Combating Post Traumatic Stress, Depression and Suicidal Thoughts in the aftermath of the terrorist attacks on the New York Worl

Post Traumatic Stress Disorder
My view of Post Traumatic Stress Disorder is where a witnessed event or series of events is so traumatic (foreign to what we are used to and extremely severe) so that an emotional and possible autonomic response is implicitly embedded into our unconscious mind regardless of our cognitive input.
The horrendous sight of those two airplanes slamming into the World Trade Center Towers on September 11, 2001 was implicitly embedded into our unconscious minds. What is even more traumatic was our view of the towers each collapsing in succession, as this in an instant dashed our hopes of rescuing those remaining in the towers.

Make no mistake, there will be many cases of Acute Stress Disorder (short term) and Post Traumatic Stress Disorder-PTSD (long term and more severe) as a result of these attacks, it may even reach national epidemic proportions. The incidence and severity of possible Post Traumatic Stress will be directly related to several factors including; your proximity to ground zero during the terrorist attacks, your emotional attachment to anyone killed or injured, your personal support systems, the ability of our people to sustain the renewed patriotism felt after the attacks, possible unjust reprisals against like ethnic groups in our country, the national and your individual economic health, subsequent terrorist attacks in this country or against our allies, and the success or failure of our political and military operations in reprisal of these dastardly acts.

Symptoms of Post Traumatic StressTraumatic memories are stored in the emotional unconscious in the implicit form, and are less influenced by cognitive thought or reason and logic. The triggers that will cause a flashback are anything which reminds us of the traumatic event, yet these triggers may be seemingly unrelated events such as a child jumping off a playground gym where the posture of the arms and body in flight trigger the emotional memory of someone jumping off a building.

In addition to the emotional flashback many people experience autonomic responses which may include:
Feeling detached or emotionally numb.
Constant Anxiety or Panic.
Irritable and more aggressive.
Easily startled.
Hyperactive or hyperstressed.
Sleep problems and nightmares.

Some may tend to avoid activities which remind them of the event, deny the event or its effect on them, or are unable to recall some aspect of the traumatic event.

Most people will have some of these symptoms for a few weeks, maybe up to two months and that will be the end of it, except possibly on the anniversary of the event. Others may experience flashbacks even years after the event.

Depression and Thoughts of Suicide
The two prime reasons that a person becomes depressed, are a loss of control, over their life situation and of their emotions, and secondly a loss of a positive sense of their future (loss of hope).

The fact that our emotional and autonomic responses to trauma are independent of our cognitive input places undue stress on our conscious mind and we begin to feel a loss of control. We do not understand why this is happening to us, and negative ruminations about our inability to control this process causes further loss of control of our emotions. We begin to lose hope that we will ever gain control of our emotional and autonomic responses.

It is the genetic responsibility of the unconscious mind to maintain control of our being in order insure our survival and pro creation as a species. As we begin to lose control of our emotional response the unconscious mind will initiate a protective depressive response so that our lack of emotional control will not destroy us. Yet the protection afforded us by the depressive response is short lived if our conscious mind cannot solve the problem and alleviate the stress. In that case the depression itself becomes debilitating and we are at risk of becoming suicidal in order to escape from the pain of depression and lack of control.

Those people who were already suffering from depression when the New York World Trade Center and Pentagon were attacked by terrorists are especially at risk of becoming further depressed and of triggering suicidal thoughts. The depressed will tend to personalize the terrorist attack to the point of it confirming that they are not in control and there is no hope left in their future.

Combating Post Traumatic StressCarol S. North, MD, MPE, a Washington University psychiatrist authored a study of survivors of the Oklahoma City bombing. One in three developed PTSD and almost half suffered depression or alcoholism. They found that those who relied most on numbing (alcohol and drugs) and those who avoided thinking or talking about the bombing were most likely to develop long-term problems.

The general population of the USA is more at risk of suffering PTSD after the New York attack than it was after the Oklahoma City bombing. This is due to the increased scope of the disaster and the fact that many of us witnessed the despicable event live on TV, and again and yet, again.

I shall not, nor have I ever, written about personal pain and emotional trauma without, to the best of my ability, attempting to help ease the pain and normalize the emotional trauma. These are my suggestions to help combat our Post Traumatic Stress:

1. First and foremost is to become informed. You should know why you are having flashbacks, unusual emotions and unexplained autonomic responses. These symptoms are natural reactions to trauma. The conscious mind is not innately aware of how or why the unconscious mind reacts to trauma in order to maintain control of our being. If our conscious mind over reacts to the symptoms of trauma we risk making it worse and may become depressed.

2. Think about and talk to others about your experience and your feelings. Your thoughts and talks should be directed. THIS IS VERY IMPORTANT! If you do nothing but re hash the horror of that event and leave it at that, you will reinforce and strengthen the unconscious response to that trauma. You must end each thought or talk affirming that you will do everything within your power to regain control, and that there is hope in the future, however slight. Tell the truth, it may be that your only chance to regain control is to seek help and that you failed today but you WILL try again tomorrow. If you cannot do this then I suggest that you seek professional help.When you think and talk about the event in this manner, over time it will help to desenseitize the emotional and autonomic responses and you will be less likely to become depressed.

3. Do not try and hide or mask your symptoms by using alcohol and drugs, it will do no good and may hasten the depressive response.

4. Exercise , eat right, and cleanse your body of toxins by drinking more water and possibly a short one or two day juice fast. This will clear your mind, strengthen your immune system, and help combat negative thoughts.

5. Take a break from thinking about this incident. Right after the terrorist attacks I was glued to the television set for days on end. I had to force myself to return to work and finally decided to write this article. I know that this article is about the attacks, but my focus is on presentation and finding solutions and not on the negative aspects. Of course you need to keep informed and I am not suggesting hiding from it, but your mind needs a rest, find other things to do.

6. Find ways to help others. This keeps you from over personalizing the event. Right after the attacks many people donated blood and financial contributions have been extraordinary. At the appropriate time you could write letters to the survivors showing your support, and later there may be people in the armed services that might appreciate a letter of support.

You also might organize and attend a local support group for people, especially the young, who have been suffering PSTD because of this event.

ConclusionMy hope is that this situation is resolved in a timely manner with the least possible loss of life and that very few people suffer from Post Traumatic Stress. My fear is that further bad news will exacerbate the incidence and severity of PTSD and depression. Either way I hope that the professional and governmental mental health communities are prepared and take some action before things get out of hand.

© Stephen L. Bernhardt - 2001 steveb@frii.com