After weeks of tremors rattling the Cycladic island of Santorini, seismic activity appears to be easing, experts report. Thousands of residents who had temporarily left are now returning, and daily life is gradually resuming.
With Easter approaching and the summer tourist season on the horizon, businesses in the tourism sector are gearing up to welcome visitors, while schools have reopened, allowing students to return to their classrooms. These developments suggest a return to normalcy—but has the island truly moved past the recent wave of earthquakes?
Psychiatry Professor Antonios Dakanalis, an internationally prominent figure in the field of mental health, spoke to TO BHMA International Edition suggesting that the impacts of such phenomena can be multifaceted and prolonged.
FILE PHOTO: People board a ferry to Piraeus, during an increased seismic activity on the island of Santorini, Greece, February 4, 2025. REUTERS/Alkis Konstantinidis/File Photo
How does ongoing seismic activity affect the mental health of people living in high-risk areas?
There are fundamental principles in psychiatry that help us understand how various situations impact individuals, whether it is prolonged seismic activity in Santorini or any other major stressor. One key principle, well-documented by research, is that any significant change in daily life requires individuals to mobilize their physical, mental, and emotional resources. When these changes lead to tension, frustration, anger, or distress, they trigger what we call “stress.”
When stressors accumulate over a short period, individuals become more vulnerable to physical illnesses, mental disorders, and even injuries from accidents. Certain parts of the body are more susceptible to stress-related illnesses, though the precise mechanisms linking cause and effect are not always clear. Stress-related illnesses include digestive disorders, lung diseases, heart conditions, oral conditions (mouth ulcers), skin and hair problems (alopecia) and reproductive health problems.
The brain is also affected, leading to mental health disorders such as anxiety, depression, nervous tics, and phobias. Stress can even exacerbate Parkinson’s disease tremors.
The greater and more severe the changes in daily life and the less capable people feel of managing them, the more stress they experience and the higher the risk of developing one or more of these conditions.
Studies indicate that between one-third and half of natural disaster victims may develop depression, anxiety, or post-traumatic stress disorder (PTSD).
PTSD manifests through nightmares, flashbacks, and prolonged distress. Other symptoms include memory loss, changes in appetite and weight, fear of death, panic disorders, phobias, prolonged grief, sleep disturbances, outbursts of anger, and irritability. Nearly 10% of the population may require significant and ongoing clinical care. While many victims recover within months, others continue to experience symptoms for years.
Red Cross rescuers with rescue dogs map the area, as the increased seismic activity continues on the island of Santorini, Greece, February 8, 2025. REUTERS/Stelios Misinas
What are the most common psychological disorders associated with long-term exposure to seismic threats?
Santorini presents a unique situation. While no disaster has yet occurred, ongoing and prolonged seismic activity keeps residents in a constant state of anticipation and anxiety. This persistent stress is particularly harmful. When a disaster strikes, people eventually come to terms with it and rebuild their lives. However, continuous uncertainty and the need to remain constantly alert lead to physical and emotional exhaustion.
Having a sense of control reduces stress, but earthquakes are inherently unpredictable. The human brain under prolonged stress functions like a car with its hazard lights permanently on—eventually, the battery drains. Similarly, human resilience collapses, leading to chronic stress, depression, anxiety disorders, panic attacks, phobias, sleep disturbances, and other psychosomatic illnesses.
How does the unpredictable nature of earthquakes contribute to chronic stress and anxiety among affected populations?
Unpredictable, intense, significant, inevitable, and unfamiliar events create stress, a sense of powerlessness, fear, and uncertainty—especially in regions with a history of seismic activity, where residents live under the constant threat of another quake. Unfortunately, earthquakes fit this description, contributing to chronic stress and severe psychological consequences.
What coping mechanisms or resilience strategies help individuals manage the psychological burden of ongoing seismic activity?
Acknowledging stress and sharing thoughts and emotions with loved ones or mental health professionals is essential. During such difficult periods, people should avoid additional major changes or decisions whenever possible. Proper nutrition, physical exercise, relaxation techniques, and social connections are always beneficial.
(Santorini Animal Welfare Association – SAWA), Πέμπτη 6 Φεβρουαρίου 2025. Οι συνεχείς σεισμοί ανάγκασαν πολλούς κατοίκους (πανω από 10.000) να αναχωρήσουν από το νησί, αλλά οι εθελοντές μέλη της SAWA συνεχίζουν να φροντίζουν τα ζώα του καταφυγίου αλλά και τα αδέσποτα του νησιού. Στο καταφύγιο φιλοξενούνται δεκάδες ζώα (σκυλιά, γάτες, ιπποειδή, κατσίκες και άλλα) που εντοπίστηκαν παρατημένα ή κακοποιημένα.
(ΚΩΣΤΑΣ ΤΖΟΥΜΑΣ/EUROKINISSI)
Maintaining a routine helps both children and adults feel a sense of control and purpose. Keeping the mind occupied with other activities is also beneficial.
Support groups, whether formal or informal (such as neighbors in affected areas), provide emotional and practical assistance.
Taking practical protective measures—securing heavy objects, gathering essential documents, food, water, and medicine, and preparing for emergency procedures—also contributes to psychological stability. Families should keep open communication with their children, explain the situation in an age-appropriate manner, and practice emergency drills. Encouraging children to express themselves through drawings can be an effective emotional outlet.
Avoiding excessive exposure to news and social media is crucial, as constant updates can exacerbate stress. Children, in particular, mirror their parents’ emotions, so caregivers must manage their own anxiety to support their children effectively.
How do children and the elderly differ in their psychological responses to frequent earthquakes?
While resilience is partly innate, it is also shaped by upbringing, experience, and practice. As people mature, they generally become better at handling distressing situations and unexpected events.
Children express their reactions more outwardly (fear, crying, etc.), while older adults tend to internalize their anxiety and focus on practical concerns.
For some elderly individuals, past earthquake experiences heighten fear and anxiety, while for others, they serve as a source of adaptation and resilience. Personal resilience, social support, and overall health condition play a key role.
Yiannis Renieris, 92, and his wife Fotini Renieri sit in their house in the village of Imerovigli, as the increased seismic activity continues on the island of Santorini, Greece, February 8, 2025. REUTERS/Stelios Misinas
Children’s psychological responses depend largely on their parents’ attitudes, especially their mother’s. If caregivers panic, children may feel even more insecure. Providing a stable environment and emotional support is crucial for both children and older adults in managing fear and stress.
What role does community support and social cohesion play in mitigating the psychological impact of recurrent seismic activity?
Community support and social cohesion are crucial in reducing the psychological effects of ongoing seismic activity, providing a network of solidarity, security, and resilience.
Research shows that the severity of personal loss, the time required for recovery, and perceived inadequacies in assistance all contribute to psychological distress. Receiving clear and actionable guidance from authorities, witnessing community-level preparedness, and maintaining daily routines as much as possible help individuals regain a sense of control and feel less isolated.
The presence of a team of psychologists is essential in challenging times. Often, the act of listening can be more valuable than offering advice, as true listening is not merely about hearing words but about understanding their deeper meaning and the emotions behind them.
Feelings must be expressed, accepted, and never discouraged. People need reassurance that emotions such as anger, sadness, guilt, and fear are entirely natural responses to an unnatural crisis. A comforting hand on the shoulder may sometimes be more powerful than a thousand words.
The Church also has a significant role to play, as many people instinctively turn to faith for spiritual solace and support. For those with religious beliefs, the strength of a shared perspective, a common purpose, and the sense of belonging to a community of like-minded individuals can provide them with the resilience needed to overcome adversity and despair.
Local Vangelis Pilitsis, owner of a horseback riding business owner, holds a hose as Greek-flagged research and survey vessel “Aethra” and the islet of Anydros, the epicentre of the recent seismic activity, are seen in the background, on the island of Santorini, Greece, February 19, 2025. REUTERS/Nicolas Economou
How Can Governments and Organizations Implement Preventive Mental Health Strategies for Populations in Earthquake-Prone Areas?
Governments worldwide often focus their disaster preparedness efforts on practical measures—an essential aspect, no doubt, but experience has shown that it is not enough. Psychological support is crucial before, during, and after an earthquake—not just for direct victims but also for so-called “secondary victims,” such as relatives and friends, who may not have been physically affected but still experience emotional distress due to their empathy and shared suffering.
Disaster response planning must take into account that psychological symptoms often do not appear immediately but may surface weeks after the event. Moreover, support is also essential for rescue teams, medical personnel, and mental health professionals working in affected areas, as they are at high risk of experiencing compassion fatigue or even burnout.
Governments and organizations must collaborate with mental health professionals, scientists, and local community members to develop and implement mental health strategies tailored to the specific needs and circumstances of each population.
