The physical aftershocks that followed northern California's monster quake haven't let up, and authorities say the psychological shockwaves are just beginning.
"We are getting people who are starting to call in now with some of the things we expected to have follow this earthquake," Eve Myer, executive director of the San Francisco Suicide Prevention Hotline, said Thursday."We're seeing the depression that sets in after the adrenaline dies down and when the television stories (about the quake) start to repeat themselves."
The usual load of 200 calls a day is up at least 10 percent since the quake, Myer said. The "first wave" of callers, generally elderly people who felt particularly vulnerable, is giving way to a second group that seems exceptionally confused by overpowering feelings of sadness and gloom, she said.
Many callers are reporting trouble sleeping, sensing the incredible fright caused by the temblor all over again, and they appear to be linking the earthquake to other traumatic events in their lives and intensifying their discomfort, she said.
Myer said she understands how they feel.
When she couldn't find her husband immediately after Tuesday's earthquake, she felt tension and frustration. She said she later realized she had unconsciously associated the events with her mother's unsuccessful search for her husband in Nazi Germany.
"That old story bubbled up in my head and I didn't realize I was reliving a war I had never been in . . . and that's happening to other people, too," she said. "This will happen more and more. That's a fairly natural thing."
That's one reason the city is sending special mental health teams to help some of the newly set-up homeless shelters.
"It's like the rug is pulled out from under you - the firm stance you have in the world gets shaken," said psychologist Daniel Weiss of Langley Porter Psychiatric Institute at the University of California, San Francisco.
"It forces you to confront your own mortality: that you don't live forever, that bad things happen to good people - sometimes for no reason at all," Weiss said Thursday.
Dr. Lenore Terr, a San Francisco psychiatrist, said area residents expect earthquakes, so it may not be as traumatizing as other disasters.
But for those who are severely distressed, symptoms include jumpiness, irritability, nightmares, emotional numbness and detachment, recurrent images of disaster, difficulty concentrating and sleeping, and fear of entering buildings or double-deck freeways like the one in Oakland that collapsed.
People who survived unscathed often display disbelief of surrounding destruction, followed by relief, then guilt that they lived while others died, Weiss said. For those who had relatives die or homes destroyed, "questions arise like `Why me? What did I do to deserve this?'
"There is no one to get angry at, and sometimes feelings of anger at having been victimized are put onto other innocent people."
Children are vulnerable, too.
Those younger than age 3 "may be a little bit more anxious, a little more clingy. If their parents are upset, their children will be upset," said Dr. Glen Elliott, director of child and adult psychiatry at Langley Porter.
Some help has come from computer communication systems.
Prodigy, a venture of IBM and Sears, Roebuck & Co. based in White Plains, N.Y., had a system going less than four hours after Tuesday's quake, said Brian Ek, communications manager.
It also put a psychologist on line Wednesday night "to help these people deal with the trauma. We had one person who knows some of the people involved in the Nimitz Highway situation who was pretty distraught," Ek said. By Thursday afternoon, 1,530 messages were posted.
CompuServe, the Columbus, Ohio, based computer information service, with 550,000 individual and 1,800 corporate customers worldwide, has created an "earthquake forum" where people concerned about what's happening to loved ones and friends in the wake of the quake can leave messages and information.