Hawaii has weathered the effects of hurricanes Lala, Lowell and now Nolo, part of a stretch that has produced at least 19 named storms across the eastern and central Pacific. None of the three hurricanes has made landfall in the islands, but the repeated threats have worn on residents.

Alameda told NBC News that anxiety has built up over the weeks of watching storms approach without knowing which one might finally hit. Some residents also experienced catastrophic flooding on Hilo's south side, adding to the strain.

For people on the Big Island, the toll isn't just about wind and rain damage. Alameda said residents are showing signs of fatigue and even PTSD after cycling through alert after alert with no clear resolution. Watching a storm spin offshore for days, waiting to see if it turns, wears people down. Even when the worst case never arrives, the anxiety lingers.

Three hurricanes have threatened the islands this season, and none has made landfall. Still, the mayor is using the word PTSD to describe how his own residents feel about the weather.