March 19th, The New York Times Deborah Sontag reports on Haiti’s mental health system after the earthquake.

The foreign psychiatrists emphasize that they have found Haitians to be impressively resilient, but the disaster has nonetheless set off reactions ranging from anxiety through psychosis. Most worrisome are cases like that of Guerda Joseph, a 41-year-old woman who tumbled into a catatonic depression shortly after she was pulled from the rubble of her home. Mute and nearly immobilized ever since, she lies on floral sheets at the General Hospital, her Bible tucked beside her pillow, her 25-year-old adopted son by her side day and night.

More common, though, is what Dr. Lynne Jones, a child psychiatrist and disaster expert with the International Medical Corps, calls “earthquake shock,” a persistent sensation that the earth is still shaking, which makes the heart race and causes chest pain.

“This is an understandable response, and it’s important to let people know, ‘You are not crazy,’ ” Dr. Jones said. “I use a kind of metaphor: ‘Your body has a very effective fire alarm. One of the reasons you’re alive today is that it went off during the earthquake. You ran out of that building. Great, you survived. Unfortunately, the fire alarm is now sensitive and goes off when you don’t want it to, or maybe it never shut off.’ ”

An earthquake offers extreme examples of how mental illness takes hold and progresses. This analogy of a fire alarm, that doesn’t shut off, is a useful way to think about anxiety and panic in our lives.