New York City Department of Health - Project Liberty / New York Needs Us Strong




		The terrorist attacks that occurred in New York City and Washington, D.C. on Sept. 11, 2001 staggered the nation. What happened affected all New Yorkers: those who lost their lives at the World Trade Center...the people who were injured, and those who escaped...the rescue and relief workers...people whose relatives or friends were killed...those who saw it happen from the street, or from their windows, or over and over again on television...people who lost their jobs or homes as a result of the catastrophe. Unlike other disasters that seem to have an end, the attacks on New York and Washington have been followed by other disturbing events, including the threat of bioterrorism. There are many normal reactions to these events that can at times be overwhelming. Some may occur immediately, and others may take longer to develop. *These include:*

			Emotional Reactions
			Physical Reactions

		These are difficult times. But despite our losses, and despite our fears, there is much that New Yorkers can do to help ourselves recover and to keep ourselves strong.

			What You Can Do to Help Yourself
			If You Were Directly Affected
			What to Avoid
			Helping Children
			If Your Problems Get Worse
			In an Emergency
			Help Is Available
			Project Liberty Services

			Other Online Resources


		People feel and express their reactions to a crisis differently. You may: Feel intense anxiety, loss, helplessness, fear, sadness, or anger. Have a sense of hopelessness about the future. Feel detached, hostile, or unconcerned about others. Feel numb or flat, unable to experience love or joy. Be irritable or have outbursts of anger. Get easily upset or agitated. Experience recurring and distressing dreams or memories. Avoid people, places, and things associated with the disaster. Forget important aspects of the event. Have trouble concentrating. Feel that your surroundings are unreal. (back to top)



		How people physically react to a disaster varies. You may: Have an upset stomach, eat too much or too little, or have other gastrointestinal problems. Experience a pounding heart, rapid breathing, severe headache, or sweating when thinking about the event. Have trouble falling or staying asleep, or sleep too much. Be in a daze. Feel on guard and constantly alert. Feel jumpy and easily startled at unexpected noises. Experience a worsening of certain chronic conditions. Feel exhausted. (back to top)



		Remember that stress can cause physical problems. It can increase the risk of heart attack or stroke, worsen some conditions (like gastrointestinal problems) and make others (like diabetes and arthritis) harder to manage. So if you're under a doctor's care, be sure to keep your medical appointments and take medications as prescribed. Rely on regular exercise to help relieve stress. Walking every day, and managing stress with relaxation techniques, can make a big difference in how you feel. Show up for the things you enjoy: rent a movie, play cards, watch sports, read a book, go to the zoo, explore a new neighborhood, invite people over. Take care of yourself. Remember to H-A-L-T: Don't get too Hungry, Angry, Lonely, or Tired. Eat right, get enough sleep, and share your thoughts and feelings with people around you. Learning how others are coping will help you feel less alone. If you need to talk now and no one is available, call 1-800-LIFENET anytime, 24-hours-a-day. (back to top)



		If you were injured or lost a relative or friend, you may need extra help to deal with your grief. Talk with your spiritual advisor or friend. For a free, confidential referral for support, call 1-800-LIFENET. Many New Yorkers have needed help since Sept. 11 with disaster-related problems, like loss of a job or income. At 1-800-LIFENET, we always have up-to-date information on where to go for help, no matter what the problem is. (back to top)



		Drinking alcohol, using drugs, or even taking more medication than your doctor prescribes to numb yourself will only make matters worse in the long run. People who turn to alcohol and other drugs to cope with their feelings are more likely than others to develop serious problems after a disaster like Sept. 11. So if you think you have a problem, this is a good time to look into it. Call 1-800-LIFENET for help. For some problem drinkers and drug users in recovery, the World Trade Center disaster and its aftermath have made it particularly difficult to remain sober. If you have a history of alcohol or drug dependence, or just think you'd be better off by avoiding the temptation to drink or drug right now, remember the old adage: stay away from the "People, Places, and Things" that you associate with drinking and drugging. (back to top)



		A child's reaction to the World Trade Center disaster will depend on many factors, including whether the child was directly affected by the death of a parent or relative; the age of the child; whether the child has experienced trauma in the past; and how much of the disaster the child witnessed in person or on TV. Children, even more than adults, may experience delayed reactions. Loss of trust in adults and fear of the event occurring again are responses seen in many children and adolescents exposed to traumatic events. Other reactions vary according to age. For children 5 years of age and younger, typical reactions include fear of being separated from a parent, fear of the dark, increased crying, clinging to the parent, and a return to younger behavior, such as thumb-sucking and bedwetting. Children aged 6 to 11 may show withdrawal and disruptive behavior, and may have trouble paying attention; they may avoid school, have sleep problems, and be irritable, with outbursts of anger, and complain of stomach aches or other symptoms that have no medical basis. Adolescents may exhibit symptoms that are more like adults, including flashbacks, nightmares, emotional numbing, depression, substance abuse, and anti-social behavior. They may also feel extreme guilt over the failure to prevent injury or loss of life. Young adults, particularly college students, may exhibit many of the same reactions as adolescents. Their response to the trauma may be complicated by geographical separation from family and support systems, which increases anxiety and feelings of isolation. In addition, many college students may find the common reaction of being ÒspaceyÓ or in a daze especially troubling as they attempt to complete class assignments. Parents and other adults can help children cope. Take the time to listen without passing judgment. Let children know that their feelings are normal and that it is okay to express them. Let them know that it is okay to cry and be sad, and be sure they know they don't have to be "tough". If you would like more help with reassuring your children or others, call 1-800-LIFENET. Our staff will help you figure out what makes the most sense for your and your children's needs-from sending you information about helpful ways of talking with your children to connecting you with experts in childhood trauma. (back to top)



		Emotional and physical reactions to Sept. 11 are normal. For many people, these reactions are short-lived. For others, they go on. It's a good idea to seek professional counseling if you feel that your reactions to the disaster are lasting too long or getting worse instead of better. Professional help may range from seeing a therapist to talking about the problems to taking one of several effective medications to relieve anxiety and depression. (back to top)



		If you are unable to manage everyday activities (such as eating and bathing), if you're finding it hard to show up for work or take care of your children, or if you're relying on alcohol or drugs to cope, talk to someone you trust or call 1-800-LIFENET, 24-hours-a-day. If you're feeling like hurting yourself or others or have other urgent or frightening symptoms, please get help immediately! Go to the nearest emergency room or call 911 for assistance. Someone will help you. (back to top)



		At 1-800-LIFENET, counseling professionals provide free, confidential information and referral services, 24-hours-a-day. We always have the latest information on where to go and who to call for help with problems related to the World Trade Center disaster. Anyone can call. Help is available in several languages. In English: 1-800-LIFENET (1-800-543-3638) In Spanish: 1-877-AYÚDESE (1-877-298-3373) In Chinese: ASIAN LIFENET (1-877-990-8585) *For other languages, call 1-800-LIFENET and ask for a translator.* *TTY: 212-982-5284* (back to top)



		*New York Needs Us Strong* is made possible by Project Liberty, a disaster-recovery program created to provide support to you, your family, your neighbors, your employees, and your spiritual community. Through Project Liberty, free counseling services are available to anyone affected by the terrorist attacks of Sept. 11, simply by calling 1-800-LIFENET. Examples of these services include: Meeting with a small group of relatives to hear how they have been feeling since the disaster, to help them understand their responses, and to think of ways they can support each other in handling them. Training the health staff of a large financial firm to help employees recognize signs that may indicate trouble coping with the disaster and what to do. Referring people to a grief support group in their own neighborhood. When you call, a trained counselor will talk with you about your concerns, work with you to determine how best to meet your needs, offer options, and link you with the resources you need. One-to-one or group sessions can be arranged wherever you wish to have them–in your home, school, business, office, or place of worship. Project Liberty was created by the New York State Office of Mental Health to provide free, immediate crisis counseling, education, and referral services to people affected by the World Trade Center disaster. Funding is provided by the Federal Emergency Management Agency, with support from the federal Center for Mental Health Services. For more information about Project Liberty, visit www.projectliberty.state.ny.us. For more information about health in New York City, visit nyc.gov/health. To obtain copies of this booklet, call 1-800-LIFENET. (back to top)