After Hurricane Maria, signs of a mental health crisis haunt Puerto Rico – “When it starts raining, they have episodes of anxiety because they think their house is going to flood again”

By Caitlin Dickerson
13 November 2017
SAN JUAN, P.R. (The New York Times) – Her memories of the storm came in flashes: neighbors’ screams, gushing water, swimming against the current with her son.
For Milagros Serrano Ortiz, a 37-year-old grandmother with long, curly hair, the nightmare did not end there. After two days of sheltering upstairs in a house across the street, she returned home to find the walls caked with mud and a vile stench emanating from her cherished possessions, which were rotting in the heat.
Anguished and overwhelmed, she confessed recently to a psychologist at an emergency clinic that she had begun to have disturbing thoughts and worries that she might act on them.
“Like what?” the doctor asked.
Like swallowing a bottle of pills, she said, “never waking up, and not feeling pain anymore.”
The violent winds and screeching rains of Hurricane Maria were a 72-hour assault on the Puerto Rican psyche. There are warning signs of a full-fledged mental health crisis on the island, public health officials say, with much of the population showing symptoms of post-traumatic stress.Puerto Rico was already struggling with an increase in mental illness amid a 10-year recession that brought soaring unemployment, poverty and family separation caused by emigration. Public health officials and caregivers say that Maria has exacerbated the problem.Many Puerto Ricans are reporting intense feelings of anxiety and depression for the first time in their lives. Some are paranoid that a disaster will strike again. And people who had mental illnesses before the storm, and who have been cut off from therapy and medication, have seen their conditions deteriorate.
“When it starts raining, they have episodes of anxiety because they think their house is going to flood again,” said Dr. Carlos del Toro Ortiz, the clinical psychologist who treated Ms. Serrano Ortiz. “They have heart palpitations, sweating, catastrophic thoughts. They think ‘I’m going to drown,’ ‘I’m going to die,’ ‘I’m going to lose everything.’ ” [more]

After Hurricane, Signs of a Mental Health Crisis Haunt Puerto Rico