The warm rush of a morning shower threw Jessica MacNeil into a waking nightmare.
For months, the hiss of water would bring a debilitating fear that her house was on fire and she was trapped inside it, alone. She'd hear sirens and smell smoke — flashbacks to May 3, 2016, when thousands fled the Fort McMurray wildfire.
"I would go out of my head," she said. "My boyfriend at the time would have to come and console me … and tell me, 'Everything's fine. Nothing's burning down. There's no sirens here.'"
Nearly 88,000 people fled the fire. More than 1,900 family homes were lost.
The devastation inflicted on the municipality left a mark on residents like MacNeil, unseen scars that have followed them through the past five years.
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Psychological wounds have not easily healed. Many evacuees remain traumatized. Researchers continue to examine the lingering impact in a bid to help.
MacNeil was home alone when the evacuation in May 2016 began.
She left the next morning, snaking through deserted neighbourhoods before reaching the chaos of the highway under the menacing glow of a haze-choked sunrise.
One month later, she returned home and worked on the clean-up, helping families recover cherished belongings from the charred wreckage.
MacNeil — who still lives in Fort McMurray and now has a young family — says her PTSD symptoms linger. She struggles to fall asleep, scared of waking up to another fire. Her dreams still sometimes turn into night terrors.
People can struggle for years, even decades, after a traumatic event, says Dr. Vincent Agyapong, director of the community psychiatry department at the University of Alberta.
"This is a city that's actually experiencing four major traumatic events: a recession, wildfire, floods, as well as a pandemic," Agyapong said of Fort McMurray.
Studying city's mental health
A lingering economic downturn has been felt deeply in this oil-dependent community, while climbing cases of COVID-19 have placed the municipality under a state of emergency.
Following a challenging effort to rebuild fire-ravaged neighbourhoods, record flooding surged through the lower townsite in April 2020, destroying 1,200 structures.
A new study led by Agyapong and his team is trying to measure the impact of the fire and each subsequent disaster, assessing rates of PTSD, anxiety and depression among residents.
Based on the survey, researchers will make recommendations to Alberta Health Services (AHS) about mental health supports needed in the region.
People who take part will also be enrolled in FMMStrong, a free, daily supportive text messaging program.
"The ultimate goal is to provide support for the city," Agyapong said.
'Like the world was ending'
A previous study led by Agyapong found disproportionately high rates of PTSD among junior and senior high school students in the region.
Paul Tuccaro said his 15-year-old daughter remains haunted by the family's frantic escape.
That day in 2016, the sky turned black as Tuccaro, returning from work, realized he would not be able to reach home on the jammed highway.
His girlfriend and two children ran down the steep hill from their neighbourhood of Abasand and hitched a ride to a nearby parking lot.
Tuccaro remembers telling his children to cover their eyes as they drove off, fearful that the heat from the flames lapping at the windows would cause them to shatter. "It was like the world was ending."
Tuccaro says he has struggled to find adequate mental health support for himself and his children.
"My daughter, she is traumatized, I have no doubt," he said. "Every time she smells smoke, it just kind of triggers her."
Tuccaro's home was levelled in the fire along with much of the neighbourhood. He said it's still hard to think about all their belongings turning to ash.
'A collective trauma'
Kellie Bosch is familiar with that sense of loss. She felt paralyzing terror as the flames breached the highway, forcing her family to escape. After she returned home, depression and anxiety set in.
"My body just started to feel worse and worse and I started not wanting to leave the house," she said. "I am doing better now, but it changes who you are."
Two weeks ago, her family home burned to the ground.
She suspects the fire was sparked by a loose connection in an electrical panel. Her husband, asleep upstairs, was lucky to escape in time, Bosch said. Her two cats died.
"It just brings you right back," she said. "It's like there is no end to the feeling of what we had gone through, because even still today, you look around and you can still see the burnt trees.
"It's always a reminder of what we all went through as a city — a collective trauma."