PTSDIt was a sunny October day in 1989. Game 3 of the Battle of the Bay baseball World Series between Oakland and San Francisco. Then the largest earthquake in almost a hundred years hit the bay area.

I was, as it happens, in my therapist’s office, my wife was at work. I rushed home to make sure that all was well, it took her three hours to make it home because of the terrible traffic as everyone rushed to get back to their loved ones.

The Bay Bridge collapsed. Parts of the Marina district were on fire.

We were horrified, but it was very hard to know how bad things were. We turned on the television and stayed glued to it late into the night, as did most of the people living in San Francisco at the time, except where the electricity was out.

Through the night we were drawn to the pictures of injuries, damage and fire. We listened as the newscasters talked of looting in the downtown area. Things seemed to be getting worse by the hour.

I wondered if we would be safe in our house.

We slept poorly that night and in the morning it was hard to escape the sense that things were spiraling out of control.

As it happened, the worries we had that night and the next day were completely misplaced. There was a very small amount of looting. Bay area residents rallied, many heroically to rescue those injured and recover from the earthquake.

Stop replaying the tragedy

I later concluded that the worst thing that you could do after a natural disaster was stay glued to the screen (which realization, by the way, had no impact on me on 9/11).

But how bad is it to watch TV?

Researchers recently published a study that looked at the development of acute stress responses in those who directly witnessed several recent tragedies, including 9/11, the Boston Marathon bombing (BMB) and the Sandy Hook Elementary School shooting and in those who did not see the events but watched them on TV (Holman EA et al., Proc Natl Acad Sci U S A 2014 Jan 7; 111:93).

They discovered that watching traumatic events for hours on the media leads to acute stress — even more stress (in many cases) than actually being at the site of a tragedy.

Their study surveyed 846 Boston-area residents, 941 New York City residents, and 2888 people from other parts of the country after the BMB. The questionnaire assessed acute stress responses to the BMB as well as the number of hours spent watching media stories. Among 4652 respondents, 10% were at or near the site of the BMB, and roughly a quarter of participants had direct exposure to 9/11, the Sandy Hook Elementary School shooting, or Superstorm Sandy.

Watching video over and over again is worse than being there

Levels of stress after the BMB were associated with prior mental health problems (almost every study finds this to be the case), 6 or more hours of daily BMB media exposure, and direct exposure to 9/11 and Sandy Hook, but not with direct exposure to Superstorm Sandy or the BMB itself.

Six or more hours of media exposure resulted in much higher stress than direct BMB exposure.

In most disasters, the thing that you can do that is most likely to cause you to develop acute stress symptoms is to watch the TV or video on the internet. And this is especially true if you have been exposed to a previous traumatic event or have a history of depression or anxiety.

Except in the most catastrophic events (9/11 and Sandy Hook), media exposure is worse than direct exposure to the events.

Now the challenge is to use this information to change our behavior. After all, it seems essential to know what is going on, in the moment.

One option that can work is to switch from video reports to written ones (track the events on the New York Times blogs, for example). Pictures have a greater effect than words in terms of causing acute stress reactions.