Treatment:

Treatment aims to reduce symptoms by encouraging you to recall the event, express your feelings, and gain some sense of control over the experience. In some cases, expressing grief helps to complete the necessary mourning process. Support groups, where people who have had similar experiences can share their feelings, are very helpful.

People with PTSD may need to treat depression, alcohol or substance abuse, or related medical conditions before addressing symptoms of PTSD. Behavioral therapy is used to treat avoidance symptoms. This can include being exposed to the object that triggers your symptoms until you become used to it and no longer avoid it (called graded exposure and flooding).

Medicines that act on the nervous system can help reduce anxiety and other symptoms of PTSD. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), can be effective in treating PTSD. A doctor should monitor you if you take these drugs, because they can have side effects. Sedatives can help with sleep disturbance. Anti-anxiety medicines may be useful, but some types, such as benzodiazepines, can be addictive.

Support Groups:

You can find more information about post-traumatic stress disorder and coping with a national tragedy from the American Psychiatric Association -- www.psych.org.

Expectations (prognosis):

The best outcome, or prognosis, depends on how soon the symptoms develop after the trauma, and on how quickly you get diagnosed and treated.

Complications:

• Alcohol abuse
• Depression, anxiety, and fear of things that are not usually frightening to other people (phobia), may be part of this disorder
• Drug abuse

Calling your health care provider:

Although traumatic events like the September 11 tragedy can cause distress, not all feelings of distress are symptoms of PTSD. Talk about your feelings with friends and relatives. If your symptoms last longer, or are worse, than those of your friends, contact your doctor.

Seek help immediately by going to the emergency room or calling the local emergency number (such as 911) if:

• You feel overwhelmed by guilt
• You are impulsive
• You are thinking of hurting yourself
• You are unable to contain your behavior
• You have other very distressing symptoms of PTSD

You can also contact your doctor for help with ongoing problems such as recurrent thoughts, irritability, and problems with sleep.