Maya (name changed) hasn’t seen akka (older sister) in a long time. Years ago, their impoverished parents had left both sisters with a neighbour in Chennai before committing suicide. Akka was sent to live with another family and she became just a fading memory. The floods that wrecked the city in December last year dredged up more misery than the 13-year-old could handle. When Syjo Davis met Maya after the floods, he found that the cruelty of her past and the uncertainty of the present had taken a toll on her mental health.

“She imagined her sister had been washed away, and had nightmares of her calling out to her. She started self-harming,” says Davis, a psychiatric counsellor with city-based mental health institute SCARF. With counselling and from a death wish in December 2015 to successfully moving up to Class 9 in June 2016, Maya managed to steer her mind through choppy waters. The worry is that many others who were similarly affected have not found help so far.

As the gloomy grey skies gave way to sunshine and the broken-down city staggered back on its feet again, volunteers from SCARF, the Madras School of Social Work, and other organisations began efforts to address the psychological damage that the floods left behind. For most Chennai-ites the sun was here and the worst was over, but there were also many whose minds were enveloped by a darkness that was not easy to dispel.

Post-traumatic stress disorder (PTSD) resulting from natural disasters is usually marked by fear, sleepless nights, palpitations, excessive sweating under stress, preoccupation with the disaster, and flashbacks.

Full-blown PTSD cases were thankfully rare after the Chennai floods, says Dr R Mangala, a consultant psychologist and assistant director of SCARF. The institute treated 400-500 people for symptoms of anxiety and stress, which sometimes persisted for a couple of months. Even a minor drizzle was enough to trigger fear in them.

Davis and his team reached out to nearly 1,300 schoolchildren. As many as 350 of them showed signs of psychological disturbance, ranging from a fear of water to a breakdown in communication; 310 needed treatment and 60 were further referred to local hospitals.

“My seven-year-old used to wake up screaming in the middle of the night,” says Dinesh Mani, a father of two. The family had been stranded in the submerged neighbourhood of Velachery for hours, until they were rescued.

Elsewhere, children who had initially appeared excited at the ‘adventure’ of being rescued from flooded homes, later showed signs of trauma and mental disturbance. Kesang Menezes, a certified parent educator with the support group Parenting Matters, says not many parents realised that their children were having difficulty processing what they had gone through. Many children withdrew into silence.

Even those who saw the disaster unfold on TV can display similar symptoms, Menezes says. Davis concurs. “The visuals of people stranded, wailing for help, the music and sound effects used can have a deep impact on many people, especially children,” he says.

Mani says his older son often asks if it’s going to flood again. After using resources made available by Parenting Matters, Mani is heartened to see a positive outlook in the child. “He’s sure everything will be fine. He even plans rescue strategies with his friends.”

In the middle of the flood, NGOs and volunteers trained by SCARF attempted to reach help and care to people with mental illness. Dr Mangala mentions a slum resident with bipolar disorder who had lost his medication during the flooding and had relapsed.

From posh residential colonies to slums, the floods proved a great leveller.

As the ravaging waters took their homes, slum-dwellers moved to the ‘safety’ of arterial roads. “For people living in the slums along rivers, rising water levels and displacement are a part and parcel of their life. Thus, for the poor, through the floods and after it, the focus was on relief material — food, shelter, clothing,” explains Dr Mangala.

For the middle-class citizens, however, seeing destruction unfold on this scale was unprecedented. “Diverting their attention toward getting their lives back in order — paperwork, repairs, and so on — gave middle- and upper-middle class people a sense of normalcy,” she says.

At a psychological level, while the middle class ignores mental health out of a fear of stigmatisation, the poorer sections do so for a lack awareness, says Davis. An oft-heard response on the ground was, “What’s the point talking about it when everything is gone?”

It is precisely this brushing-off that Keren Fredrick, assistant professor of psychology at Ethiraj College, warns against. Failure to deal with the psychological issues and phobias at the initial stages will lead to internalising them, she says, and they will unexpectedly resurface later in life.

Fredrick is a flood victim herself: she was a bride stranded in a submerged house, waiting for a fire truck to take her to her wedding. “Until an hour before the wedding I wasn’t sure if I’d get married that day; I had lost all contact with my fiancé... there was no phone connection for an entire day,” she recalls. Today she is able to look back and laugh at her strange predicament. But, equally, she is aware of the stress her loved ones underwent.

Fredrick’s husband, who wasn’t directly affected by the floods, began to show symptoms of stress after the incident. His anxiety stems from the helplessness he felt during the episode. Frederick says she took a faith-based approach while counselling her family, and adds that interventions should be tailored to suit individual needs.

Playing down her own feelings of distress during the flood, she says “My approach was problem-focused.” Simply put, if you want to keep your head above the water, stay focused... and keep swimming. If you can’t make it alone, call for help.