November 8, 2018Sally awoke to the stench of smoke and a call from her child, begging her to flee her house. It was 8:15 a.m. and the sky was still dark from smoke. Paradise, California was being ravaged by the Camp Fire. The entire town was under evacuation orders. The warm air from the encroaching flames was so hot that she forgot her coat and mistakenly thought it was a fall morning for a summer evening.
As Sally, 69, drove away, she heard her neighbors’ propane tanks explode. She led a group of cars on narrow roads that were sometimes blocked by steep ravines. Sally, who requested that her last name not printed, could only see the pavement in front and the flames to her east, making it seem that she was driving into the fire rather than away.
“To survive this, I intentionally shrunk my awareness to absolute essentials—I was like an automaton responding to the police order to evacuate out this road, just trusting that this would get me out,” she said. “That kind of hyperfocus—put one foot in front of the other and repeat—persisted long after I was safe from the fire.”
It took her over two hours to reach Chico’s relative safety, just 14 miles away. She had survived the worst and most tragic. most destructive wildfire in California’s history. Her house and 95 percent of Paradise’s structures were destroyed.
Eight months later Sally woke up to the sound of rain on her garage apartment in Redwoods. She began packing a carry-on bag to help her fall asleep. Driving on roads that border steep drops made it almost impossible for her to overcome an intense fear of heights. She became so afraid of heights that she stopped driving on freeways with overpasses after she returned to Chico in 2020. She had become hypervigilant to potential threats from her environment—a common manifestation of post-traumatic stress disorder.
Sally was finally diagnosed with PTSD. Sally is not the only one. A 2021 StudyUniversity of California, San Diego found that Camp Fire survivors had PTSD rates on par with veterans and were also at higher risk of anxiety and depression. That’s not necessarily new: Psychologists know that mental health issues always spike in the wake of natural disasters. What’s changed is the climate.
Extreme weather events are becoming more frequent More severe and frequentNow, the next hurricane, fire or flood often strikes before the hard work and recovery work is complete. Already, trauma is accumulating in certain regions that have been most affected by climate change.
These effects might be most obvious to counselors and therapists who work in disaster mental healthcare, a field that is growing rapidly. Research was the catalyst for the development of.The mental health effects of war. Today, mental health professionals in this field are often deployed in the immediate aftermath of all kinds of traumatic events, delivering what experts call psychological first aid—ensuring that survivors have access to food, water, shelter and someone to talk to.
Karen Koski Miller, the Disaster Mental Health Leader for the American Red Cross spent two weeks volunteering after Hurricane Katrina in 2005. She returned to Louisiana in 2020 to serve as the Disaster Mental Health Lead for the American Red Cross. This was due to two back-toback storms. She returned to the same region during this year’s hurricane season.
“You’re talking about people, who, if they’re fortunate enough to be in the process of rebuilding, have to drop everything and evacuate again,” she said. “It sets them back.”
The Federal Emergency Management Agency (FEMA) deploys mental health professionals to disaster zones, as well, and typically provides counseling services for about a year. However, a 2020 Center for Public Integrity investigation found that the program does not reach a sufficient number of people. A tiny fractionof the people who require it, and is often distributed inequitably, just like other forms of federal assistance.
Studies also show that wealthier homeowners are more likely to receive disaster aid because it is based on property value. Stay ahead after disasters, while renters and those who live in neighborhoods with lower property values—usually low-income and minority communities—fall further behind. (Low income and minority communities are more vulnerable(This is due to the effects of wildfires in general. These disparities can be Mental health problems can be exacerbatedFor the poor.
This type of psychological aid can be a great way to start your recovery process, Karla Vermeulen of the Institute for Disaster Mental Health, State University of New York at New Paltz said. For a small subset of people with PTSD, reliving the event is equivalent to reliving it. The body is primed to fight or flight as stress hormones rise and heart rates rise.
Back-to back disasters can hinder recovery, making it more likely for an acute stress response to develop into a chronic problem like PTSD. According to Ben White, a Colorado-based therapist specializing in climate psychology, the best predictor that a soldier will develop PTSD from being exposed to traumatic events is past trauma. Trauma, he said, “is like a repetitive stress injury.”
Darla Lynn Gale is the founder and executive director at Heartstrings Counseling. This non-profit offers low- and free counseling in Loomis. She said that many of her clients who survived Camp Fire responded well to therapy, helping them to develop coping skills and work through their trauma. “Then the Bear Fire hit, and then the Dixie Fire hit,” she said. “And then there’s also a whole new group calling in. It’s like Groundhog Day.” About three-quarters of Heartstrings’ clients are now fire survivors.
Every year since the Camp Fire, a wildfire burns close enough to Sally’s new home in Chico to fill the sky with smoke. She keeps track of its progress all night. “Everybody here has had plenty of opportunities to have their PTSD rekindled,” she said.
Trauma treatment is a long-term process. Gale says that each person’s treatment for trauma will vary. Therapists use specialized techniques to help clients deal with traumatic memories. Eye movement desensitization therapy and reprocessing therapy, which allows clients to recall traumatic memories while making rhythmic eye or body movements, has been shown by Gale to reduce the emotional weight of these recollections. And cognitive behavioral therapy, which focuses on altering emotions by changing thought patterns, is often used after what Vermeulen calls “acute” traumas, once the initial threat has passed.
These kinds of long-term mental health inventions tend to only be accessible to a small portion of the people who need them—Only about half of people with mental illnesses get treatment, due to financial barriers, limited providers and stigma, according to the National Alliance on Mental Illness—and they become even harder to access after large-scale disasters.
“The resources here have been totally congested for people with fire trauma,” Sally said. Because of the scarcity of mental health resources in her area, she said she hesitated to seek EMDR treatment. “I didn’t want to take those resources away from somebody who needed it more,” Sally said.
Sally noticed that her anxiety about driving began to ease after she saw a video of her cousin riding a rollercoaster. The algorithm began serving her dozens more rollercoaster videos and she found that watching them helped to lessen her fear of driving close to drop-offs. She is now able to drive on all Chico freeways, but she still avoids the Sierra foothills.
What’s still not clear: how the existential threat of climate change could compound the trauma of these increasingly common, acute disasters. “What we’re seeing is this rising sense of ‘maybe there is nowhere to go to feel safe,’” said Leslie Davenport, a therapist who specializes in climate psychology. “With climate change, there’s no going back to that sense of safety and stability that we may have known before, because there is this escalating path that we’re on, with rising levels of threat and rising levels of distress.”
“It’s something people in my field are struggling with. How do we adapt our practices that came out of the more traditional acute threat model to deal with something that is just so inescapable?” Vermeulen said. “There’s no easy answer to that, unfortunately.”