PARIS — Two months after the terrorist attacks that killed 130 people, mostly young Parisians enjoying a Friday night out, Paris is still counting what could be thousands of psychological victims.
And as members of what has been called “Generation Bataclan” experience symptoms of post-traumatic stress disorder, or PTSD, they say the French medical system is not well-prepared to cope amid a culture that tends to stigmatize mental health issues like PTSD.
The survivors’ stories are as harrowing as their memories of the night of November 13 are persistent.
“My girlfriend and I were a few yards away from the Bataclan concert hall that night,” said F. Cariou, a 27-year-old Parisian who asked to keep his first name confidential. “We heard the gunshots but thought there were only fireworks. After a few seconds, a man ran towards my girlfriend and me. He looked really shocked and could not talk to us. I started talking to him in order to understand what was going on. And a minute after, his girlfriend ran towards me as well. She was covered with blood from head to toe and grabbed my forearms so hard I was covered in blood, too. My girlfriend was really shocked. I helped this woman sit and then people started running and screaming in the streets. It was complete chaos.”
Cariou continued, “My girlfriend could not take public transport for the first days after the attacks, she could only travel with cabs, doing round trips to work.”
Then, he said, she started having symptoms consistent with PTSD, officially defined by American Psychiatric Association in 1980 in the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Symptoms as defined by the National Institute of Mental Health as including “flashbacks, bad dreams, frightening thoughts, feeling emotionally numb, feeling strong guilt, depression and having angry outbursts.”
“The slightest sound in the street made her freak out, she still has trouble sleeping and mostly gets angry with me because I do not understand what she has,” Cariou said, adding that she has declined to enter treatment.
France is a country where psychological therapy is still seen as shameful by many, hence trauma victims often keep their symptoms to themselves. And PTSD is no exception, said Dr. Gabrielle Lesvenan, psychiatrist at Hotel Dieu in Paris. It’s one of the oldest hospitals in Europe and opened an emergency psychological unit to treat patients experiencing symptoms of PTSD following the Nov. 13 attacks.
The unit has been overwhelmed with cases, with 30 doctors fielding 1,000 patients exhibiting symptoms of PTSD brought on by the attacks.
“We are obviously understaffed and completely underestimated the need, as there are not enough doctors who are specialized in PTSD treatments in Paris,” Lesvenan said. “Those patients must be taken care of very quickly. It is like a broken bone, you can not see it or feel it when it happens, but symptoms are likely to appear a few weeks, even a few months afterwards. We have to be patient as doctors, as I think there will be more and more people coming in the following months.”
Lesvenan said the short-staffed doctors treating PTSD patients are doing their best to balance protocol and common sense.
“We have a serious issue of discontinuity around here,” she said. “I do my best so patients do not have to tell their story over and over again, but the problem is that we have to redirect them to other doctors to start a therapy, so they have to repeat their nightmare once more, and that can be very discouraging. But it is mandatory, as it is the only way we have to see whether it is a very bad situation or just a temporary shock.”
She said she has limited prescription of pharmaceutical drugs.
“Most of the time we see Bataclan victims suffering flashbacks with agoraphobia,” she said. “We only prescribe Xanax if patients struggle with anxiety and trouble sleeping,” Lesvenan said.
In the days following the attacks, the French government distributed leaflets on “How to protect yourself if another attack happens near you,” advising civilians to put their phones on mute and stay away from windows while hiding. But so far there have been no campaigns regarding PTSD.
Many victims and witnesses of the attacks do not want to be treated, like Mounir M., a 39-year-old Uber driver who happened to drive along Rue Alibert, the street of the restaurant Le Petit Cambodge (Little Cambodia), where jihadists killed 15 customers that night.
“See, they were shooting only a few meters away from me”, he said, driving past a few weeks later. “I had to pick up a client by the Quai de Jemmapes, and I turned left,” he recalled.
Because the neighborhood where the attacks happened is know for occasional gang violence, he thought it was a “gang fight or something with guns.”
Mounir, of Algerian descent, continued, “But when I drove straight up, I clearly saw corpses by the terrace, and clearly understood this was not a mob thing.”
Mounir joined hundreds of Uber drivers who gave free rides home to the victims in the Paris region. “People were going crazy on their phones, calling each and every relative to make sure they knew they were safe,” he said.
Though he was on the front line of the attacks, Mounir said he does not need any psychological support, although he reported symptoms that could be consistent with PTSD.
“Several times a day, I turn left with my car and have a flashback and feels the two shooters are right in front me and are targeting me,” he said. “My wife is here to support me, and I think it is enough.
The reason he downplays what happened that night? He has seen worse.
“You know, I have lived in Algeria for so many years, and I was there during the Civil War. I saw corpses, body parts, and even a head rolling on the ground towards me. So people getting shot like this in the street, that does not really impress me, even if it is going to take quite some time for Paris to go back to normal,” Mounir said.
Dr. Lesvenan at the Hotel Dieu hospital said that a month after the attacks, she started seeing “more and more people coming to the hospital,” unsurprising as PTSD commonly takes time to appear.
While she is taking care of the patients at the hospital, she said, she is pushing as hard as possible to encourage victims of the events to go back to work, stay surrounded by relatives and avoid talking too much about their trauma to any third party that is not a medical practitioner.
“What they need to do is to talk to their doctors,” she said.