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11/17/2017 How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later – Press Enterprise LOCAL NEWS How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later Paula Harold has a moment with Heidi, a horse she spent time with in a horse therapy program through Equus Medendi Equine Assisted Therapy in Redlands on Wednesday, May 24, 2017. In back is her husband Anthony. Paula is a survivor from the Dec. 2nd terrorist attack in San Bernardino and is now dealing with PTSD. She has completed at least a dozen sessions of the horse therapy program to help her deal with the issues. (Stan Lim, The Press-Enterprise/SCNG) By SUZANNE HURT | [email protected] | The Press-Enterprise November 17, 2017 at 8:22 am She’d never been afraid of horses before. Yet she froze outside the corral — her mind racing with fear as she watched the palomino quarterhorse walk around the corral in an isolated box canyon. Since the Dec. 2, 2015, terrorist attack in San Bernardino, Paula Harold had been afraid, distressed and despondent — diagnosed with post- traumatic stress disorder. Now she was supposed to go in there and begin equine therapy. But she stood behind the fence – heart beating fast, breathing shallow, her body ooded with anxiety. “I’m scared,” she said soly to horse expert Angie Sheer and therapist Susan Lilly at Buffalo Meadows Ranch in Redlands. “I don’t know if it’s going to charge me.” Most days, Paula just stayed home. Reading. Doing housework. Afraid to go out. http://www.pe.com/2017/11/17/how-san-bernardino-terror-attack-survivors-are-struggling-with-ptsds-invisible-wounds-2-years-later/?utm_so… 1/10 11/17/2017 How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later – Press Enterprise She had tried things to stop the anxiety and the depression and the fear aer the attack, when she’d seen bullets come through walls as she crawled down a hall to get away while a grazed coworker fell to the oor. Now she wondered how she could return to her job as a San Bernardino County Environmental Health Services supervisor when she no longer believed in herself. Interview with Paula Harold SCNG Invisible wounds Paula is among 57 county workers trying to put their lives back together aer an attack by their coworker, health inspector Syed Rizwan Farook, and his Pakistani-immigrant wife, Tashfeen Malik, at the Inland Regional Center in San Bernardino. Fourteen people were killed and 22 others wounded when a couple bent on hatred walked into a county holiday party/training event with assault ries and opened re shortly aer pledging allegiance to the Islamic State. At the time, the FBI called the mass shooting the deadliest terrorist attack on U.S. soil since 9/11. RELATED: A look back on the San Bernardino terror attack on its rst anniversary Trauma experts say survivors were le with the invisible wounds of post-traumatic stress, which can haunt people like Paula for years or the rest of their lives. http://www.pe.com/2017/11/17/how-san-bernardino-terror-attack-survivors-are-struggling-with-ptsds-invisible-wounds-2-years-later/?utm_so… 2/10 11/17/2017 How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later – Press Enterprise http://www.pe.com/2017/11/17/how-san-bernardino-terror-attack-survivors-are-struggling-with-ptsds-invisible-wounds-2-years-later/?utm_so… 3/10 11/17/2017 How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later – Press Enterprise Sources: National Institute for Mental Health; PTSD: National Center for PTSD<br />Graphic by: Paul Penzella —SCNG Documented as early as Homer’s “Iliad,” the condition has been known by many names, including “soldier’s heart” and “shell shock,” but was seared into public consciousness by the troubling experiences of returning Vietnam War vets. In the late 1970s, it was given the name post-traumatic stress disorder or PTSD. Researchers estimate 70 percent of U.S. residents, or 226.2 million people, have experienced trauma, and at least eight percent later developed post-traumatic stress. There don’t appear to be studies less than 10 years old updating gures for the new millennium’s era of increased terrorism and mass shootings. In 2005, the National Institutes of Health reported PTSD would likely rise sharply in the next decade and become one of the century’s top health issues. Post-traumatic stress can occur aer someone has experienced or witnessed a frightening event, such as natural disasters, terrorist attacks, military combat, rape and sexual abuse, neglect, serious accidents, violent attacks, hostage situations and diagnosis of a life- threatening condition. According to trauma experts and the American Psychiatric Association’s latest diagnostic manual, PTSD involves disabling, simultaneous reactions to trauma lasting more than a month. Those reactions include distressing, intrusive memories taking shape as nightmares and ashbacks; avoidance; negative thoughts or feelings like guilt and helplessness; hypervigilance and fear, which limits sleep, concentration and feeling secure. While anatomical or physiological differences in the brain and harmful childhood experiences such as abuse or illness can leave people more at risk for PTSD, the most inuential factor is how close they were to the traumatizing event, said trauma science pioneer Frank Ochberg. “A perfectly normal person will get PTSD given enough stress,” he said. Journey toward healing Paula was standing in the conference room, waiting to be in a group photo, when she saw a man in black walk in with a rie. She remembers her confusion as bullets and gunpowder ew. She heard the shots but can’t remember seeing or hearing anything else. Her mind blanks until she’s in the hall, crawling away while Marilyn Krichbaum, a coworker returning from the bathroom, drops to the ground aer a bullet grazes her stomach. Paula crawled into a nearby room following others who’d escaped, then saw there was no way out. She crammed into a storage cabinet and prayed the shooting would stop. Coworkers hid in other cabinets while lead Environmental Health Specialist Hal Houser, Vector Control Program Manager Jason Phillippe and Public Health Assistant Director Corwin Porter held the doors closed. Paula’s husband, Tony Harold, drove her home that night and held her the rest of the evening. They’d always been a strong team. Shaken up aer not reaching her for hours, Tony knew he’d have to be mentally tough — the backbone who’d pull the family together. He answered the front door when journalists came knocking – which sounded to Paula like gunshots. http://www.pe.com/2017/11/17/how-san-bernardino-terror-attack-survivors-are-struggling-with-ptsds-invisible-wounds-2-years-later/?utm_so… 4/10 11/17/2017 How San Bernardino terror attack survivors are struggling with PTSD’s ‘invisible wounds’ 2 years later – Press Enterprise He set up cameras outside the house. Applied for a concealed weapons permit. And never le her side. When it was clear she’d been le with post-traumatic stress disorder, they began a journey toward healing whose end remains out of sight. “I’m not a cheap tent. I’m not going to fold up when things are bad,” he said. Panic and fear Post-traumatic stress can last for decades or become a life-long condition. Those who get early, effective treatment usually recover quicker and are less likely to have long-term PTSD. Dec. 2 survivors didn’t get counseling the day of the attack, yet rst responders did – as did survivors of the North Park Elementary School shooting that killed a teacher and student in San Bernardino this year. Houser said what people need to know about that day is no trauma experts helped survivors at the scene. “I don’t think there’s a dedicated, trained, terrorist response aer-effects team – and that really needs to happen,” he said. Time, his family and focusing on everyday life — lugging the kids to school, getting groceries and walking the dogs — have helped reduce his post-traumatic stress. “All these things help you realize your life is still going. But you do always look over your shoulder,” Houser said, sounding sad. Interview with Hal Houser SCNG He’s felt relief and guilt over surviving. He’d like the public, including mental health professionals, to better understand post-traumatic stress and legitimize what survivors feel aer terrorist attacks. “Especially for some of the survivors that laid on that oor in that room while the killer went around and shot people methodically that were still in agony, or sat there wondering whether he was going to come and shoot them – listening to these sounds for ve minutes, wondering when the police were gonna be there to rescue them – that’s a lot of terror that can really mess up somebody’s mind,” he said. Ray Britain, who was interim chief of the Environmental Health Services division Dec. 2, and other survivors never understood the term PTSD until they experienced the physical and emotional symptoms. He’s had high anxiety that’s kept him home. Depression. And tension, with his body aching from adrenalin that ows in ght-or-ight reactions stuck on overdrive. Insomnia – both going to sleep and staying asleep – comes as the event replays over and over in his head. He’s had panic attacks where his heart raced and he felt about to asphyxiate. “I never experienced a panic attack before.

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