As Houstonians mark the one-year anniversary of Hurricane Harvey’s landfall on August 25, psychologists say we have just begun to see the long-term mental health impacts of the worst hurricane to hit Texas. 


“It’s fairly common to see post-traumatic stress disorder, depression, and anxiety in people who lived through a natural disaster,” said Alok Madan, Ph.D., a Houston Methodist psychologist. “And these mental health concerns can be seen in people who lost loved ones, homes, cars, but also in people who were untouched by Harvey’s flood waters. You may have been untouched, but you weren’t unaffected.” 


Concerning symptoms can include flashbacks, trouble sleeping, lack of interest in previously enjoyed activities, and avoiding certain situations. If experiencing any of these symptoms, Madan said the first step is to acknowledge that something is wrong and to seek help. He said that sleep disturbances is often the easiest symptom for people to spot in themselves. 


“It’s harder for people to realize they are avoiding certain scenarios, but their friends and family probably see it and should start a conversation about it,” said Madan, who also serves as the vice chair of psychiatry at Houston Methodist Hospital. “Things that we avoid tend to gain greater power over us. Someone might start avoiding driving on the freeway during a thunderstorm, and then it could progress to avoiding driving when it’s drizzling to even refusing to leave the house when it’s cloudy. When avoidance paralyzes us, that’s a major cause of concern and another reason to seek help.” 


Every Houstonian had a slightly different response to Hurricane Harvey based on their life experiences leading up to August 25, 2017. Some people have a higher risk for depression or anxiety and a small amount of stress can overwhelm them, whereas others who have a lower risk can take more stress and not seem to be affected. 


“For example, Harvey will shape the life experiences of the children in Houston who were old enough to form memories of this disaster,” Madan said. “That is why there is no real way to say how long we will see the mental health effects of Harvey. Someone who was five when Harvey hit could develop anxiety 20 years from now if they were to experience a similar situation. Much like the families who moved to Houston after Hurricane Katrina could have experienced emotional distress because Katrina shaped their life experience and how they responded to Harvey.”


Similarly, Madan said there is no limit or timeframe to when someone could be diagnosed with depression following a natural disaster. The weekend of rain was an acute stressor, but losing a home, losing possessions, finding another place to live, dealing with insurance, seeking government assistance, finding a contractor, etc., are the chronic stressors that people have been dealing with for a year. This continuous stress is what wears on people and can lead to depression even months after a traumatic event. 


Madan recommends that people who are still trying to rebuild their homes make a to-do list, but only take on one item at a time to avoid burnout. It is also important to include spending time with friends and family, taking care of yourself and engaging in activities enjoyed before Harvey on the to-do list. Seemingly small things can go a long ways in helping you cope – especially over the long haul. 


“People are incredibly resilient, even in the face of horrible adversity,” Madan said. “The more typical response to an event like Hurricane Harvey is resilient survival. Communities come together, bonds are formed, people help each other up, and we survive and thrive. This wasn’t Houston’s first hurricane, and it won’t be our last. But where there is tragedy, there is resiliency that makes us stronger.”


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