The primary panic assault befell two weeks after Sarah (not her actual title) was caught in the midst of a night protest in Admiralty on September 29, throughout which a number of rounds of tear-gas have been fired by the police.
“I’ve by no means felt afraid for my life. I’ve at all times been courageous,” she advised HKFP. “I’ve at all times been the one which encourages folks to remain, regardless of the specter of tear-gas.”
For most of her life, Sarah, a third-generation Hongkonger, has felt emboldened to “stand up for what is right.” She went to her first protest in 2003, together with nearly 700,000 other people, to oppose Article 23. Only 12 years old at the time, she doesn’t remember much of the march but recalled feeling empowered walking through the streets with her parents – both of whom were journalists and encouraged her to speak her mind from a young age.
During the 2014 Umbrella Movement calling for universal suffrage, Sarah said she felt it was her duty to once again to take to the streets to show her support. She would buy supplies, donate food and water, and help with stocking the book library in Tamar Park in Admiralty.
And throughout this year’s summer of dissent, she has played what she said was a “middle-person role.”
Not on the frontline, but not trailing behind either, Sarah is usually part of a group that holds up open umbrellas to “shield protesters” while they remove road barriers, or commit acts of vandalism. When she’s not covering protesters, she helps with translation, as well as provides food and water for frontliners.
But that evening in Admiralty was a turning point for Sarah. The sounds, smells and memories of being “totally trapped” would set off multiple panic attacks caused by “extreme fear and terror.”
“[The police] closed all the walkways out of Admiralty, and we couldn’t run anywhere,” she says. “And the amount of tear gas that was fired was totally inhumane. It sounds dramatic but I really thought this was the end, and that I was going to die there.”
Two weeks later, Sarah would be triggered by the sound of a popping balloon at a child’s birthday party. She started crying uncontrollably, and soon couldn’t breathe.
Not long after that, a friend who startled Sarah by walking up to her from behind prompted another panic attack. She has also experienced distressing nightmares, which included images of police in riot gear and guns.
“Now any loud noises are a trigger for me,” she says. “The thing is, when you’re at a protest and hear rounds of tear gas being fired, you don’t know whether they’re rubber bullets, bean bag rounds or even live rounds.”
Sarah saw a therapist about these episodes and was told that they were symptomatic of post-traumatic stress disorder (PTSD), caused by stressful or particularly traumatic events.
Hong Kong has experienced waves of mass protests since summer, initiated by the now-shelved extradition bill, which would have allowed case-by-case fugitive transfers to mainland China. Over the course of over six months, peaceful protests have morphed into sometimes violent displays of dissent over alleged police brutality, Beijing’s encroachment into the city, and other community grievances.
Since June, the police have fired more than 12,000 rounds of tear gas, more than 6,000 rounds of rubber bullets and 19 live rounds. Three people have been shot with live-rounds by officers – two of whom were left in critical condition and required emergency operations. A university student died from a head injury after falling from a car park near police-protester clashes. Another 70-year-old man died after he was hit in the head with a brick during a skirmish with masked protesters, and a 57-year-old man was left in a critical condition after being set on fire during a confrontation with protesters.
The physical wounds of recent clashes are clearly visible, but in a society that continues to stigmatise mental health problems, the psychological trauma will leave a harmful – yet hidden – effect on Hong Kong people.
‘A mental health crisis’
According to psychiatrist Dr Phyllis Chan, Hong Kong will “absolutely experience a mental health crisis.”
She said that it is not just active protesters who could experience PTSD symptoms, but even those watching events unfold on the news, who live in affected areas, or work in jobs that are related to the movement – for example nurses, doctors, reporters, police, and street cleaners.
Chan, together with a group from the Hong Kong College of Psychiatrists, runs “Care4ALL,” a mental health programme that provides subsidised consultations for people who are experiencing mental health problems directly related to the unrest.
“This is an ongoing, unpredictable movement,” she said. “There’s something new happening every day and this will cause multiple stress-related disorders as it’s ongoing.”
Chan said that there are different levels of stress-related disorders that members of the public ought to be aware of. Those who have experienced traumatic events may develop an anxiety disorder called acute stress disorder, with symptoms emerging within hours or days after exposure to the event.
“Most of the time, these are short-term symptoms and can be cured with ongoing therapy within a few months,” Chan said.
But if the symptoms persist for more than four weeks, the condition becomes known as PTSD. This can take the form of intrusive memories, changes in mood, slipping into a dissociative state, depression and suicidal tendencies, according to Chan. Some experience delayed symptoms, and often they will be unaware of their condition. When this happens, PTSD is more difficult to treat, Chan said.
Since “Care4ALL” was launched on August 19, more than 160 calls have been made to the platform’s hotline, and more than 50 people have been deemed eligible to meet with professionals. Of this number, a handful have already displayed PTSD symptoms.
PTSD has been reported amidst people involved in various prominent protest movements around the world.
Ukraine witnessed an uprising in 2014, similar to Hong Kong’s pro-democracy movement known as the Umbrella Revolution. The pro-European, anti-Russian protests started off as peaceful, before descending into violence and bloodshed. Reports of PTSD instances have since come to gentle, amongst war veterans, clergymen and others concerned.
Thailand’s polarised politics led to large-scale protests from 2010-2014, leaving greater than 90 folks dead in 2010, and 1000’s of others injured afterwards. The demonstrations have been organised by pro-democracy group the Nationwide United Entrance of Democracy Towards Dictatorship – often called the “purple shirts” – which believed that makes an attempt by the army to regulate Thai politics have been a risk to democracy.
Nick Nostitz, a journalist and photographer who coated the crackdown, advised HKFP he developed PTSD greater than six months after the army coup in Could 2014.
“The signs have been panic assaults, extreme sleep points, and hypervigilance,” he stated. “I couldn’t go to sure locations, and had recurring nightmares.”
Throughout the unrest in Thailand, Nostitz grew to become a goal for the “yellow-shirts” – a gaggle of royalists and ultra-nationalists often called the Individuals’s Alliance for Democracy (PAD). They stated his reporting was biased and accused him of being a “purple shirt.”
“The tipping level was in November 2013, once I was focused by the PAD,” he says. “I used to be overwhelmed by a mob, and so they tried to abduct me, with the intention to torture and probably kill me.”
The assault – which left him with cuts and bruises however not hospitalised – prompted him to worry for his life.
Nostitz visited a hospital in Thailand for recurring panic assaults, the place medical doctors recognized him with PTSD. However he stated lack of understanding concerning the situation meant that he wasn’t given enough assist, and was simply prescribed Valium.
Although Nostitz filed authorized instances in opposition to those that assaulted him, none was investigated.
“The police stated my case had been forwarded to the Division of Particular Investigation (DSI), however once I requested the DSI, they advised me that they had by no means obtained the case,” he stated. “They advised me [the cases] would solely see the sunshine of day if the federal government adjustments.”
This lack of justice, in keeping with him, contributed to his PTSD: “In case you lose the combat, the sensation of failure can considerably have an effect on your signs,” he stated. “It affected me loads. I used to be in a really dangerous means.”
Nostitz added that he is aware of of many journalists, protesters, and cops who suffered gravely from PTSD. He stated that a few of his protester associates even developed signs in jail, the place they weren’t supplied any psychological well being assist.
“The protests affected everybody,” he says. “Thailand is stuffed with traumatised folks and there’s such little consciousness of PTSD.”
In 2016, Nostitz left Thailand for Germany along with his spouse and son, after 23 years of dwelling and dealing within the nation, for the sake of his bodily and psychological wellbeing. In his new nation of residence, he sought correct counselling and is now not on medicine to alleviate his signs. He has since change into an outspoken advocate about psychological well being circumstances and is utilizing his story to assist others in related positions.
“Your psychological well being and well-being [are] an important,” Nostitz stated. “By no means ever be scared to say that you simply’ve had sufficient or want a while off.”
A worry of ‘weak spot’
Few frontline protesters in Hong Kong are keen to recognise – or settle for – that the pro-democracy motion is adversely impacting their psychological well being in any respect.
Chan stated one among her shoppers – a 16-year-old frontliner – has began to exhibit delayed PTSD signs.
“He tells me he is an efficient fighter,” she says. “He’s on the absolute frontline, and has witnessed folks being overwhelmed, and would possibly typically partake in violent acts.”
He requested Chan to prescribe him sleeping capsules after experiencing distressing flashbacks and nightmares.
Lately, whereas on the frontline, he advised Chan that he felt like he was in a “dream-like state” throughout violent clashes with the police.
“He doesn’t really feel something; no ache, nothing,” says Chan. “He says he fights higher as a result of he doesn’t really feel the ache.”
This, in keeping with Chan, is what is named a dissociative state, and is a standard symptom of PTSD.
Chan stated that preventing others and watching others getting overwhelmed up is extremely uncommon, and will trigger extreme psychological well being penalties. Though she had suggested her consumer to relaxation, he insisted on going again to the demonstrations.
“The concept of showing weak or ‘betraying’ his associates compelled him to return [to the frontline],” she stated.
Chan added one other one among her shoppers, who suffers from obsessive-compulsive dysfunction (OCD), performs administrative duties for protesters on Telegram. He additionally retains verify of police whereabouts on dwell streams at house and is in command of relaying data to his associates on the frontline. His OCD has change into worse in latest months.
“He has to double and triple verify each message that he sends. He’s very fearful of sending the flawed data,” she stated. “He doesn’t need to be the rationale somebody will get into hassle.”
He has skilled elevated intrusive ideas and compulsions, severely interrupting his day-to-day life, inflicting hassle sleeping, in keeping with Chan.
“Regardless of telling him to commit much less time to such duties, he’s hesitant to cease,” she stated. “There’s a large worry of betrayal and showing weak.”
Chan additionally stated that though her shoppers really feel discouraged concerning the course of the motion, quitting isn’t an choice for them.
Shifting ahead with little hope
Sarah stated she has grown to really feel despondent and doesn’t really feel optimistic about Hong Kong’s protest motion anymore.
“I don’t belief the federal government, I don’t belief the police,” she stated. “We had two million folks on the streets. It didn’t do something. I don’t think about something proper now.”
Sarah additionally admitted that studying traumatic information now doesn’t rile her up in the way in which it used to. She stated she believed that being “desensitised” by a relentless cycle of violence was as a result of she felt helpless. Although she stated she is going to typically nonetheless attend protests, she disclosed that she now feels powerless, versus empowered, like she was earlier than.
“It’s this sense that nothing you do issues,” she added. “We don’t assume something goes to alter, however not less than we went down with a combat.”
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