Fitful sleeping. Dreams of the World Trade Center attack and rescue process. Irritability. Shortness of breath. Nausea. Inability to concentrate. Unexpected crying jags. I have been experiencing all of these things since September 11th, as, I am sure, everyone around me has in varying degrees. We are all experiencing acute stress disorder.
Giving a name to the phenomenon does not seem to help, nor is there comfort in the knowledge that I am not alone. Knowing these are normal reactions to very abnormal circumstances offers only a little solace.
Nonetheless, some information about acute stress disorder can help us to know that this is a temporary condition for most people. We can also better determine what is a normal response, and when the symptoms indicate the need for professional help.
Acute stress disorder is very similar to post traumatic stress disorder. These conditions are triggered when an event involving actual or threatened death or serious injury to oneself or others either is experienced or witnessed, resulting in the individual feeling a sense of intense fear, helplessness, or horror. Whether we personally survived the September 11th attack, or have loved ones and friends among the missing and dead, or simply watched events unfold on our televisions, nearly all of us have experienced or been witness to a horrific tragedy. The symptoms are virtually the same for both conditions, except acute stress disorder usually passes for most people, while post traumatic stress may last anywhere from one month to years. These symptoms include
- Disturbing memories, images, or thoughts of the event that
are recurrent and intrusive.
- Hallucinations or flashbacks.
- Recurring dreams of the event.
- Difficulty falling or staying asleep.
- Irritability or outbursts of anger.
- Difficulty concentrating.
- Being easily startled and overly cautious.
- Numbing, withdrawal, and avoidance of anything associated
with the trauma.
- Crying spells.
- Feelings of generalized anxiety.
During the first day or two following the attack, much of the nation was shrouded in a sense of unreality, as though the next day would come and we would discover we had been dreaming. Some of us sat glued to the television, watching the horrible events take place before our eyes time after time in an almost continuous loop. It was as though we were trying to convince ourselves it had really happened. The sense of unreality is a type of denial that is often the first symptom of acute stress. We disassociate ourselves from a horrific event until the mind is able to absorb its reality, a little at a time. Some people I know are still in this numbing stage.
Once reality sets in and the numbness wears off, the other symptoms begin to manifest themselves. The expectation among mental health workers is that most of these symptoms will disappear about 4 to 6 weeks after the traumatic event. In the meantime, there are steps that can be taken to deal with these physical and emotional changes. The first suggestion is to give yourself and others permission to have these feelings; under the circumstances, they are sensible and you are not over-reacting. Second, talk about what you are experiencing with others. Be patient with others, and do not take their anger personally. Stay in touch with family and friends. Try to sleep and eat well, get regular exercise, and maintain as normal a routine as possible. When you feel your tolerance and strength is diminishing, take a break from whatever you are doing.
We need to remember that nearly everyone around us has been affected by the recent events. Each of us will work our way through the trauma and stress in our own time. But if you or someone you know has symptoms that persist beyond 6 weeks (without any additional traumatic events occurring) and the symptoms are interfering with daily activities or health, professional assistance is recommended. There are treatments available to help. For information about counseling services, residents may contact Infoline at 211 or the Mental Health Association of Connecticut at 529-1970.