Sept. 11 Eyewitnesses, 1 Year Later

12 months have passed since the tragedy of Sept. 11. So what is New York's state of mind?

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My dog, Jersey, sniffs through a heap of trash and stumbles upon a dead puppy that looks just like him. Soon, he and I discover that the dump we're walking though is littered with hundreds of lifeless Jerseys lying amid foul-smelling cans, papers, and food.

Beads of sweat run down my back. I shudder, and immediately I realize it was just a bad dream -- another one of those ghastly images that has plagued me since Sept. 11.

I keep remembering the heat of the explosion on my face when the second plane hit the south tower of the World Trade Center. I recall, too, my shock at seeing people jump off the burning skyscrapers.

Yet I saw nothing different from what fellow New Yorkers and the rest of the world witnessed from the streets, or from their TV sets. What varies appears to be the myriad responses related to the horrific events.

"Most definitely I feel I was an eyewitness to mass murder," says Catherine, a 34-year-old California native who was visiting Lower Manhattan and had to take shelter from the debris of the collapsing towers. "To think that this wasn't an accident creates a sick and chilling feeling inside me."

Catherine now avoids going into famous skyscrapers for fear they are targets for terrorists. When she is in a tall building, she feels nervous and mentally takes note of the nearest exit.

Noel, 31, a native New Yorker, seems unfazed by the disaster even though he had a view of the besieged towers from his office window, about a half mile away. As a senior manager at a telecommunications company, he had to calm down co-workers panicked by reports there might be bombs in nearby buildings and 10 more planes in the air ready to attack.

"When bad things happen, I try not to let it affect me negatively," he says. "I've just tried to cherish life more since then."

Conflicting Eyewitness Reactions

It's not unusual to have different responses to the same distressing situation, say mental health experts, who note that the way people manage trauma depends upon the degree of exposure, the quality of the recovery period, and their past experiences.

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"If you were there and you felt your life was in danger, that is going to affect you more than knowing that something happened and thinking that it's terrible," says Rachel Yehuda, PhD, director of the Posttraumatic Stress Disorder (PTSD) Program at the Bronx Veteran's Administration Medical Center.

Different biological responses are at play, she says. In one case, people are afraid for their lives; in the other, they are making a judgment about how bad something is.

This is the reason why many TV viewers have been able to work through the memories of 9/11 easier than those who got ashes on them or saw human debris in person.

The terrorist attacks, however, may have caused a chain of events that could have heightened some people's anxieties, regardless of their degree of exposure. In the past year, many people were laid off from their jobs, suffered medical problems, and worried about their housing situation or their financial resources. Additionally, the constant "high alerts" issued by government officials and the threat of anthrax contamination may have hampered some people's recovery.

"These people will be affected a lot even though they might have had moderate exposure," says Erwin R. Parson, PhD, a leading trauma psychologist who has worked with survivors of Sept. 11, the Oklahoma City bombing, and the great California earthquakes. "It's not only the intensity of exposure, but the recovery environment that matters."

Then there are persons with underlying frustrations and anxieties that are brought to surface because of the tragedy. Keith Chernin, associate director of LifeNet, a mental health hotline network for the NYC region, says many people who've called into the center have had problems in other areas of their lives that have been exacerbated by 9/11.

Gloom Over Gotham

In New York, there is new meaning to the phrase "the city that never sleeps."

At LifeNet, calls from people reporting sleeplessness, nightmares, and anxiety has roughly doubled since 9/11 to 6,000 calls per month, and the figures are expected to rise in the coming weeks.

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In addition, a recent study in TheJournal of the American Medical Association found that more than half a million people around the Big Apple may have developed PTSD, a psychiatric disorder marked by nightmares, flashbacks, or anxiety symptoms, in the wake of the September disaster.

New York may be bearing the brunt of the country's psychological wounds, but experts say the crisis could broaden everyone's understanding of mental health.

"I'm hoping that this will get us away from the notion that people who are distressed necessarily have a mental illness," says Les Gallo-Silver, CSW, a senior social worker for the New York University (NYU) Medical Center.

He says people need not be desperate to be in counseling. There are resources and activities (many of them free) that people can take advantage of to avert an emotional crisis.

Surviving September

Last Sept. 11, Jo-Ann, a 48-year-old Queens resident, found herself alone, running frantically with her cane down the stairs at her work, just across the street from Ground Zero. The experience scared her, but she comforted herself with the knowledge that her co-workers were just a few flights ahead of her.

At the one-year anniversary, Jo-Ann plans to turn off the TV and read a book. She says she's seen enough of the Sept. 11 footage and is not interested in reliving the experience. In the past year, she has survived a brain tumor, a bout with the shingles, and has had to deal with the possibility of losing her job and moving out of her apartment.

Despite all this, Jo-Ann remains optimistic. She says she's found strength in relying on her two brothers, in reading the Bible, and in making a pact with her co-workers that no matter what, they'd stick together. She has also discussed her worries with Gallo-Silver, who she befriended while she was a patient at the NYU Medical Center.

"Bad things happen," Jo-Ann says. "You've just got to smell that rose, and go to that casino and play the slot machines."

Just like Jo-Ann, experts suggest looking at what's positive in your life. "The anniversary of 9/11 can be an inspiring, life-affirming experience," says Parson, who adds that many survivors of other catastrophes have often found that they're much more resilient and have more resources (such as supportive family and friends) than they previously thought.

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It is important to mark the anniversary of the tragedy with something that has meaning for you, and experts agree that the repetitive images of the destruction could be harmful for your well-being. Yet they also warn against ignoring the day or isolating yourself. Based on Parson's experience, people who did that in Oklahoma City suffered the most negative mental and physical impact over time.

Anyone who finds themselves with the following symptoms is urged to seek help: anxiety, depression, sleeplessness, nightmares, phobias (about buildings, elevators, subways, crowded places, etc), lack of concentration, emotional isolation, and excessive alcohol consumption.

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