TORONTO (Reuters) - More than a week after a massive earthquake devastated northern Japan, psychological aftershocks are touching expatriates living thousands of miles away from the epicenter and their loved ones back home
Anyone who watched the images of the 9.0 magnitude quake and nightmarish tsunami last week could understand that living through such a disaster can have mental and emotional consequences for the survivors.
What's less apparent is the deep impact such natural disasters can have on people affected indirectly, experts say.
Although her family is safe in Tokyo, Kaori Yaeda, a student for the Teacher Training Program at Canada's National Ballet School, said she is very troubled, in part because she is so far away.
"I've been having a really hard time. Why am I continuing a normal life here without any problems while so many people are suffering in Japan? I can't do anything. I feel guilty."
Psychologists say the distress felt by expatriates in such situations is rooted in one of the most basic human response to stress.
"In life, feeling abandoned and feeling helpless are the hardest feelings," said Dr. Nicole Aube, a psychologist in Vancouver. "A lot of people over there may feel abandoned. However, people here with loved ones over there and who can't go there may feel very powerless, which is a hard feeling."
The risk of severe trauma is higher in general for those who are directly affected, said Dr. Katy Kamkar, a psychologist at the Center for Addiction and Mental Health in Toronto.
"But for people who are only witnessing all the images and hearing conversations, it still causes psychological distress. It causes even more distress if the people have a more personal connection to it."
Many Japanese expatriates who were interviewed in recent days said they did not feel the distress immediately. Instead the gravity of the news tended to seep in gradually.
"Firstly, I just didn't think it would have been that big, because an earthquake hits Japan so often," said Lisa Akita, a 39-year-old administrator for a language school, who has lived in Toronto for 12 years, when she heard the news on the radio. A sense of urgency built up steadily day after day, as more disturbing images and information came.
Back home, Ikuko Sato, an accountant, living in Tokyo, 240 miles from the earthquake's epicenter, remembered that panic wasn't her initial feeling either, even as the city's skyscrapers swayed and its streets rattled.
"We just couldn't understand what happened right after the quake, and were busy confirming our loved ones were OK. There was no time to feel panic," she said in an email. "Then, on the 6th day, this sudden uneasiness hit me and my hands started shaking."
In Toronto, Akita's anxiety grew measurably with the escalating nuclear crisis, triggered when the earthquake and tsunami compromised the cooling function of reactors in Fukushima, north of Tokyo.
Fear of a massive radiation leak that could threaten Japan's populous capital posed looming questions about future, compounding the immediate shock of the quake.
"I told my parents, who live in Ibaraki prefecture to leave the area or come to Canada, but there is no train service, major roads are closed, and there is no gasoline even if they wanted to drive," Akita said, referring to a prefecture near Fukushima.
"Immediately after the quake, we were in some sort of short-term shock. Due to the nuclear threat and planned blackouts, we are now facing a long-term worry and fear," Sato said.
Survivors usually go through three psychological phases after a traumatic event: impact, post-disaster and recovery, Kamkar said. But the healing process has so far been slow, she said
"Right now, very unfortunately, people are going through trauma day after day, such as aftershocks, concerns in regard to nuclear plants, radiations and its health consequences," the Toronto psychologist said. "It seems that people are still undergoing very upsetting events every day, so people are still in the impact phase."
One Japanese expatriate living in North Carolina sees last week's quake from a different perspective. The woman is a survivor of the 1995 Kobe earthquake, which left more than 6,400 dead.
"I feel a big impact on my mood from seeing pictures day after day, and it's been deepening my scars. The emotional damage may be bigger compared to those without a similar experience," said the woman, who asked not to be identified by name by the personal nature of her remarks.
Overcrowded phone lines, panic-buying and an insufficient understanding of the needs of victims showed that Japan still had lessons to learn on how to prepare for an emergency, she said, even though the country is so prone to earthquakes.
"It made me feel that the lesson from the previous quake wasn't learned. It hurts me more."
Aube, the Vancouver psychologist, explains that not all quake survivors will react in the same way to a new disaster.
"If you are watching this with previous traumatic experience, and if you had been healed, it would remind you of it, but it won't be painful and you won't be panicky," Aube said. "But if you weren't fully recovered or just buried the trauma, then the traumatic experience will revive that."
The March 11 quake - the most powerful in Japan's history - and the following tsunami have killed more than 8,000 people, with more than 12,000 still missing.
Children are especially vulnerable when they are exposed to such trauma, either directly or indirectly.
"Even for children with indirect exposure, it can lead to emotional distress. Media exposure to traumatic events and conversations among adults can induce traumatic images and increase the anxiety and fear," Kamkar warns.
Kyoko Hatano, in Shizuoka, about 80 miles southwest of Tokyo, wrote in an email that her 3-year old daughter has been showing signs of anxiety since a series of aftershocks and blackouts hit the area.
"Even if she just hears some rattling noise, she thinks it's a quake and gets extremely scared. She doesn't usually wet the bed, but she has done so a couple of times since the quake."
In Toronto, Shinya Kumazawa, a 40-year-old painter, is worried about the emotional impact on his 5- and 7-year olds. "We have to teach them what happened, so I showed them some pictures, but I'm trying to limit their exposure to a minimum," he said.
The psychological impact on expatriates varies considerably. While some may require counseling, for many others, doing something positive is a coping mechanism, psychologists say.
"People often feel better when they can do something to help," said Kamkar. "In turn, that decreases the feelings of helplessness and powerlessness."
A week after the quake, Yaeda organized a charity bake sale at the ballet school where she studies.
"I wanted to do something for them. I know this is just a small thing, but I thought I could do this, and it's going well. I feel much better now," she said.
Editing by Frank McGurty