Tuesday, September 11, 2007
Flashing back to 9/11

Today, on this sixth anniversary of 9/11, the country will mourn together. For most of the country, it will be a reminder, an anniversary, but for thousands of others it could be psychologically devastating. It could cause something known as PTSD or post traumatic stress disorder. The symptoms can be awful and the research shows us the reminders don't help.

We know on average 4 percent of the general American public suffers from PTSD, but one in eight 9/11 rescue and recovery workers had PTSD, even years after the attack, according to the World Trade Center Health Registry. We know firefighters developed PTSD at 2 times the rate of police officers, but both groups continue to suffer today. We also know that PTSD is an anxiety disorder that is marked by sudden and intense fear, along with feelings of desperation, hopelessness and outright horror. We know it can be difficult to treat.

During the last six years, there has been a growing body of research on PTSD, looking at the survivors of 9/11 and veterans from the wars in Iraq and Afghanistan. For example, researchers are looking at propranolol, a blood pressure medication, as a possible treatment for PTSD. The idea is that this medication will block the adrenaline surge associated with a traumatic event. If you can block that release of adrenaline, the terrible memories may not be seared into the brain, and that might reduce the risk of future PTSD. There are some emergency rooms that now give the medication immediately after a traumatic event. There also is video game technology used for returning veterans. I tried it out myself and understood the premise that by exposing someone to previously traumatic events in a controlled setting with psychologists standing by, you could learn what is specifically traumatic, and deal with it. (Watch Video)

The triggers for PTSD aren't necessarily the images you will watch on television. They could be a sound, like bells ringing, or a certain smell. The best advice is to try and recognize if you are suffering and get help. Below is a list of resources that can provide some assistance. Take care of yourself, especially on this day.

If you have ever suffered from PTSD, or know someone who did, how did you deal with it? What worked best for you and what didn't work?

9/11 NYC health website

National Center for PTSD

Hi Dr. Gupta, I've worked veteran meantal health since 1999 and have seen many cases of PTSD. We're trained to be especially vigilant and sensitive on rainy days because the rain can trigger flashbacks for Vietnam veterans. I also have a colleague who was in Vietnam and he still can't drive his car over anything in the road (trash, roadkill, even just a discoloration in the asphalt) because he flashes back to hidden road bombs during the war. PTSD is really a daily struggle and I worry about our troops overseas right now.

I currently live in New York City and have friends who still cannot go back to the place they were when they first heard we were under attack. Two months ago I had to switch places with my friend who was driving because she started having an anxiety attack after turning onto the street she drove down when news of the first plane hitting the tower came on the radio. Sudden pain, anxiety, and flashbacks are daily problems for New Yorkers. I am especially worried about Mayor Bloomberg's plans to move city and state employees who were working in or around the towers on 9/11 to the new freedom tower once it is built. I fear the PTSD and depression may be overwhelming if forced to return to the site of their trauma. No one should be forced to return to that every day or face losing their job.
Dear Dr. Gupta,

Hello again. Thank you so much for addressing the concern of PTSD. I feel so sad for those still struggling since 9/11. It was traumatic enough to see it unfold on live television; I can only imagine the anguish of those who were actually there. I’m so sorry for what they have been through ever since and keep them in my heartfelt prayers.

The suggestion of immediately addressing the PTSD concern with a patient immediately after a traumatic event could be a lifesaver.

Personally I had never heard about it before my car accident. I was diagnosed with PTSD within the first few months after. I dearly WISH I had known what was going on – I was in so much distress.

I had always been a cheerful positive person. My mother said that even as a baby I woke up giggling and happy (strange child…) Suddenly after the car crash I changed. I lost my sense of humor and could barely even smile. I was numb, completely in a fog. I was crying all the time – I would cry at the drop of a hat and all night. I had never cried like that in my life. I actually never suffered nightmares as I could not sleep (I did have severe physical pain due to the injuries) but I simply could not rest mentally either. I had never experienced anxiety before and suddenly I felt overwhelming fear – it was so frightening not to understand what I was scared of. I was in perfect shape at the time of my accident, slim and healthy but I lost more weight and became dangerously thin (my doctor commented on it). My mind went blank and I could not even tell the doctors or physiotherapists where I had pain; I was so frightened that I was going to stay in that condition. In fact, at a certain point I was actually asked to mark down my symptoms and hand it to them.

It was like I was trapped inside my body. I cut myself off from most of my dearest relatives and friends – I didn’t even recognize who I was anymore. I didn’t want anyone to see the changes in me either. I don’t know what I would have done without the support of my dear family and friends during this dark time in my life.

One day, I remember lying on the physiotherapy table and I could hear all the physiotherapy staff on the other side of the curtain joking and laughing from the depth of their hearts – the peals of laughter seemed deafening to me. I remember tears streaming down my cheeks, and I wondered: “Will I ever laugh again?”

About 8 or 9 months in my physiotherapy my sweet mother accompanied me on one of my physio appointments. My second physiotherapist and her assistant were so caring towards me and all their patients. But after they left the curtained room, my mother looked so worried and kindly whispered: “Oh Gina, they are trying so hard to be so kind to you, please, can’t you even try to be friendly?” I was lying on the physio table and it was like a stab in my heart to hear that. I felt so sad as I had no idea I was acting unfriendly. It was not consciously done. It was at that point I realized I felt absolutely nothing at all inside. I didn’t feel lovable and I wasn’t able to show any feeling to anyone. It hurt me deeply to realize it showed.

There was a dark and sad point where I truly didn’t feel I could go on. I was in so much pain physically and psychologically. My faith was all that was keeping me alive. I remember sobbing and praying from the depth of my heart to God to please, please, please help me go on…. I was tired of being in pain, so tired of physiotherapy and rehab (car accident rehab) and so tired of doctors’ and physiotherapy and car accident rehab appointments and the agony of meeting up with some of them who were so unkind. So tired beyond words. I couldn’t see the point of seeing a pain clinic psychologist but I finally agreed. That was truly an answer to my prayer…

My heartfelt plea to anyone suffering from PTSD is to please get help and not feel ashamed. Remember that it’s okay not to be okay. My feeling is that it can get worse if you ignore it. I can say that it was such a blessing for me to have someone try to help me understand why I was I had fallen apart. My pain psychologist pinpointed my PTSD exactly and what had made it worse. Kindness means the world to someone in great pain. Someone finally understood me better than I did at that point.

Then I remember being asked: “are you depressed?” I couldn’t even answer, as I felt so numb. And then immediately I was very gently told: “You know, it wouldn’t be normal if you weren’t depressed.” What a relief it was to realize that it was truly okay not to be okay. Besides pain killers I learned I needed something to help me sleep – my loss of sleep was aggravating everything. With a good night’s sleep I began to feel so much better!

After my first appointment I have such a vivid memory of walking outside of that Pain clinic at dusk and looking up at the beautiful sky and actually saying a silent prayer to thank God for helping me. For the first time my tears were for a valid reason: I felt hope. To feel anything after so long was so wonderful! I was on the road to feeling “human” again.

Honesty is so important. In my own way I was dishonest in the beginning, because I was lying to myself. In the beginning I was trying to pretend I was okay in all ways. I was trying to be so very, very brave. I was sure I could get through this all by myself. I didn’t want to complain or “bother” the doctors, physiotherapists or specialists with things. It was hard to learn how to be a “patient”. I wanted to just get better and move on with what had been my wonderful life. I just wanted everyone to please leave me alone – even helpless animals will go off to a lonely place when they are injured. I thought it would all just go away. But sometimes life is not as simple as that.

What I learned is that often the hardest thing is learning to be patient with yourself. You simply cannot rush through any sort of a grieving process including PTSD. And you must never allow anyone else to try to rush you either. With great patience, you have to learn to take life one minute, one hour, one day at a time until your body and you broken heart begins to heal. It’s not only love that breaks hearts. A trauma can break your heart and spirit. But it’s worth the patient endurance to finally see a tiny glimmer of light at the end of the tunnel.

I remember at one point my dear step-dad had some comforting words that meant so much to me. He said that we can take a lesson from creation: The sun doesn’t shine everyday and sometimes we can’t either. (Or we don’t have to shine). So sometimes we must either accept or allow those gray days, gray moments and patiently realize that the sun will come out again. We must hang in there and not give up. And we may need to seek help to do so.

So Please: Be honest. Get help. Please don’t feel ashamed. You may feel that you a have gone crazy – but you haven’t. After my car accident, I had other dear friends who were involved in very serious car accidents too. I discovered that went through the exact same cycle of feelings. And since then I have talked to many others who state the same thing. It’s such a relief to know that we are not alone.

And a few years after I read something that showed the symptoms of PTSD, it helped me to understand what had happened to me:

Dr. Gupta, if only someone had explained PTSD to me from day 1 in the hospital, it would have saved me from months of painful distress. I dearly hope that all hospitals or doctors will immediately (or do already) address this important health issue with their patients after their patients’ traumas. Thank you so much Dr. Gupta for addressing this concern – it might actually save a life.

Keep up the good work, and thank you again. Please take care.

In much appreciation,
Areti Gina by the sea

Life is beautiful........"What do we live for, if not to make the world less difficult for each other?" ~~George Eliot (1819-1880)
I developed PTSD after finding my father's mutilated body in 1999. The experience of PTSD was extremely difficult, but since I was already suffering chronic panic disorder I was familiar with many coping skills when my PTSD began. A detailed account of the experience and my gradual recovery can be read at my web site.
I'm a 9/11 survivor. I was diagnosed with PTSD and ordered to take time off work, etc. Eventually I got off the valium and started running, doing yoga and I learned meditation. I credit those things with helping me fully recover. Now when 9/11 rolls around instead of staying in bed and slipping into an anxious depression I celebrate with friends.
This is just a heads up about research related the causal relationship of vaccines to incidents of Autism, Asthma, and ADHA.

Was in a car accident [in passenger seat in car that went under a semi 20 years ago] and received poor Dx/Tx from medical-psych professionals. Being a reader with access to a major University Medical Library and an educational background that helped me, I learned to recognize the triggers that caused panic, fight and flight, hallucination, severe muscle tension, claustrophobia, insomnia and head aches. Best results were to recognize triggers and try to avoid them or prepare for them. Controlled breathing and muscle relaxation techniques worked the best to minimize the symptoms.
Exercise and finding venues that increased self-confidence helped. Gardening was good for me as it gave an outlet that put me in control.

It is difficult to find someone to discuss PTSD with because of lack of understanding and the chronic symptoms sound like hypercondria to none sufferers.
This "comment" is not about the titled subject, it is about a report Dr. Gupta made over the past week> The report spoke about how to choose a hospital. All of the items were were things I would want in my primary care facility, with this addition CRNA are as vital and as important as anesthesiolgist. We have been providing care for 125 years (Civil War). Out national orgaziation was founded in 1931 , A large percentage of the anesthesia in the US today are by CRNAs. Thank You for your attention. Catherine Sanders, CRNA
i could not believe it. i could not find a single soft drink, or even 100% fruit juice that does not contain 'high fructose corn syrup' except 100% orange juice. even 100% grap juice has that jung in it!
While watching the story about the overweight and obese children I thought about the following:

If you eat properly you will die.

If you eat properly and exercise you will die.

If you eat anyhting you want and don't exercise guess what? Yup you will die.

Live life to the fullest and eat want you want the results are the same.
Thank you Dr. Gupta, for continuing, to keep the medical crisis, of PTSD, in the news. The government's attempt, to misdiagnose PTSD as "Personality Disorder" goes back, to 1973, for me. After 2 tours in Viet Nam, as a door gunner and crew chief, I definitely needed help, when I returned from Nam. The VA said I simply had battle fatigue and was suffering, from Depression so conveniently, for the Army, it wasn't service connected and I received no disability benefits. Now again it's called Personality Disorder and not service connected. Well, after 37 years of self medicating and 3 divorces, I was finally diagnosed, with PTSD, 100% service connected. Veterans returning from Iraq and Afghanistan are facing the same hostile and enept VA system and are, in the same situation, as returning Nam Vets. Nam Vets changed the VA's policy, on PTSD, after many years, of litigation and medical studies. Unfortunately our new Vets will have to go through the same process, unless they join a group like the Veterans of Foreign Wars. Our mission is to assist veterans, with, starting the process, of claiming the benefits they're entitled to and share experiences unique, to combat veterans. This can help, when you're dealing, with the symptoms, of PTSD. The VA is not out to help you obtain your benefits. They will obstruct you. Don't give up. Get help for anger mamagement and all the nightmares. Your family will thank you.
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