Surviving AmericanSurviving
American Medicine

The Boston Marathon terrorist attack has shaken our sense of security and shown us pictures of horror and panic. In the aftermath of that event, as well as after Hurricane Sandy, we recognize that many psychological effects can be long-lasting. This is just the same as after the World Trade Center attack of 9-11, and after Hurricane Katrina or other natural disasters (earthquakes, fires, floods). You or your family may still be experiencing distress remembering those events, but not feeling able to cope with the recurring symptoms.

Preventing long-lasting psychological problems in survivors, and in people just observing the events, usually requires help of your doctor. As described by doctors Neria and Schultz (JAMA 308: 2571, 2013), approaches can include doctors and family (or friends) promoting a sense of safety, relieving immediate anxiety, increasing a person’s self-control and self-confidence, helping a person to get group support, and helping create a sense of optimism.

The types of longer lasting reactions can vary.  Symptoms of post-traumatic stress disorder (PTSD) can reappear, such as nightmares, recalling horrible events, feeling disinterested or less loving, fear of talking about the event, having increased emotional arousal (being keyed up), sleeplessness, and poor emotional control. People can have anxiety, a feeling of general distress (even if they can’t identify what they are upset about), and depression.

If you have any of these symptoms, here are tips to help you:

• Talk to your doctor about all symptoms you are experiencing, even those you consider mild.
• Expect your doctor to give you a plan to help alleviate each of these symptoms.
• Ask your doctor to consider a psychiatrist or psychologist referral to help you cope.
• If your doctor does not take action, consider asking for a specialist referral.
• If you are still not satisfied, get a second opinion as soon as possible.

It is important to get

Get help and support right away!

support as soon as possible to prevent chronic distress. Your doctor can pay immediate attention to your problems. For more tips, see Chapter 15 in my book Surviving American Medicine on how to get the kinds of second opinions you need.