Rain sounds like bullets when it hits a metal carport roof. It’s no longer the earth’s lifeblood, the broth of hydrogen, oxygen, and the minerals and microbes it absorbs along the way. It’s a weapon, designed to shred the flesh and stop the organs. In Houston, a city as well-acquainted with storms as it is with bullets, water can represent the same degree of violence as a gun.

Pastor Deb Bonario-Martin, an animal chaplain at Zelma Friends of North Houston Quaker community, notes that the ambient soundtrack of her Northline neighborhood is often punctured by gunshots on major holidays. It’s gotten hard to discern the difference between celebratory free fire and the introductory droplets of an oncoming storm.

“This new rain that we’re getting, it’s quick, the first few drops of it are very hard,” she says.

Along with her older sister Donna Viramontes, who lives next door and serves as the mission’s finance clerk, Bonario-Martin is one of an uncountable number of Houstonians for whom the rain, thunder, and lightning are not harbingers of nurturance and the promise of life. Rather, they serve as a reminder of weather-related traumas past, and anxiety for possible agony to come.

While the world watched Houston drown during Hurricane Harvey, an understudied, overlooked public mental health crisis began clawing its way into many residents’ minds. It amplified terrors already lodged in their consciousness and created new ones, leaving behind it a pained reminder of the human cost of extreme weather events that linger long after the waters recede and camera crews shut off their equipment.

August 25, 2017: Harvey Makes Landfall

In her comfortable, welcoming home full of family photos and Astros World Series memorabilia, Viramontes, along with Bonario-Martin, sips coffee and talks candidly about surviving Harvey, which began as a Category 4 hurricane when it first hit Rockport. It weakened to a tropical storm upon hurling into Houston, eventually dumping an estimated 27 trillion gallons of rain along the Texas and Louisiana Gulf Coast in the summer of 2017.

“We had our normal thing of no lights and lose all your food,” Viramontes says. “We came close to flooding because of the ditches, and we had all the neighbors go and clean them out and save our houses because the water was creeping up into them.”

The sisters’ parents lost the family home in Northline during Hurricane Ike in 2008. It has since been rebuilt, currently serving as the Zelma Friends of North Houston meeting house; Bonario-Martin lives in the front room. As Harvey’s course shifted to hit Houston like a bull’s-eye, they went through the all-too-familiar preparatory motions.

Viramontes worked for a church in the South Belt area. The Kirkwood subdivision where it was located proved to be one of the harder-hit communities as Harvey raged for four days.

“People were being rescued off of their roofs…. This ditch on Beamer Road overflowed its banks, and the neighborhood just got destroyed,” Viramontes says. “After I could finally get into work and start commuting again, it was terrible. Every day I would be driving past these houses where everything was just out of the houses and the people were flooded out and their homes were destroyed.”

Across from White Oak Bayou, the home Sara Cress and her husband, Chad Hawks, purchased five years prior to Harvey took on 33 inches of water. Much of the neighborhood had no known history of flooding, so the encroachment came as a shock to residents.

“5:30am I wake up, I see water is no longer moving down the street. I wake my husband up. We start to panic. We start to try and pick things off the ground. We just really were unprepared,” Cress says. “Water started to come in the house very quickly. It started in the back of the house because it was lower. I was in the closet trying to throw on clothes as the water was coming in. I came out of the room and noticed that there’s water starting to puddle in my husband’s office.”

Desperate, the couple rounded up their dogs and cats and took shelter in the attic, which Cress knew you’re not supposed to do. If the water rises high enough, it’s easy to get trapped inside without a tool on hand to break through to the roof. By 6am, they made the decision to evacuate after shutting off the breaker box. They stumbled down the street in two to three feet of water, the dogs hoisted over their shoulders. Their cats had to be left behind on a table, a decision she describes as “terrifying.”

“We try to stay close to the houses because it’s a little less deep, and there were still porch lights on. It was raining really hard…this is like a nightmare,” Cress recalls. “It’s really an otherworldly, traumatic experience to see the world that way. Barely light, and seeing some neighbors down the street staring out on their porches, like, ‘What the fuck is happening?’”

They took shelter on the second floor of a neighboring home—one that had previously been crushed by a tree during Ike—until a boat came by to rescue them and the dogs in the afternoon. (The kitties survived, too.)

During the height of Harvey, Paul Middendorf took part in boat rescues similar to the one that took Cress and Hawks to safety. A former field director of CrowdSource Rescue, he estimates that the majority of the rescues during the 2017 hurricane were made by civilians (precise numbers are near impossible to measure, as so many rescues went unreported). The organization, which now operates nationwide, was founded during Harvey to better connect Houstonians in need with the first responders capable of providing the required services.

“We saw a lot of awful stuff and we had to make a lot of awful decisions. There was a lot of fatality and a lot of death,” Middendorf says. “[Disaster response] is always very visceral. It’s always very brutal.”

At least 68 people are known to have died as a direct result of Harvey, and a further 30,000 were displaced. Stories like these are as common in Houston as agitated grackles and complimentary chips and salsa. But what is it that made Harvey such a notable disaster, one with an ongoing legacy of post-traumatic stress disorder (PTSD)?

When Houston Was Hell

“[Harvey] was unprecedented in the continental United States. The total rainfall over a six-county area over five days was essentially 40 percent more than had ever been recorded before,” says Space City Weather cofounder and meteorologist Eric Berger.

The website’s archives serve as a grim first-person, real-time account of the cycle of anticipation, terror, relief, and healing that comes barreling in alongside a hurricane. It’s the type of thorough documentation that historians in the far future will likely reference time and time again when they write of Harvey and Houston.

Harvey was not only catastrophic due to its immense size, but because it stalled above the aforementioned six counties, an unwelcome cyclonic houseguest hemorrhaging a never-ending assault of water.

“Essentially, what happened is the steering currents—the stuff that’s going to move weather around—just collapsed. They stopped, and you basically have this storm now that’s stuck in between a rock and a hard place and can’t move. And that’s basically what Harvey did,” says Matt Lanza, Berger’s fellow Space City Weather meteorologist. “It just kind of sat there and drifted up the Texas coast because it didn’t really have anything to move it along.”

Houston, structurally speaking, also wasn’t prepared to withstand such an assault. Harris County has always straggled on making the necessary upgrades to its flood mitigation infrastructure. One need only look at how the Harris County Flood Control District had only a $120 million budget in the decades before Harvey, a number that didn’t scale alongside population increases and subsequent development.

In Northline, Bonario-Martin and Viramontes find themselves questioning whether any upgrades will ever come, or if residents will be left on their own to deal with their neighborhood’s increasingly unsatisfactory ditch system.

“The people on the end get the worst of it where [the water] flows in. That depends on if [the ditch] is open or not, but the middle people weren’t so bad,” Bonario-Martin says. “I don’t know if we’ll ever get rid of this ditch thing.”

The conversation about extreme weather can’t happen without a conversation about infrastructure, and vice versa. Both Berger and Lanza describe talking with fellow Houstonians about how Harvey and its horrors left permanent psychic scarring. And while they had to keep on a calm, brave face for Space City Weather readers agonizing for updates, the two meteorologists are not only, as Lanza points out, “these monolithic scientists that are trying to explain weather to you.” They’re human beings just as impacted by the worst of the worst conditions as everyone else.

“It sucked, to put it bluntly…. I was getting text messages from family that lived in League City, and they were showing the water up to their house, and then the water in their house. At a certain point, it really hit and hit hard,” Lanza says. “Honestly, I broke down for five minutes and then I had to gather myself and be like, ‘OK, you still have a job to do.’”

Antediluvian Mindscapes

Viramontes was always scared of thunder, lightning, and rain. As the oldest child in a frequently moving family where Dad routinely entered and exited their lives, she often saw childcare duties fall to her during the summertime.

“I was trying to shepherd younger siblings home from school and trying not to be afraid for them, yet I was scared to death. I would go in the house, and I would make them come in, of course,” she says. “But just the sound of the thunder and the lightning would start this feeling within me. I was afraid.”

Goosebumps break out on her skin and she shivers when she discusses her life spent hunkering down for storm after storm after storm. The sisters are both in their 60s now. As Houston natives, they’ve withstood a veritable battalion of tropical storms, hurricanes, and other disasters, such as 2024’s derecho. For them, Hurricane Harvey was not a traumatic event that blew in, wreaked kaiju-esque havoc on physical and mental planes alike, leaving them to pick up the pieces for an inspiring story of resilience culminating in a happy ending. It represents just one more catastrophic event compounding their pain. Harvey carried into 2021’s Winter Storm Uri carried into the derecho carried into Hurricane Beryl, also in 2024. And before all of that, Alicia and Allison and Ike.

Their father was himself afraid of storms. They all grew up hearing stories of the 1900 hurricane in Galveston, where their family originally settled after immigrating from Sicily before moving inland to Dickinson and, finally, Houston. An estimated 8,000 people died and 3,500 buildings were obliterated. Viramontes admits that she internalized the inherent terror of the tales more than her self-described “bohemian” and “complete and utter flower child” younger sister. Generational trauma from storms they never witnessed firsthand weaves into their own reactions and approaches toward facing hurricanes.

Growing up food insecure, then having to throw out perishables that spoil when the electricity fizzles out for days on end, amplifies these traumatic experiences when one knows all too well the sting of going to bed hungry. Viramontes’s daughter was supposed to get married while Ike raged down. All that food, ruined due to lack of refrigeration and ability to cook on the available electric stove.

During Beryl, Viramontes slipped and injured her hip in the darkness, courtesy of widespread power outages worsened by CenterPoint Energy’s unpreparedness. The agony of a hurricane never begins and ends with only the flooding. It doesn’t dissipate when the rainbows shine and the housing renovations end. It always intersects and overlaps with other hardships, exacerbating the challenges and preventing Houstonians from moving forward.

Pitter-Patter Begins to Shatter

While the sound of rain so often comes up when talking about hurricane-related trauma, the complexity and breadth and deeply personal components of the experience can’t be summarized with only one neat and tidy anecdote about a shared trigger. Nevertheless, it’s a commonality many who survived Harvey contend with.

“I was driving on my way to work a couple of months after Harvey, and it started to rain, and I just had to stop my car and turn around and go back to the apartment that we were living in then. I just couldn’t handle it,” Cress says. “I would describe the feeling of rain on my skin as terror. Now it’s dulled over time. But there are certainly times when it feels ominous, threatening.”

She can now enjoy rain again, in small doses, when it’s only a gentle trickling. But there’s still an anticipatory dread that the cycle of weather trauma, as described by Viramontes, will continue its churn.

“We bought the house in 2012 being like, ‘There’s never going to be another Allison,’” Cress says, referring to the 2001 tropical storm. “It happened in Harvey. Is it going to be every 10 years? Going to be every 20 years? So the closer we get to a 10-year mark, I’m like, ‘It’s got to be happening one of these years.’”

Cress’s post-Harvey trauma manifests in her hypervigilant hurricane preparedness habits. She checks and rechecks radars. She watches the White Oak Bayou flood level obsessively, along with multiple alerts. Even though she and her husband have a solid emergency plan, Cress still fears what’s possible.

“When [the water] starts to get to that upper part of the bank, and we can see that, I start to get kind of paralyzed. I know we have our plans, but they’re really hard to make happen when you are panicked,” she says.

Middendorf began receiving treatment for the emerging symptoms of PTSD in October 2017, at the Montrose Center. The group sessions he attended were full at first, but the numbers shrank over time due to “a lot of stigmas and a lot of vulnerability,” he says. He knows he’s lucky to have access to therapy, but as a first responder who deploys to extreme weather events even outside of Houston, he consistently must relive the worst days of both his life and the lives of the people he saves. They happen in other parts of Texas, then Louisiana, then Los Angeles, then North Carolina.

As with Berger and Lanza, Middendorf’s work requires a clear head and steady demeanor despite the apocalypses in miniature that surround him. But that doesn’t mean he can’t feel every moment. He can. Intensely so. And under the strain of missing-person searches, boat rescues, and a “brain just sort of malfunctioning, [like] someone’s dumping a cup of water on a circuit board,” he began abusing alcohol.

“I just struggled so hard, and I kept absorbing, absorbing, absorbing, until I came to a crashing point,” Middendorf says. “In the States, there’s a real stigma, as I stated, with mental health. There’s a real problem with accessibility to resources and tools that people need for mental health.... We have a really poor insurance system, and our medical support is just awful.”

At one point, the services he needed for his specific PTSD experiences would’ve cost $25,000 and weren’t covered by insurance. Some of them required weeks off work, an ask that’s near impossible for most Americans. Eventually, Middendorf headed to Mexico to seek treatment. He notes that he’s lost many friends in the first responder sector to suicide, because they can’t divest their minds from “things that we weren’t meant to see or experience.”

The Shapes of Healing

Viramontes, Cress, and Middendorf all continue to receive therapy for their weather-related PTSD, eight years on from Harvey. It’s accepted among psychological professionals that trauma has a permanent physiological effect on the brain, essentially restructuring the organ’s nerves to create new and different pathways to account for unexpected inputs. The “paralysis” Cress mentions, for example, is the result of the prefrontal cortex losing functionality and placing itself in, essentially, freeze mode. It’s the human body’s own blue screen of death, a third option when fight or flight won’t register as the correct responses.

After Harvey, Texas Children’s Hospital and UTHealth Houston were among the local health care organizations that offered resilience and recovery resources to help victims process their pain. Dr. Ronald Acierno, executive director of UTHealth Trauma and Resilience Center, notes that “the acute trauma we call PTSD” is not the only mental health condition that a person can suffer from after a natural disaster. Some people who experience trauma may sink into a state of depression rather than meeting all the diagnostic criteria for PTSD.

He also points out how one’s experiences with weather-related trauma increase or decrease their likelihood of having a negative reaction to rain, thunder, and lightning.

“For the people directly affected, meaning they were present for hurricane-force winds, probably more than half have that visceral response to storm cues. For the people who evacuated and came back to nothing or lost someone, almost nobody will have the visceral response to storm cues,” Acierno says.

While the UTHealth Trauma and Resilience Center, which opened in 2018, addresses trauma on a broader scale than just extreme weather, Acierno still treated hundreds of patients whose mental health was harmed during Harvey.

Texas Children’s Hospital launched its own Trauma and Grief Center in 2017, two weeks before Harvey made landfall, and subsequently established the Harvey Resiliency and Recovery Program to address the lingering aftereffects of the hurricane. The diagnostic criteria for PTSD for adults and children over the age of 7 are similar, so the kids treated by Dr. Ana Ugueto, a child and adolescent psychologist at TCH and current clinical director of the Traumatic Stress and Resilience Program, experience many of the same triggers and trepidations as Cress, Middendorf, and Viramontes.

“Every year, we prepare for more storms starting around June 1, or maybe a little bit earlier,” she says. “And so kids who’ve experienced traumatic stress from a hurricane that’s seasonal, well, when everyone starts talking about buying more water or getting a kit together in case your electricity goes out, that may bring back more memories of what happened for those children, too.”

Dr. Julie Kaplow, who founded the Harvey Resiliency and Recovery Program, says that along with treating traumatized children, the hospital also provided training to local schools and organizations to help adults better address the weather-related mental health needs of kids in their communities. She continues her work with traumatized youth at Meadows Mental Health Policy Institute, serving as the executive vice president of trauma and grief programs and policy, and additionally in her role as executive director of the Trauma and Grief Center at the Hackett Center for Mental Health.

Exact figures for the number of children and adults who received psychological or psychiatric services as a direct result of Harvey are not available. Kaplow shares that approximately 700 mental health care professionals at Hackett’s TGC assisted around 950 youths following the hurricane. There has not been much research to investigate exactly how widespread an impact Harvey held over Houston’s mental health. When it comes to studying children especially, too many roadblocks exist to gauge the true extent.

“I think in the aftermath of a tragedy like Hurricane Harvey, most of the focus is really centered on getting kids the intervention and help that they need, as opposed to conducting a large-scale, rigorous study,” she says. “Obviously, if it’s a research study, you need institutional review board approval. You need consent from caregivers.... And in that more immediate aftermath, it’s really hard to do that. Usually the focus is just on getting basic needs met, and then clinical intervention.”

Houston Talks Back

The Houston Climate Movement is hoping to provide a glimpse into Harvey’s toll beyond the dollar signs and the inches of rainfall—even beyond Harvey itself.

Following Beryl, Jaime Lawson, community outreach chair at HCM, partnered with Texas Southern University political science and public administration professor Dr. Oluponmile Olonilua; clinical assistant engineering professor Dr. John Aliu with the University of Georgia; Daniella Flanagan, executive director of the Fifth Ward–based New Liberty Road Community Development Corporation; and Community Care Cooperative and Sankofa Research Institute, both in Third Ward. This team is working on compiling information regarding the cumulative mental health effects of weather disasters on Black and Latin American communities, which are also disproportionately harmed by climate change. This study, which is still ongoing, focuses on Houston’s Third and Fifth Wards.

“The hope is to work with the community in the way they want, find some possible solutions, come up with a plan, and then seek funding for those projects,” Lawson says.

So far, 118 anonymous respondents between the two wards have replied to surveys, and a further 34 took part in focus group sessions. Lawson notes that “regardless of whether they were impacted by Beryl or not, they were stressed, scared, and overwhelmed.” Many of the participants are old enough to have experienced Alicia in 1983, like Bonario-Martin and Viramontes. Also much like the sisters, they credit having a strong community around them with the ability to better navigate all the subsequent mental health challenges that accompany experiencing and rebuilding after a hurricane, if not multiple hurricanes.

“There’s still some houses in disrepair from Harvey. It’s cumulative,” Lawson says. “Some of us, when it rains, we’re glad because our garden’s watered. I’m one of those. Other people, it’s terrifying.”

Though they’re not running studies, Berger and Lanza at Space City Weather also reported Houstonians coming to them with their own tales of feeling dread once the rain starts up. Such feedback inspired them to partner with the neuropsychology department at University of Houston to rewrite the website’s flood scale, using more scientifically inclined wording.

“Certainly the people that were here will always remember it, and I think they’re not going to let other people forget it,” Lanza says.

Sunlight Through the Clouds

Cohesive communities, while not a cure-all, still serve as a bulwark against fully succumbing to despair. Viramontes is Catholic but works closely with Bonario-Martin’s Quaker mission to ensure their neighborhood is well prepared to stand together no matter what comes. They both devote time to connecting people on a grassroots level to address one another’s physical and mental needs before, during, and after disasters. In a low-income area like theirs, forgotten by infrastructure improvements and resource providers, they’ve come to realize that all they have is each other. And they’re organizing well before the forecast starts showing low-pressure systems in the Gulf of Mexico.

“Mutual aid, to mobilize and survive. Material support, to survive existing systems. Shared analysis of root causes to blame for crisis, not people in crisis,” Bonario-Martin says. “We’re looking at CenterPoint…. For the first time, [in the summer of 2024] people were starting to wake up and get mad. This was seen as some kind of radical thing 10 years ago.”

Hurricane trauma also helps undergird Cress’s own climate justice work. As a child, she grew up among the chemical explosions and safety problems in Deer Park and Pasadena. Before Harvey, she was more familiar with watching black smoke from the windows of her school bus than rising waters.

But these two seemingly disparate, yet equally dark, realities coalesce under an overarching issue: climate change. As such, she dedicates much of her time to working with environmental causes, including One Breath Partnership, to help promote a healthier planet. Her ultimate advice for fellow Houstonians beset by
hurricanes has more to do with self-care than activism, however.

“Stay in therapy,” she says. “Everyone in Houston should be in therapy.” 

If you or someone you know is in crisis, call or text the 988 Suicide & Crisis Lifeline at 988.

Editor’s note: This story has been updated with the correct job titles for Dr. Julie Kaplow.