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Laura Dodson
Professor Campbell
UWRT 1103
610 DecemberNovember 2016
The Plane Crash Felt Across a Nation: The Mental Impact of 9/11
Penny was staying in the Millennium Hilton Hotel directly across from the twin towers in
New York City the day of September 11th ,2001. She was just one of the millions of people who
wasere enjoying hertheir mornings until disaster struck. As sShe recalls, People were throwing
whatever they could find out of the windows to break the glass and get air. I could see them
hanging out of windows, then to my horror I realized people were beginning to jump to their
death rather than being burned alive. What a terrible choice to have to make. And there was
nothing I, or as it turned out, anyone else, could do to help. (qtd in Collett). This image was
instilled in not only Pennys mind, but the minds of all Americans who witnessed one of the
greatest cities in the United States become penetrated with sorrow. It is an extremely dark event
to move forward from and unfortunately some have not yet found their light. This leads to the
question:; How were Americans psychologically affected by the attacks of September 11 th?
Several mental disorders arose in those most impacted by the attacks, which are still
being felt 15 years later. PTSD is a one of the more serious disorders associated with the
traumatic event. While depression and anxiety are broader, more common disorders felt amongst
Americans during this time, symptoms of PTSD were discovered in the people who were most
impacted by the attacks. Based on the U.S. Department of Veterans Affairs and the National
Center of PTSD, symptoms include reliving the event through nightmares and flashbacks,

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avoiding situations that bring back memories of the event, negative changes in mood, and feeling
jittery and alarmed at loud noises. A surge of patients presenting signs of PTSD revolve around
9/11 anniversaries, when video footage and remembrances of the day are displayed to honor the
fallen. Matt Komorowski, a New York firefighter who miraculously survived the falling of the
World Trade Center on 9/11, describes his life after the events. Sometimes I cry for no reason.
When I say no reason, I know its 9/11, but theres nothing in the day that sets it off. Its just that
youre at a saturation point. (qtd in Fishman). A few days after September 11th, Matt was jolted
awake in the middle of the night by his body shaking uncontrollablyle for twenty minutes.
Similar accounts have been described by others who felt the mental impact of 9/11. Although
this is an account of a firefighter who was personally involved in the attack on the World Trade
Center, signs of PTSD spread farther than New York City residents alone. It is logical to
correlate a greater risk of mental disorders within those who personally encountered the attacks;
for example, survivors, firefighters, police, volunteer rescue workers who witnessed the horrors
of 9/11. Then there are the people who were personally involved in the traumatic event, yet show
no signs of PTSD. Mickey Kross, also a firefighter who survived the fall of the World Trade
Center on 9/11, was rescued from under 100 floors of the collapsed towers, yet immediately
returned to the scene of ground zero to help search for survivors like himself. In the Miracle of
Stairwell B , a documentary which tells the extraordinary story of 16 survivors rescued from a
stairwell of the collapsed World Trade Center, Mickey Kross justified his return to the horrific
scene by saying, I wanted to do my part to help fix this thing and it wasnt just to find the
firefighters, because Im a firefighter, but to find the people. It demonstrates the varying coping
mechanisms of humans, that a man who was buried under tons of debris can return to the scene
of his nightmares, while a person who witnessed the attacks on the television can potentially

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develop a mental disorder. In an article published in The New York Times, Dr. John Howard, the
director of the National Institute for Occupational Safety and Health and an overseer of 9/11
programs, defends the public by giving them the benefit of the doubt on PTSD. He said,
Collapsing 220 stories of a lot of material in one of the most densely populated cities in the
world is a very unique event. (qtd in Healy). This brings attention to the classification of mental
disorders and who qualifies for the diagnosis of these disorders.
Who qualifies for a diagnosis of mental disorders like PTSD?
The events of 9/11 changed the way PTSD is perceived in the medical field, from being a
mental disorder primarily dealt with by psychiatrists, to a public health issue (Healy). The attacks
of 9/11 were brought into homes, schools, and workplaces all over the country through news
coverage, allowing Americans to witness the tragic events taking place not so far away. The
degree to which the news stations captured the events unfolding, brought Americans to the scene
and gave a sense of unity amongst those who were present and those who were miles away. The
most difficult decision is whether people could developsuffer from PTSD through watching
television coverage of the attacks. It is shown that tThose who were informed of the events by
watching more graphic television coverage were more likely to report extreme symptoms of
mental disorders (Harmon). While some experts acknowledge the development of PTSD
amongst those who were not geographically near the attacks, others are skeptical to the
accusations. Dr. Robert L. Spitzer, a retired psychiatry professor from Colombia University and
an expert in mental disorder classifications, advocates for tightening the criteria of PTSD. It has
become too vague, with almost no other psychiatric disorder generating as much controversy.
(qtd in Hartocollis). As supported in a New York Times article based 10 years after 9/11,
Congress most evidentially relies on the diagnosis of mental disorders based on geographic

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boundaries, by excluding the television watchers from government aided treatment programs
(Hartocollis). It is hard to believe that potentially suffering Americans could be overlooked
solely due to the way they were exposed to the events.
Does proximity to the attacks determine the prevalence of mental disorders within
civilians?
The controversy that surrounds the mental impact of 9/11 on Americans, revolves around
the concept of geographical position to the attacks. Based on a study that examines New York
City companies affected by the 9/11 attacks on the World Trade Center, geographic distance is
associated with increased risk of developing post-traumatic stress disorder (Fisher). What implies
the distance one must be from a traumatic event to feel the emotion impact of its aftermath? A
2002 survey, published in JAMA The Journal of the American Medical Association, concluded
that some 4.3 percent of the general population had signs of PTSD, without having direct
exposure to the attacks (Harmon). Although, Ssurveys are not often reliable sources of data to
base conclusions, but more people are likely to respond to a public event such as 9/11. The
authors of the peer-reviewed article found in The Lancet, produced studies that focused on those
present in New York City at the time of the attacks that showed signs of PTSD and depression
and how long these symptoms lasted. From the studies, they concluded that chronic PTSD was
more prevalent in recovery and rescue workers than in residents alone. There is potential for
populations outside of a geographical distance from the towers to develop similar symptoms of
PTSD like those who were directly exposed, but they are not to the degree of those personally
related. After 15 years of collecting information on mental disorders associated with the attacks
of 9/11, it is evident that the complexity to which the diagnosis of PTSD and other related
disorders pose a challenge on researchers to find a consensus of how far the effects of 9/11

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spread (Fisher). Differing opinions on the subject adds a complexity that allows researchers to
continue inquiry on the developing 9/11 mental health influences on the public.
How do people inflicted with emotional distress from the September 11 th attacks move
forward?
Mental illnesses are more difficult to heal than physical ailments, involving deep
exploration into the mind and identifying the factors causing the stress that leads to depression.
When someone witnesses a traumatic event, it is usually a beneficial task to talk about the
situation. After 9/11, therapists and support groups reached out to struggling victims of PTSD
and depression triggered by the attacks. Many organizations were developed to allow victims to
have a support group and a place to turn for help moving forward. The World Trade Center
Survivors Network is a website developed to bring together victims of 9/11 to connect and share
their stories, allowing people to come together and take the steps towards recovery. There are
several forms of therapy used to treat mental illnesses, but the two most commonly used in
pinpointing the underlying aspects of PTSD and depression are cognitive and exposure therapies.
Cognitive therapy focuses on identifying what thoughts make the patient stressed and anxious,
while exposure therapy trains the patient to control the harmful thoughts. Patients can also be
prescribed medications to decrease their symptoms. Based on the National Center for PTSD,
antidepressant medications are used to increase the levels of serotonin in the brain causing the
depressed thoughts.
Depression is a common instigator of substance abuse, which is what many turned to
after the traumatic 9/11 events. They used drugs and alcohol to cope with psychological
disorders, which in the end doesnt help their problems, but gives them temporary relief. Dr.
Vlahov and the New York Academy of Medicine conducted a survey of New York City

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residents, finding that almost 29 percent of respondents reported smoking more cigarettes and/or
marijuana and/or drinking more alcohol. Dr. Vlahov concludes his findings by saying, The
increases in use of cigarettes, alcohol, and marijuana across the population are large, making this
a broad public health issue (qtd in Stress). Psychological effects are not always presented
through distinct symptoms and people handle stress in different ways, making it difficult to
determine how many people were actually impacted by the attacks on September 11 th. It is
important to help anyone who is struggling with mental illnesses despite the way they choose to
cope with them.
September 11th was an enormous event in American history, that was felt across the
nation. As people came together to rebuild their beloved city and mend broken hearts, the
emotionally distraught were left to cope with surreal aftermath of that tragic day. The
government acknowledged the need for treatment programs for those most mentally impacted by
the events. Congress passed the James Zadroga 9/11 Health and Compensation Act, which
provided $4.3 billion, allowing victims to treat their illnesses without worry of financial conflicts
(Hartcollis). Mental disorders, like those accompanying the 9/11 attacks, can be present in
victims for a lifetime. A revised James Zadroga 9/11 Health and Compensation Act was
introduced in 2015 to continue the financial support of 9/11 sufferers, demonstrating the
continuous impact of the September 11th attacks on Americans (Coalition). This Act was
especially beneficial to those who struggle financially and cant receive proper treatment for
their illnesses. Differences in economic status has been shown to determine how likely someone
is to develop PTSD. An article in Scientific American described a study which found that 9/11
survivors who had yearly incomes of less than $25,000 had a 49 percent chance of
sustaininghaving PTSD, while those who had yearly incomes of over $100,000 had only a 6

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percent risk. Those that earn less have limited recovery options due to financial restraints.
Millions are benefiting from this act after their lives took a turn for the worse during the years
following the September 11th attacks. Many victims have been able to make moves towards
recovery through treatment programs and support groups. Research published in The Journal of
Nervous and Mental Disease, proclaimed that the rate of PTSD among New York residents
eased from 5 percent one year after the attacks to 3.8 percent two years later. One group of
workers who curiously showed less signs of recovery were retired firefighters. Still some four
and six years after the attacks, around 22 percent of retired firefighters who responded on 9/11
were still suffering from PTSD (Harmon). After working in a high intensive job such as fighting
fires, retirement allows time for relaxation and recollection. This was difficult for firefighters
who now had time to dwell on the traumatic events of 9/11 and realize how psychologically
affected they were.
How do people inflicted with emotional distress from the September 11 th attacks move
forward?
Massive public events, such as terror attacks, are difficult to escape, especially when you
are reminded of the devastation every year. Anniversaries trigger emotions that lead to increased
anxiety and stress levels. As the years have progressed, 9/11 victims will be relieved to know
that Osama bin Laden has brought to justice for his actions in 2011. Dr. Dass-Brailsford,
representing the psychiatry department of Georgetown University Medical Center, says, In
doing trauma work, usually when the perpetrator is brought to justice it can be very healing for
survivors (qtd in Harmon). Once someone is held accountable for their actions, the victims can
begin to recover as they feel less anxious about the situation. Despite the devastation that the
9/11 attacks caused Americans, the United States became stronger as a country and as a people.

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Data gathered through research bases after the attacks allowed for mental health preparation of
terror attacks that may occur in the future. Is the United States prepared for another terror attack?
One could justify that the United States has increased military forces and has had 15 years of
determining what went wrong on September 11, 2001, but no one truly knows the extent to
which a country could prepare for an unplanned attack. Depression rates are at an all-time high
in the United States. According to the Anxiety and Depression Association of America, in 2014
around 15.7 million people had experienced at least one major depression episode in the last
year. Possible mental health effects are unlikely to predict, due to the change in the mental health
status between 2001 and 2016.
Parents found it challenging when explaining to their children about the hateful acts that
caused so much pain for their family and country. As the unfortunate children learned that their
mother or father would not be returning home, it fell upon the adults to explain why. Janice
Cohn, a psychotherapist and consultant to the public schools, said many parents struggled, not
only those who lost a spouse. Children found it hard to understand how humans could cause this
horrific disaster. As said by Janice Cohn, We want our kids to be empathetic, to care about
others, but on the other hand, its a dangerous world- how do you strike a balance? (qtd in
King). The 9/11 attacks brought communities together to protect the children and rebuild a
wounded nation.

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Coalition to Help Injured and Dying 9/11 Responders and Survivors. Citizens for the Extension
of the James Zadroga Act. 28 Jan. 2016. Web. 7 Nov. 2016.
Collett, Michael, and Matt Liddy. 9/11 eyewitness shares never-seen-before photos. ABbCc
News. Publisher. 8 Sept. 2011. Web. 4 Nov. 2016.

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Depression. Anxiety and Depression Association of America. Aug. 2016. Web. 4 Dec. 2016.
Fisher, Christopher. Close Proximity and Trauma Exposures More Likely to Result in PostTraumatic Stress Disorder (PTSD). BMED Report. 11 Sept. 2011. Web. 13 Oct. 2016.
Fishman, Steve. The Miracle Survivors. New York Magazine. Publisher. Web. 6 Nov. 2016.
Harmon, Katherine. Aftermath of 9/11Psychological First Aid Gains Favor Over
Debriefing. Scientific American. Publisher. 10 Sept. 2011. Web. 27 Sept. 2016.
Hartocollis, Anemona. 10 Years and a Diagnostic Later, 9/11 Demons Haunt Thousands. The
New York Times. Publisher. 9 August 2011. Web. 27 Sept. 2016.
Healy, Melissa. 9/11 attacks lead to more study of post-traumatic stress disorder. Los Angeles
Times. Publisher. 5 Sept. 2011. Web. 6 Nov. 2016.
King, Laura. Their young world crumbled. Now the children of 9/11 look back. Los Angeles
Times. Publisher. 11 Sept. 2016. Web. 4 Dec. 2016.
Loosechangeexposed. the Miracle of stairwell B (full documentary) Online Video Clip.
Youtube. Youtube, 15 March 2013. Web. 4 Oct. 2016.

Steven D. Stellman, Jeffrey Hon, and Carolyn M. Greene. "Short-term and MediumTerm Health Effects of 9/11." The Lancet. 378.9794. Sept. 2011. pp. 925-934. Web. 18
Oct. 2016.
PTSD: National Center for PTSD. U.S. Department of Veterans Affairs. 13. Aug. 2015. Web. 6
Nov. 2016.

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Stress, Depression and Drug Abuse: Fallout of September 11. MedicineNet.com. 8 Sept. 2003.
Web. 3 Dec. 2016.