Originally published in the Houston Chronicle September 29, 2017

By Chad Lemaire

We know all too well the physical destruction Harvey wrought in Houston and southeast Texas. What we don’t yet know is the mental health toll on those directly and indirectly impacted by what FEMA’s chief says is probably the worst disaster to ever hit the state.

As you can imagine, many of the victims – those who experienced severe loss and trauma – are experiencing acute anxiety, fear, hypervigilance, sleeplessness and grief. Even those who were more fortunate but had loved ones and neighbors lose everything are at risk for acute stress. Behavioral health providers across the city are on the lookout for symptoms, which could take awhile to manifest.

But the good news is that most of those impacted have a tendency to be resilient.

At NRG Park after the storm, I met a woman with significant mental health conditions who lost what little she had. She had only the donated wheelchair she was sitting in and the clothes on her back. After recounting her harrowing story, the woman said, “I guess I just needed someone to listen.” On her face, I could see her resilience kick in. Her plan, she said, was to wake up the next morning and go to church, call her case manager from a local homeless program and focus on her strengths – those that had gotten her through life’s challenges before.

Bearing witness to this level of strength in someone who has recently been through so much was, to say the least, encouraging. Actually, it was inspiring.

Resilience can come from many places: connecting with others (rather than withdrawing); being hopeful; actively problem-solving; accepting help; maintaining healthy behaviors like exercise, good nutrition and avoiding drugs and alcohol; and focusing on one’s spirituality, including but not limited to religion. The understanding that comes from talking to our support networks, the normalization of our reactions to a disaster, and the realization of it as a shared experience can help.

In fact, after disasters, something called post-traumatic growth can happen. People not only bounce back to their prior level of functioning, but they may have one or more areas where they experience growth. These areas include having a new appreciation for life, experiencing deeper and more meaningful relationships, living with more gratitude, finding a new purpose in life and having an increased focus on being present in the moment with loved ones.

I know a number of Katrina survivors who ended up in Houston, and they give me hope. They showed us what resilience and post-traumatic growth look like. We have an opportunity to stick together and continue to build on the great examples of kindness, unity, and heroism we have witnessed.

Behavioral health providers across the region are monitoring patients for depression, PTSD, and increased or new substance use, among other things. But let’s also focus on our individual and collective strengths. #HoustonStrong is not just a meme on social media. It’s reality.


Lemaire is the medical director of behavioral health services at Legacy Community Health and author of the “Grief and Resilience” chapter in “Disaster Psychiatry: Readiness, Evaluation, and Treatment.”