As I talked to one of my cousins back home yesterday, I asked how my nephews were coping after the earthquake and with the aftershocks. The response was simple, “everything is OK now, they were afraid to sleep on the upper floor.” What he said to me, kept with me. I then remembered a picture of my other nephew curled up in his father’s lap and my other cousin who is a pediatrician made sure to suggest the parents how to help kids cope with these situations.

I hadn’t given much thought about it and I agreed when I read an article about how international psychotherapists should not be flooding the country, because, we are resilient and we have strong social ties to get us through it.

But, yesterday’s conversation somehow hit me and stuck with me. I remembered a status on Facebook about how people were afraid to go back to their homes. It actually felt right to me at that particular moment. But now that I think of it, it was because, the status portrayed a tough person attitude, the one that I could identify with. In a society where we expect everyone to live up to be strong, be tough, resilient,………………….. there is little space for any sign of weaknesses, so to say.

And, fear is a weakness. Cracking under stress is not an acceptable excuse for anything.

And, it was quite natural that, while I could see myself stressed through this ordeal from this distant, I did not think about the stress and the potential repercussions that could follow.  To reveal my feelings after the earthquake, I find myself guilty for not being able to help, to contribute more. I have that nagging feeling of helplessness, it made me stop writing anything other than those that concerned Nepal, and even second guess my writing anything because I was not a victim of the earthquake, but unknowingly, I was. The greatest neutralizing factor of stress for me has been the access to talk it out and having the option to resume normal life, daily routines.

So, once I thought outside of the natural instinct built through the upbringing of the need to be tough or be laughed at, I can feel that people (who are afraid to go back to their cracked homes, who have nightmares, and trouble sleeping, etc.,) need to understand their feelings and know, how to cope with such feelings, and be able to and have access to people who understand them and can help them.

Children somehow get the benefit of doubt and receive more attention, however, children feed off of the reaction of their parents. What if parents are the ones suffering from the stress, one of the triggers of more severe mental health problems like depression?

Mental health is not a popular topic in Nepali community, similar to other Asian communities, even rest of the world. An article by Mr. Matrika Devkota cited the WHO report which placed a total of 32 psychiatrists and 6 psychologists in Nepal, and no social workers. Mental health is a stigma, and that stigma continues to haunt us in terms of reaching out to someone in stress with sympathy, with kinds words of understanding, and with advice to seek help.

However, those who are aware of the emotional toll that these catastrophic events have on people, understand that it is real and needs to be dealt with:
The Nepal earthquakes have unleashed a mental health disaster -The Guardian 

Time and trauma – eKantipur

After Nepal’s Earthquake, Emotional Care Should Be a Priority -Huffington Post

New UN guide aims to address mental health needs in humanitarian emergencies– UN News Centre

There is an immediate  need to use the social media to raise awareness on the emotional stress that people might be going through.  Knowing that there is a problem may be the quickest road to recovery.  Word travels fast in Nepali community, so reaching out to the Nepali community with information and action steps would probably be the most effective way to cater services to those that are most in need of those services. When, the depression or stress is regarded as regarded as real and treatable and not simply as a sign of weakness, people will be more open to talk about it.

Here are a few sections from U.S. Federal Emergency Management Agency (FEMA) website on  how to cope with disaster, many of which will be relevant for those affected and to those who know of someone who is affected. You can view the entire content here.

Understand Disaster Events

The emotional toll that disaster brings can sometimes be even more devastating than the financial strains of damage and loss of home, business, or personal property.

• Everyone who sees or experiences a disaster is affected by it in some way.
• It is normal to feel anxious about your own safety and that of your family and close friends.
• Profound sadness, grief, and anger are normal reactions to an abnormal event.
• Acknowledging your feelings helps you recover.
• Focusing on your strengths and abilities helps you heal.
• Accepting help from community programs and resources is healthy.
• Everyone has different needs and different ways of coping.

Recognize Signs of Disaster-Related Stress

Seek counseling if you or a family member are experiencing disaster-related stress

When adults have the following signs, they might need crisis counseling or stress management assistance:

• Difficulty communicating thoughts.
• Difficulty sleeping.
• Difficulty maintaining balance in their lives.
• Low threshold of frustration.
• Increased use of drugs/alcohol.
• Limited attention span.
• Poor work performance.
• Headaches/stomach problems.
• Tunnel vision/muffled hearing.
• Colds or flu-like symptoms.
• Disorientation or confusion.
• Difficulty concentrating.
• Reluctance to leave home.
• Depression, sadness.
• Feelings of hopelessness.
• Mood-swings and easy bouts of crying.
• Overwhelming guilt and self-doubt.
• Fear of crowds, strangers, or being alone.

Easing Disaster-Related Stress

Talk to someone and seek professional help for disaster-related stress.  The following are ways to ease disaster-related stress:

• Talk with someone about your feelings – anger, sorrow, and other emotions – even though it may be difficult.
• Seek help from professional counselors who deal with post-disaster stress.
• Do not hold yourself responsible for the disastrous event or be frustrated because you feel you cannot help directly in the rescue work.
• Take steps to promote your own physical and emotional healing by healthy eating, rest, exercise, relaxation, and meditation.
• Maintain a normal family and daily routine, limiting demanding responsibilities on yourself and your family.
• Spend time with family and friends.
• Participate in memorials.
• Use existing support groups of family, friends, and religious institutions.

Reassuring Children After a Disaster

Suggestions to help reassure children include the following:

• Personal contact is reassuring. Hug and touch your children.
• Calmly provide factual information about the recent disaster and current plans for insuring their safety along with recovery plans.
• Encourage your children to talk about their feelings.
• Spend extra time with your children such as at bedtime.
• Re-establish your daily routine for work, school, play, meals, and rest.
• Involve your children by giving them specific chores to help them feel they are helping to restore family and community life.

P.S. Mental health is as important as any other aspect of health, if not more, I leave this blog with a TED talk by Dr. Vikram Patel on

Mental health for all by involving all