NhuNgoc Pham was a high school student living in the New Orleans metro area when Hurricane Katrina hit the Gulf Coast on August 29, 2005. Her parents, immigrants from Vietnam, had recently purchased and been living in their new home for about a month when the huge storm made landfall.
Her family evacuated to Houston, Texas, expecting to stay there a couple of days. "Very stereotypical of someone who's lived in New Orleans for a long time, we just thought of it as another storm," recalls Pham. "It's going to come; it's going to pass."
But they ended up being in Houston for a couple of months. When they finally returned to their house in Jefferson Parish, La., they saw that the storm winds had caused significant damage to their new house. The roof and windows had to be replaced, Pham says. "The back patio was gone and that needed to be replaced," she says.
Pham remembers the toll it took on her parents' mental health. "As immigrants and purchasing their first house, they weren't sure how they would rebuild," she says. "I saw the physical signs of stress. There was a lot of insomnia, just a lot of worrying, constantly talking about what are we going to do next?"
Like many first generation immigrants in their community, her parents had limited fluency in English. They struggled to figure out how to apply for funds for rebuilding. So, Pham and other youth in the community, who were fluent in English and computer savvy, stepped up to help the older generation.
"It was a big learning curve," says Pham. "We had to grow up at that moment. We had to become adult[s] in some ways and to help our family and help people in our community rebuild."
She describes the experience as formative. "The Katrina experience made me grow as a person," she says. "Also, [it] made me rethink about how you recover from a major trauma."
That's a question that's stayed with her and shaped her professional life, driving her to pursue a career in public health research with a focus on disaster recovery. She now works on emergency preparedness for CNA, an independent research and analysis organization. She's also an adjunct professor at Tulane University, where she did her Ph.D.
Through that research, Pham learned that the kind of personal growth she experienced after Katrina was common to many who survived the storm's trauma.
It's something that other researchers who have conducted long-term studies of Katrina survivors have found, too. Researchers called the phenomenon post-traumatic growth, and it's one of the more surprising — and hopeful — findings about the psychological impacts of one of the most catastrophic natural disasters in the history of the United States.
The lessons of Katrina survivors who were able eventually to grow emotionally after the storm are important to understand as more places in the country prove vulnerable to extreme weather events related to climate change — disasters like the Los Angeles fires and the floods of Hurricane Helene, to name just two of the most recent such events.
What doesn't kill you makes you stronger
"Post-traumatic growth is something that psychologists have found where people go through very difficult situations, going through life threatening illnesses or accidents or disasters," says sociologist Mary Waters at Harvard University. "And a good way to kind of summarize it is 'what doesn't kill you makes you stronger.'"
Researchers assess post-traumatic growth with a detailed questionnaire that asks people about changes in several aspects of their inner selves and life experiences.
"One is 'I feel that I'm more open to new possibilities,'" explains Waters. "Another is relating to others – 'I relate to others better since this trauma.'"
They're also asked about personal strength — whether they feel like they have the strength to have survived a traumatic event. Other facets they're asked about are whether they have a better appreciation of life since the trauma, and whether they've experienced any spiritual or religious changes since then.
Waters and her colleagues had been studying a group of over 1,000 low-income parents, primarily African-American mothers, who were enrolled in two community colleges in the New Orleans area beginning in 2003, two years before Katrina.
After the catastrophic hurricane, they continued to follow this cohort for over a decade, asking them a range of detailed questions about their experiences during and after Katrina, their ability to recover and the impact of the storm on their sense of wellbeing.
In Pham's Ph.D. research, she used data collected by Waters and her team, as well as another set of data on the Vietnamese American community in the New Orleans area collected by her Ph.D. advisor, Mark VanLandhingham at Tulane. After analyzing data on nearly 350 individuals both from the Vietnamese and African American communities, Pham found that more than 80% of that group had a score of 60 (which she used as a cut off for moderate to high levels of post-traumatic growth) and above. "That's actually a pretty high percentage," she says.
While she's in the process of getting her findings published in peer reviewed journals, her results about post-traumatic growth among Katrina survivors are confirmed by multiple previous studies by Waters and other scientists.
In 2009, Waters and her colleagues interviewed a small subset of their study cohort — 32 women — and asked them detailed questions about post-traumatic growth. A majority — 26 — reported growth in several facets despite their traumatic experiences.
"What they would say is that 'the storm was terrible,'" says Waters. "'I would never choose to live through that disaster.' But they said, 'Given that I went through it, it was one of the more positive things that happened in my lifetime because it got me on a new trajectory and I see my children flourishing and I see myself flourishing in these new possibilities.'"
In one study, published this year, one of Waters' collaborators, psychologist Sarah Lowe at Yale University and her team found that more than 60% of survivors reported post-traumatic growth (PTG), with nearly 32% having consistently high PTG and another 30% having increasing PTG over the course of 10 years.
Post-traumatic stress and post-traumatic growth often go hand in hand
Now, this doesn't mean that the trauma of the storm, the displacement, the loss of homes and loved ones didn't leave a lasting scar on people's psyches.
As Waters and other researchers have shown in many published studies, the psychological toll of the storm was substantial.
"In the year after the disaster, when we found people, 44% of them reported symptoms of PTSD, intrusive thoughts, avoiding areas that would trigger terrible memories, panic attacks, things like that," says Waters. "When we interviewed them again four years after the storm. 32% reported PTSD. And by the third follow up, 12 years after the storm, 17% were still reporting PTSD."
Since Waters had been following her cohort since pre-Katrina, she could show that levels of depression went up after the storm. Nearly "6% had serious depression before the storm and it doubled to about 12% in the first year after the storm," says Waters. "And it basically has stayed high. It's been about 11% in our last follow up, which was 12 years after the storm."
Her research has also elucidated the factors that exacerbated the likelihood of poor mental health among survivors. "It was experiences that really were emotionally upsetting — losing a loved one or a friend who died during Hurricane Katrina, not knowing whether or not your relatives were safe, your children or your parents not having access to medication, fearing for your own life," all upped the risk of psychological distress in the years after.
"It was very traumatic for people," says David Abramson at New York University, who followed a separate group of over 1,000 survivors spread across Louisiana and Mississippi. "We found that somewhere between 40 and 50% of the people in our cohort were expressing very high levels of mental health distress, complicated grief, anxiety and depression."
Ambramson and his colleagues have also compared the mental health impacts of Katrina with the impacts of other disasters like the Deep Water Horizon oil spill and Superstorm Sandy.
"This particular storm has had a greater impact both on individuals and their families, and on communities than anything we have seen," he says. "It is far and away the largest event in terms of the losses and I think people felt those losses … Physical losses, economic losses, housing losses, but more profoundly, so many social losses, the loss of friend networks, kinship networks."
And yet, among the survivors who lived through their trauma, post-traumatic stress exists alongside post-traumatic growth.
"Here we were really seeing that those with the highest levels of post-traumatic stress tended to report post-traumatic growth," says Lowe, who published the results in 2014.
"It could be that it's the folks who are really affected by trauma who have to grow from their experiences," she says.
Resources that help with survivors grow after a trauma
Lowe and her colleagues have also looked into various factors that can support or impede the likelihood of growth after a major trauma like Katrina. For example, financial hardship was linked to low levels of post traumatic growth.
"So I think financial resources really matter both pre- and post-disaster," she says.
Another factor that she and her colleague found to be important in people's emotional trajectories post-trauma: social support.
"We had a measure of perceived social support. So feelings of closeness with others, companionship that someone's there for you if you need it, a sense of purpose or meaning in life, that one's life has meaning and direction," explains Lowe. "We found that improvements in social support from pre to post disaster was associated with post-traumatic growth."
Those who had more social support after the storm compared to before the storm were more likely to say they grew from their trauma, she says.
Pham's research, which she presented at a professional conference in 2023, also found that social support can even help lessen symptoms of post-traumatic stress. Another key she identified to growth after trauma: self-efficacy.
"Self-efficacy is your personal confidence in your ability to do something," or to overcome challenges, explains Pham. "Having self-efficacy was really a major predictor if one would experience post-traumatic growth or not."
And all these findings can inform how to help communities recover from natural disasters, say Pham and other researchers. She likens that process to the Japanese art form called kintsugi, which involves repairing broken pieces of pottery with lacquer.
"Survivors have the potential to mend the cracks that were left behind by Hurricane Katrina and the trauma that they experienced," says Pham, "if they have the right resources."
And they need those resources even before a disaster strikes their community, she adds.
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