Some of the most common problems people experience after a disaster are described below.

1. Fear and anxiety. Anxiety is a common and natural response to a dangerous situation. For many it lasts long after the event ends. This happens when views of the world and a sense of safety have changed. You may become anxious when you remember what happened. But sometimes anxiety may come from out of the blue. Triggers or cues that can cause anxiety may include places, times of day, certain smells or noises, or any situation that reminds you of the disaster. As you begin to pay more attention to the times you feel afraid you can discover the triggers for your anxiety. In this way, you may learn that some of the out-of-the-blue anxiety is really triggered by things that remind you of your experience.

2. Re-experiencing of the event. People who have been traumatized often re-experience the traumatic event. For example, you may have unwanted thoughts of the disaster, and find yourself unable to get rid of them. Some people have flashbacks, or very vivid images, as if the disaster were occurring again. Nightmares are also common. These symptoms occur because a traumatic experience is so shocking and so different from everyday experiences that you can't fit it into what you know about the world. So in order to understand what happened, your mind keeps bringing the memory back, as if to better digest it and fit it in.

3. Increased arousal is also a common response to a traumatic event such as a disaster. This includes feeling jumpy, jittery, shaky, being easily startled, and having trouble concentrating or sleeping. Continuous arousal can lead to impatience and irritability, especially if you're not getting enough sleep. The arousal reactions are due to the fight or flight response in your body. The fight or flight response is the way we protect ourselves against danger, and it occurs also in animals. When we protect ourselves from danger by fighting or running away, we need a lot more energy than usual, so our bodies pump out extra adrenaline to help us get the extra energy we need to survive.

   People who have been traumatized often see the world as filled with danger, so their bodies are on constant alert, always ready to respond immediately to any attack. The problem is that increased arousal is useful in truly dangerous situations, such as if we find ourselves facing a tiger. But alertness becomes very uncomfortable when it continues for a long time even in safe situations. Another reaction to danger is to freeze, like the deer in the headlights, and this reaction can also occur during a disaster.

4. Avoidance is a common way of managing disaster-related pain. The most common is avoiding situations that remind you of your experience during the disaster, such as the place where it happened. Often situations that are less directly related to the disaster are also avoided, such as going outside if you were outdoors when the disaster hit. Another way to reduce discomfort is trying to push away painful thoughts and feelings. This can lead to feelings of numbness, where you find it difficult to have both fearful and pleasant or loving feelings. Sometimes the painful thoughts or feelings may be so intense that your mind just blocks them out altogether, and you may not remember parts of what happened during the event.

5. Many people who have been traumatized feel angry and irritable. If you are not used to feeling angry this may seem scary as well. It may be especially confusing to feel angry at those who are closest to you. Sometimes people feel angry because of feeling irritable so often. Anger can also arise from a feeling that the world is not fair.

6. Experiencing a disaster often leads to feelings of guilt and shame. Many people blame themselves for things they did or didn't do to survive. For example, some survivors of a hurricane believe that they should have evacuated immediately, and blame themselves for getting hurt because they did not get out of the area sooner. Others feel that they wouldn't have gotten hurt if only they had not tried to evacuate. You may feel ashamed because during the disaster you acted in ways that you would not otherwise have done. Sometimes, other people may blame you for what happened during the disaster.

   Feeling guilty about what may or may not have happened during the disaster means that you are taking responsibility for what occurred. While this may make you feel somewhat more in control, it can also lead to feelings of helplessness and depression.

7. Grief and depression are also common reactions to a disaster. This can include feeling down, sad, hopeless or despairing. You may cry more often. You may lose interest in people and activities you used to enjoy. You may also feel that plans you had for the future don't seem to matter anymore, or that life isn't worth living. These feelings can lead to thoughts of wishing you were dead, or doing something to hurt or kill yourself. Because the disaster has changed so much of how you see the world and yourself, it makes sense to feel sad and to grieve for what you lost because of the event.

8. Self-image and views of the world often become more negative after a disaster. You may tell yourself, "If I hadn't been so weak or stupid this wouldn't have happened to me." Many people see themselves as more negative overall after the disaster ("I am a bad person and deserved this.").

   It is also very common to see others more negatively, and to feel that you can't trust anyone. If you used to think about the world as a safe place, what happened during the disaster may suddenly make you think that the world is very dangerous. These negative thoughts often make people feel they have been changed completely by the disaster or by what other people have done during or after the event. Relationships with others can become tense and it is difficult to become intimate with people as your trust decreases.

9. Sexual relationships may also suffer after a traumatic experience. Many people find it difficult to feel sexual or have sexual relationships.

10. Some people increase their use of alcohol or other substances after a disaster. There is nothing wrong with responsible drinking, but if your use of alcohol or drugs changed as a result of your traumatic experience, it can slow down your recovery and cause problems of its own.

    Many of the reactions to disaster are connected to one another. For example, a flashback may make you feel out of control, and will therefore produce fear and arousal. Many people think that their common reactions to the disaster mean that they are "going crazy" or "losing it." These thoughts can make them even more fearful. Again, as you become aware of the changes you have gone through since the disaster, and as you process these experiences during treatment, the symptoms should become less distressing.