The relentless spill is bringing back feelings that are far too familiar to Robin and others still dealing with the physical and emotional toll wrought by Katrina five years ago.

 

"I can't sleep at night. I find myself crying sometimes," said Robin, of Violet, a blue-collar community on the southeastern edge of the New Orleans suburbs, along the highway that hugs the levee on the Mississippi River's east bank nearly all the way to the Gulf.

 

Psychiatrists who treated people after Katrina and have held group sessions in oil spill-stricken areas say the symptoms showing up are much the same: Anger. Anxiety. Drinking. Depression. Suicidal thoughts.

 

"Everybody's acting strange," said Robin, 56. "Real angry, frustrated, stressed out, fighting brothers and sisters and mamas and family."

 

Fishing families, the backbone of the coastal economy, are especially hard-pressed as the waters that make up their livelihood are sporadically closed because of fears the oil will taint fish, oysters and shrimp.

 

Oil field workers, whose salaries are among the best the region can offer, worry about their industry's long-term future.

 

And there is still the rebuilding after Katrina, which in August 2005 devastated a swath from Louisiana to Alabama — almost as big as the area affected by the oil — killing more than 1,600 and forever changing the region's relationship with the water.

 

No one is fishing any more out of Zeke's Landing Marina in Orange Beach, Ala., though most charter boat captains are making some money pulling boom and doing other jobs in BP's cleanup program.

 

Looking at oil all day can be harder than staying home, said Joe Nash, a boat captain there. "Seeing everything that you've been used to for years kind of slowly going away from you, it's overwhelming," he said. "Because you can't do anything about it."

 

That helplessness, coupled with the uncertainty about what's going to happen with the spill and when the next check from BP PLC will arrive, leaves boat captain George Pfeiffer angry all the time.

 

"Our families want to know what's going on," said Pfeiffer, 55, who keeps two charter boats at Zeke's Landing. "When we get home, we're stressed out and tired, and they want answers and we don't have any."

 

His wife cries, a lot.

 

"I haven't slept. I've lost weight," said Yvonne Pfeiffer, 53. "My shoulders are in knots. The stress level has my shoulders up to my ears."

 

Social services agencies have not seen a significant increase in people seeking help since the spill began, but that doesn't mean the need isn't there, said Jeffrey Bennett, executive director of the Gulf Coast Mental Health Center in Gulfport, Miss., whose state saw oil wash up on the mainland for the first time Sunday.

 

"Unfortunately, the people most affected, shrimpers and fishermen, are not people who traditionally seek mental health services," Bennett said. "They're kind of tough characters, and look at being depressed or not being able to handle their own problems as weakness."

 

On Sunday evening, many in Alabama's coastal fishing community planned to attend services for a popular charter captain who committed suicide on his docked boat. Authorities had no way to know whether his death had anything to do with the spill, but they hoped it would move others to seek help.

 

John Ziegler, a spokesman for the Alabama Department of Mental Health, said no one had walked into counseling centers set up in fishing communities since the disaster. Then on Friday, two days after the captain's death, five people came in saying they needed help because of the spill.

 

As news of the captain's death spread east to Pensacola, Fla., Baptist Health Care's Lakeview Center publicized its 24-hour help line, and several calls about the spill came in the following day.

 

"People saying they were sad, they were angry, they were grieving, they have lost a lot," marketing director Tish Pennewill said. "Grandmothers talking about how they took the children to the beach for the summer and could no longer do that. People wondering if it was ever going to be the same."

 

Even people whose livelihoods aren't affected by the spill find themselves crying on beaches, like Nancy Salinas, who was on Pensacola Beach last week when Florida officials closed it because oil was washing up. "It just breaks your heart," she said. "I can't get my feet in the water."

 

Mental health professionals say it is too early to have reliable data to understand the full severity of stress issues spawned by the spill.

 

However, their work so far indicates the problem is taking root, and the backdrop of Katrina means it is likely to get worse. Tropical systems such as the one that swirled over the Yucatan Peninsula on Sunday won't help matters, even though it was forecast to bypass the spill.

 

"This is a second round of major trauma for children and families still recovering from Katrina. It represents uncharted territory," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University and a member of the National Commission on Children and Disasters who has worked with Katrina survivors.

 

Dr. Howard Osofsky, chair of the psychiatry department at LSU Health Sciences Center, said focus groups he's monitored in spill-affected areas confirmed those emotions.

 

Ziegler, the Alabama mental health chief, said counselors have gone out to marinas, docks and other places frequented by fishermen and others affected by the spill.

 

"They've had folks break down and weep," he said. "They've had people share some of their deepest feelings about their future and how they're feeling now that things seem imminent."

 

In Mississippi, Bennett's group is working with Catholic Social Services in Biloxi on a proposal to train people in fishing communities to work as "peer listeners" to try to identify people who might be having problems and encourage them to seek help.

 

The social and psychological toll on residents of the Gulf will last long after the oil is cleaned up, say veterans of the Exxon Valdez spill in 1989.

 

"Every day you're dealing with this thing," said John Calhoun, former mayor of Homer, whose community was devastated. "If you're not working on it, you're worrying about it. Frankly, they sold a lot of alcohol during this time. I saw some of the toughest guys I know break down in tears because the stress had gotten to them."

 

Michael Herz, who served on the commission that investigated Alaska's spill, visited the Gulf and said it was like seeing it all over again, only worse.

 

"It took away livelihoods and it split families," he said. "Some members of family took money from Exxon and others were so upset they didn't. The rate of mental health, spousal abuse, alcoholism all skyrocketed."

 

Robin, the Louisiana shrimper, fears the spill will have similar effects on himself and his neighbors.

 

"This is a slow-moving hurricane," he said. "You're looking at it, and you can't do nothing about it."

 

(Stacy reported from Orange Beach, Ala. Associated Press writers Kevin McGill in New Orleans and Noaki Schwartz in Los Angeles contributed to this report.)