The September 11 Attacks (also called 9/11 and September 11) were a set of four coordinated suicide attacks on the United States by al-Qaeda terrorists on September 11, 2001.

Tuesday, September 11, 2001, 19 terrorists hijacked four separate passenger jets and intentionally crashed two airplanes into the Twin Towers of the World Trade Center, thereby killing everyone on board these planes and thousands working in the buildings.

Within hours, both towers collapsed, destroying and damaging others as the world looked on, horrified.

A third hijacked plane crashed into the Pentagon in Arlington, Virgina.

The fourth plane had been redirected toward Washington DC but crashed in a field near Shanksville, Pennsylvania after passengers tried to take control over the planes.

The Attacks:

At 8:46AM, 5 hijackers crashed American Airlines Flight 11 into the North Tower of the World Trade Center. This building collapsed at 10:28AM. The debris caused the eventual collapse of 7 World Trade Center.

At 9:03AM, 5 hijackers crashed United Airlines Flight 175 into the South Tower of the World Trade Center. This building collapsed at 9:59AM.

At 9:37AM, 5 hijackers flew American Airlines Flight 77 into the Pentagon.

At 10:03AM, 4 hijackers crashed United Airlines Flight 93 in a field outside Shanksville, Pennsylvania after passengers tried to gain control of the aircraft.

These aircraft were chosen carefully by the terrorists so as to have a large amount of fuel to maximize damage and casualties.

Casualties of the September 11 Attacks:

World Trade Center: 2,606

American Airlines Flight 11: 87

United Airlines Flight 175: 60

Pentagon: 125

American Airlines Flight 77: 59

United Flight 93: 40

Total Casualties: 2,996 (including the 19 hijackers)

Response To Traumatic Events Including The September 11 Attacks:

Physical Response to Traumatic Events:

  • Headaches
  • Visual Disturbances
  • Dizziness
  • Fatigue
  • Weakness
  • Chills and/or profuse sweating
  • Gastrointestinal problems
  • Grinding teeth
  • Twitches and tremors
  • Chest pains
  • Rapid heart rate
  • Difficulty breathing
  • Worsening of existing medical conditions

Emotional Response to Traumatic Events:

  • Emotional numbness
  • Panic
  • Agitation
  • Irritability
  • Anger
  • Shock
  • Uncertainty
  • Guilt
  • Self-doubt
  • Denial
  • Grief
  • Loneliness
  • Helplessness
  • Sadness
  • Depression
  • Loss of interest in previously enjoyable activities

Behavioral Response to Traumatic Events:

  • Withdrawal
  • Hypervigilance
  • Suspiciousness
  • Acting out
  • Frequent outbursts
  • Crying
  • Being argumentative
  • Increased work and home conflicts
  • Impaired work performance
  • Excessive activity
  • Overeating or undereating
  • Changes in sexual drive
  • Increased substance use and abuse
  • Avoiding reminders of the event

Cognitive Response to Traumatic Events:

  • Confusion
  • Blaming others
  • Changes in level of alertness
  • Poor concentration
  • Poor memory
  • Difficulty making decisions
  • Difficulty solving problems
  • Nightmares, flashbacks, and intrusive thoughts.

Spiritual Response to Traumatic Events:

  • Questioning one's core beliefs
  • Withdrawal from place of worship
  • Loss of meaning
  • Loss of purpose

Effects of the September 11 Attacks:

Physical Health Effects of the September 11 Attacks:

  • Those exposed to WTC-related dust were more likely to develop respiratory problems, asthma, sinus problems, or other lung-related issues.

  • Marked declines in pulmonary function was detected among firefighters and emergency medical service providers within a year of the attacks. These changes in pulmonary function have persisted.

  • Sarcoidosis (non-specific inflammation most often affecting the lungs) was detected among rescue, recovery, and clean-up workers who worked with the debris.

  • Extreme dust cloud exposure on 9/11 increased risk of developing asthma. At greater risk were rescue, recovery, and clean-up workers who arrived early at the WTC site or worked for extensive periods of time. Also at greater risk were lower Manhattan residents who didn't evacuate, or who returned to their homes covered in a thick pile of dust as well as those who lived and/or worked in lower Manhattan post-9/11.

  • Many of those exposed to the WTC reported heartburn, acid reflux and/or gastroesophageal reflux symptoms, in addition to respiratory or mental health symptoms.

Mental Health Effects of the September 11 Attacks:

  • Post-traumatic stress disorder symptoms has been the most common mental health-related effect of 9/11. PTSD was especially common among those who experienced intense WTC dust, suffered an injury on 9/11, witnessed brutal horror or knew someone killed or hurt on 9/11, or those who had little-to-no emotional support post 9/11.

  • Depression - Those who directly witnessed the WTC attacks or participated in the rescue efforts are at greater risk for developing depression with or without PTSD.

  • Generalized Anxiety Disorder - Those exposed to the horrors of the WTC attacks are at an increased risk for developing generalized anxiety disorder.

  • Substance Use and Abuse - Stress and exposure to traumatic events such as the attacks on the WTC may increase the risks for developing substance abuse disorders.

Current Day Issues:

As with all anniversaries, milestone dates such as the first year following and the 10th, attract heightened attention. 

In the case of 9/11, this guarantees images, sounds, and recordings of the actual event, as well as retrospective rehashing of the years following the events have already, and will continue to be, played repeatedly by the media. This may trigger new feelings of depression, anxiety, and sadness both in those who witnessed or were directly impacted by the events of that day or those who watched it on television or read about it in the papers. 

The following are some resources that may help to address and process feelings that come with the anniversary of 9/11, both for adults and children:

How To Talk To Children about September 11: Tips for talking with kids about 9/11.

9/11 Anniversary May Create Worries in Some Kids: Q & A with child psychologist about the September 11 attacks.

How To Talk To Your Children About The News: Talking with kids about the news in general.

National Association of School Psychologists:

Anniversary Reactions: National Center for PTSD, lists symptoms and tips for coping.

The Pain and Promise of Anniversary Events:  Run by psychologists, it has a very succinct outline of reactions and coping tips.

Resources for the September 11 Attacks:

WTC Centers of Excellence: the WTC Centers of Excellence provide specialized testing and treatment for physical and mental health conditions. They offer treatment by health professionals specializing in 9/11-related conditions and medication for WTC-related illnesses with no out-of-pocket costs to patients.  They also offer assistance with applying for 9/11-related benefits, such as Workers' Compensation.

9/11 Memorial: a tribute of remembrance and honor to the nearly 3,000 people killed in the terror attacks of September 11, 2001 at the World Trade Center site, near Shanksville, Pa., and at the Pentagon, as well as the six people killed in the World Trade Center bombing in February 1993.

The September 11 Digital Archive: uses electronic media to collect, preserve, and present the history of September 11, 2001 and its aftermath. The Archive contains more than 150,000 digital items, a tally that includes more than 40,000 emails and other electronic communications, more than 40,000 first-hand stories, and more than 15,000 digital images.

World Trade Center Survivors' Registry: non-profit and volunteer organization representing survivors' interests regarding redevelopment of the World Trade Center site including the memorial and museum. They also participate in conferences on terrorism and its aftermath, speak about survivors' experiences at schools, houses of worship and community meetings, forge alliances with survivors of other terrorist attacks both within and outside the US, and provide survivors with a forum where they can connect with each other.

9/11 Attacks - 102 Minutes That Changed America: for 102 minutes on September 11, 2001, the world looked on in horror as terrorists flew hijacked passenger planes into New York City's mighty twin towers, destroying the iconic buildings and killing more than 2,700 people. Watch unfiltered videos from nine New Yorkers who witnessed the day that changed America.