Rescued Miners May Be Trapped by Psychological Issues

Oct. 13, 2010 -- Amid cheers and celebration and a throng of loved ones, officials and media, the 33 Chilean miners emerged, one by one, from the ground.

A spokesman for the hospital in Copiapo, where some of the miners are being treated for a number of heath conditions, said the miners haven't slept yet because they are overjoyed and want to spend time with their families.

But once the jubilation is over, experts say the men may have to confront a number of medical and psychological issues.

"The probability they will have PTSD symptoms is very high," said Edna Foa, director of the Center for the Treatment and Study of Anxiety and a professor of psychiatry at the University of Pennsylvania School of Medicine in Philadelphia. "How permanent those symptoms are, or if they're going to develop further, is something we need to wait and see."

After surviving more than two months trapped underground and facing tremendous uncertainty, including the prospect that they could have died, experts say the miners may now suffer a number of symptoms related to PTSD and other psychological issues. How they respond to them depends on each miner's individual psyche as well as the amount of support they get from mental health professionals, their families and the community.

For full coverage of the miners' rescue, stay tuned to ABC News. Watch "World News" at 6:30 p.m. ET, then "A Special Edition of 20/20: Miracle at the Mine," anchored by Diane Sawyer at 10 p.m. ET, and a special edition of "Nightline" at 11:35 p.m. ET.

"Some may have depression, anxiety or phobic symptoms, some may socially withdraw, some may become hypervigilant and some may have traumatic reminders of the event," said Dr. Jon Shaw, professor of psychiatry at the University of Miami School of Medicine.

For those that do suffer from PTSD, those symptoms will emerge later, usually within a few weeks. .

"There may be severe psychological distress, including cognitive symptoms such as loss, a sense of confusion, concentration problems, a sense of disorientation, nightmares, dreams, a loss of appetite," said Neal Walker, a clinical psychologist with the Substance Abuse and Mental Health Services Administration, a U.S. government agency. "There may also be behavioral symptoms, such as anxiety, irritability, insomnia, they may cry easily, and some men will try to make fun of their experience -- 'gallows humor,'" said Walker.

Shaw said their body clocks will likely have trouble readjusting after months in darkness.

"They will have trouble with the sleep-wake cycle, their Circadian rhythms," he said.

'Band of Brothers' Will Now Break Up

During their ordeal, experts say the miners probably formed strong bonds with each other in order to survive.

"There will also be a sense of loss from the 'band of brothers' and the cohesiveness they experienced," said Shaw. "A lot of the support actually came from the group, and that's analogous to what happens in the military."

Now that the group is no longer together, the miners will need a lot of support from other sources.

Chilean Miners: Psychology of Having Survived

"Their ability to recover also depends on if they have family support around them," said Foa. "I think these people will get a lot of support from families and the entire population of Chile and especially from the people in their hometown."

She added that relationships in the family may be difficult at first as the men attempt to adjust.

"It's possible to have strained family relationships. One symptom of PTSD is irritability and a feeling of alienation from other people, because other people did not go through the same experience they did, and can't possibly really understand what they went through."

The experts also say the miners may have trouble returning to normal life after the notoriety is gone, re-establishing their roles in the family after months of absence, and other problems returning to their regular lives.

Will They Return to the Mines?

One miner's wife said she doubts that her husband will return to work in the mines. Other miners may feel the same way.

"There may be a fear of going back to work," said Foa. "There's a very realistic risk of working in the mines. Events like this one don't happen every day, but the risk is there."

But Al Holland, a senior operational psychologist from NASA who's on the team advising Chilean officials on the rescue effort, said he doesn't think the miners will feel that way, although it is possible that some will.

"There's no reason to expect there will be any problems with work. They were trapped where they work, which is different from being trapped in an unusual situation," said Holland.

Holland said Chilean officials are giving miners access to counseling for six months so they can deal with their issues. But Foa said counseling might not be enough.

"We don't have evidence that counseling is helpful for PTSD, but there are treatments that are effective. We have treatments that are very helpful to reduce the probability of getting chronic PTSD."

But experts are optimistic the miners can recover.

"The majority of them are likely to recover," said Foa. "Recovery doesn't mean they will forget completely, because they won't, but recovery means they will go back to functioning where they won't have symptoms severe enough to cause major distress and will get readjusted to daily life."

Shaw agreed: "We should never underestimate the ability to recover from trauma."