isolation also caused problems with medical care; it took such a long time to get to the farms that when children fell sick they frequently died. This caused a lot of trauma for the parents, and contributed to prairie madness. Another major cause of prairie madness was the harsh weather and environment of the Plains, including long, cold winters filled with blizzards followed by short, hot summers. Once winter came, it seemed that all signs of life such as plants, and animals had disappeared. Farmers would be stuck in their houses under several feet of snow when the blizzards struck, and the family would be cramped inside for days at a time. There were few trees, and the flat land stretched out for miles and miles. Some settlers specifically spoke of the wind that rushed through the prairie, which was loud, forceful, and alien compared to what settlers had experienced in their former lives. Risk factors Many stayed very attached to their way of life back East, and their attempts to make their new homes in the West adhere to the old ways sometimes triggered prairie madness. Others tried to adapt to the entirely new way of life, and abandoned the old ways, but still fell victim to madness. Some coping mechanisms to escape the emotional trauma of moving to the prairie was to continually move around to new locations, or to move back East. Immigrants were particularly at risk for prairie madness. Immigrant families not only had to suffer from isolation, but the settlers who lived in their area often had different languages and customs. As such, this was an even further separation from society. Immigrant families were also hard-hit by prairie madness because they came from communities in Europe that were very close-knit small villages and life on the prairie was a terrible shock for them. There is a debate between scholars as to whether the condition affected women more than men, although there is documentation of both cases in both fiction and non-fiction from the nineteenth century. Women and men each had different manifestations of the disease, women turning towards social withdrawal and men to violence. Symptoms Since prairie madness does not refer to a clinical term, there is no specific set of symptoms of the affliction. However, the descriptions of prairie madness in historical writing, personal accounts, and Western literature elucidate what some of the effects