Psychological scars from October wildfires cut deep in Sonoma County

On particularly bad days, Sherinne Wilson's thoughts go back to that moment just before she realized how bad the fires were.

She's standing in front of a second-floor closet in her home on Pine Meadow Place near Coffey Park, trying to decide which box of photos and family videotapes to take and which to leave behind.

She thinks she has time.

Wilson, 52, looks out a window next to the closet - fiery embers the size of her hand are floating on a strange draft of air in her yard, barely moving, surreal, an ominous foreshadowing of what's coming. Mesmerized for a moment, she snaps out of it and leaves the house without grabbing a single thing.

“When I have ‘one of those days,' that's what I go back to,” she said. “I could have taken one box, but I didn't.

“Now, with the littlest, smallest amount of smoke my heart races - I'm sure I'm not the only one,” said Wilson, whose house was among the 1,200 homes in Santa Rosa's Coffey Park neighborhood destroyed by the Tubbs fire in October.

“It causes a lot of anxiety, and with the fire season you just can't really get away from it,” she said. “I don't think it's something that will ever go away.”

Nearly 10 months since the North Bay was ravaged by historic wildfires, fire survivors, their friends, family and neighbors are still grappling with disaster-related trauma, anxiety and stress that just doesn't seem to go away.

For many local residents not directly affected by the fires, the devastating event is receding into memory. But for those who lost a loved one or a home, they find themselves constantly “triggered” or “activated” by the firestorm's nagging legacy - insurance woes, construction costs, empty lots, fire-scarred neighborhoods, repeated red flag warnings and incessant California wildfires. The deadly blaze in Redding and new fires this weekend in Mendocino, Lake and Napa counties were grim reminders of that heavy toll.

Such reactions are not uncommon, according to local and national mental health experts familiar with disaster-related trauma. The good news, they say, is that psychological and emotional recovery can be achieved. The bad news: It is going to take a long time, as unprecedented destruction brings unprecedented trauma.

Wilson, a supervisor with Santa Rosa's Recreation and Parks Department, said she, her husband and everyone else who lost everything to the fires continue to struggle with the day-to-day challenges of rebuilding. With so many thousands of homes lost, Wilson said she finds support among those directly affected by the fire.

In fact, the only time she has talked to a mental health professional was a few days after the firestorm, for a few minutes as part of the city's immediate response to staff impacted by the fire. Wilson recalls being asked how she was feeling, a question she had trouble answering because she was in absolute shock.

The process of rebuilding mental health in the North Bay is no less important than the timely reconstruction of fire-damaged neighborhoods, and the two go hand-in-hand, said Sonoma County Supervisor Shirlee Zane.

Even as the city and county work to streamline reconstruction by fast-tracking construction permits and waiving certain fees, mental health experts are trying to map out countywide recovery efforts that include free therapy sessions, specialized disaster trauma training for counselors and therapists, novel therapies that reconnect wildfire survivors with nature, and even a self-help app aimed at assisting people with post-disaster stress and trauma.

“We're not just rebuilding brick and mortar, we're rebuilding people's lives and that is a long process,” Zane said. “Increasingly, we're seeing two worlds in the county: The world between those who experienced the fire and those that didn't.”

Doreen Van Leeuwen, a local marriage and family therapist, agrees. While most county residents are moving on with their lives, those who lost everything are reminded of the fires every day - because everything in their lives changed, said Van Leeuwen, president-elect of the Redwood Empire chapter of the California Association of Marriage and Family Therapists.

“It's two populations that are really at different places,” Van Leeuwen said. “People need to know they are not wrong for feeling what they're feeling. ... Of course you're upset, your whole life has been ripped from you. This is a real long journey. There is support available.”

Disaster trauma

Dr. Carol North, professor of psychiatry at the University of Texas Southwestern Medical Center, has spent a significant portion of her career studying the mental health outcomes of disaster survivors. A psychiatric epidemiologist, her work with survivors of the 1995 Oklahoma City bombing was instrumental in helping some mental health professionals assist survivors of the Sept. 11, 2001, terrorist attacks.

In 2012, North published a study that examined post-traumatic stress disorder among hundreds of survivors of 10 disasters, from October 1987 to April 1995. Her research shows the main link between PTSD and recent disasters is the level of destruction, North said.

“It's not the type of disaster that drives adverse mental health outcomes,” she said. “Rather, it's the scope and magnitude of the disaster, measured by the amount of destruction and lives lost.”

Her study on survivors of the 1991 Oakland Hills fire offers some insight into what North Bay firestorm survivors are going through and how they may fare going forward. The study found that survivors of the Oakland Hills firestorm exhibited a great deal of resilience, despite their high levels of distress.

“There's an important difference between psychiatric illness and distress. They are very different phenomenons,” North said, adding that most people who live through severe disasters do not develop psychiatric illnesses.

North said those with a history of psychiatric illness before a disaster are at much higher risk for adverse mental health outcomes, while those who do not have a mental illness will see a fairly rapid decline in their level of distress. But it never completely goes away, she said.

“It may never go away because disasters are life-changing events, even among the resilient,” North said.

Betsy Waters, whose home on Wikiup Drive is among the few spared in her neighborhood, said she has been diagnosed with PTSD. After moving back into her home in March, she is constantly reminded of the destruction every time she drives to her neighborhood, located just east of the fire-scorched section of the Larkfield-Wikiup area.

Though her home did not burn down, Waters said she had to have the house completely cleaned and painted and everything inside replaced because of smoke damage. That included all the furniture and even insulation under the floors.

Waters said she and her husband are in the process of suing her insurance company, which has stopped returning her calls and emails.

“Some days I can cope with it better,” she said. “I do have triggers around the PTSD. The smoke from the recent fires was very difficult.”

She said her PTSD is improving, but she is still triggered by sirens. She recalls hearing sirens all day long on Oct. 9 while she was staying in her son's house in Montgomery Village, near Highway 12.

While mental health can be a sensitive topic to discuss, Waters said it's important that people realize the effects of the fire on those who lived through it - the PTSD, feelings of helplessness and the frequent state of hyper-awareness - are real and enduring.

“I believe, a lot of us believe, the earlier that we attend to these symptoms is going to determine how we will go forward,” she said.

Disillusionment phase

In the weeks after the October firestorm, local mental health professionals warned a “phase of disillusionment” would follow the initial phase of cohesion where communities unite after a disaster, whether natural or man-made. Locally, that period was marked by the popular slogan “Sonoma Strong.”

Local therapists say the disillusionment period is here and is only exacerbated by the early start of the Northern California fire season.

Van Leeuwen, the marriage and family therapist, said she believes local residents who suffered significant losses in last year's firestorm are more or less in the fourth stage of the familiar five stages of grief and loss, which include denial and isolation, anger, bargaining, depression and acceptance.

She said the initial denial has worn off. Guilt and regret - about not being prepared, not taking the right things, not being able to save a pet - is less pressing but still felt. Anger comes and goes, Van Leeuwen said, and now there's less bargaining - the wish to somehow “influence the universe” in some way to ease the pain of loss.

“Depression sets in when we realize that we cannot undo what has been done. The loss is real and permanent,” she said, adding that the pain “just is” and must be both felt and worked through.

Teaching people the tools to overcome their distress is key, as the local community, especially those directly affected by the fire, approaches the anniversary.

Help with long-term recovery

Van Leeuwen said some fire survivors have become frustrated over being unable to completely “get over” their symptoms.

“They say, ‘It's been nine months, I shouldn't be feeling these things now,' or, ‘What's wrong with me? Why is this still bothering me now?'?” Leeuwen said. “I'm not making these things up. I've had people say these things to me.”

She said one resource that's now available is sponsored by the Wildfire Mental Health Collaborative, an initiative spearheaded by the Healthcare Foundation of Northern Sonoma County.

The collaborative, which seeks to address the county's long-term mental health recovery needs, has launched mysonomastrong.com to help fire survivors learn more about post-disaster stress and coping methods. A mobile app version of the site is expected to be made available to the public in September, she said.

The collaborative, she said, also is sponsoring special training for local therapists and counselors in a coping method known as “skills for psychological recovery,” or SPR. The collaborative's first trainings were held on Friday and Saturday and more are expected to be scheduled, she said.

The training focuses on five core skills that can be taught to anyone going through trauma, Van Leeuwen said. These include:

developing problem-solving skills

promoting positive activities

managing reaction

promoting helpful thinking

rebuilding healthy social connections

Van Leeuwen compared it to training for a long-distance race, where the athlete's body needs a strict regimen of conditioning and strength building. To combat stress and anxiety, the mind also needs conditioning, she said.

“Let's say you know you're going to get activated by this fire in Yolo County, but you tell yourself ‘I have these skills,'?” she said, adding that in times of extreme stress, the brain is “hijacked” by the amygdala, which is linked to emotions, particularly fear.

“In a fire, the thought could be ‘Oh, my God, I'm going to lose everything again' - that's fight or flight,” she said. “That's the thing that happens when we get activated. Our brains get hijacked.”

Van Leeuwen laid out simple steps in such situations: call a relative or friend for support or go check with an authoritative information source, such as Nixle.com, to see if there's any real danger nearby.

If there is no present danger, she said, fire survivors may consider doing physical exercises to release some of the energy that has suddenly built up in the form of stress hormones cortisol and adrenaline.

Those who were not directly affected by the fire, the vast majority of the Sonoma County residents who have largely moved on, can recall the widespread empathy that followed the days after the fire.

“Remember that everybody knows someone who lost a home,” Van Leeuwen said. “If so, those of us who are better off, we need to be really caring, thinking about and reaching out to someone who is less well-off in terms of their total well-being.”

The one-year anniversary will likely bring a flood of reminders for fire survivors as community leaders, government officials and local media commemorate the event and its impact on North Bay residents.

For Wilson, that level of remembrance has been taking place every day.

“The one-year anniversary scares the hell out of me,” she said. “I don't even want to think about it. I think there's a lot of us who don't want to remember. We already remember enough.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.