Trauma ‘could be a lifelong struggle’

The ordeal is far from over for the young Thai soccer players — whose rescue began yesterday when four were painstakingly led out underwater by divers — who face the prospect of longterm trauma even if all make it safely out.

“They may show extremes in behaviors ... they sleep too much, or have difficulty sleeping,” said Dr. Jamie D. Aten of the Humanitarian Disaster Institute and a psychology professor at Wheaton College in Illinois. “Some may withdraw, while others need more attention. Over time these symptoms may lessen, but for some it could be a lifelong struggle.”

Aten said the boys will need to be monitored closely.

“Those caring for these boys need to realize they may develop triggers that weren’t there previously. They’ve been in a cave, it’s dark, it’s enclosed, there is lots of water around,” Aten said. “Each of these could become a trigger. And other triggers could be harder to identify. It could be a scent ... a wet mold smell, for example, could lead to a spike in anxiety.”

Dr. Gary Sachs, a psychiatrist at Massachusetts General Hospital, said the boys will need reassurances from family and caregivers that their PTSD is OK.

“One of the first parts of overcoming trauma is that if you identify the feelings as normal, that’s the first step,” said Sachs.

Sachs cited the groundbreaking work of Harvard psychiatrist Dr. Erich Lindemann and his findings of “somatic distress” — a term he applied to survivors of Boston’s 1942 Cocoanut Grove fire. People who survived a traumatic experience often feel worry and grief so intense that it creates physical discomfort, including shortness of breath, weakness or outright pain.

Lindemann said, “There is restlessness, inability to sit still, moving about in an aimless fashion, continually searching for something to do.

“Your heart will race almost to the point of feeling paranoid,” Sachs said. “So it’s almost like a vaccine to explain that this is normal. The symptoms exist, but they don’t have to be scarred for life.”