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What We Know About the Health Impacts of 9-11
By Thomas Farley, MD, MPH, NYC Health Commissioner
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9/11 Health - What We Know
More About Mental Health
The events of September 11, 2001, exposed hundreds of thousands of people in New York City and beyond to distressing experiences, events and images. Studies conducted after 9/11 suggest that rescue, recovery and clean up workers; friends and relatives of victims and survivors of the WTC attacks; and those who repeatedly witnessed the events on television and in newspapers are at greater risk of developing long-term 9/11- related psychological problems.
Psychological Impact of the WTC Attacks
  1. People exposed to traumatic events such as the 9/11 attacks and their aftermath may experience emotions such as fear, helplessness, or horror, especially if the events include serious injuries or death.
  2. Most people exposed to the WTC attack showed some signs of stress in the immediate and short-term aftermath of the event. This is a normal reaction that usually disappears in a few weeks. Some people, however, continue to experience stress or their symptoms worsen, even years after the WTC attacks.
  3. The most common long term mental health conditions seen in those exposed to the traumatic events of 9/11 are post traumatic stress disorder (PTSD), depression, general anxiety disorder (GAD), and substance use disorders. A person can suffer from more than one of these conditions.
  4. Trauma related disorders can be treated and help is available.
Learn more from the NYC Department of Mental Health and Hygiene:
How People React to Traumatic Events   PDF Document (Reader Required; Click to Download)
Seeking Help After Exposure to Traumatic Event   PDF Document (Reader Required; Click to Download)
Mental Health Conditions Most Commonly Associated with the WTC Attacks
Post-Traumatic Stress Disorder
People, who continue to experience stress for a long time after their exposure to the events of 9/11 or have stress that gets worse with time may suffer from Post Traumatic Stress Disorder (PTSD) and should consider seeking professional help.
Symptoms: PTSD is an intense physical and emotional response to the thoughts and reminders of the traumatic event; this response lasts for weeks, months or even years after the exposure. The three most common symptoms of PTSD are:
Re-living the events in flashbacks and nightmares along with feelings of guilt, extreme fear of harm, and numbing of emotions. Shaking, chills, headaches and fast heart beat are also common.
Avoiding places and activities that reminds the person of the events of 9/11 or feeling detached from others.
Increased reactions such as feeling overly alert or easily startled, and experiencing difficulty sleeping, irritability and angry outbursts.
Other symptoms may include, panic attacks (sudden instances of intense fear and discomfort and fast heart beat, sweating, trembling, feelings of choking, shortness of breath), depression, drug and alcohol misuse, feeling isolated and thoughts of suicide.
Learn more about PTSD from the NYC Department of Health and Mental Hygiene, and from the National Center for PTSD:
Post Traumatic Stress Disorder   PDF Document (Reader Required; Click to Download)
What is PTSD?   PDF Document (Reader Required; Click to Download)
Depression
People who directly witnessed the WTC attacks and those who participated in the rescue and recovery efforts may be at increased risk for developing depression, with or without PTSD.  Depression can be a disabling condition that affects many aspects of a person’s life.
Symptoms: extreme sadness, inability to enjoy things, guilt, helplessness, hopelessness, trouble sleeping or concentrating, loss of appetite and thoughts of suicide and/or death.
Learn more about depression from the NYC Department of Health and Mental Hygiene: 
Get Help For Depression   PDF Document (Reader Required; Click to Download)
Generalized Anxiety Disorder
People exposed to the WTC attacks are also at increased risk for developing Generalized Anxiety Disorder (GAD), a mental health condition characterized by persistent, excessive and uncontrollable worry and anxiety about daily life and routine activities.
Symptoms:  Restlessness and irritability, muscle tension, difficulties with concentrating, difficulty falling or staying asleep, body-aches, trembling, jumpiness, headache, difficulty swallowing, stomach discomfort, diarrhea, sweating, hot flashes, and feeling lightheaded and breathless.
Learn more about GAD from the National Institute of Mental Health: 
Generalized Anxiety Disorder: A Real Illness   PDF Document (Reader Required; Click to Download)
Substance Use Disorders
Stress and exposure to traumatic event may increase the risk of developing substance use disorders (such as dependence on alcohol and other drugs, including tobacco) or cause relapse among people who previously had a substance use problem.
People who have a substance use problem may feel they:
  1. cannot cut down on their drinking or drug use
  2. annoyed when people criticize their drinking or drug use
  3. cannot start the day without an “eye-opener” drink first thing in the morning
  4. need to have alcohol or drugs in order to feel better
People with this type of disorder continue drinking or taking drugs despite problems at work, school and home, or placing themselves and others in hazardous situations such as driving after drinking, or have problems with the legal system.
Learn more about substance use disorders from the New York City Department of Health and Mental Hygiene, and the National Center for PTSD: 
How Much Is Too Much?   PDF Document (Reader Required; Click to Download)
Still Smoking? Cigarettes are Eating You Alive   PDF Document (Reader Required; Click to Download)
Disasters and Substance Use or Dependence: A Fact Sheet   PDF Document (Reader Required; Click to Download)
What You Can Do: Getting Help
For people who meet certain eligibility requirements, mental health services are available at no cost to people with psychological distress related to the 9/11 terrorist attacks through New York City's three WTC Centers of Excellence.
New York City residents who were enrolled in the 9/11 Mental Health and Substance Abuse Program which ended in December 2007 are eligible for a similar program, the NYC 9/11 Benefit Program for Mental Health and Substance Use.
Residents of New York City who have symptoms of psychological distress that can be detected through brief screening tools and that are likely related to the 9/11 terrorist attacks also are eligible for the NYC 9/11 Benefit Program for Mental Health and Substance Use.
Additional mental health resources can be found here.
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