Rescue Workers commonly become traumatized by the things that they have experienced through helping. Problems and symptoms can arise immediately during the rescue work, or be delayed for weeks or months, appearing suddenly.

• Being a rescue worker commonly leads to sleep problems. You may not be able to make yourself go to bed, you may lie in bed for hours and can’t get to sleep, you may go to sleep immediately, and wake up two to four hours later. Some workers say they wake up a hundred times a night. As you sleep, you may be very restless, throwing yourself around during sleep. If this continues, you will become sleep deprived and this will greatly affect your ability to function well on your job and in your personal life.

“He had lots of trouble sleeping. The first month, he had a lot of nightmares; since then, he yelled out and was frantic in bed, about once a month and he jerked in his sleep, especially in his legs. If I tried to wake him up to stop the nightmare, or bumped him in his sleep, he was instantly and loudly awake. If he fell asleep on the floor, I could not wake him up gradually…he startled awake.”

• You may have one or more different flashbacks of any part of the bombing or your rescue work. Flashbacks are often so vivid, it may seem like you’re back at the site. They may occur a hundred times a day, or just once a day. Flashbacks may just be of smells or tastes or the way your body felt. Flashbacks may come during sleep, as nightmares or night terrors. A few workers will violently act out these nightmares.

“I was standing there when the building collapsed. I knew how many people were in there. Half the guys in my station were in the building. I keep seeing the building come down and imagining what they must have thought. It happens all day.”

“People were jumping out of the building. They were pieces of people falling everywhere. I see it all the time. I thought I’d seen everything, but I never saw anything like that”

“I saw some woman’s hair sticking up. I ran and pulled it up. It was attached to the front of her face; everything else was gone. I still see it every time I shut my eyes”.

“Whenever I see a fire, it reminds me of everything in the event. I hate how it makes me feel. It colors everything I do and say and feel and think.”

• You may have a great deal of trouble concentrating, reading, writing or doing anything that requires that you pay attention. Your mind may seem to be racing.

“I do anything to avoid writing my reports. I take long lunches, make phone calls, and do anything that requires physical activity and moving. I just can’t make myself write them.”

I couldn’t concentrate or read. I wasn’t interested in anything. I just sat in the dark and smoked.

My mind was always racing and on a thousand things; I would be hearing someone’s voice, but I would be thinking about all kinds of other things.

“Ever since he was involved in the rescue work, my husband would say, “You’re not listening to me-I just told you that.” But he hadn’t just told me that. I think he must have been thinking the words in his head, and thought he said them to me, but he didn’t. If I wanted him to listen to me, I had to make direct eye contact with him to make sure he was listening, or he wouldn’t hear me. He was in his own world.

• You may have survivor guilt.

“All my life I wanted to be a policeman. I loved being a policeman, but since my partner was killed when the Trade Center collapsed on him, I don’t care about the job anymore. I feel like it’s my fault. I should have been doing the job he was doing. I should have been helping him. Maybe I could have saved him or maybe I could have died in his place.”

“Ten of my friends died when the building collapsed. They all had families and kids. I’m single; I should have died in their place. They were fighting the fire; they were running up the stairs. I was working the fire, too, but they died and I didn’t. I feel guilty for being alive.”

• You may get angry very easily in a way that causes problems for you.

“After I came home from working OK Bomb, I didn’t talk about what I went through with any one. I wanted to forget it, but my mind wouldn’t let me forget. I kept getting pictures flashing in my mind that pulled me back there. I got in a fight with a defense attorney. We were screaming at each other. I used to be so calm and let everything roll off my back. The judge wrote a letter to my supervisor. That’s why I’m here for treatment.”

• You may pull away from the people you care about, feeling like there is a wall around you. When this happens, you may stop talking to them, may stop laughing, wanting to do anything that is fun, you may think of things to say to them, but find it’s too much trouble to communicate, you may feel like you are numb inside.

“Since it happened, I don’t feel anything for anyone. I feel numb, except I do feel love for my daughter.”"I feel shut-down. I don’t have anything to say. I can’t join in conversations. I’m very uncomfortable.”

“My partner will start talking to me….I’m hearing him, but it’s like an echo. My mind’s thinking a million other things.”

• You may have memory problems.

“I would start to tell a story and after the first sentence, I would forget what I was going to say. It happened all the time. I was afraid to talk to anyone.”

• You may become obsessed with working, while you neglect other activities that you used to enjoy.

“I’m down at the Firehouse every day. I stay long after my shift is over. I volunteer for anything and everything. I’m obsessed. I really don’t care about anything, but being at work. It’s killing my marriage.”

• You may find that you are too impatient to do the normal, everyday activities of everyday life, like listening to your family talk about routine things, standing in lines, paying bills. After all, what can compare with this tragedy?

“He lost patience. He couldn’t tolerate standing in line, being stuck in traffic, doing the normal things that make a family run, like paying bills. We had shared the duties, but I had to take over all of them. He thought most things weren’t important enough for him to participate in. It was as if this event was so important that nothing else could compare, so he didn’t want to hear the normal every day problems of me and the children. I started having to handle them all.” “When driving, he was more rigid, forceful and impatient. He drove faster and the safety zone between him and the car in front of him disappeared.”

• You may find that you no longer feel safe; you avoid activities that you used to do because of this feeling.

• You may start drinking too much, because it numbs the symptoms you are experiencing. Drinking may lead to greater problems.

“Every night after work, I go out with my buddies and drink. I can’t go home without drinking. I’m drinking now on my days off. I have to drink to get to sleep.”

• You may begin to think about suicide or engage in dangerous and life threatening behaviors.

“When we get to a fire, I rush in; I do things which I know can get me killed. I don’t care”

“Every time I’d put my weapon away, a voice in my head would say, ‘just do it’. I’d put the gun in my mouth, but I’d get a picture of my son finding my body and I couldn’t do that to him. I’d put my gun away, but the voice would talk to me the next evening and I’d have to fight it again.”

“I know I’m taking chances and doing all kinds of dangerous things. It’s driving my Chief crazy. I figure if I die, I die. That way life takes care of it. I don’t really care if I die, but I’m not going to kill myself.”