The city of Houston is recovering from catastrophic flooding for the third year in a row.  Late this spring, Ellicott, Maryland, encountered devastating flooding that destroyed the entire town, after having rebuilt from a severe flood only two years ago. Nearly year-round wildfires are the norm, not the exception, in places like California, Washington, Colorado, Oklahoma and Texas. Hurricanes have begun spooling for this year — will the season be more severe than last year?

This column isn’t about the natural/physical effects of a changing climate. Nor does it address how to reduce the effects of climate change. Those discussions already receive plenty of space in national and global conversations.

Instead, the column concerns the 6-year-old in Houston who, after living through three seasons of dramatic and life-threatening floods, remains so scared of water that she doesn’t want to take a bath or go outside when it rains. It is about the long-term mental health effects of a changing climate, both for adults, certainly, but even more so for children who experience life-threatening climatic events.

A growing number of studies report the experience of living through extreme climate stress has serious mental health impacts on survivors, young and old. Some even liken the trauma inflicted by such events to the behavioral consequences of service members returning from combat and other life-threatening experiences. A study sponsored by the American Psychological Association documented depression, anxiety, grief, despair, stress and even suicide as potential effects.

The loss of home, belongings and loved ones can understandably produce behaviors like PTSD. But what if the threat of these events occurs not every hundred years, or even every 25 years, but yearly, and sometimes more than once in a season?  The hypervigilance of veterans over months and years after the trauma of conflict, or after a sexual assault, is shared by those who lived through a life-threatening flash flood or a wildfire.

Another study revealed that long-term climate extremes such as elevated temperatures and increased rainfall produce other consequences, including chronic effects, especially among children. For instance, when communities vulnerable to flooding, like Ellicott, also experience higher temperatures, other public health impacts such as mold on a large-scale can result. The impact on children’s immune system can be lifelong. Increased asthma or infectious diseases, which hit young children the hardest, likewise can occur.

Not surprisingly, climate change disproportionately affects communities of people living in poverty here in the U.S. However, in Third World countries, the damaging effects of climate change are even more severe for children and the poor, including food shortages from extreme and long-lasting droughts and flash floods, infectious diseases, mental health disorders and frequent and long-term displacement due to weather.

We are all touched by climate change, even if events are less frequent or not immediately life-threatening. Haunting images of hurricanes, tornadoes, wildfires and mudslides are never far from our eyes, our minds.  When the storms or fires come, fear is already alive in the mind of a 10-year-old, less tempered by an adult outlook and experience. But that same fear is sometimes equally alive and real for 61-year-olds.

Hiding or shutting off from climate reality can dramatically affect our ability as individuals and as part of a community to survive our local events. Building resilience can help mitigate the stress and anxiety in the moment and in the future, while also preparing for impending climate events. The APA report suggests that for all age groups, it is important to be truthful about the effects of climate events, foster optimism, adopt meaningful activities that can help promote awareness, strengthen family and community ties, and involve the entire community in developing preparedness plans.

As a child, I hated taking baths because that meant bedtime was near. Nobody should fear a bath because they survived a flood and others didn’t.

Robert Greene Sands is an anthropologist and CEO of the non-profit Pamlico Rose Institute for Sustainable Communities located in Washington.