As Neria points out, as well, "the mental health toll of disasters and terrorism is not limited to post-traumatic stress disorder." They can also trigger major depressive disorder, generalized anxiety disorder, complicated grief (recognized in the mental health world as being unusually strong and long-lasting), substance abuse and a host of other symptoms that might come and go over time.
But diagnosing these conditions and getting the right help to the right people has become much more efficient in the past decade. Researchers have learned to work through schools, workplaces and other institutions to more efficiently screen larger populations of people and address their specific needs.
The hazards of an anniversary
A decade is more than enough time for most witnesses to 9/11 to have recovered from any initial stress response. But that does not mean that the anniversary this year will be smooth sailing—at least emotionally.
A major anniversary of any difficult event—the death of a loved one or a damaging natural disaster—can be a tricky time. And the already extensive rehashing of 9/11 means that, "for many people, they begin to re-experience the reactions they would have had at that time," Dass-Brailsford says. Whether they were at the site of the attacks or not, people might have nightmares, trouble sleeping, difficulty concentrating or a general sense of irritation. These symptoms can be especially difficult because they "can creep up on you, and you will start feeling odd, and you won't know why," she notes.
But there is one event that might help those especially affected by the events of 9/11 to further ease their anxiety. "The new wrinkle this year will be that bin Laden was captured and killed," Dass-Brailsford says. "In doing trauma work, usually when the perpetrator is brought to justice it can be very healing for survivors," she explains. As when a burglar who has been on the loose is finally captured, locals fell safer
But in this instance, "that safety is very relative because we know that the organization that he belonged to didn't depend just on him," Dass-Brailsford says. Nevertheless, now that he has been dispatched, "for some people, now they can start working on healing and recovering.
Fortunately, large-scale traumatic events such as terrorist attacks are relatively rare, but that means that their effects on mental health are tricky to study systematically. And as Neria and his co-authors noted in their paper, "In the immediate aftermath of disasters, it may be both inappropriate and unethical for researchers to assess some of [the] key variables related to exposure [and] short-term outcomes."
In the meantime researchers are pressing on to better understand how major disasters play out in minds across the world. Disasters can leave a vastly different mental health footprint depending on where they happen, Watson notes. "Disasters occurring in developing countries, whether human-caused or natural, cause more numerous and severe mental consequences than do disasters in developed countries," she says.
And despite the new cautions against assuming people exposed to trauma are unable to rebound on their own, Watson says that she and peers in the field are hoping "to get the message across that people may need a little assistance to feel better or function better, without needing formal diagnosis or treatment," to help overcome the stigma that remains attached to seeking psychological help.
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9 Comments
Add CommentThank you for this article. The theme of resilience and stress reactions being a normal response to abnormal events is core to traumatic experience recovery in my professional experience as the mental health clinician over the past 25 years. I do wish to comment, however, that associating stress debriefings, designed originally to help first responders deal with events outside their usual response situations, and mental health crisis response should not be paired or compared. My clinical specialty for many years has been crisis response and longer term trauma recovery with individuals and groups from military combat members to abuse and hostage survivors , internment camp survivors and victims of crimes including family violence. I also am CISD advanced level trained and experienced. These techniques and their goals are entirely different. Each has merit in the correct context. I believe to repeatedly view CISD as a mental health response is erroneous and a disparagement of a technique that is much like a psychological autopsy, piecing together for responders and rescuers the mosaic of coordinated response so that their roles fit within a larger picture and their sensory and emotional experiences have a context of normal for them. The purpose of this is to quickly enable them to be on scene again without being brought to a standstill by evocation of neurosensory memory bringing them to a halt just when they need to be lightning fast in their work. The last piece of a CISD is to provide education for self-care and recommendations for support as and if needed without an assumption all are traumatized pathologically. With mental health crisis response the usual affected group is usually far more repeated trauma naive so that the sensory impact and resources for coping are not attuned. The type of response, whether individual or group is sensitive to this psychological exposure naivete and require tremendous cultural, generational and situational attunement. THe goals and techniques are completely different.
Reply | Report Abuse | Link to thisBest regards,
Aliceann Carlton, LCPC
For a thorough debunking of the 2002 JAMA paper, point by point, see
Reply | Report Abuse | Link to thishttp://www.psychologytoday.com/blog/the-skeptical-sleuth/201109/september-11-2001-did-americans-suffer-virtual-trauma-television-co
and
http://www.psychologytoday.com/blog/the-skeptical-sleuth/201109/after-911-the-mental-health-crisis-never-came
PTSD is a terrible thing. I have a friend who just returned from Iraq and he was suffering from PTSD. We try to help him but he is half the man he was.
Reply | Report Abuse | Link to thisAlvin, you are right and I am sorry for the loss of the friend you knew before his Iraq experience. This article is really trying to redefine what is acute stress and a normal and expected reaction and what is post-traumatic stress which persists and becomes debilitating over time. I take issue with the concept that there is less PTSD than the author and cited sources are presenting because whatever it is defined to be, a person exposed to such emotional and neurosensory impact is forever changed and will never be the same. So what is happening in the United States now is an effort to "neutralize" horror and turn it into something a resilient mind can survive. That's a "well duh" sort of claim as most of us who grew up with children whose parents were in Nazi death camps learned very quickly. It's like watching a sturdy tower collapse and then rebuild itself, sometimes haphazardly and sometimes with sand rather than stone and morter. I am literally stunned by the lack of inclusion of first responders and family members in the 9/11 NYC Memorial as the trauma was shared by all at ground zero, and by the entire country where the ripple effects still wash over the consciousness of citizens, fueled of course by a warmongering leadership for some years. To say that an acute stress reaction and post-traumatic stress problems are normal reactions to abnormal events is accurate, to say many "get over it" is partly accurate, to say that life resumes as normal for most people is inaccurate unless you also posit that "normal" is the adaptation to hypervigilance, hypersensory or hyposensory acuity, flashbacks triggered by normal life events many years after the experience, and relationship changes so profound many are ruptured or badly strained for ever.
Reply | Report Abuse | Link to thisI did not think about 9/11 disaster much in past decade but after bin ladens death its having an impact on my mind.Its like iam being lifted to a new state of mind.
Reply | Report Abuse | Link to thisHi,
Reply | Report Abuse | Link to thisMany years ago I fought in Vietnam.One of the things that often bothered me was I would wake up often thinking I was back there.It went on for years.
I did have a problem with depression .My kindly therapists recommended Recovery Inc.I have been going for several years now and have setbacks only whe I didn't practice their method.
Dr. Low the founder of Recovery Inc.has a saying about memories.The brain knows very well how to forget.All you have to do is not keep reviewing the past.Don't work up the past,it's outerenviroment and we can't control it.
My mental health is most important to me.That is why I continue going to Recovery Inc. meetings and practice.
John,
Reply | Report Abuse | Link to thisThank you for your service and sacrifice. Also, you are to be commended for your continuing work to deal with your PTSD.
My father was WWII veteran who fought at Gaudal Canal. When he was in his early '80's he was still waking up from nightmares screaming "Japs, Japs, Japs."
My father was always on edge. Some said he was a rage-aholic, but in my early adult years after reading about PTSD in children of alcoholics, I realized why my father was the way he was. My family was horrible. Because of my father's condition, by mother and the 4 kids were all abused emotionally and physically, to the point that we suffered PTSD ourselves. Few seem to realize the devastation that occurs not only to our Vets, but to their family members as well.
Those interested might appreciate the work of the Climate Institute who are looking into the effects of natural disasters on mental health. You can read more about the Climate of Suffering at www.climateinstitute.org.au
Reply | Report Abuse | Link to thisThose interested might appreciate the work of the Climate Institute who are looking into the effects of natural disasters on mental health. You can read more about the Climate of Suffering at www.climateinstitute.org.au
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