Judi Casale takes an anti-anxiety pill every day. She sees a therapist every other week. Any strong gust of wind or heavy downpour sends her into panic mode.

Superstorm Sandy dumped five feet of water in Casale's Long Branch home in October 2012, and the emotional toll has not let up since.

Judi Casale's Long Branch home was flooded with five feet of water during Sandy. (Photo provided by Judi Casale)

"I hate thinking about this because it really screws me up," Casale told New Jersey 101.5. "It was a really horrific experience."

And memories of that horror are reignited each day as Casale continues the process of rebuilding and remediating.

Casale's story is just one of many that make up the 40 percent of hardest-hit Sandy victims who say their life is worse now than it was prior to the storm.

In a survey from the Monmouth University Polling Institute, 25 percent of respondents said life will never be the same.

Since a few months after the storm made landfall in the Garden State, Monmouth has been tracking hundreds of New Jerseyans who were displaced from their homes or suffered significant property damage.

In its latest checkup — the findings of which were released on Thursday — Monmouth learned the mental health of Sandy victims has improved overall, but a significant number of survivors continue to suffer from psychological distress.

Since the same question was asked in 2014, an additional 7 percent of respondents report having received some type of counseling or therapy. Down from 23 percent three years ago, 17 percent of participants exhibit signs of a provisional PTSD diagnosis, using a 20-question index.

Fifteen percent of respondents currently register "serious distress" — down from 25 percent four years ago. Sixty-eight percent show no signs of emotional distress; that figure was at 53 percent in 2013.

“As expected, psychological distress has continued to improve for Sandy victims over time, however the overall rate of serious distress for Sandy victims as compared to the general population remains a cause for concern," Dr. Christine Hatchard, director of Monmouth's Clinical Psychology Research Center, said in a news release accompanying the poll. "Being in distress for long periods of time can increasingly have a negative impact on all areas of people’s lives, such as relationships and careers."

Matthew, of Toms River, vacated his home for four months after the storm. He was approved for the state's RREM (Rehabilitation, Reconstruction, Elevation & Mitigation) program years ago, and hopes to finally obtain a certificate of occupancy within the next few months.

"You have to have a lot of patience ... because things don't go as quickly as you'd like them to go," said Matthew, who chose not to share his last name for this piece. "Your focus becomes trying to maintain your job and trying to maintain your sanity."

The Monmouth survey showed a strong correlation between one's emotional distress and one's housing status. Just 10 percent of those who've returned to their pre-Sandy home, for example, display serious distress. The level spikes to 24 percent among those who have permanently relocated and 40 percent among those who are still waiting to return home.

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Contact reporter Dino Flammia at dino.flammia@townsquaremedia.com.