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Laura Dodson
Professor Campbell
UWRT 1103
10 November 2016
The Plane Crash Felt Across a Nation: The Mental Impact of 9/11
Penny was staying in the Millennium Hilton Hotel directly across from the twin towers in
New York City the day of September 11th ,2001. She was just one of the millions of people who
were enjoying their mornings until disaster struck. She recalls, People were throwing whatever
they could find out of the windows to break the glass and get air. I could see them hanging out of
windows, then to my horror I realized people were beginning to jump to their death rather than
being burned alive. What a terrible choice to have to make. And there was nothing I, or as it
turned out, anyone else, could do to help. This image was instilled in not only Pennys mind,
but the minds of all Americans who witnessed one of the greatest cities in the United States
become penetrated with sorrow. It is an extremely dark event to move forward from and
unfortunately some have not yet found their light. This leads to the question; How were
Americans psychologically affected by the attacks of September 11 th?
Several mental disorders arose in those most impacted by the attacks, which are still
being felt 15 years later. PTSD is a one of the more serious disorders associated with the
traumatic event. While depression and anxiety are broader, more common disorders felt amongst
Americans during this time, symptoms of PTSD were discovered in the people who were most
impacted by the attacks. Based on the U.S. Department of Veterans Affairs and the National
Center of PTSD, symptoms include reliving the event through nightmares and flashbacks,

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avoiding situations that bring back memories of the event, negative changes in mood, and feeling
jittery and alarmed at loud noises. A surge of patients presenting signs of PTSD revolve around
9/11 anniversaries, when video footage and remembrances of the day are displayed to honor the
fallen. Matt Komorowski, a New York firefighter who miraculously survived the falling of the
World Trade Center on 9/11, describes his life after the events. Sometimes I cry for no reason.
When I say no reason, I know its 9/11, but theres nothing in the day that sets it off. Its just that
youre at a saturation point. A few days after September 11 th, Matt was jolted awake in the
middle of the night by his body shaking uncontrollable for twenty minutes. Similar accounts
have been described by others who felt the mental impact of 9/11. Although this is an account of
a firefighter who was personally involved in the attack on the World Trade Center, signs of
PTSD spread farther than New York City alone. It is logical to correlate a greater risk of mental
disorders within those who personally encountered the attacks; for example, survivors,
firefighters, police, volunteer rescue workers who witnessed the horrors of 9/11. Then there are
the people who were personally involved in the traumatic event, yet show no signs of PTSD.
Mickey Kross, a firefighter who survived the fall of the World Trade Center on 9/11, was
rescued from under 100 floors of the collapsed towers, yet immediately returned to the scene of
ground zero to help search for survivors like himself. In the Miracle of Stairwell B documentary,
Mickey Kross justified his return to the horrific scene by saying, I wanted to do my part to help
fix this thing and it wasnt just to find the firefighters, because Im a firefighter, but to find the
people. It demonstrates the varying coping mechanisms of humans, that a man who was buried
under tons of debris can return to the scene of his nightmares, while a person who witnessed the
attacks on the television can potentially develop a mental disorder. In an article published in The
New York Times, Dr. John Howard, the director of the National Institute for Occupational Safety

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and Health and an overseer of 9/11 programs, defends the public by giving them the benefit of
the doubt on PTSD. He said, Collapsing 220 stories of a lot of material in one of the most
densely populated cities in the world is a very unique event. This brings attention to the
classification of mental disorders and who qualifies for the diagnosis of these disorders.
Who qualifies for a diagnosis of mental disorders like PTSD?
The events of 9/11 changed the way PTSD is perceived in the medical field, from being a
mental disorder primarily dealt by psychiatrists to a public health issue (Healy). The attacks of
9/11 were brought into homes, schools, and workplaces all over the country through news
coverage, allowing Americans to witness the tragic events taking place not so far away. The
degree to which the news captured the events unfolding, brought Americans to the scene and
gave a sense of unity amongst those who were present and those who were miles away. The most
difficult decision is whether people could suffer from PTSD through watching television
coverage of the attacks. Those who were informed of the events by watching more graphic
television coverage were more likely to report extreme symptoms of mental disorders (Harmon).
While some experts acknowledge the development of PTSD amongst those who were not
geographically near the attacks, others are skeptical to the accusations. Dr. Robert L. Spitzer, a
retired psychiatry professor from Colombia University and an expert in mental disorder
classifications, advocates for tightening the criteria of PTSD. It has become too vague, with
almost no other psychiatric disorder generating as much controversy. Congress most evidentially
relies on the diagnosis of mental disorders based on geographic boundaries, by excluding the
television watchers from government aided treatment programs (Hartocollis). It is hard to believe
that potentially suffering Americans could be overlooked solely due to the way they were
exposed to the events.

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Does proximity to the attacks determine the prevalence of mental disorders within
civilians?
The controversy that surrounds the mental impact of 9/11 on Americans, revolves around
the concept of geographical position to the attacks. Based on a study that examines New York
City companies affected by the 9/11 attacks on the World Trade Center, geographic distance is
associated with increased risk of developing post-traumatic stress disorder (Fisher). What implies
the distance one must be from a traumatic event to feel the emotion impact of its aftermath? A
2002 survey, published in JAMA The Journal of the American Medical Association, concluded
that some 4.3 of the general population had signs of PTSD, without having direct exposure to the
attacks (Harmon). Although, surveys are not often reliable sources of data to base conclusions.
The authors of the peer-reviewed article found in The Lancet, produced studies that focused on
those present in New York City at the time of the attacks that showed signs of PTSD and
depression and how long these symptoms lasted. From the studies, they concluded that chronic
PTSD was more prevalent in recovery and rescue workers than in residents alone. There is
potential for populations outside of a geographical distance from the towers to develop similar
symptoms of PTSD like those who were directly exposed, but they are not to the degree of those
personally related. After 15 years of collecting information on mental disorders associated with
the attacks of 9/11, it is evident that the complexity to which the diagnosis of PTSD and other
related disorders pose a challenge on researches to find a consensus of how far the effects of 9/11
spread (Fisher). Differing opinions on the subject adds a complexity that allows researchers to
continue inquiry on the developing 9/11 mental health influences on the public.
How do people inflicted with emotional distress from the September 11 th attacks move
forward?

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September 11th was an enormous event in American history, that was felt across the
nation. As people came together to rebuild their beloved city and mend broken hearts, the
emotionally distraught were left to cope with surreal aftermath of that tragic day. The
government acknowledged the need for treatment programs for those most mentally impacted by
the events. Congress passed the James Zadroga 9/11 Health and Compensation Act, which
provided $4.3 billion, allowing victims to treat their illnesses without worry of financial conflicts
(Hartcollis). Mental disorders, like those accompanying the 9/11 attacks, can be present in
victims for a lifetime. A revised James Zadroga 9/11 Health and Compensation Act was
introduced in 2015 to continue the financial support of 9/11 sufferers, demonstrating the
continuous impact of the September 11th attacks on Americans (Coalition). This Act was
especially beneficial to those who struggle financially and cant receive proper treatment for
their illnesses. Differences in economic status has been shown to determine how likely someone
is to develop PTSD. An article in Scientific American described a study which found that 9/11
survivors who had yearly incomes of less than $25,000 had a 49 percent chance of having PTSD,
while those who had yearly incomes of over $100,000 had only a 6 percent risk. Millions are
benefiting from this act after their lives took a turn for the worse during the years following the
September 11th attacks. Many victims have been able to make moves to recovery through
treatment programs and support groups.
Mr. Howard was a paramedic supervisor called out to the disaster after the collapse of the
second twin tower. He tearfully recalls the hundreds of alarms going off, signaling a firefighter
that had stopped moving, also admitting that he kept a list of the missing. After turning away
from his job and eventually his family, Mr. Howard was diagnosed with PTSD in 2009. After
treatment, covered by the Zadroga Act, he has recovered enough to return to work (Hartcollis).

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Mr. Howard is just one account of the beneficial qualities that has been produced by the Zadroga
Act. It is impossible to tell how many people suffered from mental disorders caused by the
September 11th attacks, but through time and further discovery Americans can together move
forward. Recovery can only come with acknowledgement of the turmoil victims are going
through and acceptance of their impacted mental health.

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Work Cited
Coalition to Help Injured and Dying 9/11 Responders and Survivors. Citizens for the Extension of the
James Zadroga Act. 28 Jan. 2016. Web. 7 Nov. 2016.
Collett, Michael, and Matt Liddy. 9/11 eyewitness shares never-seen-before photos. Abc News. 8 Sept.
2011. Web. 4 Nov. 2016.
Fisher, Christopher. Close Proximity and Trauma Exposures More Likely to Result in Post-Traumatic
Stress Disorder (PTSD). BMED Report. 11 Sept. 2011. Web. 13 Oct. 2016.
Fishman, Steve. The Miracle Survivors. New York Magazine. Web. 6 Nov. 2016.

Harmon, Katherine. Aftermath of 9/11Psychological First Aid Gains Favor Over

Debriefing. Scientific American. 10 Sept. 2011. Web. 27 Sept. 2016.
Hartocollis, Anemona. 10 Years and a Diagnostic Later, 9/11 Demons Haunt Thousands. The
New York Times. 9 August 2011. Web. 27 Sept. 2016.
Healy, Melissa. 9/11 attacks lead to more study of post-traumatic stress disorder. Los Angeles
Times. 5 Sept. 2011. Web. 6 Nov. 2016.
Loosechangeexposed. the Miracle of stairwell B (full documentary) Online Video Clip.
Youtube. Youtube, 15 March 2013. Web. 4 Oct. 2016.
Perlman, Sharon E, Stephen Friedman, Sandro Galea, Hemanth P. Nair, Monika Ers-Sarnyai, Steven D.
Stellman, Jeffrey Hon, and Carolyn M. Greene. "Short-term and Medium-Term Health Effects of
9/11." The Lancet. 378.9794. Sept. 2011. pp. 925-934. Web. 18 Oct. 2016.

PTSD: National Center for PTSD. U.S. Department of Veterans Affairs. 13. Aug. 2015. Web. 6
Nov. 2016.