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How Do You Know When to Face Fears, and How Do You Know When to Go Get Some Help?

Aired May 22, 2002 - 11:38   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LEON HARRIS, CNN ANCHOR: Of course, no one can or will forget these images of terror attacks on September 11th. But for many people, getting over the fear factor of that day, coupled with the renewed terror warnings that we've been seeing and hearing in news reports since, have made terror anxiety too much to bear. So how do you know when to face the fears and how do you know when to go get some help?

Well, that is the focus of today's Paging Dr. Gupta segment. Last hour, medical correspondent Dr. Sanjay Gupta gave us the facts on anxiety disorders, and now, we are going to hear from you. A lot of folks out there have sent us e-mails, and Dr. Gupta is going to join us here, and he's got some help. He is joined here by Dr. Charles Raison. He is Emory University -- he works at Emory University here in Atlanta and is an expert in these matters.

Thank you for coming in.

DR. CHARLES RAISON, EMORY UNIVERSITY: My pleasure.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: It's really interesting. One of the things that sort of struck me, just to start with, you and I were talking about this. We saw the interviews with people that we did earlier today or yesterday. A lot of people didn't seem that fearful about all the things that were going on. And then we get all these e-mails, hundreds of e-mails, and a lot of these e- mails, people staying at home, they're watching TV all the time, and they are very scared.

RAISON: Yes, absolutely. And you and I talked yesterday about the fact that they actually studied children, showing that there was a stronger correlation between how many hours of TV children watch of those images of September 11th and developing anxiety symptoms, even compared to actually seeing it happen with their own eyes.

You know, you and I were talking about this. But terrorists benefit from the fact that human beings were symbolic animals. So that things like seeing buildings blown up and things like this have affect on our psyche which is beyond sort of the actual damage it's done.

GUPTA: Let's get right to some of the e-mails I'm talking about here. First e-mail, "I lost a friend on September 11th. Since that time, I have become engaged, bought a condo and been promoted at work. Stress? You got it. Starting yesterday, I have reverted back to my old ways of worrying myself to illness. What can I do to prevent relapses like this that are caused by all this talk of government warnings and suicide bombings."

What can he do? It's ruining his life.

RAISON: I think there is a couple of things. One thing is what you have alluded to, which is I think rather than focusing on it, I think it's very helpful to try to get on with their lives, to try do oh more normal things. TV and media bring in the images so close we start to have a feeling that it happened us to. I think going out in the real world and doing sort of normal things, one, is very sort of stabilizing. The other thing, though, is that we are hard wired to have these stress responses, and if a stress response starts, sometimes it can't be turned off. Even people with a rational mind who would be able to say, you know, I'm overreacting, but the body...

GUPTA: It takes over.

RAISON: It takes over. In those cases, you want to get help. Have therapy and medicine sometimes.

HARRIS: Let me ask you about this. I thought about that as you were answering that, about people who live in New York.

We got an e-mail from Nancy O'Shaughnessy, and she says, "How are New Yorkers supposed to go about their daily lives with terrorist attack alerts so close to home? Our security has been taken away ever since September 11th. Many have fears that could possibly be our last." That's got to be a very almost concrete thought in the minds of many.

RAISON: Absolutely. And it's a classic example also, though, of what happened when people -- when certain buttons get hit in the stress system, things like people really start feeling that their, for instance, demise is imminent in a way that in actuality it is probably not. I mean, if you look at the actual percentages, the odds of being blown up in a building are much smaller actually than being hit with a car. But because these are so symbolically powerful to people, it becomes intimate and personal. So I think one of the things that helpful is to recognize this and realize that this is how terrorism thrives.

I mean, terrorists are like parasites on this human tendency to personalize everything, and then media even brings it in closer. It seems so real and so actual to the person, that part of how we can actually fight terrorism, but also take care of our mental health is to recognize that aspect, that factor in human nature and make a concerted effort, a, to go on with our lives and be safe. But it really is important to do daily things and go on with life. That is a way of thwarting terrorism.

But, b, I think it's also our responsibility, given what's happened in the world, that if we are overcome by symptoms like this, we should seek help. It is amazing how powerful help can change things.

GUPTA: One of the things is people really don't know sometimes whether they're overreacting or underreacting. Our next question sort of speaks to that.

Bruce from Atlanta says, "I'm fine during the day, but in the evening, I find it hard to fall asleep, and when I do, it is for short periods of time, three to four hours, then back until sleep until 6:30, when I am supposes to awake. This ha been going on since September 12th of last year. Do you think there is a big problem?"

RAISON: Yes, I absolutely think this is a problem. In fact, again, earlier, we were talking about depression and how to recognize depression. Both depression and anxiety probably the single most common symptom of sleep disturbances. There is hard wire between one's emotional state and one's sleep state, and in fact, you can make people get depressed if you alter their sleep in alter ways.

So it's like the canary in the coal mine. When sleep starts getting altered, that is a real indication that people are starting to get in trouble. It is interesting, the kind of sleep alteration this person is having when they have a hard time going to sleep is characteristic of anxiety disorders. Sometimes when people actually develop a full natured depression, and then it's more characteristic for them to start waking up in the middle of the night. But for sure, when that starts up, that's a marker. And if it has been going on for more than a few weeks. That's a marker you should get help.

GUPTA: Two weeks.

RAISON: Two weeks is sort of what psychiatrists say, but you know, if you've had these disorders in the past, if it's been going on for a week, odds are if you don't do something about it, cows sort of get out of the barn and you start to have problems.

HARRIS: Speaking of a couple of weeks (ph), here is something that has been happening for the last couple weeks, these terror warnings that we have been getting and we have been reporting here.

Mona from Burlington says: "I think the worst part of the terror warning is that we are not given instructions on what we should do if something did happen. Evacuate? Stay in place? It only furthers the sense of helplessness to be told there's this impeding doom, but no directions on what preparedness steps we should take."

How about some advice for Mona and maybe for the government who's issuing these warnings.

RAISON: Right, exactly, you can see the government is clearly stuck between a rock and a hard place, by that I mean criticism for not making warnings, but then when you make warnings and there is not a clear sense of what to do, this is -- I mean, there is lots of studies showing the greatest predictor of developing post traumatic stress disorder, anxiety after the trauma, is lack of control over the trauma so they have done studies showing that if people are given a chance to prepare for a trauma, they won't develop anxiety symptoms. It very much has to do with the fact it is an intrusion, loss of control and this thing that just erupts from outside.

So, you know, poor Mona, she is exactly right. You get this sort of sense that doom is going to happen, there is nothing you can do about it or nothing clear can you do about it. One thing the government can do is help sort of make suggestions, practical suggestions to people about things that they can do to give them a sense of mastery. Practical things that do enhance mastery, but also a lot of studies showing that even if people feel they have mastery, that in itself is protected. Yes, absolutely.

GUPTA: Let me get to you give a quick comment to this last e- mail, and this sort of speaks to the point about some of the anxiety that people are feeling out there.

James from Brooklyn. He's a new father a 10-week-old boy experiencing tremendous anxiety, because he feels like he should protect his family, but is unable to. A native New Yorker he is, feels like he has brought his son -- quote -- "into the crosshairs." People all over the world have had to face death and war. Am I overly anxious? Is he overreacting, or is this amount of dread unwarranted?

RAISON: Yes. I think that amount of dread probably practically is unwarranted, but it is what happens within the minds and hearts of people when these stress systems are kicked up. Again, it's like once this happens, the mind starts telling you, or the brain starts telling you, that these things are of incredible immediate danger, in a way that if you look at the numbers, it's not true. But when that starts up, you really want to get help.

RAISON: No question, no question, a lot of anxiety out there.

HARRIS: It must be. As you say, we have got hundreds of e-mails about this, and we only starting taking e-mails like in the last hour or so.

GUPTA: Some good tips.

HARRIS: Yes, good tips. Thank you very much Dr. Raison. We sure do appreciate it.

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