Women, the caretakers who often put others first, may be at special risk for trauma in the aftermath of the terrorist attacks on the World Trade Center and the Pentagon, according to mental health workers.
Although both women and men experience a range of emotions in the wake of disasters, in the short term, women sometimes sideline their own mental health concerns in order to tend to children, other family members or survivors.
In addition, twice as many women as men are diagnosed with post-traumatic stress disorder, according to the Post-Traumatic Stress Disorder Alliance. Women's past experiences with sexual trauma also may put them at risk in new circumstances.
People's reactions to the attack on the twin towers of the World Trade Center vary enormously, according to Elaine Hurst, a therapist at the Center for Modern Psychoanalytic Studies in New York, where 40 volunteers opened the doors for drop-in group counseling.
"We're seeing a range of reactions from fear to desire for revenge to anger," said Hurst. Men and women, workers and neighbors, were slowly filling up the sessions. "Sleeping problems, nightmares, irritability, physical symptoms -- these are all within the normal range of immediate reaction to stress, even if it's just from seeing the incident on TV," she said.
Talking about the attacks and feelings that are aroused by them is essential, said Lore Stone, a Los Angeles clinical psychologist and a specialist in critical incident management. "If women have children, the tendency is to take care of the kids first. The problem is that makes women's own recovery slower and prolongs it significantly," she explained.
Stone lost her husband in an airline crash outside Chicago in 1979, and based on that experience as well as her professional training, she advises women to make sure their own needs get attention.
"A support system is so important, someone to talk to, someone who listens," said Stone. "It should not be someone who is also suffering from trauma. But someone who says, 'Hey, I'm here, how can I help?' Often, there is nothing they can do and they need to say, 'That's OK, I'll just be here with you,' " said Stone. Women, she believes, respond well to the validation of feelings that can arise in support groups.
At a workplace, Stone said, co-workers may find that people affected by traumatic events have mood swings, difficulty concentrating, tendencies to isolate and alternating periods of high and low productivity.
"Some people overreact to criticism, so take it easy on them," she advised. The two things that should never be uttered to the sufferer, said Stone, are: "It could have been worse," and "I know exactly how you feel."
In addition, people suffering from trauma should make sure they are eating regularly, keeping busy physically, avoiding excessive drug and alcohol intake and seeking medical intervention if they are unable to sleep.
If severe symptoms of distress do not wane after a prolonged period, a diagnosis of post-traumatic stress disorder may be considered, said Esther Giller, president and director of the Sidran Foundation in Towson, Md., a national nonprofit organization dedicated to education about post-traumatic stress disorder.
"Initially, after a traumatic event, everyone feels disrupted. Many people have nightmares. If time passes and the symptoms are still disruptive to their lives, a diagnosis of post-traumatic stress disorder is considered," said Giller.
Despite a common myth that post-traumatic stress disorder only affects war veterans, women are twice as likely as men to suffer from it. One in 10 women suffers post-traumatic stress disorder in her lifetime, according to the Post-Traumatic Stress Disorder Alliance.
"When there is some kind of overwhelming stressor, women who have had overwhelming stressors in the past will likely be more vulnerable to an experience like a bombing or a situation like the World Trade Center, where there is such devastation," said Giller.
Statistically, the stress-producing event mostly likely to produce psychological stress is rape, said Giller. Fifty percent of rape victims suffer from post-traumatic stress disorder, compared to 15 percent of those involved in a shooting or stabbing.
"Because more women are rape victims, more develop the disorder. More women have histories of childhood sexual abuse. Women are also more likely to experience interpersonal violence than are men," she said.
Since trauma is cumulative, one sad consequence of the prior trauma of sexual abuse is that women are more vulnerable to post-traumatic stress disorder when another terrifying event takes place, said Giller.
Post-traumatic stress disorder may occur if a person has experienced or witnessed a horrifying event or ordeal and that person has felt intense fear, terror or a sense of helplessness that does not dissipate. For a post-traumatic stress disorder diagnosis, symptoms must have lasted for more than one month, present themselves from each of three clusters and disrupt daily life, according to the Post-Traumatic Stress Disorder Alliance.
The three clusters are:
Life-like flashbacks or nightmares that are more than memories;
Hyperavoidance and disassociation of people or events that might be reminders of the trauma;
Physiological arousal that manifests itself in being jumpy, easily startled and suffering panic attacks. "All of these symptoms are not unusual and are common in the immediate aftermath. The problem is if time passes and you still feel that way," said Giller. Treatment for post-traumatic stress disorder is quite successful with a combination of medication and psychotherapy, said Giller.
For more information
Sidran Traumatic Stress Foundation: www.sidran.org.
National Mental Health Association, Post-Traumatic Stress Disorder Fact Sheet:
Post-Traumatic Stress Disorder Alliance: www.ptsdalliance.org.