Between four and ten percent of the population experiences Post-traumatic Stress Disorder, or PSTD (as cited by the National Institute of Mental Health and the American Psychiatric Association, respectively). PSTD is a type of anxiety disorder, which occurs according to NIMH, "after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened." Potential sufferers include survivors of terrorist attacks, victims of natural disasters such as hurricanes or earthquakes, and people who experience manmade trauma, i.e. warfare, fires, crime, etc. According to Scientific American magazine, interestingly, people at greater risk for developing PTSD are those who suffered deliberate violence rather than natural disasters.
However, not everyone involved in a traumatic event experiences post-traumatic stress disorder. According to Mayo Clinic Health Information, victims more likely to experience it are those who have a history of trauma or abuse, i.e. combat experience, a previous emotional disorder, being part of a dysfunctional family, leading to incest or domestic abuse; alcohol or drug abuse-any form of long-term suffering. In people with such backgrounds, early trauma can be triggered by a similar, painful event, setting in motion PTSD.
The World Trade Center disaster would certainly qualify as a terrifying ordeal, either primary or secondary. With bodies flying, buildings collapsing, loved ones lost, blinding smoke, and complete devastation at ground zero, September 11th certainly fits the definition of a situation which could result in PSTD. The World Trade Center disaster would certainly qualify as a terrifying ordeal, either primary or secondary. Bodies flying, collapsing buildings, loved ones lost, blinding smoke, complete devastation at ground zero, fits the definition of a situation which could result in PTSD.
According to Hella Thorning, M.S.W. of the Psychiatric Institute, the range of response includes four categories: physical, emotional, mental, and behavioral.
Physical responses are gastro-intestinal disorders, headache, dizziness, increase in or loss of appetite, chest pain, and sleep disorders. Emotional results are: emotional blunting or numbness; irritability; anger, depression, guilt, and hypervigilance/arousal, in which danger is seen in neutral situations. Mentally, people experience nightmares; avoidance of thoughts about the disaster; distorted perceptions, such as imagining that people had parachutes on while falling; and thoughts/memories of heightened intensity, leading to flashbacks and intrusive thoughts about the event. Finally, behavioral difficulties include avoidance of the scene, extending also to areas which might trigger memories, such as tall buildings or construction sites; and withdrawal from other people or the community.
The universal recommendation of psychiatrists and psychologists for recovering from the immediate effects of PTSD is the reassurance that their symptoms are normal. Under the paradoxical effects of PTSD, the abnormal becomes normal. Furthermore, symptoms will pass. Knowing what to expect helps victims to hold on to reality and to cope more effectively with symptoms.
Second, experts recommend that survivors of traumatic events talk about the experience: to clergy, doctors, self-help groups, or members of their community.
If, however, sufferers do not show improvement within one to three months, time alone will not bring cure and you need to seek help, says Mark Spellman of the NYU Psychology Department according to an article in the Daily News, Dec. 17 2001 by Maki Baker. Methods of treatment include: pychodynamic, cognitive, reintegrative, exposure, and medication.
In the psychoanalytic method of treating PTSD, the doctor explores the patient's individual responses to the tragedy. Cognitive therapy helps to change the thoughts of sufferers and thus reshape their reactions to the event. If someone has withdrawn from a normal life of work, family, and friends, therapist Carol Lindemnn, PhD., tries to integrate them in the normal functioning community. She and most other therapists treating PTSD also recommend exposure therapy, in which the patient relives the traumatic event in a controlled situation, working through his or her emotions in the safe environment of therapy.
Finally, research is underway as to how medication might help in some situations, affecting, or at least predicting, both emotional and mental symptoms. Researchers are exploring the fear response, which helps in situations of danger, but which hampers normal functioning if it continues too long: the amygdala, the organ responsible for the fear response, shows abnormal activity in those with anxiety disorders. Other findings show that key hormones produced during stress act as opiates to shield from pain; however, in PTSD their production continues, creating emotional blunting and numbness inappropriate in normal situations. If opiates could be inhibited, normal functioning should follow.
Selective seratonin reuptake inhibitors and other antidepressants relieve symptoms of depression and anxiety.
CPF, or corticotropin releasing factor, is responsible for stress response, and creates the tendency to be easily startled. It is elevated in people with PTSD; drugs that reduce CRF activity are useful in treating the illness.
Thought disorders, in which pictures, sensations and events are recorded with heightened impact, create flashbacks or intrusive thoughts. Such thoughts originate from the hippocampus, a site for organizing information. The hippocampus is controlled by the chemicals norepinephrine and epinephrine; therefore high levels of these hormones lead to abnormally strong memories in sufferers of PTSD. Another hormone, cortisol, limits production of both norepinephrine and epinephrine. People with low levels of cortisol are thus at greater risk for developing thought disorders.
People suffering from PTSD as a result of the World Trade Center disaster should refrain from destructive behavior such as alcohol or drug abuse, panicking, and of course suicide. Seek help, from discussions with family and community to psychiatric intervention. The condition can be treated. Though difficult, healing can be successfully achieved.