NEW YORK (AP) — The roar of a plane above Lower Manhattan. The rise of a pristine tower where ruins once smoldered. News of terrorist attacks in far-off lands.
For New Yorkers in or near the World Trade Center on Sept. 11, 2001, the sights and sounds of everyday life can still — even 13 years later — trigger painful memories.
Thousands of people continue to struggle with the effects of 9/11. And they're coming forward for treatment in droves, seeking a way out of recurring nightmares, self-isolation and substance abuse through a nine-year-old program that's in danger of closing if Congress doesn't extend funding next fall.
In the last year alone, more than 1,100 people have signed up for services through the city hospital system's World Trade Center Environmental Health Center for people who lived or worked within 1½ miles of ground zero. Nearly half the program's 7,735 patients enrolled in the past five years.
"Even though it's 13 years later, we're really appreciating that there's a long wake and legacy of the World Trade Center disaster," said Dr. Nomi Levy-Carrick, the program's mental health director.
About 60 percent of patients in the program show symptoms of post-traumatic stress disorder, anxiety or depression attributed to 9/11, administrators say, and about 40 percent have sought treatment for a mental health condition.
The delayed enrollment is a byproduct of recent outreach efforts and the apparent reluctance of survivors to bring attention to their psychological trauma.
"There was tremendous survivor guilt," Levy-Carrick said. "So people who survived didn't feel worthy of wanting to seek care. The fact that they had survived, they felt, should have been enough."
She said people who tried moving on despite the lingering psychological effects of 9/11 realized they weren't getting better.
Rebecca Lazinger's awakening came in 2010.
The trauma of the attacks — her ears blowing out as American Airlines Flight 11 slammed into the north tower, a man screaming seconds when he was crushed by falling debris, and the flood of Morgan Stanley co-workers evacuating as she lay in shock on a lobby floor — sapped her of emotion and turned the rest of her 20s into a "sludge" of eating, drinking and vague memories.
Lazinger, now 36, would joke with friends that she was dead inside.
"I didn't know what was going to happen to me, or if my life was going to be just one big fuzzy mess," Lazinger said.
Finally, after fits and starts with private doctors and an outpatient psychiatric clinic, she found the World Trade Center Environmental Health Center, where she entered therapy and started taking medication to mitigate her symptoms.
She had cried over 9/11 a handful of times in private. The first time she cried in front of another person came a few minutes into her first session with one of the center's social workers.
"That was an enormous breakthrough for me," Lazinger said. "It was like, I'm home. Like I'm in a place that understands me, and that can help me."
The treatment program, funded through the federal James L. Zadroga 9/11 Compensation Act, carries no out-of-pocket costs and is available regardless of insurance or immigration status. The act's funding component for health services is scheduled to expire in October 2015.
A group of New York legislators said this week they would introduce bills in the House and the Senate to extend funding for another 25 years.
Just one more year of treatment, Lazinger said, isn't enough.
"I can't be the only one like this," she said. "There are more people that would just be crumbling again. This is saving my life right now."
New York City Health and Hospitals http://www.nyc.gov/html/hhc/html/home/home.shtml
To enroll in the New York City program, call 1-888-982-4748