Jimmy Caraway was safe.
It had been a week since he was evacuated from his east Houston apartment, a week since rescuers had plucked him from the rising waters he couldn’t escape on his own because of his debilitating arthritis. Now he was 12 miles away at the George R. Brown Convention Center, physically removed from the dangers that could have killed him.
But he was sad and anxious. He had survived — but how was he supposed to live now?
“All I got is the clothes on my back and the shoes on my feet,” Caraway said. “I need a place to stay. Do you know a place I can stay?”
As Hurricane Harvey’s floodwaters recede, it leaves behind more than 40 deaths, fires at a Crosby chemical plant, 185,000 destroyed or damaged homes and tens of thousands of people in shelters. But it also leaves emotional wreckage that will take time to heal.
Experts say it can take weeks to months, even years, to regain some sense of psychological normalcy after such traumatic events.
“Our world view has shifted,” said Suzanne Phillips, a New York-based psychologist who specializes in trauma. “Our sense of control has been assaulted. We don’t understand how this could happen.”
The storm after the storm
In the days after Hurricane Harvey’s onslaught, tens of thousands of people flowed into area shelters to seek safety from the storm. Volunteers gave them food, clothes and beds. Federal Emergency Management Agency officials were on site to help people fill out forms to cover temporary rental costs, home repairs, uninsured expenses and other immediate needs.
But Darryl Barker was still in survival mode.
Barker, who used to work as a performer on Sixth Street in Austin, weathered Hurricane Harvey under a bridge near downtown Houston. As the water rose, he quickly escaped by wading through the rising torrent, watching logs and other debris float past him. Last week, safely ensconced at the shelter, Baker couldn’t shake his memories of the experience and was constantly replaying it in his head.
“I thought I was going to have to ride one of those logs out,” he said. “I think about it all the time now.”
All across the convention center, mental health professionals were on the lookout for people like Barker. They could see the symptoms of trauma in the storm survivors: pacing, crying, irritation, sleeplessness. Annalee Gulley with Mental Health America of Greater Houston, said counselors and social workers approached them with a simple question: How can I help?
“This entire facility and the community is dealing with extreme trauma and profound loss,” she said.
Officials had prepared to handle different kinds of mental health need, she said. They paired with drug stores to make sure people with pre-existing psychiatric illnesses had their medications. They set up beds for people with mental illness and addiction. They created an area for people with autism and developmental disabilities and set up a children’s zone where kids could play.
Even though they were safe from the flood, evacuees had a slew of new experiences to deal with. Now that their homes were gone, they had to live in close quarters surrounded by strangers in beds that were not their own. They had gone from running their own lives to relying on others for their survival.
“There are too many people in there,” Caraway said, sitting outside the convention center in his blue metal walker. “I can’t stay here.”
He said he couldn’t sleep, not just because of proximity of strangers, but because the bed was physically hurting him. So he was waiting for a friend to come pick him up, he said. He didn’t know where he would stay the night.
“It’s really bad and sad,” he said. “I don’t know what to do.”
In the days and weeks after a trauma, the body changes, Phillips said. People can’t eat, they can’t sleep, they are hyperalert and might be fixated on their experiences. It’s the body’s way of preparing for the next trauma, she said.
When that next trauma doesn’t come, the body begins to relax, she said. This generally happens in 2-3 weeks.
But that’s not how it works for everyone. Very young or old people, as well as medically fragile people, sometimes take longer to heal. People who have already experienced trauma in their lives can also be slower to recover.
Clinical psychologist Nora Baladerian led emergency response trauma teams in New Orleans after Hurricane Katrina. Four months later, people remained sad, overwhelmed, shut down and operating on a lower level, she said.
“It was devastating,” she said. “There are no words to describe it. … There was desperation. There was like a gray filter over the city.”
Finding a new routine
First responders are prone to experiencing trauma, too. Scooping up people from floods, feeling the terror and panic of those around them, leaves its mark. Even hearing those stories from people at shelters can affect first responders.
Houston police officer Kimberly Neal had been working for six days straight, catching about three hours of sleep at a time, and was feeling the effects as she patrolled the George R. Brown Convention Center.
She was exhausted, she said. And loopy. And sometimes grumpy.
“It’s stressful because you’re away from your own family and trying to take care of the community,” she said. “You get to the point where you don’t know what day it is anymore.”
Meanwhile, many Houston officers were dealing with storm effects of their own.
“Their houses and cars were flooded, but they’re still coming to work,” said Houston police Capt. D.C. Angelo.
Officials were encouraging officers to take advantage of the department’s chaplains or psychologists.
Survivors might bounce around in their emotions, from anger to fear, and have difficulty making decisions and prioritizing. Anger is a step up from depression, Baladerian said, because anger takes energy and depression is the lack of energy.
People can help themselves through the trauma in a number of ways.
In the wake of a tragedy, some people become fixated on media coverage of the event, essentially retraumatizing themselves, Phillips said. While keeping informed is one thing, obsessing is another.
“They need to turn off the television,” she said.
How people recover often depends on their belief system. People who think they are prone to bad luck, for example, might take longer to recover. People who take a more practical approach, perhaps by focusing on future plans, could heal more quickly.
Children look to their parents or caregivers for guidance on how to process the experience, Phillips said. If children feel like the danger has passed, they feel safe. If their caretakers continue to relive the experience, children will reflect that. It’s important to show them that they can still play and have fun in their new reality.
Even in shelters, people can try to move forward.
“A daily routine is obviously gone for them, and now they need to replace it with something else,” Baladerian said. “It’s important for them to start a new daily routine. Whatever they can do in the shelter, not only for themselves, but for their children.”
Take time to do the things you like, Phillips said, be it aerobic activity or a crossword puzzle. Singing and laughing is great because it helps regulate breathing, which eases anxiety and stress, she said.
Reaching out to other people is important in these situations, because human connection is critical to overcoming suffering, Phillips said.
“Take it one step at a time,” she advised. “Look for people to help you. Be with groups to help you. People need to know that this is all very normal.”