As September 11 approaches, many Americans brace for impact. After 20 years, we have come to expect the grief, the sadness, the fear, the anger. Or, even an overwhelm of all of these emotions at once.

For some—especially those who lost loved ones on this fateful day—it never gets easier; these emotions feel as intense as ever before. And while we can’t say for certain that these emotions will lessen or resolve over time, we can offer a little comfort, support, and advice to turn to when it all comes flooding back.

Sadness and Grief on 9/11

Grief is a deep sorrow that results from death or loss. When it comes to 9/11, many Americans suffer from firsthand and/or secondhand grief. Firsthand grief is the pain that results from personal loss, while secondhand grief can describe the pain that you might experience as a result of someone else’s loss.

While firsthand grief might be more powerful, all forms of grief can be difficult to grapple with. “Grief is a very complicated emotion,” explains Crystal Smith, Licensed Professional Counselor at Thriveworks Counseling in Sterling Heights, MI. “Often, people will process their grief at the time and then experience a resurfacing of the grief at a later date.” In this instance, grief returns year after year, as September 11 comes and goes again. Smith says you might “feel irritable, angry, sad, lose interest in activities, or experience changes in appetite” on or around the anniversary.

Simply acknowledging that you are grieving is a step in the right direction. “Recognizing that you are experiencing grief is important and that it’s okay to feel this way,” Smith explains. Additionally, you can remedy the grief and sadness that you might be experiencing by:

It can also help to remember that there are millions of other people who are grieving today, too. Indeed, there is strength to be found in numbers.

Effects of Trauma: The Progression of PTSD

Trauma is our response to distress. As with grief, many Americans suffer from firsthand and/or secondary trauma from 9/11. Those who suffer from firsthand 9/11 trauma witnessed the events themselves, in person or on TV. For example: first responders, passersby, and those who watched or heard the breaking news 19 years ago. Those with secondary trauma, on the other hand, suffer as a result of hearing about these firsthand experiences. For example: Kids at the time who rely on their parent’s or older relative’s memory of the events. Either way, your emotions are valid.

“It is normal to experience strong emotions tied to the tragedy of 9/11 even if a person was not directly impacted,” Smith explains. “The events were so tragic and shocking and involved that many people who were not directly involved became engrossed in the story and other peoples’ losses.” If you struggle with trauma as a result of 9/11, be extra kind to yourself during this time. Find support in your loved ones and consider talking to a trauma therapist (especially if your symptoms are severe). It might also be helpful to talk to other survivors or those who can relate to the profound effect that 9/11 has had on your life.

Fear and Anger on the Anniversary

Fear and anger are both strong, unpleasant emotions. These, too, are ushered in with the anniversary of 9/11 each year, as we remember the ill-fated events and continue to grapple with the grief and trauma we are left with. “The events of 9/11 were incredibly shocking and unexpected and continue to be impactful to the citizens of our country. It is helpful to acknowledge our feelings and spend a few minutes recognizing where they’re coming from,” says Smith. Here are a few additional tips for navigating these difficult emotions:

  1. Journal. To coincide with Smith’s tip above, consider writing your feelings down. It might feel silly or pointless at first, but as soon as you put pen to paper, you’ll open yourself to that relief you’re looking for. The weight you’re carrying can be lessened by acknowledging your feelings and exploring them a little farther in your journaling.
  2. Open up to loved ones. You can also work through these tough emotions by talking to your loved ones. “Talking about these feelings with trusted family or friends can be helpful as it validates and helps to normalize the feelings, so the individual feels less alone in them,” says Smith.
  3. Write letters to first responders. As a final tip, Smith suggests writing thank you letters to first responders, as “it can be helpful to channel the anger and sadness into something positive.”

The casualties of the September 11 attacks were not only physical but mental, too. Many Americans are left scarred by these tragic events: The first responders who put themselves in harm’s way to save others; those who watched the shocking footage on TV with tear soaked eyes; those who lost a friend or family member in the attacks; and even those who hear others recount their memories of 9/11 each anniversary.

However you are affected, be sure to take care of yourself during this painful time. And don’t hesitate to reach out for a little extra support if you need it.