“When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.” Fred Rogers  Since the tragic events of Monday's bombing at the Boston Marathon there has been a tremendous outpouring of emotions and I was particularly moved by the above quote that is making the rounds on Facebook and twitter.  Perhaps this resonated with me because I grew up watching Mr. Rogers or because this is an empowering and hopeful reframe; but it made me think about how this event will impact my patients, my practice, my community and my family.

 I looked to the literature to better understand the impact of this traumatic event and found some reassuring data relating to mental health following terrorist attacks.  Not surprisingly, the prevalence of ‘substantial stress’ is extremely high in the first few days after the incident even for those geographically distant from the incident.  Within the first two weeks and by 6–8 weeks, symptoms have fallen by two-thirds. Thus for the majority of individuals significant stress symptoms are temporary and are unlikely to have lasting mental health implications.  However, 2-5% will meet criteria for subsyndromal post-traumatic stress disorder six months later.  You can the read the entire article here.  http://m.bjp.rcpsych.org/content/190/2/94.full


So why am I sharing this with you?  Both professionally and personally, this event affects all of us, and I wanted to normalize our own response and to offer resources to help us through the coming days and weeks.  The American Psychiatric Association offers the following advice:


  • Keep informed about new information and developments, but avoid overexposure to news rebroadcasts of the events. Be sure to use credible information sources to avoid speculation and rumors.
  • Take control of what you can. If possible, stay out of heavily damaged areas that will cause you unnecessary stress and anxiety.
  • If you feel anxious, angry or depressed, you are not alone. Talk to friends, family or colleagues who likely are experiencing the same feelings.
  • Keep an open dialogue with children regarding their fears of danger and the disaster. Let them know that in time, the tragedy will pass. Don’t minimize the danger, but talk about your ability to cope with tragedy and get through the ordeal.
  • Seek help if feelings of anxiety and depression continue, even after order has been restored, or if these feelings begin to overwhelm you.


Regardless of our specialty, we will see the emotional impacts of the bombings in our patients and I hope the above advice helps you provide comfort to your patients.  Additionally, I hope this helps each of us as we get further from this tragic event.

Please send me your questions or comments at president@nhms.org or post your comments below.