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In the past couple weeks, we have bared witness to multiple category 5 hurricanes including Hurricane Harvey and Hurricane Irma, which claimed the lives of many and devastated too many communities to count. But now, another natural disaster fights for the limelight—a deadly earthquake in Mexico. Ringing in at a 7.1 magnitude, the quake managed to destroy much of the country and take at least 220 lives. And now, those who managed to survive must face the aftermath of the terrifying tragedy: from rescuing victims trapped in the rubble, to cleaning up the mess left behind, to—perhaps most difficultly—picking up the pieces of their own personal devastation.

We immediately see pictures of crumbled buildings, stray dogs, and the heroic actions of rescue workers, following this harrowing disaster. But what we don’t see or understand are the lasting effects an earthquake may have on its survivors. We don’t typically get an inside look at their thoughts and feelings—we can only imagine what something so devastating must do to the makings of one’s mind. At least, that’s the case for most of us. But there’s a party in the middle there that gets the slightest peak into what psychological effects experiencing a major earthquake may cause—none other than the guys tasked with helping these survivors cope with the detrimental consequences: psychologists. And they’re here to help us better understand some of these most common effects:

1) Hypervigilance

According to Carolyn Wagner, licensed professional counselor and psychotherapist at Linebarger & Associates, survivors of earthquakes often experience hypervigilance. “Any little noise causes you to run for cover. A well-meaning, but unexpected touch from a loved one can cause you to yell out in fright. This is because the body is on high alert for another threat to your safety, which may make you feel jumpy and on edge,” she says. Typically, this response goes away on its own, but may be a characteristic of something much more serious if it doesn’t, like PTSD.

2) Anxiety and Depression

After one’s life is threatened and turned on its side by an earthquake, it is not uncommon for them to show signs of anxiety and/or depression, says Nikita Banks, a licensed clinical social worker and psychotherapist in Brooklyn, New York. The two illnesses present similar symptoms such as fatigue, loss of sleep, a decreased interest in daily activities, irritability, and an inability to concentrate. These symptoms may come and go with time, but if they prove lasting, it is important to seek treatment.

3) Mental Roadblock

According to Banks, it is also typical for survivors of earthquakes and other natural disasters to continuously relive the event in their head. “It is necessary to get them to stick to and have a routine as soon as possible to help them return to some sense of normalcy as it will help them become more secure in their environment,” she says.

4) Earthquake Phobia

Dr. Craig April, Ph.D., a licensed psychologist and Director of The April Center for Anxiety Attack Management in Los Angeles, says that with this phobia or fear, “the focus tends to be a desire to control the possibility of another earthquake occurring.” However, this is obviously out of our control and the impending failure then results in anxiety, he explains.

5) PTSD

According to clinical psychologist Dr. Jana Scrivani, Psy.D., who has personally experienced an earthquake herself, “most folks directly impacted will exhibit many psychological symptoms that look like PTSD.” The majority will recover, but “a minority will become stuck, somewhere in the recovery process, and go on to develop PTSD.” Symptoms of PTSD include intense fear, flashbacks, and nightmares. This is the most severe and lasting psychological effect an earthquake may have on an individual.

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