The Lingering Effects of 9/11

It has been a decade since the 9/11 terrorist attacks, and while the acute pain and anxiety for many has diminished, the after effects are far from forgotten. Plus, read more poignant stories and watch videos in remembrance of the 10th anniversary.

What was the initial psychological impact of the Sept. 11 attacks?
After 9/11, our national self-view of being safe inside a bubble where terrorism could never happen on American soil changed forever. A study published in the New England Journal of Medicine in 2002 showed that approximately 7.5 percent of New York City residents suffered from post-traumatic stress disorder (PTSD) in the months after Sept. 11, while the national average was just above 4 percent.

As a nation we walked around with varying degrees of anxiety and fear about when the next attack could happen. It was apparent in the way traveled (less flying), visited landmarks (more cautiously) and how we kept a suspicious eye out for abandoned bags, lurking men, or saw an increased police presence as an indication that there was an imminent threat to our lives. Today we still struggle with at least a little anxiety about flying and about being the target of violence.

What can you do if you still have a fear of flying?
A fear of flying is a specific phobia and can surface with or without trauma from an event such as 9/11. If you just feel nervous about flying, you can usually manage it with relaxation techniques. But, if you make decisions based on your fear, like declining a job offer that involved air travel, or you avoid flying all together (or need to drink heavily to get through it), then the problem needs to be addressed. Treatment usually involves a form of desensitization, a technique that will expose the patient little by little to their fear of flying to ultimately prevent anxiety that comes with getting on a plane.

Are people still as affected by anxiety 10 years later?
On the 10 year anniversary of 9/11, many of us may feel an intensification of the fears and feelings we have struggled with since that day. For those directly affected by the attacks, the anxiety may be even greater and the sense of loss more profound.

Even though 10 years have passed, many of the first responders, those who lost someone, and people who were in close proximity to the attacks are still struggling with PTSD, depression, panic disorder and substance abuse. Additionally, people with a history of past trauma, past depression or a lack of social support were also at greater risk for PTSD or depression after 9/11.

How do you know if you or someone else has PTSD? How can it be treated?
PTSD is a set of symptoms that include being plagued by memories, nightmares and thoughts about a traumatic event for a long period of time. Other PTSD symptoms include depression, irritability, anxiety or being easily startled, as well as avoidance of things that are a reminder of the event. PTSD needs treatment; your healthcare provider will work with your to treat whichever symptoms are the worst. Other treatments might include medication for anxiety or depression, or sleep and talk therapy to discuss feelings and functioning associated with the trauma.

For more severe and long-lasting PTSD, Joanne Difede, M.D., the head of Program for Anxiety and Traumatic Stress Studies at The Weill Cornell Medical College department of Psychiatry, has been doing research on treating patients with Virtual Reality treatment, where patients watch a simulation of the events of 9/11 through a visor while Dr. Difede (or one of her group) talks to them. Called cognitive therapy, the technique is used to help patients feel calmer and become desensitize to the brutal images. It also allows Difede and her colleagues to teach patients how to change their thoughts around their 9/11 experiences. She continues to see patients, mostly first responders who are still struggling with PTSD.

How can people cope with loss?
In New York City between 11 and 14 percent of adults reported losing a friend or relative on 9/11; nationally, 4 to 11 percent of adults experienced a personal loss of some kind that day. If you suffered a loss on 9/11, you may feel sadness and longing leading up to, and including, the day. Anniversaries typically amplify the feelings of grief and loss you may have thought were healed.

Even if you didn’t lose a friend or loved one, the anniversary of 9/11 may rekindle symptoms of anxiety, depression, fear and loss. It’s normal to be preoccupied with thoughts about where you were on 9/11, the images of what happened, to feel afraid of another attack on U.S. soil, and be sad about those who were lost. What helps the most is connecting to those around you who may be feeling the same way. Be with friends and family to share your thoughts and feelings and to find distraction. Negative thinking has a way of making us feel alone -- being with other people reminds us that we are not. Consider minimizing your exposure to media outlets that replay disturbing images from the attacks in the days leading up to the anniversary. Another way to combat difficult feelings is to be helpful to others. Volunteering with a local group can make you feel less helpless, more connected and more positive all in one fell swoop.

What if I just want to tune out the 10th anniversary of 9/11? Should I feel guilty?
People react in all different ways to the anniversary of a tragic event. No way is right; no way is wrong. If you don’t want to be involved with observing the anniversary of Sept. 11, then don’t be. And you don’t need to feel guilty about that.

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