As rioters looted a CVS and other businesses at Pennsylvania and North avenues earlier this month, Lekisha McCray's two youngest children huddled in terror listening to it all from their apartment across the street.
Windows shattered and people cursed and screamed, frightening the 3- and 5-year-olds so badly that they ran to the back bedroom where they could lock the door and hide.
"They are going to come in here and get us," the oldest of the two cried.
It was the worst of the unrest that engulfed the city for two weeks after 25-year-old Freddie Gray died from a spinal cord injury suffered in police custody last month. The streets of Baltimore have calmed significanlty since then and CVS said they will rebuild.
But the emotional scars left behind will take much longer to heal. Sociologists liken the mental health effects of a riot to those of a natural disaster such as an earthquake or a hurricane, but with the added twist of being inflicted by other humans rather than happenstance.
McCray said her kids still get skittish when crowds gather on the street. "Ma, they're coming back," they'll say, hugging her leg. The sight of the boarded buildings sometimes makes McCray feel hopeless and cry. She said she lost her job as a cashier at retailer Downtown Locker Room, which burned down during the riot, and constantly worries how she will take care of her family.
"My emotions are just all over the place," she said.
Now that the Maryland National Guard Humvees have rolled away and the police have pulled down their barricades, city and health officials are bracing for the aftermath as the community left behind struggles to recover. The destruction of a neighborhood can be as traumatic as the death of a loved one, experts said.
Many of the hardest-hit neighborhoods have suffered from years of poverty, violence and neglect.
"We know that trauma is already everywhere in our communities," said Baltimore's health commissioner, Dr. Leana Wen. "Our families who are exposed to rampant violence, health disparities and signficant poverty face it every day. This latest traumatic event will only make things worse."
The two days that protest boiled over into violence just pile on to the problems and emotional stress many of its residents have grappled with for generations, health officials said.
"It's almost like a kettle they put on the fire," said Tanya Sharpe, an associate professor at the University of Maryland School of Social Work who studies how African-Americans are affected by homicide and how to help them. "You can only expect that it will boil over eventually after people have experienced trauma, after trauma after trauma."
Historically, people who endure riots suffer years later, research has found.
Max Herman, an assistant professor at New Jersey City University interviewed residents of the 1967 Newark and Detroit riots decades later and found many still dealt with emotional trauma from the experience.
Many described grief over loved ones who died and the loss of businesses they had worked hard to build. Some distrusted the police, and those who had been children at the time relived memories of tanks, gunfire, helicopters and breaking glass.
"One can readily see the scars left on the physical landscape, the empty lots, burnt out buildings, abandoned homes," Herman wrote. "But beyond the physical destruction wrought by the riots is the emotional trauma inflicted on the survivors, both personally and collectively."
In Baltimore, to help address the issues, the city health department is working with schools, churches and community organizations to help get the word out about counseling services. Residents also can call the city's 311 information line for referrals. Wen said the trauma can extend beyond the community to businesses that lost their properties.
The University of Maryland Baltimore School of Nursing has parked a wellness van at the corner of Pennsylvania and Fulton Avenues.
That's where McCray went one day last week to see if she could get counseling for a family member. She said he has become angry and withdrawn because he can't find a job or his way in life. She worried the recent events could harden him more.
Throughout the community, parents and teachers have found themselves trying to explain to their students and children the complexities of what took place.
What got less attention than the images of protesting and rioting were people on the streets crying, said Nikkia Rowe, principal of Renaissance Academy in West Baltimore. After the rioting, teachers at her school gathered the students in circles to talk about the experience. They told them to use one word to describe how they felt.
Panic, sad, anger, disappointment, the kids said one by one.
There was an unsettled feeling throughout the community, Rowe said. She wanted the kids to have an outlet to express their feelings in a productive manner.
"When you're an adolescent you have all these emotions, but you're not always connected to those emotions," Rowe said. "We try to help them process those emotions."
Kenyetta Willis of East Baltimore said her 5-year-old son was too scared to go to his grandmother's house since he needed to walk by members of the National Guard with their big guns. She took him to meet some of them, but it wasn't enough to ease his fears.
"They come into our neighborhoods with all this extra police and they don't realize how it can scare people," she said.
Janice Spells-Bell, a crossing guard who lives in Sandtown-Winchester, said she also found the National Guard intimidating. The night of the riots she flashed back to 1968 when she was a child and similar destruction occurred in the neighborhood. Segments of the community never recovered from that turmoil.
Spells-Bell has used prayer and her faith in God to try to manage. The night of the riots, she sat with her forehead on the table, arms extended and asked God not to let those looting the CVS inflict the same destruction to her home a block away. The rioters took another path, but not before disturbing Spells-Bell's peace of mind.
But everyone may not have a spiritual base or other way to cope, city and health officials worry. It may be weeks or months before people even realize they are affected, Wen and others said.
Exposure to violence can cause the build-up of stress in the body without people even realizing it. The symptoms will show up in unexpected or unnoticed ways, researchers and social workers have found. Children have trouble concentrating in school or must deal with behaviorial problems. Adults may suffer from depression and anxiety and feel a sense of hopelessness.
Counselors at Baltimore Crisis Response Inc., who have partnered with the city, are expecting to hear from people in the community later.
"Sometimes people don't connect the dots," said Edgar K. Wiggins, the group's executive director. "People will say I'm just not feeling good. I'm just not sleeping. As you start to talk to them you find out there was a traumatic experience."
If this trauma is left untreated, it can lead to problems down the road. In particular, if children are not helped, they could turn to violence themselves, become more likely to struggle to hold jobs and have a hard time becoming productive members of society.
Healing will mean addressing the deep-rooted issues in communities like Sandtown-Winchester and involving the residents as part of the rebuilding, said one expert.
"The only good that can come out of this is if people don't just focus simply on a burning car," said Diana L. Morris, the director of the Open Society Institute-Baltimore. "We need to probe deeper and ask what level of frustration and feeling of being invisible would make these young people feel their actions simply don't matter."
Elder C.W. Harris, a local pastor in Sandtown-Winchester is hopeful change will come. He applauded the community coming together against the riots and planning many peaceful protests. He and others have fought hard for years to make the community better, opening a school, community center and urban farm. He said he will continue to do his part to help the neighborhood recover.
"We will turn despair into positive action," he said.