Helaina Hovitz had just started seventh grade in Lower Manhattan when the planes struck the World Trade Center on September 11, 2001. Like thousands of others who survived the events of that day, Hovitz has experienced lasting effects on her mental health. This week, just before the 15th anniversary of the attack, Hovitz published a book about her life since that day. After 9/11tells her story, and the circuitous path she followed to recovery. —Kate Lowenstein
I was in school three blocks away from the World Trade Center on 9/11, separated only by a highway and a few sidewalks. It was my second day of seventh grade. After the first plane hit, we were led down to the cafeteria and told not to stop at our lockers. We weren't sure what we were waiting for, we were all speculating about what was going on, but at that point, I wasn't afraid. Not yet. Some kids who had working radios on their portable CD players said two planes had hit the towers.
When the bomb squad burst through the doors, along with droves of hysterical parents crying and screaming, I knew my parents wouldn't be among them—they were still at their far-away jobs. I did see Ann and her son Charles, who I walked to school with every day, who I instinctively hustled over to, knowing they could get me home so I wouldn't have to evacuate to wherever the other kids were going. Outside the school building, the burning smell instantly stung our eyes, our nostrils, as the buildings vomited paper and people. The crowds were almost impossible to move through, but we had one objective: Get home to the east side, to our neighborhood, which was also just three blocks away from the World Trade Center, on the other side of town. But police on the west side kept refusing to let us through, directing us uptown only.
Soon, we were running from a giant cloud of smoke and debris that Ann told us not to look at. "Just cover your faces, don't look back, and run!" The scene for the next hour, as we tried every possible way into our own neighborhood, was the stuff that nightmares are made of: bleeding bodies. People covered in debris, piercing, blood-curdling screams and cries. I was covered in debris and kept forgetting to pull my shirt over my face to protect it. We spent an hour navigating the horror, trying to get home, normally a ten-minute walk from school, but police blocked every possible way. Once we finally made it back to our apartment, we found our neighborhood had become a war zone.
The lobby was dark. People hid inside, covered in ash.
When I pushed open the staircase door, I saw Grandma at the end of the hall, standing in the doorway of her apartment, holding the white-chorded phone to her ear.
"She's here, Paul!" Grandma cried into the phone. "She's here! Oh my God!"
My grandmother gently thrust the phone to my ear, smoothing my hair and kissing my head as I assured my dad that I was OK. There was this sense that time was limited—the dark lobby, the elevators out, Devin's cellphone that had stopped working. We quickly called my mother next. She was still at work. Out the window, I could see nothing but black. On TV, which was still working for the time being, I saw what we had been running from the whole time—the collapses—and saw the Pentagon had also been hit, and yet another plane had been hijacked. I thought planes and bombs were destroying the entire country.
Soon the power would go out, the phones, the water. When we wrapped towels around our heads to use the payphone across the street, we were entirely alone in that dust storm that came from the towers, which were still on fire. The payphone worked for long enough for my dad to tell me that the police told him everyone had been evacuated.
But we hadn't been.
I saw my dad the next morning, covered in a thick film of debris, dust, and sweat.
As days turned into weeks, we only had the food and medication my father helped coordinate from New York Downtown Hospital across the street. We also had more threats of collapsing buildings, bomb scares on nearby landmarks, and instructions to pack an emergency bag and have the whole family ready to leave on a split-second's notice—without having any idea where we would go.
The National Guard showed up, the sound of a plane sent me into a hysterical panic, I wasn't sleeping, I was always worried, paranoid, ready to take off at the next attack, having nightmares and flashbacks, feeling like a sitting duck waiting to die. While the rest of New York City above Canal Street and the rest of the world resumed "life as normal," it became very clear to me that because of what was happening in my brain and my body, and what continued to happen outside of my front door, nothing would ever be normal again.
"Do you feel that your moods are very up and down?" Dr. C, my new psychiatrist, asked me. Her office was on the ground floor of a residential building on Park Avenue, and I sat on the couch, looking at her in her big chair as she took notes on a legal pad.
"Yes," I said, because it was true.
"When you're up, when you're high, do you feel so happy it's like you're on top of the world? And when you're low, do you feel like you're at the lowest point ever?"
"Yes," I said, because that was also true, and because I was desperate to put a name on this thing and have her fix it.
"Tell me what else is going on," she said.
I launched into it with no problem, so used to having to explain the same thing over and over again. "I'm afraid that people are looking at me like they want to hurt me. In school, on the subway, everywhere," I said. "I'm nervous all the time, and when I get upset, I feel like I'm out of control. I'm scared of things other people my age aren't scared of. I feel like I'm suffocating half the time. I'm having headaches so often that I've stopped identifying them as headaches. It's like a permanent background feature of my life, changing only in severity. And I'm always fighting with my boyfriend over things that he thinks aren't a big deal."
"Your mother said that you're throwing a lot of tantrums, hitting and kicking and screaming, in these highly emotional states," she said.
"Yeah," I said, looking down and shrugging. "I guess so."
"Do you feel like you're hyper-talkative?"
I didn't even know what that meant, but I wanted to make sure I wasn't going to say anything that would cause her to not fix me. So I said, "Maybe."
What she didn't account for in her line of questioning was cause and effect, triggers, and reactivity—it all came from somewhere. Yes, I had periods of depression, and yes, I couldn't sleep. I made bad choices, but I did not have inexplicable, manic episodes, and I never had grandiose or delusional ideas. I did not think I was "chosen" for anything, and I did not go on spending sprees, or disappear for days and then remain unable to account for what had driven that decision or what I had even done.
What she didn't account for was that sometimes, "fight or flight" is as simple as a reaction. If someone made me feel threatened, whether it was my parents, or my boyfriend, or someone at school, or someone on the street, I reacted, impulsively, quickly, aggressively. I would later learn that she had added something called "potential secondary trauma due to 9/11" to my chart when we first met, just one sentence long. But Dr. C seemed to think that the reason for all of this behavior was because I was bipolar, so she started writing me prescriptions for that.
By late spring of 2005, my life was overflowing with orange pill bottles, medication my body rejected along with the last meal that I ate. After I got sick the first time I tried a drug, she lowered the dose, unless I got so sick that I was too scared to try again. We tried Seroquel, then Lamictal, then Lexapro, then Prozac, then Depakote, to try to tackle some of these symptoms, which, no matter what, continued to get worse. I sat there like a test subject, being analyzed instead of taught how to do anything differently. She was just a psychiatrist, so I was still ushered in and out of therapists' offices, always going in hopeful, unlike most reluctant, brooding teenagers who sat there and grimaced because their parents "made them go." I tried to explain to therapists what was wrong with me over and over and over again, only to find they couldn't help me, either. I did begin to feel more foolish for getting my hopes up, then resentful of the therapist I was talking to. Nothing seemed to be working.
I was always going for blood tests, and I was no longer the "brave" girl that the nurses marveled at. I had become squeamish. I was already charged up from the trip, from trying to find an address I couldn't find, another crisis. "I'm not good at this," I would warn the technician as she wrapped a rubber strap around my arm. I'd look the other way, squeezing my eyes shut, trying to sing a song in my head. But no matter how many blood tests I got, the answer never seemed to be swimming around in those vials.
Years later, as I begin to answer people's questions—How did they miss it? and What took so long? and How could it not have been obvious that the diagnosis was post-traumatic stress disorder?—I learn that the proper treatment for my condition is cognitive behavioral therapy, then dialectical behavioral therapy, then, to get sober and start learning how to actually deal with life in a healthy and effective way without reaching for something that would temporarily put a band-aid over things but actually make them much worse.
Kids don't really have the words to describe most accurately what's happening to them, or what their symptoms are really like, or trace them back to where it began. They don't "connect" the dots that far back, and frankly, adults typically don't either, everyone collectively rolling their eyes when asked about their childhood. But it's not the patient's job to connect the dots, or the parents, or the teacher's: It's the doctor's.
But since symptoms can take years after the trauma to surface, and existing issues can present themselves as similar to those that partially fit another diagnosis, some doctors feel there is often no time to dig that deeply; the symptoms as they present themselves feel like the most urgent thing to treat. Sometimes, the clinician just doesn't have the training to diagnose and treat trauma. Other times, they don't want to walk down that road with the patient, having to relive some painful and disturbing memories of their own. So, in addition to bipolar and ADHD, other misdiagnoses that continue to flood the medical records of young people everywhere include acute stress disorder, adjustment disorder, obsessive compulsive disorder, and panic disorder, to name a few. Some will give up, not wanting to start from the beginning over and over again with this doctor and that one, feeling hopeless and unable to live the kind of life where the world, both inside and outside of their own skin, feels too dangerous, sad, unbearable.
There was no magic pill that was going to get me there. It took years of work, but I was able to put myself back together again from these fragmented pieces of a girl living in a world full of continued crime and terror and violence, and, through a lot of hard work and determination, I was able to rebuild my own life and keep it from collapsing during the most stressful of times. But one out of every two children in this country will live through a trauma, whether that's living in an unstable or abusive home or in an "unsafe" neighborhood, an accident, a natural disaster, sexual assault, a shooting, terrorism, medical trauma, and the list goes on. Children may be naturally resilient in the sense that they "keep going," but true resilience has to be learned and taught over time. Otherwise, the invisible scars of trauma can lead to worse damage in the present.
Excerpted and edited with permission from After 9/11: One Girl's Journey through Darkness to a New Beginning by Helaina Hovitz. Copyright 2016, Carrel Books, an imprint of Skyhorse Publishing, Inc.
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