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After two years of uncertainty, Christchurch is rife with anxiety and despair with more than 66,000 Cantabrians popping anti-depressant pills, mental health referrals at an all-time high and severe psychological disorders starting to emerge.
Like a chronic disease, the earthquakes have eaten away at the resilience of everyday Cantabrians with about one in eight using anti-depressants, according to Pegasus Health figures.
Almost 12,000 people were treated at Canterbury District Health Board (CDHB) mental health facilities from October to December 2012 and the occupancy rate of the mental health adult inpatient acute unit is about 90 per cent.
The region holds the highest anti-depressant prescription rate in the country and post-traumatic stress disorder (PTSD) is beginning to rear its head.
The CDHB handed out 209,000 prescriptions for anti-depressants last year, while the Auckland District Health Board, which covers a similar population, had only 125,000, Pharmac figures show.
Nationally, prescriptions for depression, anxiety, insomnia and pain leapt 60 per cent over the past five years - amounting to an extra 800,000 patients swallowing 3 million more bottles of prescription pills.
Associate Professor Dee Mangin, of the University of Otago Christchurch campus, said the Garden City had "always been at the high end" of national anti-depressant rates but GPs had been warned not to "overprescribe" pills in the aftermath of the quakes.
Internal Pegasus Health data analysis shows Canterbury's depression rate climbed from 9.2 per cent in 2006 to almost 12 per cent last year.
However, other parts of the country also fielded an increase, with Auckland jumping from 6.7 per cent in 2006 to 8.6 per cent in 2012.
Christchurch's Pegasus Health primary care mental health service had also been hit with heavy, ongoing demand since the quakes - leaping 15 per cent to 12,500 appointments last year.
Mangin, who also works as a GP in Phillipstown, described the quakes as a "chronic disease with enduring mental health effects" and said only now were the most severe side effects emerging.
Some of her patients had reached the end of their resilience, citing frustrations over broken homes, delays, insurance and Earthquake Commission (EQC) woes, job losses or relationship breakdowns.
In the past few weeks Mangin has diagnosed several patients with PTSD who "feel as though they are falling apart".
Many Cantabrians were initially very strong, but the "seige mentality" (where the community pulls together to survive) had worn off, she said.
"Now it is just frustration and lack of control. People are hanging in limbo and feel as though they have no control over their lives."
Everyday "high-functioning" people, who had never needed mental health support before, were now leaning on primary care services.
"We can see what it is that is causing the mental health issues and we know that if this person could get their housing issues sorted they would be transformed."
Mangin has written "so many letters I cannot remember" to EQC, the Canterbury Earthquake Recovery Authority (Cera) and insurance companies urging them to fast-track repairs, but said her pleas were largely ignored.
Pegasus Health GP mental health manager Cerina Altenburg said pre-quake referrals were sitting at 90 per week but over the past three months they had soared to 150 per week.
"Frustrated and powerless" Cantabrians who have "held on for a little too long" were leading the demand.
Toni Gutschlag, manager for CDHB Specialist Mental Health Services, said 80 fulltime community support workers were providing services to about 1100 people in the region every day.
"Our services are really busy and feedback is that some services are feeling quite stretched."
Cera's 2012 wellbeing survey showed more than 50 per cent of Cantabrians believed their quality of life had deteriorated since the quakes.
Almost 100 per cent of respondents had experienced stress that had a negative effect on their lives.
Health professionals urged struggling Cantabrians to seek help from their GPs sooner rather than later.
ANXIOUS, DEPRESSED AND NOW ANGRY
First we were scared, then we were anxious. But now, we are angry.
Pegasus Health senior clinical leader Simon Wynn Thomas reports a rise in mental health referrals at his Christchurch medical centre but also a noticeable shift in the mood of patients.
"The words patients use have gone from, ‘I am anxious' or ‘I am depressed' to ‘I am angry'," he says.
Fendalton homeowner Carmel Jaggar is "angry at the world". She hates what the earthquakes have made her become.
Her TC3 house "broke in half" in the February 2011 quake and authorities are still debating whether it is a repair or a rebuild. Meanwhile, she has to stuff rolled-up newspapers beneath her carpet to block the draughts.
Two years of fighting and delays have taken their toll.
The mother of three swears "far too much" and has found herself "filled with hatred toward people I don't even know".
"It's the people from my insurance company or EQC who answer the phone or reply to emails. I don't even know them and I hate them. My first instinct now is not to listen to what they are saying but to listen to what they are not saying."
Jaggar believes she has become distrustful and jealous but most disconcerting is that she feels she has become a worse mother.
"I am actually a sane, strong person and I hate what this disaster has caused me to become. But the bastards will not make me sit and cry in front of my children in my kitchen."
Jaggar believed that when the quakes first hit, Cantabrians were grateful to be alive and happy to put their faith in authorities but have been disappointed too often.
"You become so angry, almost like you are angry at the world. I am angry with insurance companies, angry with Cera and angry when I drive past a home having earthquake repairs. To be envious is one thing, but to be jealous is not a very nice way to feel about people you don't even know."
- © Fairfax NZ News