New Orleans, US - Most people believe only those who have experienced war can know post-traumatic stress disorder (PTSD). But those living in the impact zone of BP's 2010 oil spill disaster in the Gulf of Mexico know differently.
John Gooding, a fisherman and resident of the coastal city of Pass Christian, Mississippi, began having health problems shortly after the disaster began. He became sicker with each passing month, and moved inland in an effort to escape continuing exposure to the chemicals after being diagnosed with toxic encephalitis.
He experiences seizures regularly, and two of his dogs even died of seizures from what he believes was chemical exposure.
"I've been married 25 years, and my wife and I've never had problems. But recently we've started having problems, mostly because of finances and my health," Gooding told Al Jazeera.
"I can no longer work because of my physical sickness from the chemicals. My wife is struggling with depression, and is going through grief counselling due to having to deal with my ongoing health issues. Our savings is gone. Our retirement is gone. This has been a living hell and continues to be a nightmare."
Gooding's story is not uncommon among countless Gulf residents living in areas affected by the BP disaster.
"People are becoming more and more hopeless and feeling helpless," Dr Arwen Podesta, a psychiatrist at Tulane University in New Orleans, told Al Jazeera back in August 2010. "They are feeling frantic and overwhelmed. There is already more PTSD and more problems with domestic violence, threats of suicide and alcohol and drugs."
BP's attempts to minimise the amount of compensation it pays to those affected is not helping to improve what now are chronic psychological, community, and personal impacts along the Gulf coast.
"BP's claims process is still completely unfair. They now want to charge you for them to reconsider your claim," Gooding added. "So we have to pay them to look at our claims if we think it is unfair. It's like everything has been designed to benefit BP."
Podesta warned of the consequences of BP breaking their initial promises to "make people whole".
"There is an acute event [the initial oil disaster], but then a long-term increase in hopelessness with every promise that is broken," said Podesta, who believes the psychological impacts from BP's disaster could persist for two to three decades.
"People are put through red tape and each time they fail to move forward, they take five steps back in their psychological welfare."
Repeated calls to BP seeking comment did not elicit formal responses.
During testimony before the House Judiciary Committee on July 21, 2010, Kenneth Feinberg - a prominent lawyer chosen by BP and President Barack Obama to run the compensation fund for victims of the spill - said the fund was not likely to pay for individual claims of mental illness and distress alleged to be caused by BP's spill.
"If you start compensating purely mental anguish without a physical injury - anxiety, stress - we'll be getting millions of claims from people watching television," Feinberg said. "You have to draw the line somewhere. I think it would be highly unlikely that we would compensate mental damage, alleged damage, without a signature physical injury as well."
To date, no compensation claims have been paid out to an individual regarding mental healthcare needs.
However, at the state level in May 2012, as part of the BP Deepwater Horizon oil spill settlement, $36m in grant money was earmarked to support behavioural and mental healthcare needs in southeastern Louisiana.
'Explosion of New Clients'
Social scientists and mental health professionals such as Podesta say psychological suffering continues to worsen two--and-a-half years after the spill. "We're seeing newly identified people," Podesta recently told Al Jazeera. "We're successfully dealing [with] some of the chronic mental illness, but are seeing an explosion of new clients."
Dr Janet Johnson, an associate professor of psychiatry at Tulane University, sees other long-term negative consequences as well. "People are on edge. People are feeling grief. I'm hearing of physical illnesses related to the oil, and people are worried about losing their home, their culture, their way of life."
Joe Yerkes, a cast-net fisherman from Destin, Florida, worked for five months on BP's clean-up operations. "Fishing was my whole life, so it was only natural for me to return to the livelihood I was so proud to be a part of," Yerkes told Al Jazeera. "Saltwater flowed through my veins and I wouldn't have traded my old life for anything in the world."
But after being exposed to BP's oil and dispersants while trying to fish, Yerkes began bleeding from his nose, ears and mouth. Like Gooding, he had to move from the Gulf to seek healthcare away from the coast, in order to protect himself from further exposure.
"I have spent the last three years trying to survive," he said of his ongoing health and economic problems. "Seven out of 10 on a pain scale is bearable and normal for me these days."
The combination of his failed health, inability to work, and economic stress has Yerkes in what he describes as "a vice grip". "I've fought depression through this and the last six months have been particularly tough due to my economic situation," he said. "It's wearing on me every day. It's there, like a big giant weight on my chest."
"What we find in our field when we study technological disasters, i.e. human made disasters, is that the impacts are chronic," Dr Anthony Ladd, a professor of sociology at Loyola University, told Al Jazeera. "They don't really end, whereas with a natural disaster people move through it once it ends."
Sociologists point towards the drawn-out period of recovery and accompanying uncertainty that make technological disasters such as the BP oil disaster much more threatening to the health and welfare of affected people and communities along the Gulf Coast.
"With natural disasters, there is this sense that they will get through it and there is a light at the end of the tunnel," Ladd explained. "But with technological disasters you don't get that. It's a very different spiral into a malaise, into anxiety, into a feeling that there is no end in sight. You don't know when the impacts are going to stop."
Ladd, whose research focuses on environmental disasters' effects on communities, highlighted the negative impact of the ongoing litigation around the disaster.
"You don't know when the BP check is going to show up in the mail, if ever. You don't know when the Feds and the state are going to do their thing toward recovery. It's a chronic unending spiral of people into often deeper and deeper levels of anxiety, and research shows that one of the major sources of anxiety is the litigation process itself.
"So on top of everything else the disaster throws at you, then you have the decade-long experience of trying to litigate your way back to your economic livelihood, or trying to get some kind of economic compensation for what you've lost, and of course that never comes."
Podesta's work as a psychiatrist has uncovered countless examples of what sociologists have predicted would happen with this disaster. "The timeframe makes this worse. PTSD is usually one incident that results in hopelessness, helplessness and fear of death. It usually peaks then comes back down. But with the continued insults to hope and welfare, instead of dropping back down, it kind of step-ladders up with each insult."
Ladd said he believes psycho-social recovery from the BP oil disaster will take decades.
"We need to stop thinking of this as a sprint and think of it as a marathon. This disaster and its impacts are going to go on for at least a decade and it could be more. It's hard to put into words the astronomical ways in which this disaster is likely to affect the Gulf Coast."
Meanwhile, Gooding's description of his life today reminds one of a war veteran trying to find a way to live with the scars.
"I'm watching everything I created over my life deteriorate," he said. "If you don't use your boat, it starts to break down. Everything I own is breaking down. I used to be someone who helped out the community, and now I'm someone who needs help from the community, and that's hard to adjust to. There's really nothing left to look forward to."