The American Psychological Association says this is new territory for the mental health profession, which is struggling to redefine and expand the usual definitions of such conditions as post-traumatic stress disorder to include not just survivors but also witnesses to the event — even those who only saw it on television.

"This tragedy is different from natural disasters in that there was an initial event, but the ripple effects of this event will continue for months, potentially years from now," said Stephanie LeMelle, a public psychologist at Columbia Presbyterian Medical Center in New York. "What is normal going to be? If we send people to fight in a war, that's going to change our sense of normal. If there is potential retaliation, will there be more terrorist attacks? We don't know. There's no way to predict what's going to happen, because this is an ongoing event, with potentially multiple traumas to come. We really need to be alert to the fact that we don't have a normal state right now, and to be as flexible as possible within our families, within our work settings, in our lives, to be able to adapt to these changes as they come about."

Those feeling wrung-out by what's going on in the world right now should know that this Thursday (October 11) is National Depression Screening Day. Call 800-520-6373 to find out where you can go to speak with a mental health professional near you. In addition to screening for depression, the National Mental Health Association has added an extra component this year to help determine if you're suffering from post-traumatic stress disorder. For more information, or for a referral, log on to the APA Web site at www.helping.apa.org. You can also check out www.nostigma.org for additional information.

One of the first things that the APA recommends, in terms of coping with the trauma-related stress of what happened on September 11 and with what continues to happen as we go to war and hear of possible future terrorist attacks, is to understand that our feelings — be they anxiety, depression or anger — are a normal reaction to an abnormal situation. It's also normal, if not expected, to have recurring thoughts or nightmares of the incident, to isolate yourself and to feel a sense of loss, as well as a sense of loss of control over your life ... to a point.

When those feeling disrupt your ability to function, causing disruptions in sleeping and eating patterns, or when they last more than a month — the usual benchmark for when healing should begin — psychologists say that those could be signs of post-traumatic stress disorder.

"This is no real textbook answer," said Melvin Oatis, assistant professor of clinical psychiatry at New York University Child Study Center in New York. "But initially, you can look at this in terms of our reactions over the two to three weeks following events of this magnitude. You are altered, your sensations are altered, you do look at things a bit differently, you are thinking about this and talking about this, so it's at the forefront of your mind. But when it begins to be a month, two months, three months later, and you're still having a lot of trouble and impairment in this arena, and not getting back to what you were doing, that's when it becomes more problematic."

Adding to that, of course, is that it's difficult to return to what we were doing when so much has changed. With no finite end to September 11's aftermath in sight, how do we cope? The persistence of our troubled feelings may become more widespread as we go to war, if threats of retaliation become a reality. Is it so wrong to feel bad about these things?

"In terms of dread and gloom, you can't go on with that over your head all the time," Oatis said. "But you know that there are people who have jobs to serve and protect us and they are going to do this. That is going to happen. And there are some things that are inevitable and that we can't control, so we want to focus on those things we can control. We can control what we do, what we think, we can control our actions and we can focus on ourselves, on a day-to-day basis, and let other things take place."

LeMelle notes the importance of regaining control wherever we can in ways that increase our own security. Developing emergency evacuation procedures at home, in the workplace and when we travel is one such way to do this.

"Having a safety plan in place can really ease the tension," she said. "We are not the first nation to be at war, or to be attacked by terrorists. Other countries have learned to cope with it. And that's going to fall to the individual to be flexible, to be alert but not overly cautious, and to try to take it one day at a time, to do what you can to reset some sense of safety and security."

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