PARADISE, California - Tasha Ritza lost her house, her job and her hometown on the day a wildfire destroyed Paradise, California. A year later, her life is still in tatters, she said.
"I'm at a loss. I deal with a lot of anxiety. I can't figure out if I want to stay, if I want to go," she told the Thomson Reuters Foundation. "I haven't worked in a year.
"In a day it was all taken from me, and it's not getting any easier," said Ritza, who ran a kitchen in one of the Paradise public schools before the fire. She has moved to nearby Chico while she struggles to decide what to do next.
In California communities haunted by wildfires losses and new fire threats, the damage has not been only physical. Anxiety, depression and other mental health challenges linked to the fires are growing - and residents say they fear more trauma is ahead.
"This whole county has PTSD, depression," said Michele Evans, a young mother who worked at a dance studio in Paradise before the fire, referring to post-traumatic stress disorder.
"Everybody could use some counseling, the whole county," she added.
The wildfire that swept through the northern California town of Paradise in November 2018 was the most deadly in state history, killing 85 people.
Panicked residents fled burning homes and abandoned their cars on blocked streets, running through flames down the main roadway to escape their mountain town, once popular with retirees.
Today only about 10% of the 27,000 people who once lived there remain.
Some moved just up the road to the small mountain community of Magalia and others to bigger cities nearby such as Chico and Sacramento. But many left the area altogether after the fire destroyed almost 18,800 structures, more than half of them homes.
In the charred remains of Paradise, a few people still live in trailers on the burned-out lots where their homes once stood.
California has long suffered seasonal wildfires, but longer dry seasons and more powerful winds - which scientists link to climate change - are helping make the blazes far more destructive, raising risks - and fears.
Rebecca Schmidt, a researcher at the University of California, Davis, has studied mental health among pregnant women during wildfires ever since 2017 blazes tore through the state's Napa and Sonoma wine regions.
"The most commonly reported symptom even a year later was stress and anxiety," she said. That included sleeplessness, headaches, difficulty concentrating and depression.
"It's even more worrisome when communities are disrupted, like Paradise. A lot of them lost their support system," she said.
The losses can have long-standing mental health impacts - and fear of more fires also is taking a toll, Schmidt said.
"The feeling of not being safe affects the mental health of people all around, and it's a long-term thing," she said.
In Sonoma County, where the Kincade fire burned nearly 80,000 acres (32,400 hectares) before being extinguished this month, officials are considering asking residents to vote on a 1/4 cent sales tax to fund mental health services.
County officials there also recently declared a climate emergency in an effort to make climate risks a top priority in policies and decision-making.
"I've seen more mental illness in the last two years than I've ever seen in Sonoma County before," said Kellee Ziegler, an emergency room nurse at Santa Rosa Memorial Hospital.
During the Kincade blaze, people filled the emergency room with complaints of PTSD and suicide attempts, she said.
"This fire threw people over the edge," she said.
Dr. Grant Brenner, a New York-based psychiatrist and expert in disaster-related mental health, said mental health threats from disasters tend to be overlooked.
But as global warming brings growing threats - from stronger hurricanes and more frequent floods and droughts to larger fire risks, "the damage psychologically from climate change is going to be massive," he said.
One way to ease the pressure is letting survivors help other survivors, said Janet Leisen, whose home in the northern California city of Santa Rosa burned two years ago.
She and other Santa Rosa residents who lost homes in the 2017 blaze traveled to Healdsburg during the Kincade fire to offer advice and support on recovering and rebuilding, working from a local assistance center set up for newly affected residents.
"As a victim, we know that it's difficult to talk to people who haven't been there," she said. "It's easier to talk to someone who understands that it's not just stuff (lost), that this is a traumatic event."
Jessie Mercer, an art therapist who lived in Paradise, said she poured her grief into creating a "Phoenix" sculpture, built from the keys of homes lost in the blaze.
The sculpture was unveiled as residents returned to Paradise this month to mark the fire's one-year anniversary.
"I brought us home, even if just for today," Mercer said at the unveiling.