collective trauma," depending on the resilience of each individual, which is conditioned by his/her history, personal journey, and genetic background. In addition to PTSD, the August 4 disaster caused mental pathologies such as mood disorders (depression or bipolar) or other anxiety disorders such as phobias, panic disorder, and anxiety to recur in people who were already treated and probably stabilized.”

"Social networks do not make it easy since the individual is bombarded all day long with images reminiscent of the disaster," said Dr. Naja, who also warned that some people may suffer from "survivor's guilt.”

For example, Nora * has been struggling with survivor guilt. “I feel guilty that I was not injured when other people have lost their lives or have been disabled,” she said. "I feel ashamed and guilty because I am back to practicing sport. I find it indecent to live normally when others are still healing from their wounds, mourning their dead, and repairing their homes. "

“In general, survivor’s guilt resolves on its own,” reassured Dr. Naja. “Friends, activities, and sports help a lot. Sometimes analytical or psychodynamic therapies are used, which can also help overcome this condition.”

"After a trauma of this magnitude, especially one that was unexpected, it is difficult to resume normal life immediately, you have to follow a certain routine that allows you to find your bearings, without feeling guilty. Routine is reassuring. It is therefore important not to remain isolated and idle, but to keep busy and play sports. Alcohol should be avoided since it can easily be abused and this will not help overcome the disaster. On the contrary, it could rekindle the memories even more" Dr. Naja cautioned.

"My bunker"

Omar has indeed found himself in a certain routine, "as far as his recovery allows." But the fire at the port on September 10 rekindled the trauma he experienced during the explosion. “I'm still active on social networks, and I thought I overcame the trauma until the fire started," he said. On that day, Omar was also at home alone. “We didn't know what was going on and the fire seemed difficult to control,” he said. "My hands were shaking and my heart was pounding. I couldn’t control it, I was in a state of panic. I had to take two tranquilizers to calm myself down. I no longer knew where to go in the house. I wanted to avoid the hallway, which I had thought was the safest place, but that was where I was injured the first time. I was trying to think fast. I remembered that my room was the place that suffered the least damage, so I took refuge there. I picked up my phone, but I couldn't press the keys. Suddenly the room was not safe enough. I imagined the windows were going to shatter. I saw in my head the images of people who had been disfigured. I then protected my face with the pillow, then I thought it was just not enough. Finally, I remembered that the cat that escaped the explosion had taken refuge in the closet. It is a large wooden cabinet with a power strip inside. I finally locked myself in there. I brought my phones and my laptop with me and remained there for two hours until my family arrived. But I didn't get out right away. Since the fire seemed out of control, I took refuge in there again for half an hour. It was my bunker. Due to the toxic smoke, my wife decided to leave Beirut for a couple of days. I love my house. But that day, I was delighted to leave. I couldn't stay in Ashrafieh, but I returned three days later. "

A legitimate anger

Sandra * is consumed with anger. "All (politicians) knew and they did nothing to prevent the catastrophe," she accused. "I blame them for leading the country into this abyss. What angers me is that none of them were compassionate. Half the city has been destroyed and not a day of mourning has been declared. Even more, they continue to live as if nothing has happened. They continue to argue without any qualms, over their share of the cake. As if there is still something to share in this country. They don't even want to get us out of the crisis they are responsible for! "

Celine*, for her part, feels a deep pain. “After the explosion, I felt I was dead,” she recalled. "For a few seconds, I couldn't breathe or move. I told myself that I was dead and that was stupid. But I am a fighter by nature, and when I feel deep pain, I don't let myself go. That night I went home and swept the kitchen for over four hours. The next day, I continued cleaning because the house was damaged. I couldn't sit still. The pain I felt was immense, like the one you get after the death of a loved one. Three weeks later, I went to the corniche again. This is my favorite place and I didn't want to dwell on this memory of death. "

“Everyone reacts in their own way,” explained Dr. Naja. "Some need to be angry. If channeled properly, anger can be constructive and saving. There are people who have taken refuge in spirituality. Others have lost their faith and are considering leaving Lebanon for good. "

Marc*, in his forties, is among those people. “I've been thinking about rebuilding my life elsewhere for a while. After the port explosion, I made my decision. It is impossible to continue to live in this country. We don't even have the luxury of thinking about the future. The fire at the port reinforced my decision. I love Lebanon, but I can't live here anymore. From now on, I have a love-hate relationship with my country."

*The names have been modified to maintain anonymity

(This article was originally published in French in L'Orient-Le Jour on the 21rst of September)

More than forty days after the explosion that rocked Beirut on August 4, Roula * still experiences severe anxiety every time she visits Ashrafieh. That day, she had just arrived at her house in Accaoui neighborhood when the disaster struck. Her apartment was badly damaged, but she was “miraculously saved”, along with her husband and her mother-in-law. “I've never heard or seen anything...