Post-Traumatic Stress Disorder
Post Terrorism Trauma May Affect Psychiatric Patients Differently
Post terrorism trauma can affect people quite differently depending on their background and mental health disposition.
Psychiatrists reported a wide disparity in patients' reactions to the events that unfolded on September 11. Some were understandably distraught from the widely broadcast assault "on the symbols of our freedom, our American way, and our safety," as one psychiatrist noted. For others, the events of the day had a positive outcome. It made them realize that in the scheme of things, their own mental problems pale in comparison to what others have and are going through. Many have got themselves busy in a variety of social services and voluntary activities to help the victims of the terrorism. This helped them forget about their own problems. People who benefited most were those suffering from borderline personality disorder, chronic depression, and even schizophrenia. For some with prior suicidal thoughts, the exposure to this event had a positive impact. They trivialized their own situation in light of the national tragedy.
For some patients with mental illness, this event triggered negative associations. Especially vulnerable are those previously stricken with trauma. The trauma can be from a variety of causes: not just from war or terrorism, but from abuse and other unrelated events.
The severity of response of people depend on their degree of closeness to the event, both in terms of tangible proximity to the catastrophes and also in terms of their emotional connections to what they may have witnessed on television. Those suffering from PTSD are more vulnerable than others. But they may or may not have an exaggeration of symptoms.
For others, this event may have put them back on the path they have succeeded in conquering. For example, one schizophrenic patient reportedly became destabilized and psychotic as a result of the events after enjoying many years of stability.
Psychiatrists and other mental health professionals agree that the worst is yet to come. The real test, according to them, may come down the road, when posttraumatic stress disorder (PTSD) complicates patients' already burdened mechanisms for coping with everyday life.
Psychiatrists identified several groups of people as at higher risk for having PTSD as a result of September 11 related events:
Those who worked in lower Manhattan and ran as buildings collapsed around them. These people will be at increased risk for PTSD if they had previous psychiatric diagnoses. In one study conducted after the Apri11995 bombing of the Oklahoma City federal building, preexisting psychiatric illness was one of the strongest predictors of PTSD in survivors. (JAMA 282:755-62, 1999).
Those who recently suffered personal losses and had trouble coping with fresh shock, grief, and fear associated with the terrorist attacks. Some of these patients may get totally decompensated, regressed, and may express self-destructive thoughts they never had before. These patients may not have complained of any psychiatric disorders prior to the loss of their significant others.
People of Arab descent also are highly vulnerable. Many of them had suffered previous trauma. They have come to the USA to escape from this terror and thinking America as their safe haven. They are now traumatized like the entire country. But they have the added burden of being perceived as part of the threat.
For the victims, the feelings of grief and loss may persist intensely for many months. "While most Americans who were less affected will be recovering from what they saw on television, those with PTSD are likely to take a much different path. They may be sleepless or tormented by dreams of a shrouded danger they can't quite identify. Their partners and friends will be confused by their fits of rage and irritability. Quietly, they may become nearly phobic in their avoidance of multistory buildings and airplanes," says Dr. C. Scott Saunders, associate director of the UCLA trauma psychiatry service.
Source: Clinical Psychiatry News, October 2001