From the moment that someone is told to evacuate, distress can take over for the simple reality that they might not know if or when they’ll be able to return home, says Sarah Lowe, PhD, professor of Social and Behavioral Sciences at Yale School Public Health. And even if they do suspect or learn that they will be able to return at some point, they may not know whether their home and belongings will be intact, further magnifying the potential for stress and anxiety at the outset.

In a hurricane’s immediate aftermath, displaced people may not have the bandwidth or the opportunity to process these feelings, as they focus on meeting their food, water, and shelter needs. “There’s an initial sort of ‘honeymoon phase’ where communities will come together over a shared adversity, and there’s a sense of being made whole again as people support their neighbors,” says Joshua Morganstein, MD, chair of the Committee on the Psychiatric Dimensions of Disaster at the American Psychiatric Association. But then, headlines of the disaster quickly fade, resources diminish, and the reality of some “new normal” sets in, he says.

“There’s a feeling of uncertainty, of not knowing the magnitude of the impact.” —Sarah Lowe, PhD, professor of Social and Behavioral Sciences at Yale School of Public Health

The question of what that new normal really looks like can prompt another wave of distress with long-lasting implications. “There’s a feeling of uncertainty, of not knowing the magnitude of the impact,” says Dr. Lowe. As the aftermath unravels, people become increasingly aware of the losses they’ve experienced, which can encompass everything from losing loved ones and pets to losing rituals, routines, and a sense of normalcy.

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“Even when you move to a new home under positive circumstances, you’re likely to encounter stressors, like having to create a new social network, navigate your way around, and find a new job or school,” says Dr. Morganstein. “So, for people who are abruptly displaced, all of that can happen without the planning, without the desire to be somewhere else, and without the things that bring them comfort and give them a sense of identity.”

Storm casualties often include deeply beloved belongings that might offer such comfort, like a “photo album that reminds them of loved ones, or the locket that a significant other gave them, or that picture of a deceased parent that they used to look at every night before bed,” says Dr. Morganstein. Without even these seemingly small things, it may be incredibly tough for someone to feel mentally grounded in the aftermath, he adds.

Any of these dimensions of sudden loss can serve as a shock to the system. For some people, such distress can lead to trouble with sleeping, anger and irritability, and a decreased sense of safety, which, Dr. Morganstein points out, can have adverse effects even if they are in a physically safe and secure place.

To cope with these distressing emotions, displaced people commonly begin to use or up their intake of substances like alcohol and tobacco, according to studies conducted after the 2004 Florida hurricanes and Hurricane Katrina. This presents “a serious public mental health problem, regardless of whether people have prior substance-use issues,” says Dr. Morganstein. Increased alcohol use, alone, for example, can raise the risk for violence in communities, errors and other problems in the workplace, and family conflict, he says. And any of the above will only deepen the psychological effects that people are already facing by being displaced by a hurricane.

This interplay of stressors can also put people at higher risk for developing mental-health disorders, like post-traumatic stress disorder, depression, and anxiety—all of which have been demonstrated to occur in the wake of both human-made and natural disasters, including earthquakes, wildfires, and drinking-water contamination, in addition to hurricanes. “To be clear, these mental-health conditions do not arise in the majority of people, but when they do, they can cause considerable morbidity and mortality,” says Dr. Morganstein.

8 factors that make certain people displaced by a hurricane more likely to experience negative psychological effects

1. Pre-existing mental- or physical-health conditions

People who are most vulnerable, from a mental- or physical-health standpoint, when a hurricane strikes are also at higher risk for experiencing more significant mental-health fallout. “This includes those who are already dealing with health challenges or conditions, and who are suddenly cut off from systems of care—for example, their dialysis facility or their case manager—because of electrical outages or road flooding,” says Dr. Morganstein.

2. Previous traumatic experiences

If a devastating hurricane isn’t a person’s first traumatic blow, its effects can pile onto existing trauma. “You might think that you’d gain resilience with time, but that’s not necessarily true,” says Dr. Lowe. “These events can have a cumulative impact, wearing away people’s mental health over time.”

3. Low socio-economic status

While people of a low socioeconomic status are more likely to have pre-existing medical conditions and have experienced previous traumatic experiences when a storm hits, doubly disadvantaging them from the start, they’re also more likely to live in places that flood easily, says Emanuela Taoili, MD, PhD, professor of population health and science at Mount Sinai in New York. This makes them “more likely to have a psychological response to a disaster,” says Dr. Taoili, “which also makes them more susceptible to developing a condition like anxiety, depression, or PTSD.”

4. High exposure to trauma during the disaster

The severity and duration of a person’s exposure to the negative effects of a hurricane will also play a role in how likely they are to experience psychological consequences down the line.

“For example, consider people who lay eyes on human remains, and who might engage in something called psychological identification,” says Dr. Morganstein. “This refers to looking at a dead body and thinking, ‘That could be me,’ or, ‘That could be my loved one.’ When that happens during a disaster, it increases a person’s risk for psychological distress.”

5. Loss of a loved one

To no surprise, experiencing the loss of a loved one(s) in the midst of a hurricane will worsen a person’s capacities to cope with the crisis. This includes the loss of a beloved pet, or “having to leave a pet behind while evacuating because they won’t be welcome wherever you’re going,” says Dr. Lowe, “which can create significant sadness and guilt.”

6. Being alone or with stress-inducing people

Those folks who can lean on trusted community and family members for support during a hurricane will also fare better than those who are alone—or stuck with family members they dislike or with whom they have conflict-ridden or abusive relationships, says Dr. Lowe.

7. Being placed in a shelter or evacuation center

“Mental health signatures of anxiety and depression tend to show up more often in people who are displaced in a shelter or evacuation center versus those who are displaced and living with family and friends,” says Dr. Taoili. And that’s a direct result of how these shelters tend to be set up.

“During Hurricane Katrina, folks evacuated but then often found themselves in circumstances that were dangerous, in shelters where crimes were committed or where they were assaulted or where they were otherwise uncomfortable, sleeping on a blanket or sleeping bag on the floor,” says Dr. Lowe. These kinds of conditions can understandably make it hard to get good sleep, says Dr. Morganstein: “Without sufficient sleep, it can then become more difficult to think and make decisions that are sound, health-promoting ones for ourselves and our loved ones,” he says.

As the fallout from the hurricane changes over time, people are also often moved from shelter to shelter, increasing the sense of anxiety that can come with not having a home base, says Dr. Taoili. “This gives people the stressful feeling that they have to be prepared to take all their things, whatever few things they have, and go at any point,” she says.

8. Loss of income

Being displaced to either a shelter or a loved one’s home after a disaster could make it difficult or impossible for some people to access their work, particularly those whose jobs cannot be done remotely. “Any disruption in employment or income creates a financial toll that can worsen the psychological effects of the crisis, too,” says Dr. Morganstein.

4 ways to mitigate the psychological effects of being displaced by a hurricane

Even the best climate-supportive initiatives won’t prevent all hurricanes. As a result, it’s essential for post-disaster recovery plans to include strategies that address the psychological impact of hurricanes by “improving the sense of social connectedness, self-efficacy, and hope among those who were affected,” says Dr. Morganstein.

Reaching these goals certainly requires work on the part of local authorities to create and promote safe storm shelters with private spaces and mental-health counselors on-site, says Dr. Taioli. It’s also important for community leaders to communicate truthfully about the state of the crisis and the damage from the start in order to engender trust, and to practice “grief leadership” by “recognizing the many losses that people have experienced, and also articulating these losses out loud,” says Dr. Morganstein. “This ultimately helps people make meaning out of a tragic event.”

Outside of effective leadership, however, there are things that people can do personally—even amid the trauma of being displaced—to help ease the psychological burden. Below, Dr. Morganstein outlines the most important behaviors to consider, if you were ever to find yourself in this high-stress situation.

1. Develop a new routine

“As much as you can, even if you’re in a shelter, try to plan a time during the day to read or do another activity, a time to do a physical exercise, and a time to go to bed each night,” says Dr. Morganstein. “A sense of regularity can reduce the feelings of uncertainty that a disaster inevitably brings.”

2. Take a media break

Watching TV or scrolling the internet in the wake of a disaster is likely to put you face-to-face with a ton of inflammatory headlines and upsetting statistics. In fact, “people who report consuming more disaster-related media tend to have higher levels of psychological distress, don’t sleep as well, use more alcohol and tobacco, and are more likely to develop depression and post traumatic stress disorder symptoms,” says Dr. Morganstein.

That’s why he suggests actively taking a pause from media consumption as you figure out your new normal and only turning to technical news platforms—like the National Weather Service— should you need real-time disaster information to make a decision for you or your family.

3. Perform a daily act of kindness

Kindness might be the last thing on your radar in the wake of a serious disaster. But it’s a real route toward building hope, which can improve your mental health. “We sometimes think of hope as something that we wish for, or that we’re going to find, but really, hope is something that we create,” says Dr. Morganstein. “When we do something kind for others, we build hope.”

That might look like comforting a crying neighbor, helping someone carry a piece of heavy debris or search for a lost possession in their home, or giving someone a bottle of water in an evacuation center. “All of these acts of kindness remind people that there’s goodness in the world to look forward to at the end of a crisis, and create social connectedness,” says Dr. Morganstein.

4. Tap into your personal skills

When something as out of our control as a hurricane strikes, it’s easy to feel helpless. But there are many ways for any single person to help in a crisis. Doing so just requires thinking about how you can put your personal skills to good use.

“Inside a shelter or evacuation center, there might be religious officials who can hold services and welcome people of all faiths, teachers who can organize classes for children, or fitness instructors who can host informal exercises classes or sporting activities,” says Dr. Morganstein. And these kinds of practices aren’t just worthy distractors from the chaos of the moment; they’re integral in restoring that all-important sense of routine noted above.

“Displaced people may not be thinking about their skills because they are understandably distracted,” says Dr. Morganstein, “but by using those skills, they can feel a greater sense of efficacy, as in ‘I can actually do something to help other people.’ Then, those other people also stand to benefit from whatever it is they’re doing, so that both the individual and the community gets stronger.”

To contribute to relief efforts following Hurricane Ian, consider donating money to organizations supplying food, shelter, and other support, including the Florida Disaster Fund, the American Red Cross, and the Salvation Army.