Deerfield Beach, Florida — As a specialist in acute stress and trauma issues with experience leading support groups for family members with direct loss from the September 11th, 2001 attacks on the World Trade Center who had the unique distinction of losing my own Long Beach, N.J., home of 18 years, it was my privilege over the next four years to run two long-term support groups on the island for Sandy survivors: one, in the Long Beach City Hall courtroom; the second, at St. James of Jerusalem Episcopal Church.

Several of those who participated in the post-Sandy support group have asked me to write to express our support and concern for everyone, including pets, who are coping with the acute stress of surviving a major catastrophe. We know what it’s like to lose everything and we also know that you have a long road ahead. Our thoughts and prayers are with you.

As you are now forced to make survival decisions while still in shock, we hope that the Top Ten Things Hurricane Sandy Taught Us will be helpful as you prepare for the next phase of survival.

10. Get all dollar estimates in writing.

Yes, there are angels who will come to your aid but the vultures are about to descend. Demolition companies from out-of-state will quote you a price for stage one demolition but they will not write that number on the paperwork, telling you that your insurance company will pay them directly. Not so. To protect yourself, get all dollar estimates in writing! If the demolition company tells you that is not their policy, find a local company and get it in writing or you will get a bill for double or triple the price quoted. If you attempt to negotiate for a lower price, some companies will threaten to put a lien on your home. Seriously: Get all dollar estimates in writing. If possible, get the name of a local lawyer who can assist you when needed. These companies are not your friend.

9. Reach out.

Don’t isolate. The tendency to isolate post-disaster can be dangerous. People who stuff down their feelings and don’t talk about what they are going through are more likely to develop alcoholism, substance abuse and suicidal thoughts. Don’t let yourself slide down that chute. Keep telling your story. Ask a friend or family member for a few minutes of their time and keep talking. (If you would like to speak to someone from the Hurricane Sandy community, please contact me at [email protected]. We are here for you.)

8. Keep records.

At some point, FEMA and the insurance company will need to see receipts for every item and service you have paid for since #Harvey. Ask someone for a ziplock bag to store paper receipts. Take lots of pictures of the damage. Get a notebook or start a document file on your phone and write your story and the names and phone numbers of everyone to whom you speak for the first year after the storm. It’s going to get complicated and you will be grateful for your phone log.

7. Know the signs of acute stress.

No, you are not going crazy. You are a normal person having normal reactions to an abnormal situation. Expect changes in sleep patterns, appetite and breathing. There may be dizziness, headaches, muscle tension, digestive issues and rapid heartbeat. Internal emotional responses may range from a “deer in the headlights” paralysis to numbness, shock, fear, depression and guilt. You may feel sorrowful, lonely, vulnerable, frustrated or angry. Or all of the above.

Behaviors — how feelings get expressed — can range from crying, outbursts of anger, irritability, substance abuse, loss of self-worth, a sense of hopelessness, and withdrawal from others. These patterns are usually short-lived and resolve naturally. The American Red Cross has excellent disaster mental health services and there will be post-disaster counseling available. If you are having trouble coping after a few months, please seek out professional help.

6. Practice Emotional First Aid.

When you get overwhelmed, breathe in a calming color and feel it traveling to any part of your body that is holding tension. After a few breaths, release that tension by exhaling a different color. Inhale a calm color. Exhale tension and pain as a different color. This technique is Safe, Effective and Quick (SEQ). It works in less than a minute.

5. Stay hydrated.

Avoid alcohol and caffeine. Drink lots of water. Nap whenever you can. Eat regular meals. Alternate exercise and relaxation. Avoid a lot of sugar and appreciate being able to choose what you eat. Disaster takes away your sense of control. A simple step like choosing meals helps reaffirm that although you were helpless to prevent this tragedy, you still have control over your food choices. It may sound simplistic but it works.

4. Focus on one positive moment a day.

Keep a “News and Goods” log where you jot down one nice thing that happens every day: someone smiled or charged your cell phone or offered you some peanut M&M’s, for example. It doesn’t need to be complicated. The important thing is to notice it and keep a record for yourself. It will help you in the months to come when the financial trauma hits.

3. The help cycle lasts two months.

For the first eight to ten weeks, people will come from all over the country to offer help and support. People want to be generous in the wake of a disaster. It’s inspiring and comforting. But they tend to go after a couple of months, leaving you to struggle with the day-to-day mechanics of survival. You will learn who your real friends are and it will surprise you. People whom you did not know well will come through for you while others whom you thought you could count on will step away, leaving you disappointed.

Disaster shakes up the social foundation of your life and at some point, it will be hard for you to spend time with people who don’t get it. Find people who are in the same boat or who have gone through something similar. Keep sharing information, resources and experiences. Giving of yourself when you think you have lost it all is the best way to nurture and replenish yourself.

2. Get ready for the long haul.

Nobody likes to hear this but healing from a catastrophe usually takes from three to five years. The first year is all about shock and survival. Take good care of yourself and your family. Don’t lose faith. Don’t give up. It will get get better but it’s going to take time. You will need five gifts: humility, patience, empathy, forgiveness and growth.

1. Your life will be changed forever.

As you move into the long, complicated and frustrating process of seeking funds to rebuild, you will wonder what happened to your old way of life. You will grieve it and miss it. That’s normal, too.

There’s good news and bad news. Bad news first: It’s not coming back. That knowledge will hit you again and again. Good news: You will discover that you are stronger than you realize; you will learn who your real friends are; and, in time, you will move forward into your new life with appreciation for all you have learned, all who have helped you, and for others who are hurting when disaster strikes.

Laurie Nadel, Ph.D. is the author of The Five Gifts: Discovering Healing, Hope and Strength When Disaster Strikes (Coming April 2018) Foreword by Dan Rather (Health Communications Inc.)