The Psychological Impact of Losing It All

Sept. 16, 2008 — -- When Galveston, Texas, resident Martin Carroll returned home to assess the damage left by Hurricane Ike, what he discovered was devastating.

"It don't look good back at home," said Carroll in a phone call to his family. "We've lost everything."

Walking through the soaked floors in his home, Carroll showed ABC's "Good Morning America" how all of his belongings had been destroyed.

"Everything in here was just floating," said Carroll. "The washer and dryer were upside down."

Of the millions who fled from Ike's treacherous path, some will return to find little or nothing left of their lives before the storm -- a realization that could affect many psychologically, mental health professionals told ABCNews.com.

"For those who were leading a marginal existence economically and psychologically before [a storm hits and they lose everything], it's going to be a huge hit," said Charles Goodstein, a psychiatrist at New York University Langone Medical Center.

"It's a truly devastating feeling – a sense of being helpless and feeling homeless – that suddenly happens overnight," said Goodstein.

Hurricane Causes Grief

The range of emotions for those who return to devastated areas after natural disasters is wide, according to mental health counselor Jack Herrmann, who is the senior advisor for preparedness at the National Association of County and City Health Officials based in Washington, D.C.

Herrmann, who coordinated the mental health response for the Red Cross in New Orleans after Hurricane Katrina in 2005 and most recently during the aftermath of Hurricane Gustav, said that while many people do become upset at the discovery that they've lost everything, others are resilient enough to spring into action and start rebuilding almost immediately.

"There is a common misperception that people are going to fall apart and they are going to have lifelong psychological consequences," said Herrmann. "But the reality is that most people who experience traumatic events are psychologically resilient."

"People may be distraught initially but most are able to activate their internal resilience and do what they need to do to move on," he said.

But in the worst cases, individuals who are unable to wrap their minds around the overwhelming loss have trouble focusing on their future, said Herrmann.

"Others have difficulty trying to prioritize what they have to do because they are just so shocked or overwhelmed by the visuals of having lost everything or they may be trying to clean up and they'll find things that were most precious to them gone or destroyed," said Herrmann.

"I've seen people who are crying so hard and have no ability to look beyond where they are at that moment and consider what the steps are they need to take," he said.

Former New Orleans resident Valerie Bocage knows that feeling all too well – she lost everything during Hurricane Katrina, save for two pairs of jeans and two shirts.

"I felt like I was in shock," said Bocage. "I was hurt and it was just horrifying."

Bocage said that she too had trouble focusing, and at one point remembers telling aid workers that she didn't need any help – despite having had no where to live and no food to eat.

"I couldn't even think straight," she said.

How a person reacts to devastation and loss is often determined by their situation prior to the event, psychiatrist Goodstein said.

"It's not just what happens when event occurred but what was going on beforehand," said Goodstein. "Those in a good situation can weather the storm, so to speak, and for those who were on shaky ground this sort of thing can hit them in a very hard way."

"The better you are psychologically before an event occurs the better you'll be able to cope afterward," said Goodstein, who said signs of depression like the inability to sleep, eat or a general sense of withdrawal is commonly seen among survivors.

"But some psychological traumas will overwhelm anyone – no matter how healthy they are," he added.

Mental Health Professionals Adapt Practices to Jumpstart Healing

Herrmann said that lessons have been learned by mental health professionals with each passing natural disaster or terrorist attack, leading to a change in how these counselors are trained to help victims and survivors.

"Initially we thought that people were going to be suffering long term psychological affects and lots of post-traumatic stress disorder, but most people we found recover over a short period of time," said Herrmann.

"So the majority don't need mental help they need support," said Herrmann.

"Handing someone a blanket isn't something that a traditional mental health professional consider a clinical intervention, but that is what we're training them to do now," said Herrmann. "To learn to be supportive without sitting them down in a quiet room for a therapy session."

Dr. Spencer Eth, the medical director of behavioral health services at St. Vincent's Catholic Medical Centers in New York, said that people must be vigilant about seeking out mental help only if their symptoms persist or worsen.

"Most people in the early aftermath of a devastating event experience shock or anxiety – all symptoms that you would expect to see in nearly everyone," said Eth. "Over time these symptoms tend to subside for most people but if they persist or get worse it could be a warning sign."

"If one develops bad habits – like smoking cigarettes or drinking or any kind of unhealthful living as a coping mechanism – it should be seen as an indication of a need for professional help," said Eth.

But for Katrina survivor Bocage, who said that she never sought out professional help after the hurricane but instead leaned on family and friends for support, learning to let go was key to her moving on and starting over.

"I had to stay focused and stay positive as much as I could," said Bocage. "I kept doing things to surround myself with positive people and instead of talking about the past we would say 'OK things happened for a reason now let's think about how to turn this around into a blessing.'"

As for those dealing with loss after Hurricane Ike, Bocage has some advice: "Remember, it's just things. And things can be replaced."

"Start looking to the future and remember, you're alive."