It's a night many East Texans can't shake.

On April 29, unpredictable tornadoes carved a path of destruction through Henderson, Hopkins, Rains, Van Zandt and Wood counties.

A total of nine tornadoes ripped through those communities, ranging in intensity from an EF-0 to an EF-4. Four people died that night and dozens of people suffered injuries.

Almost three weeks have passed since that terrifying night, and many are still suffering in silence from the images that continue to flash through their minds. May is mental health month, but with all the cleanup efforts underway many people may not recognize that they are struggling with post-traumatic stress.

Lisa Smith was able to survive the EF-4 Canton tornado by taking shelter in a closet. As she hung on to dear life, her home was ripped off the ground.

"I heard the top of the house just lift off, I heard walls being ripped apart,” said Smith. “I heard glass shattering and I just got under my pillow and closed my eyes and held on tight. The next thing I knew I opened my eyes and I was outside, there was no walls, there was nothing here."

Lisa's twin sister Laura Williams and her husband Biff lived next door. They were also able to escape unharmed by hiding in a closet.

With homes turned into piles of rubble, East Texans had no choice but to pick up the pieces of what was once their safe-haven. With so much damage, it's easy to focus on the work to be done instead of taking time to address one’s mental health after such a traumatic event.

"I think disaster victims tend to focus on the devastation and other members of the family and everyone but themselves,” said Tammy Prater, Executive Director of the American Red Cross Serving East Texas. “Very often don't necessarily pay attention to their own feelings."

The damage left behind goes further than the eye can see and some of the biggest wounds are not physical, but emotional and mental. If left untreated they could have lasting effects.

"If someone doesn't talk to anyone, has symptoms of anxiety or depression that they don't get any help for, those are the ones that will fairly certain be affected by that PTSD," said John Hopkins, a licensed professional counselor.

Hopkins says victims of trauma caused by natural disaster are at risk of developing Post Traumatic Stress Disorder (PTSD). PTSD is when a person re-lives or is affected by the trauma well after it has passed.

"I see it when I close my eyes,” said Stephen LeRosen. LeRosen was driving on Highway 198 with his mother when the EF-4 tornado ripped through the area. He and his mother survived by getting out of their car and lying in a ditch on the side of the road.

"I was in the Navy for four years and I never once was afraid the way I was afraid that day," said LeRosen.

Hopkins says a lot of times, those who are affected, don't know they are displaying symptoms of PTSD. Those symptoms include changes in sleeping and eating patterns.

"We have not been able to sleep, my mind races,” said Laura Williams.

You can also experience depression and anxiety. Often that anxiety is triggered by an event similar to the one that caused the trauma.

"The wind picked up at her house and my first thought was alright we have to get away from the windows, let's go get in the hall," said Biff Williams.

Not everyone who lived those terrifying moments will develop PTSD. Hopkins says there are ways to prevent long-term damage.

"Just being able to talk about it every day. We would think about it at a certain time and her and I would say ok well let’s just talk about it, how are we feeling right now?" said Biff Williams.

Hopkins says the first step to recovery is reaching out to loved ones and talking about it. He says for some, clinging to their religious faith is also a crucial part of healing.

"That's really how I’m dealing with this, it's my faith,” said Lisa Smith. “My faith has gotten stronger through this and I’m not going to live in fear."

Hopkins says it's also important to know it's ok to ask for help or see a professional while trying to keep some consistency through the process.

"I think it's helping to try to get back to our normal routine,” said Jay Smith, Lisa’s husband. “Like yesterday was the first day we went back to the gym.”

Those who physically endured the violent tornadoes aren't the only ones affected, it's important to remember that often their family members are also left to carry emotional scars. Scars that were caused by the fear of losing someone they love.

"I wasn't there but it's been emotional," said Jay Smith.

The good news is those who have been affected don't have to heal alone. "When disaster strikes, it doesn't strike individual families it strikes communities," said Prater.

The community can heal together.

"Honestly everything has been real positive but I think what's helped us the most is the out poor of support from family, the community and strangers,” said Laura Smith.

There are many resources available for those struggling to cope. Red Cross offers around the clock support. You can reach a counselor through the disaster distress helpline at 800-985-5990.