As the 20th anniversary of 9/11 approaches, many Americans will relive the trauma and nightmares that were triggered by the unprecedented attacks on the World Trade Center and the Pentagon. Experts say that we may experience an "anniversary reaction" to the event and warn that the same mental challenges that we faced 20 years ago are being repeated during COVID-19.
According to UW Medicine, an anniversary reaction occurs on or around the anniversary of an impactful event.
"They are periods of time when you experience potentially intense emotions, a loss of feeling connected to others and difficulty with your routine," says Jennifer Erickson, a board-certified psychiatrist at UW Medical Center. Erickson says that these responses are characterized by an increase in feelings of anger, guilt, frustration, and grief. They are similar to the reactions of many Americans who are now suffering another historical world crisis.
"As different as these events are, there are obvious points of comparison," says Jonathan M. DePierro, an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai. He told Medscape Medical News that "both were unprecedented life-threatening situations, presenting threats to individuals’ lives and profoundly traumatizing to not only society as a whole but also first responders."
DePierro, who is also the clinical director of the Center for Stress, Resilience, and Personal Growth at Mount Sinai, believes there are many lessons to be learned from our mental health response to 9/11 that can be applied to those traumatized by the pandemic.
He noted that every one of our hospitals became a "ground zero" during the COVID-19 pandemic so our institutions needed to design interventions to deal with the stress and trauma of healthcare workers. He noted that Mount Sinai has a 20-year-old history of dealing with physical and mental needs of those traumatized by 9/11.
"We saw a number of first responders experiencing clinical depression, anxiety, a lot of worry, symptoms of posttraumatic stress disorder (PTSD) and an increase in alcohol and/or substance abuse," he told Medscape Medical News, adding that recent studies have shown healthcare and essential workers displayed similar symptoms during COVID-19.
Dr. Judy Kuriansky, a well-known psychologist who volunteered at ground zero has been a patient of the Mount Sinai program, suffering from lung damage and other health issues.
"I’ve had terrible nightmares and now, after I contracted COVID-19, I am being treated by the doctors at Mount Sinai for long-haul symptoms," she tells Newsmax. "This anniversary is going to be a nightmare for those of us who were traumatized by the events of 9/11."
The same long-term interventions that were put into place for the 9/11 responders — and are still in place today — need to be implemented for COVID-19 essential personnel and surviving family members, said DePierro. According to research, social support before and after a traumatic event may help mitigate the risk of developing PTSD. Professional help may be needed, but DePierro says "with effective care, one doesn’t necessarily need to be in treatment for years."
The number of Americans seeking mental health services surged during the COVID-19 pandemic. With anxiety and depression rising, mental health experts across the nation have been inundated with patients desperately needing help but unable to secure appointments.
A Gallup poll last December found that America’s mental health deteriorated to the worst point it has been in two decades. Only 34% of U.S. adults say their mental health is excellent, down from 43% last year.
"Never at any time in my practice have I had a five-person waiting list," said psychotherapist Brooke Huminski, of Providence, R.I., according to The New York Times.
A poll conducted last November by the American Psychological Association found that 74% of the psychologists surveyed said that since the COVID-19 pandemic they were seeing more patients with anxiety disorders, and 60% said they saw an increase in depressive disorders. Overall, the experts saw a 30% increase in patient load.
However, DePierro says, as a first responder himself during 9/11, he witnessed how professionals worked together to help the public, with seasonal medical personnel helping interns. He says he is noticing the same support and camaraderie with COVID-19.
"One of the things I've seen on medical floors is that COVID actually brought some units together, increasing their cohesion and mutual support and increasing the bonds between people," he said, adding that this support increases the resiliency of everyone involved.
Social and community-based support was critical during 9/11 and continues to be pivotal during the pandemic. People look to experts for advice on whether they should be tested or vaccinated.
"We were there to be a steady presence for the community physically, psychologically, emotionally and medically, which helped center us as well," Dr. Danielle Ofri, a primary-care internist at Bellevue Hospital and clinical professor of medicine at New York University Grossman School of Medicine who was working at Bellevue Hospital on 9/11, told Medscape Medical News.
Both Ofri and DePierro noted, during both crises, religious leaders have played an enormous role in providing support and a sense of purpose to those who were emotionally floundering and needed "to help make sense of what they were going through and connect with something greater than themselves," according to Medscape Medical News.
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