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As thousands work to pick up the pieces following Hurricane Florence in the Carolinas, and natural gas explosions and fires in Massachusetts, experts say the effects on victim's mental health may be just beginning.

On September 13th, dozens of homes caught fire or exploded across three towns in Massachusetts, killing one person and injuring nearly 20 more. Thousands of residents evacuated as natural gas seeped into homes in Lawrence, Andover, and North Andover, not knowing if their's would be the next to catch fire.

Ana Camareno was a first responder at Ground Zero after 9-11. Her Lawrence home survived the fires and explosions, but she says her training quickly kicked into action. "As soon as the lights went off we situated ourselves, did two tours. My husband did eight to three o'clock in the morning and I did three to seven in the morning. We went with the flashlight checking that nobody got in the houses. All these people walking around, loitering, taking tv's from the houses that were affected. They were abusing the situation that we had."

Now, she's one of thousands thankful to still have a home, but left without gas as the utility works to figure out what went wrong, and replace 48 miles of pipe to turn it back on. "We don't have hot water, we have little kids. We don't have the gas, we have to improvise", Camareno said.

Further South, thousands are returning to their homes after Hurricane Florence drenched the Carolinas and Virginia. Hundreds had to be rescued from floodwaters as highways were shut down, and some towns cut off by the rising water. More than 40 people died in North Carolina, South Carolina, and Virginia. Many returning home are finding trees on roofs, windows shattered, and houses full of debris left behind by the filthy floodwater.

Dr. Frank Ochberg says victims in both areas are dealing with trauma, but in different ways. The explosions are "sudden, loud, and scary", while the flooding is "gradual, insidious, and leaves a stench". Both have profound physical and psychological effects on the victims, and Dr. Ochberg says "on top of the trauma there's the tedium and uncertainty, financial uncertainty, all the extra burdens." Those cleaning up homes, rugs, and furniture from flooding are "exposed, if not to toxins, to something that's almost similar to rotting flesh. Only it's rotting furniture, and these are personal possessions. And, we do have extensions of ourselves in our homes and our belongings", he adds.

Dr. Ochberg is the founder of the International Society for Traumatic Stress Studies and former associate director of the National Institute of Mental Health. He edited the first treatment text of Post Traumatic Stress Disorder, which he now advocates to be referred to as Post Traumatic Stress Injury. He says the most important thing victims can do as they recover from these disasters is focus on the fact that they're alive, and try to prevent the traumatic consequences. How victims are supported plays a big role in how they will recover. "If people are compassionate with one another that's a powerful force", notes Dr. Ochberg.

Dr. Ochberg says victims should look out for a number of symptoms pointing toward Post Traumatic Stress Injury in the months following the disasters.

First, a different pattern of memory. Instead of remembering things as they happened and when they want to recall them, memories of the traumatic event can come flooding in at seemingly random times. It can be unwanted, and very frightening, Dr. Ochberg says. And, in the worst scenarios, victims think the trauma is happening again, and they can't stop it.

Second, victims may start curtailing their normal life to avoid being triggered to think of the trauma. Dr. Ochberg says it can give the victim negative thoughts. They may start thinking they're no good, people are no good, and have difficulty accessing loving feelings.

Third, the victim may become very nervous, and hyper vigilant. They may not sleep well, and behave as if they're in a life-threatening situation, even if they are not.

Dr. Ochberg says these symptoms are not rare, in fact, 10 percent of women and five percent of men experience post traumatic stress in their lifetime.

Right now, he says the best thing for victims to do is to note their symptoms, and try to make it through the first month following the disaster. He says sometimes the symptoms can subside, and it's normal to not sleep well immediately following a trauma like this.

But, he says, "it's a good thing to get information and make sure you're talking to people in your own life you're happy with. It helps to be with the kind of person you can trust and like and in general makes you feel good." He says it's especially important to pay attention to your sense of humor, exercise, and if you're a spiritual person, connect with your congregation.

If your symptoms last for more than a month, if you're having suicidal thoughts, drinking to cope or engaging in other self-destructive behavior, Dr. Ochberg recommends seeking professional help. Community members who don't have issues can help by being respectful and knowledgeable about those who do have it. Dr. Ochberg says many times victims worry that people will look down on them for suffering from post traumatic stress, or for seeking help for their symptoms. Among other resources, he recommends The Gift from Within, a non-profit focusing on PTSD, for both victims and community members, saying "the more we do to make this syndrome understood and respected, the better."