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Stress and anxiety
Still stressed by September 11th: Am I overreacting?
Originally Published: January 25, 2002
 

Hi Alice,

i watched the wtc disaster from across the river in brooklyn. my view is of downtown manhattan from most of my apartment. i also live on a flight path. i watch the planes come in for landing towards my front windows, and can watch them continuing on from my bedroom windows. i lost a close friend in the disaster, someone who was close to members of my family as well as myself.

my question is, could i be experiencing post traumatic stress disorder? i was numb for a while, then seemed to come out of it, which i found surprising. but lately it seems that i can cry at electronics commercials. maybe it's the upcoming holidays and dealing with loss during this time.

in addition, i mentioned this (much more briefly) to my older sister and she scoffed at me and rolled her eyes. i can't forget her reaction. i felt as if she meant i was overreacting, and i am hurt and angry at her. i also feel guilty now for thinking that i may be experiencing ptsd. p.s.: i was laid off in september and have been spending more time alone than everyone else i know. HELP!!!!

 

Dear staring out the window,

Wow, it's amazing that you had the wear-with-all to even write this letter. Based on the feelings that you listed, it's hard to say if you have post-traumatic stress disorder (PTSD). You might, but you might be grieving the loss of your friend, those in the Twin Towers when they collapsed, and the buildings themselves. PTSD, grieving, shock, or numbness... there are thousands, maybe millions, of other New Yorkers, New Jersians, Californians, New Zealanders, and people from places in between who are still reeling from the events of 9/11 and their aftermath, which continue as we speak. And not one of us should feel guilty about these feelings. No, we weren't in those planes and buildings, and whether or not we knew someone who was, our lingering upset is exactly what's expected in the wake of major catastrophes — and September 11th was no ordinary major catastrophe.

It's also just as normal for these reactions, including those symptoms associated with PTSD, to come and go, to start long after the event(s) that sparked them, and to last for months, even years. Current events can also bring back memories of past ones: the death of a parent, a fire, and even a bad flight. These recollections can add to our upset, and if we're not aware that these bad memories are being sparked, we might think that we're overreacting to something that we should have gotten over by now. And thanks to the anthrax scares during the months following 9/11, and the continuing threat of additional attacks, our reactions may hang around even longer, as these realities have made it difficult to obtain closure — an important part of the healing process.

It's really important to remember that people react in many different ways to disasters, death, violence, and the like. You and your sister's responses to the terrorist attacks and the death of your family friend appear to be very dissimilar, but this doesn't mean that either one of them is wrong. Post-traumatic stress disorder is a condition when the memory of extreme emotional stress triggers psychological and physical symptoms including:

  • difficulty concentrating
  • nightmares
  • insomnia
  • anxiety
  • fear
  • agoraphobia (a panic disorder characterized by intense anxiety about being in places that would be difficult to escape, or where it might be embarrassing to experience symptoms of panic)
  • feeling numb, or feeling nothing at all
  • avoiding people and places that remind you of a traumatic event
  • sweating
  • crying
  • flashbacks
  • panic attacks
  • increased breathing and heart rates
There have been many studies of how people respond following war, natural disasters, and terrorism, including one just released by the New York City Department of Health. You are clearly not alone in feeling the way you do; 40 percent of a group of 400 lower Manhattan residents had symptoms connected with PTSD when surveyed in late October 2001 — almost two months after "the Tuesday that will live in infamy." Over time, PTSD lessens, but a large part of the population is still expected to experience some of those reactions well into the future.

Since PTSD symptoms, and other unpleasant feelings not a part of any disorder, are brought on by recalling traumatic events, it's no wonder that you and others living near "ground zero" continue to feel the way you do. Not only did you watch this series of horrific events literally take place right in front of you, but you are reminded of them all the time: when looking out your windows at a completely different view; seeing planes overhead every minute; perhaps smelling the burned debris on occasion; seeing the all-night glow of work lights at ground zero; hearing the jets overhead — passenger and military ones; walking by firehouses, police stations, and hospitals with their remaining memorials; riding rerouted subways; and, the list goes on. Even if you never left your apartment, 9/11-related news and features fill the airwaves. The closer you are to what used to be the World Trade Center, the more difficult it is to escape what happened — even downright impossible for some. Again, those living and working far, far away from the former WTC site are not immune to what took place there — someone living in Bombay can be as profoundly affected by 9/11 as someone living in the Bronx.

Oh, then there are/were the holidays — geysers of troubling memories no matter their cause — the loss of your close friend and the loss of your job due to the disaster, it appears. It's not a contest, but for people who were already trying to deal with health problems, family crises, work and/or money troubles, or whatever other huge stress-promoting situation you can think of, 9/11 likely made those things even harder to live through, to say the least.

Of particular concern is the part about your spending more time alone than anyone else. Past traumatic times have taught us that spending time with others — just talking or getting involved in some kind of community service — helps people get through these difficult feelings a little, or a lot, easier. Many steer clear of counseling because it will probably include talking about September 11th. This may very well be a concern for our neighbors mentioned earlier — half of whom said that they did not want counseling. This is understandable, although, clearly, many New Yorkers and others are going that route, and finding it helpful, given the big increase in short- and long-term visits to psychologists, social workers, psychiatrists, and other qualified mental health care providers. Resources at the end of this answer will give you some options for the help you are wisely seeking.

There's also been an increase here in the United States in alcohol and other drug use and abuse. You don't have to be a genius to know that drinking and drugging are popular coping devices when people are under a lot of stress. Why? Because they work. The problem is that they are too often needed in increasing amounts to do the trick, and become the primary method of dealing with all stress, great and small.

All of us handle stressors — this one included — in different ways. Some become immobilized, unable to work, exercise, socialize, eat right, sleep, and problem-solve, while others slide right back into their routines, seemingly without a problem, nor any negative and long-lasting reactions that call for some kind of assistance. Know that some in the latter group may be reacting by not reacting — getting right back into the swing of things because it may be a lot easier not to think about what's happened. They may not know how to deal with adversity — especially when it's anywhere near the current magnitude. For some in this group, a pot of problems stemming from not addressing and processing life-altering events eventually boils over — sometimes years on down the road. Although former New York Mayor Rudy Giuliani's post-9/11 leadership and support were stunning and incredibly helpful to a lot of people, that message from him and other politicians shortly after September 11th, to resume life as "normal," sent a message to some to "get over it," and may have contributed to that guilt felt by many who just couldn't go back to the way things were, and who, fortunately, took time to focus on themselves even though that might have seemed selfish when so many others were affected so much more directly by what had happened. Those thoughts were stated in the past tense, but are certainly still real issues for many near and far from NYC, The Pentagon, western Pennsylvania, and other locals, where the ripple effects of the events of that day are now being felt. This is certainly not to say that if you're not incapacitated, or if you never lost sleep over 9/11, that you're screwed up and in need of serious therapy.

There's more where all of that came from, but maybe we should talk about a few things that might help get some of us back to where we want to be, or at least closer — some of them have already been discussed:
  • If you're okay with what you've read here, or if you think it could help to start healthy conversations with your sister and others, forward the Q&A to them by clicking the "send to others" button at the bottom of this page.
  • Be selective about with whom you share your feelings and concerns. As with any sensitive topics, try to talk with people who are good listeners, who don't tell you how you should feel, and who will respect your feelings whatever they are.
  • If you're working again, or even if you're not, you may be able to get help in the way of counseling from your company's employee assistance program (EAP). If you're still out of work, you may be allowed to use their EAP in the same way.
  • Volunteer, play football, take a walk in Prospect or Central Park? do something that will get you out of the house and be active — especially if you're not working or job hunting. Helping with activities related to 9/11 might not be right for you because of the reasons raised above, or it might help you feel as though you're doing something, anything, to help recover from this tragedy.
  • Get out of New York City, if you can. Even if it's just for an afternoon, go somewhere — up the Hudson, to the beach, to cousin Junior's farm — with many fewer reminders of all that we've been talking about. Go alone, or find someone else with whom you can "escape." Remember, living is not ignoring and forgetting.
  • Cut back on looking out your windows, or think about the vibrancy, resourcefulness, dedication, and the incredible view that still looks back at you from across the river. This doesn't bring back anyone who perished on September 11th, but it may help you see what remains of lower Manhattan in a different, more positive way.
  • Resist watching television "news" programs that are clearly capitalizing on the horrors of 9/11 and the pain of those who lost parents, children, fiancι/es, etc. The stories are usually interesting and compelling, but can make it more difficult to get back on your own road to recovery.
  • If you can't get the support you want/need close to home, try to get it somewhere else; these resources may really help you and others:

Since nothing like September 11th has ever happened here before, we're all kind of in it together, figuring out how to help each other and ourselves. "You're not alone" is an overused and usually meaningless clichι, but for some reason, it seems to work right now in a city where every person for him-/herself is a common mindset. So many are feeling so similar for so long. You and your family were/are more on the "front line" than most, and a lot of us have been reminded by your letter that strength and healing can come from taking time to reflect, to respect our emotions, and to ask for help in sorting it all out.

Thanks,

Alice

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