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CHICAGO - Weeks after Hurricane Katrina slammed into the Gulf Coast, Orvilla Pupp still sees the children's faces, sweet and sad.
Recalling stories of the storm's smallest victims, the 82-year-old Schaumburg woman reaches out her arms and hugs the air, embracing images that continue to haunt her.
"It gets depressing. As an older person, what can you do?" asked Pupp, who admits she has suffered bouts of the blues. "You feel helpless. You want to do more but you can't. It makes you feel empty."
The emotional toll of Hurricane Katrina, experts say, has reached far beyond the storm's path to affect people like Pupp who have no ties to the demolished region. In the three weeks since the storm hit on Aug. 29, the grief is starting to wear on people, especially those already prone to depression and anxiety, psychiatrists say.
No one knows how many have been emotionally affected by the disaster and its aftermath. But psychologists across the nation say they have seen spikes in the number of patients who complain that the hurricane has made them feel worse. The levels, doctors say, rival those reported after the Sept. 11, 2001, terrorist attacks.
Others are experiencing intermittent sadness triggered by the disaster, although typically, such periods last only a few days, said Nancy Molitor, a clinical psychologist at Chicago's Northwestern University School of Medicine.
"I have not seen this level of agitation since 9/11," said Molitor, who said nearly all of her patients have brought up the hurricane during counseling sessions. "I have people calling who want to have a session who I haven't seen in a long time. It is certainly pushing buttons with people."
Natural disasters such as hurricanes, tornadoes and earthquakes typically don't affect the general public as profoundly as a terrorist attack, experts say. Natural calamities are foreseeable, so people are usually emotionally braced for the impact.
Not so with Katrina. Many Americans, unprepared for the catastrophic aftermath, were caught off guard, psychologists said. Their sense of security has been shaken, said Jana Martin, a clinical psychologist in Long Beach, Calif.
"It makes them feel more vulnerable, like there's nothing they can do," she said. "And not only was it something that turned out worse than they thought it was going to be, it's not over."
Rosemary Schwartzbard, a member of the American Psychological Association's Disaster Response Network, said the emotional impact is similar to what followed the terrorist attacks.
But unlike the response to Sept. 11, which fostered national pride, Schwartzbard said, the perceived bungling of the rescue effort in Louisiana and Mississippi has added another emotion to cope with: disappointment.
"With this one, it is,
How can this happen?'How could we have let those people down?'" she said. "When have we ever seen a city under water?"
Katrina's story also is unfolding more slowly than other disasters, with trickles of information that leave the public in a suspended state of sadness. It's likely to be months before the true toll of the storm is known, before the lingering issues of recovery, accountability and racism are addressed, experts say.
Adults are not the only ones susceptible. Children also are at risk to develop emotional symptoms from prolonged exposure to news coverage of the ongoing relief and reconstruction efforts.
Robin Gurwitch, an Oklahoma City-based clinical psychologist, said parents should not allow very small children to watch the coverage. They are too young to understand what is happening and can be re-traumatized by replays that they confuse with new events, she said.
Parents should discuss the disaster with older children, making sure they understand what happened and how they can help, Gurwitch said.
But they must be careful not to transfer their emotions to their offspring.
"Children are looking to see how their caregivers are handling this. If adults are very nervous, anxious and upset, children are going to pick up on that," she said.
Mental health professionals recommend that adults and children limit the amount of Katrina coverage they watch and read, particularly at bedtime.
Laura Ehrhard, a regular at the Neighborhood Inn in Hoffman Estates, Ill., says she has been following that advice for days.
On a recent evening, most of the 10 televisions that wrap around the bar were tuned to the evening news, but Ehrhard and friends weren't watching. She just can't do that any more.
"The dogs, the puppies," she said. Videos of the people are sad, "but the pets, ugh. The sadness. It is just too much."
In Mt. Prospect, Ill., Voula Popovich said she wants to stay informed about relief efforts and the plight of displaced Gulf Coast residents, but shies away when the stories get too sad.
"I change the channel. I am a sensitive person. I don't process (stories of grief) well," said Popovich, who lost her home when an earthquake struck her native Greece in 1986. The hurricane, she said, "was a flashback from the past."
Medical professionals encourage donations of time and money to help Katrina victims as a way of helping people regain their sense of empowerment.
"We need to remind people to take care of themselves and to do something, to help other people in their community, to be concerned and pro-active," said Schwartzbard.
University of Maryland journalism professor Susan Moeller warned of "compassion fatigue," a condition that sets in when people believe a tragedy is beyond their control.
Stories about crises are more digestible when people are empowered to help, said Moeller, an expert on the media's coverage of conflict and disasters.
"In the aftermath, many people opened their hearts, their wallets, some opened their homes, a lot of people did what they thought they could," she said. Three weeks later, everyone understands "the rebuilding is going to take weeks and months and years. It no longer looks like a problem the individual can solve."
Orvilla Pupp relates to that. She has donated money to several charities. All she can do now, she said, is look forward to when the situation will get better.
Though the aftermath of Hurricane Rita has added a new layer of uncertainty, there have been some improvements in the disaster zone. Mixed in with the sadness are stories of hope, volunteers and the stream of donations. Families have been reunited, parishes drained of water. The body counts are lower than expected.
When Katrina's final act unfolds, Pupp vows she'll be watching.
"You want to see if things are being accomplished," she said. "You feel a little less helpless (seeing others being helped), even if it's not you doing it."
(c) 2005, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.