PANAMA CITY, Fla. — Amy Cross has a hard time explaining the stress of living in a city that was splintered by Hurricane Michael. She’s fearful after hearing gunshots at night and she’s confused because she no longer recognizes the place where she has spent all of her 45 years.

“I just know I don’t feel real, and home doesn’t feel like home at all,” Cross said.

Health workers say they are seeing signs of mental problems in residents after Michael, and the issues could continue as a short-term disaster turns into a long-term recovery that will take years.

Tony Averbuch, who leads a disaster medical assistance team that is seeing 80 to 100 patients daily in tents set up in a parking lot of the badly damaged Bay Medical Sacred Heart hospital, said some people are showing signs of fraying.

It’s not hard to imagine: Just getting to the treatment site involves navigating streets with roadblocks and fallen utility lines, and the hospital building itself was ripped open by Michael’s powerful winds.

Signs of trauma aren’t a surprise for those who studied people after Hurricane Katrina in 2005. Damage in Mexico Beach was similar to that in southern Mississippi, where entire communities were flattened by wind and storm surge, and Panama City could take years to rebuild, as did parts of New Orleans after the metro area flooded.

Irwin Redlener of the National Center for Disaster Preparedness at Columbia University observed widespread, long-lasting psychological effects after Katrina. One study found that five years after the storm, parents reported that depression, anxiety or a behavior disorder had been diagnosed in more than 37 percent of children.

Redlener said that is partly because parents are overwhelmed and are less able to buffer their children from bad experiences.

“They survived a major catastrophic event, which is good. But everything they knew is gone,” he said.

Research scientist David Murphey said children look to their parents for cues as how to respond to completely new and frightening situations.

“If they see parents kind of falling apart at the seams, that’s going to create anxiety for the children as well,” he said.

Panama City Mayor Greg Brudnicki said a high school football game played Saturday was part of an effort to “create normalcy.”

“People have been stressed. They’ve had no means of communication, no utilities. It’s been hard. But we’ve worked very, very hard to create an environment that makes it as good as possible,” he said.