It has been 18 years since tragedy struck America on September 11, 2001.

You may have been at work with a group of colleagues, taking in the news while huddled around a TV set. Maybe you were sitting in a classroom when a staff member informed students of what happened. How did you react to the news? How did you feel in the days and months that followed?

The events of 9/11 affected countless people worldwide and many are still dealing with its effects. Watching newsreels of two airplanes crashing into the World Trade Center buildings triggered a strong emotional response in many Americans.

For some people, the emotional distress of 9/11 lingered for months and years. People of all ages would go on to develop mental health disorders that resulted from the tragic event. Some turned to substances in order to cope with their newly developed mental health issues. Studies show that many people living in New York City were strongly affected by the events — especially those who witnessed the tragedy.

New Yorkers Affected by 9/11

The September 11 attacks traumatized many Americans, creating or worsening mental health problems in people across the United States. They dealt with higher levels of stress and anxiety in the day’s aftermath. In some cases, people began using drugs or alcohol to escape their distress. New Yorkers, in particular, seem to have been affected the most.

People like Marcy Borders experienced lifelong effects caused directly by the event. Known as the “Dust Lady” in the media, Borders was working on the 81st floor of the north tower when a jetliner struck the building. In the years after 9/11, she grappled with severe bouts of anxiety and depression that stemmed from the event. To numb her mental health issues, she began using alcohol and cocaine. The mental impact of the tragedy and subsequent substance use affected her until she died of stomach cancer in 2015.

Borders is just one of many New Yorkers who were affected by the attacks. A study of 36,897 members of the World Trade Center Health Registry (WTCHR) showed that many experienced long-lasting effects from the event. Specifically, 14.2% suffered from post-traumatic stress disorder (PTSD) and 15.3% suffered from depression when studied in 2015–2016, 14 years after the event.

A variety of factors influenced the development of disorders such as depression and PTSD. A 2008 report on 71,437 WTCHR members showed:

  • 51% were in the dust clouds caused by tower collapses
  • 70% witnessed traumatic events
  • 13% sustained an injury

These kinds of events can directly lead to mental health disorders like PTSD and depression. WTCHR members also had new or worsened respiratory issues such as asthma. Physical health issues, such as injuries or the development of respiratory problems, can lead to depression and substance use disorders.

Anxiety disorders like PTSD were common among New York City residents after 9/11. Estimates show that between 34,600–70,200 adults experienced PTSD after the events. Some New Yorkers would panic at the sight of an airplane or whenever they heard sirens. Counseling for symptoms of PTSD increased in New York in the months after the attacks.

Psychological Effects on First Responders

Though New Yorkers generally felt the effects of 9/11, first responders suffered the brunt of its impact. Some studies show that as many as 42% of first responders experienced PTSD due to the event, though some believe the prevalence rate is approximately 10%. A study showed that police responders who suffered from PTSD in 2003–2007 were still experiencing it in 2011–2012.

Six years after the event, the rates are still widely variable. However, some studies show that the rate was still as high as 16.5% in 2007. In addition, PTSD was more prevalent in non-traditional first responders, such as volunteers who helped firefighters and law enforcement.

From the day the attacks occurred to now, recovery workers have suffered from a wide range of physical and mental health issues. Physical issues can lead to mental health disorders, and the traumatic event itself caused problems with PTSD, anxiety and addiction. Any of these conditions can cause risk-taking behaviors that lead to substance use disorders.

How 9/11 Affected the Rest of America

September 11 affected more than just New York residents. News programs replayed video footage of the tragedy continuously in the days following 9/11, forcing many Americans to deal with feelings of stress, anxiety and depression. This far-reaching media coverage affected people who were not directly involved in the event but saw it on television.

nationwide study of 2,273 adults found that the prevalence of PTSD in America was 4% following 9/11. These rates are believed to be a direct result of TV and news coverage of the event. Another studyinterviewed 560 American adults about their reactions to the tragedy. According to the study, 44% dealt with at least one symptom of PTSD, such as disturbing memories or insomnia.

The children of these respondents were also affected by the attacks. Researchers found that about a third of these children experienced a stress response to 9/11, including nightmares and angry outbursts. A small study in the Southeast on children aged 5–11 also showed that children who saw the events through media outlets had elevated PTSD symptoms. Another study showed 18% of adolescents in grades 6–12 sought psychological services after 9/11. Many teens who used these services experienced symptoms of depression and post-traumatic stress.

In another survey of 2,700 adults, around 10% reported experiencing high levels of acute stress, such as post-traumatic stress or fears of future terrorist attacks. A follow-up three years later showed that some respondents who reported distress had dealt with cardiac problems and were at an increased risk of heart disease.

Mental illness can affect the way people think, feel and behave. Mental health disorders like PTSD and depression are also closely associated with substance misuse and addiction. If you or someone you love is experiencing a mental health and co-occurring substance use disorder, The Recovery Village can help. Our trained addiction experts can cater to your specific needs and teach you how to better manage your addiction and mental illness. Contact us today to learn more about treatment options that can work well for you.

a man wearing a blue and white striped shirt.
By – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

du Lac, J. Freedom. “9/11 ‘Dust Lady’ Marcy Borders, feat[…] has died of cancer.” Washington Post, August 26, 2015. Accessed September 9, 2019.

Jordan, H.T., et al. “Persistent mental and physical health im[…]r terrorist attacks.” Environmental Health, February 12, 2019. Accessed September 9, 2019.

Farfel, M., et al. “An overview of 9/11 experiences and resp[…] Registry enrollees.” Journal of Urban Health, November 2008. Accessed September 9, 2019.

Lowell, A., et al. “9/11-related PTSD among highly exposed p[…]rs after the attack.” Psychological Medicine, March 2018. Accessed September 9, 2019.

Cone, James E.; et al. “Chronic probable ptsd in police responders in the world trade center health registry ten to eleven years after 9/11.” American Journal of Industrial Medicine, April 7, 2015. Accessed September 9, 2019.

Smith, E.C., et al. “The Forgotten Responders: The Ongoing Im[…]ro Recovery Workers.” Prehospital and Disaster Medicine, August 2018. Accessed September 9, 2019.

Schlenger, W.E., et al. “Psychological reactions to terrorist att[…]ons to September 11.” JAMA, August 7, 2002. Accessed September 9, 2019.

Schuster, Mark A.; et al. “A National Survey of Stress Reactions after the September 11, 2001, Terrorist Attacks.” The New England Journal of Medicine, November 15, 2001. Accessed September 9, 2019.

Mardikian, Jackie. “Mental Health Consequences of September […]Sciences Literature.” Rutgers, 2007. Accessed September 9, 2019.

Graeff-Martins, A.S., et al. “Use of mental health services by childre[…]Trade Center attack.” Psychiatric Services, February 2014. Accessed September 9, 2019.

Holman, E., et al. “Terrorism, Acute Stress, and Cardiovascu[…]tember 11th Attacks.” Archives of General Psychology, January 2008. Accessed September 9, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.