Fairfield, Connecticut (Reuters) - The devastating winds and catastrophic flooding of Superstorm Sandy may have subsided, but psychological distress from the disaster and its patchy recovery is likely to be growing, trauma experts say.
Those most vulnerable to long-term emotional fallout from the storm are people who lost loved ones or whose homes were destroyed. But the disruption to normal life could well affect millions of others, experts say.
From New York City to commuter towns to Atlantic Ocean seaside resorts, daily routines have been turned upside down by power outages, fuel shortages, blocked roads, closed schools and canceled trains and buses.
Thousands of people are scrambling to find housing, and children missed as much as a week of school. Homeowners are relying on candles, flashlights and canned food as temperatures dip to wintry levels.
Elderly people have been trapped in high-rise apartments with no lights or working elevators, and sick people living alone have been unable to refill prescriptions.
In Fairfield, Connecticut, a waitress at a downtown cafe brought her elderly mother to work. "She has nowhere to go and can't function alone in the dark," said the frazzled waitress.
Such challenges are "the grinding, daily wear and stress of a natural disaster," said George Bonanno, a clinical psychology professor who specializes in post-traumatic stress disorder at Teachers College at Columbia University in New York.
Some people will develop anxiety, despair and relationship problems, he said, while others could over time see their immune systems compromised and get sick more easily.
Psychological research shows the leading impact of natural disasters is post-traumatic stress syndrome, characterized by nightmares, flashbacks or a sense of detachment, along with depression and other anxiety disorders.
Among those particularly at risk are people who feel they have little control over their lives or have a fatalistic world view, according to research.
"You definitely worry about folks getting depressed, hopeless, feeling they don't have control," said David Yusko, assistant clinical director at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania.
Many people may experience sleep problems, panic attacks, rapid heartbeats and gastro-intestinal distress, he said.
That sense of control is key, said Scott Feldman, a social worker who recounted helping a young displaced mother on New York's Staten Island, which was devastated by the storm.
The woman, with one baby 18 months old and a second just seven weeks old, called the delivery at a shelter of some special baby formula a miracle, he said.
Feldman reminded her that, rather than it being a miracle, she had advocated for her children, let neighbors know what she needed and was part of a community.
"It gave her more of a sense of control over her life, and that's really important," Feldman said.