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Experts: Trauma, fear natural reactions

By Rhonda Rowland
CNN Medical Unit

(CNN) -- For rescue workers and medical teams working at the sites of the World Trade Center and Pentagon tragedies, the emotional reality is starting to set in.

And for those who escaped the horror of the terrorists' destruction, the thrill of being alive may now be tempered by the shock -- and guilt -- of surviving.

What has been termed "post-traumatic stress disorder" affects hundreds of thousands of people who have survived earthquakes, plane crashes, violence and terrorist bombings.

Terri Shaw, an Oklahoma City bombing survivor, says the ailment is very real. She was buried in rubble, then rescued.

"I thought I was going to die once I realized it wasn't a dream," she says.

In the days following her rescue, her mood varied widely.

"At first it was pretty much shock," she recalls. "Not a whole lot of emotion, kind of happy. (I) didn't realize the impact at all."

Symptoms develop within days

Emotional numbing, along with loss of pleasure, lack of concentration, insomnia, headaches, alienation and distrust are the symptoms of post-traumatic stress syndrome, says Dr. Karen Sitterlee, a mental health expert at the University of Texas Southwestern Medical Center who counseled victims of the Oklahoma City bombing.

Experts give tips on how to cope with stress caused by traumatic events. CNN's Rhonda Rowland reports (September 13)

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"What we'll see is that, in the first few days -- and really even the couple of weeks -- following an event, people develop symptoms associated with trauma," she says.

Victims aren't the only ones who can suffer. Rescue workers, family members, co-workers, and even those who watched from a distance -- including on television -- are also at risk, says Sitterlee.

"Because of the nature of terrorism and the unique features associated with terrorism, (it) really creates a much larger or greater group of victims," she says. "For children, whose only exposure to the (Oklahoma City) bombing was through television media coverage ... they actually showed symptoms of post-traumatic stress."

Fear of flying also a problem

These second-hand looks can also contribute to one of the most common psychological maladies: fear of flying. Even before the deliberate plane crashes that caused the destruction of the World Trade Center and the Pentagon, one in three Americans was anxious or afraid to fly. Mental health experts expect that number to grow, at least for now.

Experts say the most effective ways to deal with the fear is to keep flying and tolerate the anxiety. It will be reduced over time, they say. Relaxation exercises, proper breathing, and avoiding caffeine, sugar, nicotine and alcohol can also help.

Increased airport security won't hurt, either, suggests Dr. Daniel Yohanna of Northwestern Memorial Hospital in Chicago, Illinois.

"Those who are concerned about safety on airlines may see the increase of security in airports as somewhat comforting," he says.

Mental health experts say we can all help one another. If anyone you know feels stressed or traumatized, listen patiently and without judgment. Anyone can do the listening: family, friends, co-workers, or clergy, as well as mental health professionals.

For most people the emotional symptoms subside within about a month. If they persist, counseling is recommended.

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