What Are the Psychological Harms of Disaster?

The recent rash of hurricanes, wildfires, and earthquakes has done incalculable harm to human life and property, leaving a trail of destruction that is unparalleled in modern history. The enormity of these disasters raises many questions about the long road to recovery, not least of which is whether the disasters will inflict long-term psychological damage.

We often assume that the greatest psychological harm occurs during the disaster itself. Indeed, when we watch helplessly as a building collapses or the roof is torn from our home, the terror of that experience ripples through us, preoccupying us in the days and weeks that follow. As a result, we may experience intrusive memories, vivid nightmares, and intense sadness or irritability. We may feel riled up when we see reminders of the disaster or avoid situations that remind us of it.

Toppled tree after Hurricane Sandy

Source: Anthony Mancini

But these psychological symptoms are typically short-lived and leave few long-term psychological scars. We possess the skills, honed by evolution, to manage and even thrive after acute, highly disruptive, and emotionally aversive experiences.

But disasters unfold in waves, and the greatest potential for psychological harm comes later, in the face of more enduring and pervasive threats to our well-being. When disasters uproot us from our homes and impose chronic demands on us, when they separate us from family members, friends, and community supports, the potential psychological harms are greatest.

Temporary housing, geographic displacement, or long-term rebuilding can have particularly insidious effects. The sheer scale of destruction after Hurricane Katrina, for example, required a recovery effort that stretched on for years. Studies of that disaster found a highly unusual result: psychological symptoms increased, on average, over time. Typically, they decline rapidly within the first year.

Yet this is not surprising, given Katrina’s immense impact on people’s lives. Rebuilding or moving to another city is highly stressful, far more so when it strains our financial resources. We know that chronic stress contributes substantially to depression and anxiety, including sadness, jitteriness, feeling worse about yourself, trouble sleeping, and a lack of pleasure in life.

How do we combat chronic forms of stress? The most effective way is the most ordinary: our relationships with others. To the extent that we believe our friends and family will help us get through something, we can mitigate the psychological impact of chronic stress. And the good news is that we possess a kind of disaster immune system that draws us together and impels us to “tend-and-befriend” under threat, according to the psychologist Shelley Taylor.

Indeed, after a disaster, we seek out our neighbors, talk to strangers, and donate blood. We attend to others and are more trusting. As the activist Dorothy Day, who lived through the Great San Francisco Earthquake in 1906, once said: “What I remember most plainly about the earthquake was the human warmth and kindness of everyone afterward.” Indeed, disaster often brings out our best selves, and this more benevolent social environment may even improve psychological functioning for some.

But what happens when essential sources of support are choked off? It turns out that those everyday social interactions—the family routines, the weekly book club or golf game, the dinner party or backyard barbecue—are crucial to our psychological adjustment to stress.

After Hurricane Andrew, people who felt embedded in a social network experienced lower levels of depression. And after Hurricane Katrina, people who remained in the same town saw lower rates of anxiety and depression than people who were geographically displaced, likely because they retained sources of support. When we combine the results of many studies, a technique called meta-analysis, we find that a lack of perceived support from others may be the single strongest predictor of posttraumatic stress symptoms.

Put simply, disaster’s echoes can reverberate into the future, but it does so most powerfully when we feel isolated from sources of support and alone in our efforts to rebuild.

What does this mean for recovery efforts? Helping people remain in their communities may have psychological benefits. Policy-makers should focus special attention on displaced people, making resources available to address mental health needs. Community-wide interventions can also help people to maintain relationships—a critical resource—and provide assistance for navigating bureaucracies, to reduce the burden of stress.

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The potential trauma of disaster is not the overwhelming experience of the event itself, but the drip-drip of the aftermath and its corrosive effect on our relationships.