One of the common symptoms experienced by those with mental health problems is sleep deprivation. It is the first go to assessment tool I use with new and long term clients. During initial assessments and regular session status updates I inquire as to the amount and quality of their sleep . If they are getting six or less hours of quality sleep per night for more than a few days mental health challenges are going to exist. If it extends for a significant amount of time it is going to be difficult to make progress in therapy without first being able to make progress in dealing with sleep deprivation. If regular sleep hygiene methods are not effective in producing the needed sleep it may be helpful to refer them for medication management. If work stress prevents someone from getting needed sleep during the week it is unlikely a nights sleep will be much help. One or two nights of restful sleep is not sufficient to get out of sleep deprivation. Self medication with alcohol or other drugs is not helpful and compounds the problem. The sleep is often disturbed by trauma from the past which one confronts when the unconscious accesses it during sleep. A strong indicator of progress in therapy is improved sleep, whether the cause is from trauma, anxiety, pain or other mental or physical stressor.
Earthquake and resilience
A magnitude 7.2 earthquake occurred in the Eagle River area on November 30, 2018. The resilience of the community was amazing and the affect it has had on individuals has been surprising. Working with many clients with complex trauma I thought I would know who those individuals would be that had the most difficult time dealing with the earthquake and its aftermath. I was very surprised at how inaccurate my expectations were. There were several common responses to the earthquake and aftershocks that I have noticed, both in my clients and in those I have talked to in the community. The aftershocks seem to have been much more troubling to the general population than the earthquake itself. The most common identifiable characteristic of those who had the most difficult time were with those who were at home alone when the earthquake occurred. If a group of people got together immediately after the earthquake in support of one another they seemed to have had less difficulty than those who were alone. Those individuals who are first responders and were able to take action following the earthquake thrived during and after it occurred. They did however sometimes have difficulty recognizing the need for emotional support of significant others while they were taking action. Those first responders who were at home often had just as much difficulty dealing with the earthquake as those who were not first responders. Most individuals who were in cars that I have worked with had little difficulty with the earthquake. Typically, they believed something was wrong with their vehicles and only realized that was not the case when they notice lights went out with the loss of electricity in the area. Those individuals who had damage in their homes took a lot longer to get on with everyday habits than those who had little damage. It is incredible how well most houses, buildings and infrastructure did surviving the earthquake. Most had some damage to sheetrock and other observable parts of the house, however must structures and foundations did incredibly well. A 7.2 earthquake is a powerful earthquake and there was no loss of life. Much smaller earthquakes in countries where building standards are minimal or nonexisitent have resulted in significant loss of life. Pets seemed to have had a much harder time than people during and after the earthquake, which may reflect the benefit of understanding what happened. Five months following the earthquake I did not have clients who reported having difficulty with dealing with the earthquake. I do hear from some in the community who say they are leaving Alaska because of the earthquake, however I believe they generally wanted to leave prior to it occurring.
I had a couple of new clients as a result of the earthquake. They had favorable responses to short term treatment with Eye Movement Desensitization and Reprocessing (EMDR).