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We have all been affected by the events of September 11th and its aftermath. Each of us has a combination of personal strengths and vulnerabilities in our lives that affect the way we deal with stress related to being in or around a disaster.

Each person is unique. People who cope well have the capacity to reconnect with the good in their lives, and are able to ultimately grow from the experience. Those who are more vulnerable to disaster-related stress may have pre-existing health or emotional problems and/or may be experiencing other stressful life events at the same time. There are a number of common reactions.

The common reactions to trauma in preschoolers include helplessness, anxiety about death, nightmares, regressive symptoms (e.g., bedwetting, loss of acquired speech and motor skills), somatic symptoms (stomachaches, headaches), startle responses to loud noise and uncharacteristic crying, neediness or fussiness. They may have difficulty talking about the event and identifying their feelings.

School-aged children (6-11) may feel responsible and guilty over the disaster, have nightmares, safety concerns, angry outbursts, changes in behavior, withdrawal, regression to behavior of a younger child, separation anxiety from primary caretakers and a loss of interest in activities including school.

Preadolescents and adolescents may rebel at home and school, be depressed and withdrawn, have a decline in school performance, experience eating disorders, nightmares and a wish for revenge, an action-oriented response to trauma. They may retreat from others in order to manage their inner turmoil and make efforts to distance themselves from feelings of shame, guilt and humiliation.

There are many things adults can do to help young people. Adults can make the environment safe to talk about feelings and thoughts, reassure the child that he/she is not alone, help the child remember triggers that cause distress, encourage everyday routines, plan family time together, and support the child's friendships and social network. Adults should avoid power struggles by giving choices and being flexible and most important: listen.

Adults who have been traumatized suffer from ongoing post-traumatic stress reactions. These are common and understandable, but nevertheless are serious and can lead to many difficulties in daily life.

Intrusive reactions include distressing thoughts and images of the event that can occur when one is awake or dreaming, and flashbacks where one feels he or she is re-experiencing the traumatic event.

Avoidance and withdrawal reactions are ways people protect themselves from any reminder of the event. Feelings of detachment from others may lead to social withdrawal.

Physical arousal reactions include changes that make the body react as if danger is present, even if it is not. These reactions include constantly being "on the lookout" for danger, startling easily or being jumpy, irritability or angry outbursts, difficulty sleeping and difficulty concentrating.

It helps in coping with post-traumatic stress symptoms to remember that recovery is an ongoing, daily and gradual process. Taking actions to cope with problems gives one a greater sense of personal power and control.

Positive coping methods include learning about your personal triggers, and confiding in supportive friends. Other coping methods include using support groups for survivors. This can reduce one's sense of isolation and rebuild trust in others. It also provides an opportunity to contribute to the recovery of others, which can be very healing. Talk to a mental health professional if efforts at coping do not seem to work or if feelings of anxiety or depression do not improve or seem to get worse. It is important to ask for help. Taking medication for some people is indicated. Practicing relaxation techniques, being gentle with one-self and increasing positive, distracting activities might help too.

Physical self-care includes eating regularly and healthfully getting regular medical care, getting enough sleep, engaging in activities and hobbies you enjoy, taking vacations or day trips and taking sick time for yourself.

Psychological self-care methods include making time for self-reflection (for example by keeping a journal), doing something in which you are not the expert, practicing receiving from others, and sometimes saying no to extra responsibilities.

For emotional self-care, spend time with people whose company you enjoy. Seek out comforting activities. Allow yourself to cry. Express your outrage in social action, letters, donations, etc.

Spiritual self-care methods include spending time in nature, cherishing your optimism and hope and being aware of the nonmaterial aspects of life. More methods include making time for reflection, finding a spiritual community, being open to inspiration, trying at times not to be the expert and being open to not knowing.

Experts in dealing with disaster note that trauma is experienced on both an individual and a community level. Emotional and physical reactions to September 11th are normal. However, it is a good idea to seek professional counseling if you feel your reactions, or those of a loved one are lasting too long or are getting worse. Please call 1-800-LifeNet (1-800-543-3638) to speak with a counseling professional who will provide you with free confidential information about how to access mental health and substance abuse services 24-hours-a-day. Anyone can call, and help is available in several languages.