BAY ST. LOUIS, Miss. – Like the swirling images of a nascent hurricane on a radar screen, the emotional and psychological fallout from Katrina is gathering across the region. But just as weather forecasters have difficulty saying where a storm will land and how much damage it will do, therapists say the long-term mental-health effects of last year’s killer storm also are hard to predict.
“The fact is that we don’t know a lot about the actual incidence of Post Traumatic Stress Disorder (PTSD) and depression associated with Katrina,” says Dr. Raymond Crowel, vice president for Mental Health and Substance Abuse Services at the National Mental Health Association. “It’s probably useful to think of Katrina as a slow motion disaster that has continued to unfold for people.”
But eight months after Katrina inflicted a $100 billion hit on the Gulf Coast and killed more than 1,300 people, Crowel and others say some things are clear:
--Hundreds of thousands of hurricane survivors will have serious mental health issues and a large percentage of them want some kind of help dealing with psychological issues.
--Trauma from the storm and living conditions that followed have irritated and fractured relationships throughout the community.
--Substance abuse -- from cigarettes to hard drugs -- appears to be increasing.
--One set of numbers indicates a dramatic increase in suicide rates in the storm area.
--There is a special concern for the trauma suffered by children during the disaster.
Dr. Anthony Ng, who heads the American Psychiatric Association’s Committee on Psychiatric Dimensions of Disasters, spent a week in Waveland soon after the storm hit while serving on a federal team sent to assess mental health needs in the Katrina area.
Extent of trauma difficult to quantify
“We are seeing an increased rate of some of these psychiatric disorders, PTSD, depression, substance abuse,” Ng says eight months later, while agreeing with Crowel that the issues are hard to quantify. “There are no numbers because people are still scattered everywhere.”
Crowel says the federal Substance Abuse and Mental Health Services Administration has taken a stab at the big statistical picture and estimates that 300,000 to 500,000 people “are going to have some significant mental health problems from Katrina.”
He says that estimate is based on studies conducted after Hurricane Andrew hit south Florida in 1992 that found that up to 36 percent of adults met criteria for PTSD, 30 percent for depression and 11 percent for general anxiety. Up to 29 percent of children showed severe PTSD symptoms, a number that leaped to 56 percent in the hardest hit areas.
Andrew was the most destructive hurricane in U.S. history at that time, but it was far less deadly -- 23 lives -- and far less costly -- $27 billion -- than Katrina proved to be 13 years later. Initial assessments from the Centers for Disease Control are that nearly half of the people who experienced Katrina said they needed mental health care soon after the storm and 70 percent said they would make use of mental health services if they were available, Crowel says.
A spike in suicide
Most chilling, he adds, figures from the New Orleans area indicate that “suicides in the four months after Katrina were double the national average. Obviously, there’s some distress.”
Mental health practitioners in the hurricane zone say their work with Katrina survivors backs up the general views offered by Crowel and Ng, and they are beginning to see some delayed stress reactions. Whether or not there will be many cases of full-blown PTSD remains to be seen.
“It starts coming in through the back door, more or less,” counselor Lynn Holland says in her home-office on Webster Street in Bay St. Louis. Now that lives are settling down and people are back in more normal routines, they have time and space to be more affected by “the guilt … the trauma … that leads to this whole swirling inside.”
Bay St. Louis counselor Lynn Holland has seen a number of emotional and psychological reactions to Katrina. (Jim Seida / MSNBC.com)
“The symptoms of PTSD just make you feel like you’re crazy so you really don’t want to talk about it,” she says, adding that clients with whom she ends up talking about storm issues do not arrive saying they want to talk about Katrina.
“I don’t know that people know how to identify what the storm is doing, nor do I. I know that it depresses me to come down here,” from Jackson, where she spends a lot of time now. “It’s heavy when I come down here and I’m happy when I leave and I never thought I’d say that.
“A lot of people just drink, just use drugs, just use sex to try and soothe that pain. Some people run, do the socially appropriate thing of running marathons. If it’s not a peaceful place in here,” she says, sweeping the back of her hand across her chest, “you try to find it out there.”
Another Bay St. Louis therapist, Dr. Angel Carpenter, says the psychological issues she has seen since Katrina are touching but not surprising. She has been working with many clients on relationship problems, anger management and stress.
Carpenter and Holland agree that Katrina likely didn’t cause friendships, marriages and parent-child relationships to founder, but clearly compounded those issues where they existed. “They’ve lost their homes and they’re living in little tiny FEMA trailers,” Carpenter says, so it’s no wonder that tempers flare.
“All of a sudden, I think it just shakes the foundation,” says Holland. “If the problem’s not already there, I wouldn’t think this would cause it, but it would certainly exacerbate it.”
Carpenter has seen a fair number of clients “who weren’t really having any problems before.” Since the storm, they are experiencing “sleep disorders … not getting any joy out of anything … just feeling numb to it all … a lot of helplessness and a lot of hopelessness.” For many, the process is similar to grieving.
And, like Holland, she is seeing plenty of delayed stress. “Right after the storm, it was just a kind of survival mode kicking in” and emotions “got put on a back burner and people thought they were dealing with it really well.
'A point where they couldn't handle it'
“Suddenly, they reached a point where they couldn’t handle it. I’m seeing that probably in the last few weeks.”
Along with the emerging reactions to stress, Carpenter is seeing more “self-medicating” behavior. Some of her clients who were reformed smokers have started again and she sees “a lot more alcohol problems.”
While Carpenter and Holland don’t work directly with young children, they have seen and heard from other therapists that clinginess and fears about being alone or leaving the house have increased among kids.
In making a plea to pay special attention to the mental health needs of Katrina’s youngest survivors, the group Voices For America’s Children noted that “the impact this disaster has on children’s mental health is only beginning to surface and may linger for months and years to come. …Without adequately investing in the mental health of children affected by Katrina, we can never fully expect to rebuild the impacted Gulf States.”
Therapists say they’re finding that standard techniques of talk therapy and some cognitive-behavioral models, in which thoughts are connected to unwanted behaviors in an attempt to change them, are working best with Katrina clients. For some, anti-depressant medications and other drugs have helped.
“What I have seen in Bay St. Louis and Waveland is everyone talking about their experiences and I think that’s going to help a lot,” says Holland.
The passage of time also will help. “Human beings and children in particular are very resilient and will tend toward health over time,” says Crowel. “That will be true for the majority of people who were exposed to Katrina.”
Visible change, hidden pain
EMAIL THIS
TRACKBACKS
Trackbacks are links to weblogs that reference this post. Like comments, trackbacks do no appear until approved by us. The trackback URL for this post is: http://www.typepad.com/services/trackback/6a00d83451b0aa69e200d8348b256753ef
advertisement
Many years ago I read about a mother whose child panicked when she woke from a nap and could not find her mother in the house. The mother had stepped out of the house to hang clothes on the line. The mother asked the child to draw pictures of the mother hanging clothes on the line, taking garbage out, working in the basement, etc. Now, whenever the mother is in a different part of the house or outside the house, the mother tapes the appropriate picture on the refrigerator. That way her child immediately knows where the mother is.
This may help if your child is having separation anxiety. Hope this helps.
Becky Lewis, Louisville, KY (Sent May 3, 2006 11:47:09 AM)
I was a Red Cross volunteer in MS. I too am still affected by Katrina. The devastation was impossible to absorb. I was told, by the RC counselors, I put up a wall so I could deal with the situation. Normally I'm somewhat emotional, however I have shed only one (1) tear since my work there.I am putting off going for help in the hope I will get back to normal. I'm beginning to think one never fully recovers from these types of events.
Matthew Kean, Fort Lauderdale, Fl (Sent May 3, 2006 1:36:23 PM)
I thought I had cried everything out in the 2-3 months right after the storm (I am from Bay St. Louis, but now reside in Hattiesburg).
I cry a little when I go down and visit my parents and we dig through the dirt in our yard like archaeologists digging for artifacts of a life past...it's hard.
We lost our home, everything we had, and no matter how many people continue to say so flippantly, "At least you have your lives!" and other familiar phrases we've all heard a million times by now...the truth is that we may have our physical lives, but our lives are lost and will never be the same again.
The shock of it all gets to me every time I go to visit Mom and Dad, it seems as though they've aged 20 years since August 29, 2005. No wonder, it's a lot to handle.
But I don't think it truly, really hit me until the other night while I was on the phone with my boyfriend.
All of a sudden, I had this wildly vivid flashback.
I was back at my old job (Grand Casino Biloxi), and I was walking through the Associate Hallway on my way to the Associate Dining Room (ADR). I read the little Weight Watchers flyer on the wall and then swiped my ID card for a meal ticket. I went through the line and got something to eat, as well as getting a bowl of mandarin oranges from the fruit/salad bar.
I sat down near the back of the room, under the TV, and conversed with Jimmy, a cook at the restaurant where I worked as a hostess/cashier (Murano's Italian Buffet). We waved at coworkers and glanced at the TV and made little silly jokes.
It moved into slow-motion as I looked through the window, at the beautiful Gulf of Mexico, boats going along smoothly through the water, and I felt proud of where I come from...the beautiful Mississippi Gulf Coast.
It's like it just smacked me in the face like a ton of bricks. The shock of it all. I was sitting there and admiring the beauty of something that is no longer there, and never will be again. Sure other casinos and other barges and buildings will be built, but I'll never sit in that old ADR again, or at that table. I'll probably never see most of those coworkers again, either. We've all scattered to the four winds and moved on to other careers in order to survive.
Then, I remembered sitting on my dock back home, and looking out at the bayou and the point and the marsh and the houses across the way over in Garden Isles. I sat on the bench on our dock and looked back at our beautiful house, a house we built with our hands, our blood sweat and tears went into that house...and I contemplated the idea of a big hurricane coming through. I don't remember if I was talking aloud to my mother or if I'd just thought it to myself, but I remember saying or thinking that I knew a big one would come, in my lifetime, maybe more than one, and it would surely take everything from us. I just didn't think it would be very soon.
What kind of foreshadowing that was. God was trying to tell me something, I believe. Maybe He wanted me to think a little harder on those things, and prepare a little bit better.
We all sit around and think about what we should have done better, what we could have done differently, how we could have saved that thing or that pet or maybe even a person....but the fact is that, it's over. We can't. It's happened already and no matter how hard we pray or beg our chosen higher power to let us, we can't go back now and fix those broken and lost things and lives.
The only thing we can do is heal and move forward. The rest of the world has forgotten us, but we are so strong, Mississippi. We will be okay. This hurts so much, we have been battered, torn, and bruised beyond recognition...but the Coast will rise again, and we will be even better than ever.j
Accept change, it is truly the only constant.
Natalie Fields, Hattiesburg MS (formerly Bay St. Louis) (Sent May 3, 2006 2:32:11 PM)
Everyone I know seems to have some signs of Post Traumatic Stress Disorder or Depression, including myself. I lost my home, my brother lost his home, my grandparents lost their home, most all of my friends and co-workers lost their homes. Everyone I would normally lean on and talk to about my problems have problems of their own to deal with. I certainly don't want to complain about mine. We are all in the same situation. Everyone is just trying to regain some since of normalcy, familiarity, and security. Everything Katrina took from us. I am rebuilding my home, but it feels like a stranger's home. I just don't feel comfortable there. I stayed during the storm and had to be boated out. I guess I associate my home with that feeling of chaos. However, South Miss is my home and I would never leave the area. Things are frustrating, but there are hidden blessings. People from all over the country are here helping rebuild our area and I feel that people are praying for us. Those volunteers will never know how much we appreciate them or the prayers of strangers we will never meet. Together,we will rebuild the Miss Gulf Coast and it will be better and more beautiful than before!
C. Barlow, Pascagoula, Miss (Sent May 3, 2006 5:24:38 PM)
I read all this with tears in my eyes. We live in Mobile, AL and our home flooded. Only it seems like we aren't as important. My son has had behavior problems and the teachers aren't that compassionate. They extended help to MS and LA people but don't extend the same feeling to the people in their own backyards. I am depressed and yes we are lucky to have our lives but my son lost the only house he ever knew. It seems like people expect you to cope without emotions. Now my son who is an A student missed out on the National Honor Society and they can't see he has been through a disaster. He also lost his grandfather in February. My heart just aches for him. I am trying to move on and thought I had. Yes, I am grateful but it doesn't take the pain away. I guess I feel bitter for those who were not there for us. Thanks for this space to let me vent or rant whatever you what to call it.
Kelly, Mobile, AL (Sent May 3, 2006 6:00:34 PM)
shena, maybe you did't want to make new friends....but got them anyway....Smile hon...PEACE!!!
andy,booneville ms. (Sent May 3, 2006 11:15:37 PM)
We lived in New Orleans where Katrina put over 4 feet of dirty water in our house for over 2 weeks. We vacated prior to the storm and traveled north staying at different places and finally settling 6 weeks in and out of hotels. For almost 2 weeks we weren't sure if we flooded or got looted. We determined that we would rather get flooded because then maybe we would be able to save some things. My daughter was a senior in high school, her school did not open until January in New Orleans. Her car was at our house during Katrina and we found it down the street. It had floated away. Our house was destroyed from water damage and most everything in it.
We were not able to salvage much. My daughter wanted so deeply to go back to her school in January for class but I couldn't let her leave us with everything we had challenging us. We have settled into TN. and have since bought a house. Even though our world has changed now and we are fairly settled the nightmares of Katrina constantly haunt us. I can't sleep very well, eating habbits change, relationships are stressed and yes...you become numb to many things and find it hard to get excited about much. Althoug it did teach me that family is important and materialistic things don't matter as much. This storm has effected so very many and mentally I don't think any of us that experienced the rath of Katrina will ever be the same.
LMR, New Orleans, La. (now TN) (Sent May 4, 2006 5:13:41 AM)
My heart is filled with so much pain when I think of what you all have had to go through. I am at the office crying at the moment ... the strength I see in those comments amazes me. You never know what your capable of until you have nothing. Although, it is hard to see a silver lining, there is one. It is in everyone of you that carry each day a new. No matter what else life throws at you there is nothing that you will not be able to handle. What does not kill us makes us stronger. Have faith ... its the one thing that can't ever be taken away.
Ashley McAdams, Rockville MD (Sent May 4, 2006 9:45:40 AM)
The people that are going through mental changes are not close to GOD. Ktrina was an unfortunate event, however, one has to lean on GOD to provide a path of recovery, after all GOD will come to your aid if you ask. One must remember that GOD can resolve all things since he is the creator and ruler of all things. So if you are a believer then GOD will restore your fortunes, but you must have that belief that GOD can do all things and everything will be alright. Praise the LORD
theodore johnson 466 howe avenue Shelton Connecticut 06484 (Sent May 4, 2006 10:48:18 AM)
B. Francis, I know how you feel and trust me one day you will hear yourself talk and know you are coming back. I am sure it is different having young children leaving behind for work. One day you will feel like a participate in life again.
I promise you that. So try to keep healthy, still think about the future, call your kids every chance you get because you will feel better one day.
Good luck!
BettySue, Waveland (Sent May 4, 2006 11:07:23 AM)
I am from the Gulf Coast of Florida and I remember how scared I was when we thought it was going to hit us. My heart goes out to all of those who were saved and lost. Please always remember that you have your lives for a reason. Try to find something (can be small) and think about the good in that one thing. It is a start to healing you and your mind set. I can't even start to relate to your situation and say I know how you feel because I don't but you are in my thoughts and please don't loose the "sweetnesses" that are still left.
Stephanie Wilton, Sarasota, FL (Sent May 4, 2006 4:53:37 PM)
My family from Biloxi MS and New Orleans sufferred through this devastation. Ten from MS relocated to Connecticut after the storm. With a wealth of supportive family, safe housing,and all kinds of services offered to them the depression of not being home was evident everyday. Eventually 7 mos later they moved back to the coast only to homelessness. Although being warned by family members who remained on the coast that it was not a good idea to come back they returned and are suffering mentally as well as economically. Mental health problems for this population is so real so much so that they could not rationally except that there was no more (home) as they knew it. I will continue to pray for you all. Be forever empowered
Rona M Durham, Bridgeport, CT (Sent May 5, 2006 10:34:39 AM)
My house suffered no damage from the storm. I lost it in another way. My husband's elderly parents, whose Waveland home was reduced to slab by Katrina, moved in with us after the storm. One kitchen (and two women), one bathroom, one living room, two couples and a 5-year-old. It has been stressful, to say the least. And the 5-year-old has been very traumatized by the whole thing -- the evacuation, the storm itself and the aftermath of her grandparents losing everything. They sometimes forget how affected she is by what they say in front of her. And I feel guilty for complaining that my home is no longer my own! I'm alive. They're alive. I now have built-in child-care and they help with the grocery shopping and the cooking. But I miss MY house and the opportunities to be alone and quiet sometimes.
Lori, near New Orleans (Sent May 5, 2006 3:45:00 PM)
To all of you, and especially Brenda and Natalie Fields, I want to say you aren't forgotten. I am from Mississippi and though I've been living in Florida for 25 years, Mississippi is still home. I had family from Hattisburg to Tupelo and many of them lost property and were cut off from the world without electricity for days. But this was mild compared to what happened to people on the coast. The year before, Hurricane Francis paid us a vist. By the time it got to Gainesville, it was only a Tropical Storm, but it was moving at 10 miles an hour and sat on top of us for 30 hours with 70 mph winds. A huge tree came down on our house, we were flooded and still have a bedroom with a hole in the ceiling. We were without electricity or fresh food for several days. It took a year to get our new roof put on. No one helped us. Family that was on the way to visit (since we live in Florida and provide free room and board) just turned around and went home instead of coming to help. They didn't want to get a scratch on their new SUV. That was hard. Yet that was only a tropical storm. So we watched with horror what happened in NO and tried to watch what was happening in MS. Unfortunately, MS just doesn't exist as far as a lot of the news programs are concerned. So I learned to get my news from the MS TV stations over the internet. My church supported a family from Metairie and got them back on their feet. We have sent money and two work crews, including our pastors, to work on homes in Biloxi. We haven't and won't forget you. No one can give you back what you lost, or even restore your trust in this sanity of life to what it was before. But we haven't forgotten. And we won't. Best of luck to you all.
Joanne Clarke, Gainsville, FL (Sent May 5, 2006 4:28:07 PM)
natalie fields you are MOST wise.
sunny new orleans (Sent May 5, 2006 10:37:27 PM)
I am from Shreveport, Louisiana and lived in New Orleans for four years in dental school in early-mid 90's. I will always have a special place in my heart for New Orleans and the Gulf Coast. My wife and I visited New Orleans in late December and toured the ninth ward, Lakeview and other devastated areas along the Mississippi gulf coast. I was heartbroken to see the utter devastation in this area. I think about the residents of these areas who have lost everything every day and I just want to say you are not forgotten and are in many prayers. God Bless and Godspeed!
David, Knoxville, Tennessee (Sent May 6, 2006 4:47:09 PM)
You folks all are walking wounded! You had the bombardment, then the day after! Then the days of being completely alone. If anyone deserves the term traumatic stress you guys are surely in the top five. Hell your government forgot you had paid your taxes for 5 days or more. They forgot you existed! I look at the NOAA photos with stupifaction 8 months after. At the White House the occupants can get feeds from sats. in real time and they forgot to look for coastal Mississippi. It took a tv crew from France to find you I think, correct me if I'm wrong, I think it was the TF6 tv channel. So yes folks you deserve better but you don't have it. I grew from 14 to 2O in Waveland from 63 to end 7O. I have lived in NOLA and in Manhatten and I thank all the gods that anybody wants to believe in that I spent that time of my life in Waveland/Bay. In Waveland we all have private beaches! We have better weather and it is a great place to raise a family. The towns will come back but it is going to be slow, and the tensions you are under are not going to speed up the recovery. My dad just had some volunteers from Mont., Mich., NC.and Ga. clean out the junk in the shell of his home They did a wonderful job for free after a local had asked for only 9OOO! You are all in need of help and you are the only ones that can help each other Millions of people around the planet care about you and are watching your "Rising from Ruin"! You will all be fine again someday, keep on keeping on.
terry malone II Marseille, France 13001 (Sent May 7, 2006 12:15:24 PM)
Thank GOD for the omnipotent Theodore from Connecticut who knows the hearts and minds of all people, or at least the people of the Gulf Coast. I will have to pay more attention and notice that only un-GODly people suffer grief, pain, and "mental changes" from "unfortunate" events. It will be difficult though since I (unlike Theodore) am unable to determine who is or is not near to God. Perhaps Theodore will find it in his heart-a "calling"- to come here and provide Christian counsel to the many thousands of "un-godly" people who are going through "mental changes" due to this most "unfortunate" event.
P.S., Bay St. Louis, MS (Sent May 7, 2006 10:50:40 PM)
not to be an a**....but i guess i need Theodore's help...maybe unfortunate events in my life could be prevented{like natural disasters} with his counseling....we need ya so bad please come Theo!...i'm soo "un-Godly"
andy,ms (Sent May 8, 2006 8:21:45 PM)
There are lots of good people out there keeping an eye on us and always encouraging us to be strong. There are several that come into my thoughts but thanks to Andy from Mississippi who has been making concise, good, uplifting comments (and often funny ones)from the beginning of Rising From Ruin.
shena, pass christian (Sent May 9, 2006 1:32:14 PM)
SEE, I told ya you had NEW friends....want us or not we are there!!!
andy,booneville ms. (Sent May 11, 2006 9:29:14 AM)
Theodore, didn't Jesus say that the poor in spirit were blessed? Maybe they are the ones who truly can see what is important in life. To say that people who are having difficulties are not close to God doesn't make sense. They may be the ones closest to God, after having had everything else taken away. Didn't God allow Job to lose everything because he was closest to God? I don't see the people here cursing God, and neither did Job. TThey've prayed and they believe. They will be restored.
Jane, Southern Mississippi (Sent May 12, 2006 12:22:14 AM)
This is a very interesting and informative article. Being in the mental health field, it sheds much light on the many callers who have turned to the Crisis Line of Bridgeway Center for help after Katrina.
Sybie Hobbs, Ft. Walton Beach, FL (Sent May 17, 2006 9:07:04 AM)
Sybie, if your in the mental health field....i may need your help more than i need Theodore's
andy,booneville ms. (Sent May 18, 2006 6:49:46 PM)
andy, you're hysterical. i'm steve harper's sister-in-law and i've watched your comments in all of his postings and now here.
kelly, you're in my backyard honey - i'm in mobile too. have you tried counseling for your son? i have been referring all of my MS clients to www.melanieferguson.com Dr. Melanie Ferguson. she's very soft spoken, non-threatening and REALLY helps with PTSD and such. good luck and love to you
amanda, mobile, al (Sent May 19, 2006 10:16:12 PM)
SEND A COMMENT
PLEASE READ: All comments must be approved before appearing in the thread; time and space constraints prevent all comments from appearing. We will only approve comments that are directly related to the blog, use appropriate language and are not attacking the comments of others.