Earthquakes & aftershocks: fear, recovery & readiness

We rarely think about the ground under our feet. After a quake, many people feel uneasy indoors, startle at small vibrations, or check for cracks again and again.

The National Center for PTSD says that in the first days after a disaster, people often feel keyed up, on edge and unable to stop thinking about what happened. For most, this eases over the following weeks.

Relief at being alive can be followed by distress, fear or anger. Some people feel numb or strangely calm at first and only feel the impact later.

In studies after the 2023 earthquakes in Türkiye, being a woman, losing a loved one, losing your home, being displaced, losing your job and having little social support were linked to more post-traumatic stress.

Social support is one of the strongest keys to recovery after disasters.

• After a disaster: what to do: the first days, aid, insurance and cleaning up safely
• Being prepared: emotional & practical readiness: go bags, alerts and reunification plans
• Building a first aid & emergency kit (with comfort items for your mind)
• Natural & climate disasters: reactions, the emotional road of recovery and helpers
• Psychological first aid: helping people after a crisis
• Rebuilding after big setbacks: the long road months and years later

The Great ShakeOut earthquake drill programme says not to get in a doorway. In modern buildings, doorways are no safer than other places, and they don’t protect you from falling or flying objects.

Running outside during shaking is especially dangerous, because glass, bricks and other building parts may be falling. Ready.gov says if you’re inside, stay inside.

If you’re already outdoors, stay outside and move to an open area away from buildings, trees, streetlights and power lines.

The ShakeOut programme warns not to believe the so-called “triangle of life”, which has been discredited by leading experts. The main point is to protect yourself right away, where you are, instead of trying to move.

Ready.gov advises

• Cane users: Drop, Cover, and Hold On, or sit and cover your head and neck with both hands
• In bed: turn face down and cover your head and neck with a pillow
• In a car: pull over, stop and set the parking brake
• Wheelchair or walker users: lock your wheels, get as low as you safely can, and cover your head and neck

The ShakeOut programme recommends practising Drop, Cover, and Hold On at least once a year, at home, work or school, just as children do at school.

When your body already knows what to do, there’s less room for panic. Many people find that practising gives back a sense of control.

The USGS explains that the rate of aftershocks drops roughly in proportion to the time since the main quake. There are about 10 times as many aftershocks on the first day as on the tenth day.

The USGS notes that aftershocks don’t get smaller over time, only less frequent. Large aftershocks are still possible later on, and the rate can rise for a while after a big one.

That’s why being ready to Drop, Cover, and Hold On is still useful. Readiness is not the same as constant fear.

After the 2020 earthquake in southwestern Puerto Rico, USGS scientists expected quakes to be felt daily for up to several months, with aftershocks continuing for years at a decreasing rate.

The USGS also publishes aftershock forecasts for the next day, week, month and year after large quakes. Some people find these numbers steadying. Others feel better checking less often.

After an aftershock passes

1. Check you and the people near you are okay
2. Put both feet flat on the floor and feel the ground holding still
3. Breathe in slowly for 4 counts, and out for 6, a few times
4. Name what happened: “That was an aftershock. It’s over. I’m okay.”
5. Do one small, normal thing, like making tea or texting a friend

The USGS says no one can predict earthquakes. Posts claiming a big quake on a certain date can spread fear without basis.

Follow local news, official alerts and the USGS. Ready.gov notes texts may work better than calls after a quake and use less battery.

In a study after the 2016 Kumamoto earthquakes, about 42% of people reported this false sense of swaying. It was most often described as a feeling of the ground shaking.

It usually started within a week of the quake and lasted up to several weeks, more often indoors.

The study linked it with

• Anxiety
• Being 21 or older
• Being female
• Having ear ringing or fullness
• Living on the third floor or higher
• A history of motion sickness

Experts think stress and mixed signals between the eyes and body may play a part, but the exact cause is still being studied.

Ideas to try

• Fix your eyes on something still, like a door frame
• Keep a glass of water on the table: if the water is still, the ground is too
• Sit with your feet flat and feel the floor
• Take a slow walk outside in an open space

Ready.gov advises securing heavy items like bookcases and TVs, and storing heavy or breakable things on low shelves. Doing this around your bed can make it feel safer.

If shaking starts while you’re in bed, Ready.gov says to turn face down and cover your head and neck with a pillow.

Ideas that help

• Get up at about the same time each day, even after a rough night
• Get daylight in the morning
• Keep news and aftershock maps out of the last hour before bed
• Wind down with something calming, like music, prayer or a warm shower

Try this

1. Notice the bed under you, holding still
2. Breathe in slowly for 4 counts, and out for 6
3. Remind yourself where you are and that you have a plan
4. If you can’t settle after a while, get up and do something quiet in dim light

Some people sleep outdoors, in tents or cars after a quake, especially if their building is damaged. Never go back into a building that is damaged. Ready.gov says to get out and stay out.

If your building is safe but your body still says “no”, try small steps: a nap indoors in daylight, then an evening, then a night.

The NCTSN notes that cracks in walls, debris and destroyed buildings can be strong reminders of the earthquake. Seeing them every day can keep fear stirred up.

Ready.gov notes that standard homeowner’s insurance doesn’t cover earthquake damage. Finding this out after a quake can be a hard shock.

For questions about FEMA disaster assistance, apply at DisasterAssistance.gov or call the FEMA Helpline at 1-800-621-3362.

Ready.gov advises

• Don’t try to move heavy debris by yourself
• Keep children out of disaster cleanup work
• People with asthma or lung conditions should avoid buildings with mold or water leaks
• Wear protective clothing and sturdy shoes

The NCTSN advises putting off unnecessary life-changing decisions after an earthquake if you can, and not overdoing cleanup. Rest and do things you enjoy when you can.

Drinking water, eating regularly and getting sleep may sound basic, but they help you think more clearly about the choices ahead.

Losing your home and being displaced were among the things linked to more post-traumatic stress after the 2023 earthquakes in Türkiye.

Missing a café, a school or a street that is gone or changed is a normal part of grief. The “Rebuilding after big setbacks” guide covers the long road ahead.

The NCTSN says children may

• Be more sensitive to sirens, loud noises or things falling
• Cling to parents or worry about being apart
• Fear another earthquake or aftershock
• Go back to younger behaviours, like baby talk or bedwetting
• Have changes in sleep or appetite
• Have headaches or stomach aches
• Play out or talk about the earthquake again and again
• Worry about the safety of home, school and other buildings

The NCTSN suggests telling children what to do during an aftershock and explaining how you are keeping the family safe. This may need to be repeated many times.

Let children know it’s okay to ask questions. Answer briefly and honestly, and ask for their ideas. For younger children, follow the conversation with a favourite story or activity.

Be aware of what adults say around children. Kids can misunderstand what they overhear and get frightened.

Children may get anxious about being apart from parents at bedtime. The NCTSN suggests spending more time with them then, such as telling a story.

The NCTSN also suggests

• Encourage them to help in safe ways
• Keep family rules and routines like mealtimes and bedtime
• Limit news coverage of the earthquake
• Reassure them that friends are being cared for by their families
• Tell them what’s being done to clear debris and rebuild

The NCTSN advises talking with a trusted helper, like a doctor, counsellor, religious or community leader, if children still have difficulties a couple of months after the earthquake.

The National Center for PTSD suggests

• Find a quiet time and place to talk
• Just be with them, and let them know they’re not alone
• Let them talk without interrupting, as much as you can
• Offer to talk again any time
• Remind them of their strengths

The National Center for PTSD warns that playing down someone’s pain is strongly linked to longer-lasting distress.

Try not to say

• “It was only a small one.”
• “It could have been worse.”
• “You need to stop being so jumpy.”
• “You should be over it by now.”

Ways to help

• Help secure bookshelves and heavy items
• Lend a room or a sofa to someone whose home isn’t safe yet
• Offer childcare while they deal with repairs or forms
• Sit with them during aftershocks if they’re scared

The NCTSN encourages adults to spend time with relatives, friends and community members to talk and help each other, including through religious or spiritual activities.

Neighbourhood check-ins, shared meals and joining a ShakeOut drill together can build connection and confidence.

Ready.gov suggests

• Consider structural improvements and earthquake insurance
• Secure bookcases, refrigerators, water heaters and TVs
• Store heavy or breakable things on low shelves

Ready.gov suggests signing up for earthquake alerts, which may warn you before shaking starts. Make a family plan with an out-of-state contact and a meeting place.

Ready.gov suggests a kit with food and water for several days, a flashlight, a fire extinguisher and a whistle. If you’re ever trapped, use a whistle or bang on a pipe instead of shouting.

Once your plan and kit are ready, it’s okay to set them aside. Checking quake maps over and over, or keeping a bag by the door for months, can keep the alarm switched on.

A healthy rhythm

• Check your kit and plan once or twice a year
• Join a yearly ShakeOut drill
• Let the rest of the year be about living

SAMHSA’s Disaster Distress Helpline is for anyone in the U.S. and its territories feeling distress related to a disaster, including survivors, families, responders and clergy. You can reach out for yourself or someone else.

• Call or text 1-800-985-5990
• For Spanish, press 2
• Interpreters in over 100 languages
• Deaf and hard of hearing callers can use their preferred relay service

If you’re thinking about suicide or are in emotional crisis, call or text 988, or chat at 988lifeline.org. It’s free, confidential and open 24/7.

Apply for FEMA disaster assistance at DisasterAssistance.gov, or call the FEMA Helpline at 1-800-621-3362. It’s open 7 a.m. to 10 p.m. in your time zone, 7 days a week. Press 2 for Spanish, and 711 or Video Relay Service is available.

SAMHSA suggests talking with a counsellor or mental health professional, or a trusted faith or spiritual leader. At work, an Employee Assistance Program may be able to help.

Please talk to your clinical provider or therapist about what’s right for you.

Find A Helpline (findahelpline.com) is a free global directory of support lines, which the International Association for Suicide Prevention points people to.