Read Slate's complete coverage of the BP oil spill.
As millions of gallons of crude oil continue to creep toward our coastlines, doctors are increasingly concerned about the physical well-being of workers and residents near the spill site, as they breathe in vapor loaded with aromatic hydrocarbons and heavy metals. But there's another cause for public-health concern associated with the oil spill: how it will affect the psyches of those living nearby.
As I wrote in False Alarm: The Truth About the Epidemic of Fear, people tend to react emotionally to a disaster like this and over-personalize the risks. The slightest sweet fragrance of crude-oil vapor causes them to think they or their children will soon fall sick; people fret that they will lose their jobs or their hours will be cut as the region plummets into economic decline. These fears, even though based on rational thinking, can cause obsessive worry, leading in some people to anxiety and depression. The news media's constant attention magnifies the problem, bombarding us with breathless reports about the oil reaching new lands and the latest failed efforts at containment. Soon we can almost smell it from thousands of miles away.
The psychological impact of Louisiana's newest disaster is likely to dwarf the impact of the Exxon-Valdez spill in Alaska in 1989. A 1993 study published in the American Journal of Psychiatry examined 599 people in 13 surrounding Alaskan communities and found an incidence of generalized anxiety in 20 percent (3.6 times greater than those who weren't exposed) and PTSD in 9 percent (2.9 times greater than those who weren't exposed). A longer-term sociological study on Exxon-Valdez published in the American Fisheries Society Symposium in 1996 found an elevated stress level in the Alaskan communities affected for almost four years afterward.
Without an organized, communitywide intervention strategy to deal with the stress, it took several years for the area to recover. By many estimates, it still hasn't. Most affected were the surrounding communities that relied on commercial fishing, including Valdez and Cordova. According to research conducted by environmental sociologist J. Steven Picou and others, divorces and suicides increased, as well as depression and anxiety (20 percent of fishermen suffered from severe anxiety and 40 percent from severe depression), and litigation against Exxon for damages to the natives and fishermen continued on for years, casting a continuing shroud over the entire region. Herring fishing still hasn't returned to Cordova. The average fisherman has lost a significant percentage of his income since the spill. We can expect the same effects now with the 2010 spill, only on a much larger scale. Both the '89 spill and the current disaster affected poor areas of the country, which impedes recovery.
Unfortunately, Louisiana's support systems for the mentally ill—not to mention the affected residents—are still reeling from damage inflicted by Hurricane Katrina. In the wake of that storm, the city of New Orleans and surrounding areas saw a dramatic increase in depression, anxiety, and PTSD. "We lost the whole mental-health infrastructure in the storm," Kathleen Crapanzano, medical director for the Office of Mental Health for Louisiana, said to me two years after the storm. "It was inadequate before. Then we lost the clinics, the hospitals, the staff, and the administration." These cuts in services came just as people needed them most. A Harvard study revealed that 14 percent of the people living in the region had severe mental illness, compared with 6 percent before. An additional 20 percent had mild to moderate mental illness, compared with 10 percent of area residents prior to the hurricane. Post-traumatic stress disorder, including symptoms of detachment, nightmares, and obsessive thoughts, lasted for years afterward and affected one in five people in the area. More than 6 percent of people in the three-state region considered suicide, twice the national average.
The psychological impact of the current oil spill is likely to be comparable, especially when you take into account the larger scope of the spill, the more densely populated region, and the profound impact on the local economies that rely heavily on the tourist and fishing industries.
"The oil spill in the Gulf carries with it a very significant risk of PTSD and major depression, as well as other psychiatric disorders," says psychiatrist Dr. Keith Ablow, author of Living the Truth. "The Exxon Valdez spill was a one-time shock, and that alone caused tremendous suffering on a psychological level. I fear that this event, with its protracted course, could prove far more toxic."
There is persuasive scientific literature to support this fear. A study published in the Journal of Epidemiology and Community Health in 2007 looked at the Sea Empress oil tanker spill in Pembrokeshire, Wales, and found that the psychological impact on six coastal towns was quantifiable. In fact, the psychological effects were more profound, pervasive, and long-lasting than the physical effects—such as asthma, headaches, nausea, or skin rashes.
It is likely that people who lose their livelihood are most susceptible, for obvious reasons: Their lives have been radically destabilized, and they are facing financial pressures while trying to figure out what to do next. Perhaps the best way to inoculate yourself from psychological harm following a disaster is to get your hands dirty. A paper published in Epidemiological Reviews in 2005 examined the incidence of PTSD after natural disasters including fires, earthquakes, and hurricanes over a 40-year period and found a "substantial burden of PTSD among persons who experience a disaster." Women were more profoundly affected than men, and those with pre-existing psychiatric problems were predictably most susceptible to both short-term and long-term psychological harm. Rescue workers were not as frequently affected as victims, probably because their attention was channeled to the positive feelings of providing aid.
Of course, there are essential differences between a natural disaster and a manmade one. The fact that the current disaster was caused by man and was furthermore potentially avoidable may add to the stress. Psychiatric care and community care will be crucial in the weeks and months to come. Hospitals and clinics are sure to see a huge influx of patients, more than they can handle, so special clinics and emergency hotlines should be set up to deal with the severe mental-health crisis that is sure to occur. Psychiatrists and social workers may end up being just as important to the Gulf Coast's recovery as oceanographers and engineers.
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