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Sanjay Gupta MD

Stressed Out About Money and the Economy; Busting Stress in the New Year; Why Some Patients Who Call 911 Aren't Getting to the Hospital as Quickly as They Should

Aired January 24, 2009 - 07:30   ET

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

SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger.

First up, are you stressed about money and the economy? Well, you're not alone. And that's what therapists are starting to see, which is quite troubling.

Then, solutions -- busting stress in the New Year. What you can do to help keep it from making you physically sick.

And you've heard of the golden hour, maybe you have. Discover why some patients are calling 911 aren't getting to the hospital as quickly as they should.

HOUSE CALL in January is all about resolutions. You must know that by now. This week, we're talking about things you can do to bust stress in the New Year.

Consider this study. According to a report by the American Psychological Association, in September, 80 percent of Americans said the economy was a significant cause of stress, up nearly 16 percent in less than six months. That's leading some Americans to consider clinical therapy.

Now, many psychologists say that referrals are up and they're finding some surprising solutions to help patients cope and to help them pay.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): The catastrophic feeling of a layoff.

STACEY ROSENBERG, FORMER MARKETING MANAGER: It can get somebody when you lose your job and your head.

GUPTA: Stacey Rosenberg, former marketing manager in Boston knows it well. Unemployed for months, Rosenberg started retreating from friends and family, spending more and more time by herself.

ROSENBERG: I was not feeling good.

GUPTA: She eventually found a job, only thing is, it happened again. A second layoff in less than a year.

ROSENBERG: I had to figure out how to deal with it the second time around because I did so poorly the first time around.

GUPTA: For more than six months now, Rosenberg sought help here -- a psychotherapist office. In therapy, she talks to her doctor about her layoffs and about the recession.

ETHAN SEIDMAN, ROSENBERG'S PSYCHOLOGIST: You're feeling really quite helpless about things.

ROSENBERG: Yes.

GUPTA: There's no formal data on the number of Americans who are turning to therapy in the wake of the recession, but most clinical psychologists say that referrals are up.

NANCY MOLITOR, PSYCHOLOGIST: This is really unprecedented. I'm seeing patients -- I've been, you know, practice for 20 years -- and I'm seeing just an unprecedented amount of anxiety as are most of my colleagues.

GUPTA: Each session costs Rosenberg a $15 copay, when she couldn't afford the fee, her therapist started her on a tab, a financial break. Other therapists are offering flexible scheduling and payment plans on a sliding scale to help patients impacted by the economy.

SEIDMAN: It's entirely normal to feel fear about what's happening in our country. If your anxiety level is getting such that you can't function in your normal life, if you can't do the things that you need to do, if you find yourself avoiding things that you really should be doing, then you probably need help.

GUPTA: Beyond elevated anxiety levels, there are concerns about depression and suicide.

MOLITOR: We've had people who are so depressed that they are thinking that maybe life isn't worth going on. It's a small number of people but, you know, that is something that we're becoming -- as this crisis goes on longer and longer -- we're becoming more and more concerned about.

ROSENBERG: This is a personal budget.

GUPTA: With her doctor's help, Rosenberg says she's feeling better nowadays.

ROSENBERG: We've talked a lot about identity and money and how I was going to cover my expenses. And there's a lot of freaking out when this first happened to you and now, I feel like I have a team. I mean, I have my friends, I have my therapist, I have my family. I have a team behind me and they won't let anything terrible happen to me.

GUPTA: Her muddy thoughts are now more clear.

(END VIDEOTAPE) GUPTA: So, the economy, work, relationships -- all can cause a lot of stress. As we said, the economy is high on the list of worries in a recent survey by the American Psychological Association. People in the survey report mounting anxiety, feeling severed (ph) ability, headaches, fatigue -- all of it due to stress. And that's bad enough, but chronic stress can be dangerous as well, putting you at risk for depression, heart disease, decreased immune function, premature aging, possibly cancers -- you name it.

So, with us this morning to talk about de-stressing, Doctor Charles Raison. He's a psychiatrist, clinical director of the Mind- Body Program at the Emory University School of Medicine.

Welcome, doctor.

DR. CHARLES RAISON, PSYCHIATRIST, EMORY UNIVERSITY: Thank you.

GUPTA: I should add as well, you're one of our contributors on CNNHealth.com.

RAISON: I am.

GUPTA: Lots of good information you give to our viewers, and thank you for that.

Everyone is talking about the economy. I know a lot of patients of yours are probably talking about it as well. What is it that's unique about the economy that's causing so much stress?

RAISON: There's a lot of things. And it's kind of a perfect form. So, let's just pick out some.

One, we know that stress is worse when it's -- it affects people more negatively when the stress is worse than they think it's going to be. And one of the things about this economic thing is we think it's fixed, we think it's fixed, and it gets worse and worse and worse.

Another thing that is very highly predictable dealing with depression is if you feel like it's out of your control. And this is a huge thing that we all feel like it's out of our control, right?

GUPTA: Right.

RAISON: So, I mean, that's -- those are two major factors that are really rough. And when people lose their jobs, especially, even if it's a big layoff, it is human nature to feel like you did something wrong or like there's something wrong with you, and that feeling, in fact, turns out to be one of the major predictors of developing depression.

GUPTA: We're all in this together. I mean ...

RAISON: We're all in this together, and that helps in one way. But I think, in another way, that's also part of the problem. I think we literally now are so connected with Internet and TV and, you know, shows like this that we see other people suffering. We hear it coming. I think it makes it feel closer to us.

So, even if right now we're kind of OK, I think it increases general anxiety. So, it's got a good side that, yes, you realize you're not the only person if you've lost your job, but then, you know, for people who are still sort of in a normal place, I think it's closer than it would be if we weren't hearing about it all the time.

GUPTA: At CNNhealth.com, a lot of viewers asking questions. See if we can get to one now. Sarah in New York has this question specifically. "What are the symptoms of stress?" she asks. You know, it's funny, because stress in some ways, I imagine, an overused term.

RAISON: It is, and it's a diffused term. I mean, there's lots of different things that stress can be. But usually, what people mean is it's perception. It's a feeling that bad things are happening and that they're at risk.

And the symptoms of stress are exactly the same as the symptoms of depression understandably. And depression really is what happens when the stress symptom just goes wild and you can't turn it off. So stress and depression are very, very tightly linked. And that -- depression and anxiety are usually what happens to people when the stress gets the better of them.

GUPTA: But let's delve into that in a moment (ph).

RAISON: OK.

GUPTA: I think the next e-mail is a good follow up to that. This is from Patil of New Jersey who writes this, "Everyone has stress in their daily life but how can I determine if this is harming my health before it's too late? What are acceptable stress levels?" I mean, are you sort of describing a continuum, you know, stress, anxiety, depression?

RAISON: It is. There's a continuum between boredom, which isn't enough stress, and challenge, which is like an optimal stress, where you feel excitement but you feel you've got control over it. And where then it becomes what we typically call stress, where you begin to feel overwhelmed and flooded and like things are slipping away from you. And that's the point where stress begins to have negative health consequences.

GUPTA: Are there people who are more likely to develop that or more likely to tip the scale into ...

RAISON: Absolutely, yes.

GUPTA: How do you figure out?

RAISON: There's many, many factors, but it's pretty simple, actually. You are one of those people, if the stress is getting to you. If you're somebody starting to lose sleep, starting to lose hope, starting to feel miserable, starting to be anxious all the time -- those are the most subtle and reliable markers that the stress is getting to you and you should do something about it. GUPTA: Yes, that fine balance between challenge and stress.

RAISON: That's the key.

GUPTA: I think we all play with that.

RAISON: That's right.

GUPTA: I imagine you and I have as well.

RAISON: Oh, you know it, yes.

GUPTA: We are talking with Doctor Charles Raison from the Mind- Body Institute at the Emory School of Medicine. Much more with him after the break.

But if you're feeling stressed at home, your weight might be to blame. Just ahead -- find out what our guest says a weight problem is like carrying around a ball of stress.

But first -- a surge in children becoming infected by a dangerous bacteria. I've got all the details in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

It's time for a quick check in the medical headlines. First up, pet treats are now among the list of recalled products in the latest salmonella outbreak. That's right. Officials investigating peanut butter traced by the Georgia plant owned by the Peanut Corporation of America advise people to wash their hands after handling Great Choice brand dog biscuits from PetSmart.

Now, the risk may be minimal to pets. But salmonella, as you know, can be transferred to humans who touch these products.

The outbreak has sickened nearly 500 people in 43 states and it's been linked to six deaths as well. Visit FDA.gov for a full list of recalled products.

Also in the news -- an alarming increase in child ear, nose, and throat infections caused by the deadly bacteria MRSA or mersa. A new study finds infections more than doubled between 2001 and 2006, with most infections taking place outside the hospital. It's a huge public health concern, one that we're following.

The germ is resistant to penicillin-based antibiotics and they start becoming resistant to other treatments as well. Mersa can lead to potentially life-threatening infections in the bones, joints, bloodstreams, heart and lungs.

If you're stressed out, it's ruining your life and your health perhaps. We have tips on how you can get some relief. We're back with HOUSE CALL in 60 seconds.

(COMMERCIAL BREAK)

GUPTA: Got to be clear, not all stress is bad, but chronic stress sort of staying in that flight or fight mode can create ongoing wear and tear on the body. And that's where we're helping you stave off today. This show is about living longer and living stronger, and cutting stress can help you reach that goal.

With us this morning is Doctor Charles Raison, a psychiatrist, head of Emory University's Mind-Body Program as well.

You know, people have such specific questions about this but I think so many people been effected by the economy ...

RAISON: Oh, yes. It's huge.

GUPTA: ... and all the stress.

Let's get right back into another e-mail. This is from Maria in Texas who says this, "How does stress affect your weight?" You know, it's interesting, because I sort of envision this as a little bit of a vicious cycle, right?

RAISON: Yes.

GUPTA: And if people ...

RAISON: And it's bi-model, too, because some people lose weight when they get stressed out. But, unfortunately I see a lot of people began to eat kind of compulsively and gain weight. And one of the things, some of the research we do for instance is showing that right here -- and I hate to admit it -- but, you know, belly fat especially ...

GUPTA: The belly.

RAISON: Yes -- it produces exactly the same stress and immune hormones that can make you depressed as being stressed out does. It's like, as you said, it's like a ball of stress right around your midsection. So, it is a vicious cycle.

GUPTA: So, just being a little bit or having that extra belly fat ...

RAISON: Yes.

GUPTA: ... even if you necessarily weren't feeling stressed makes you feel ...

RAISON: It sends the same signal to your brain as psychological stress does, yes.

GUPTA: Another reason to try and lose some of that ...

RAISON: Absolutely, yes.

GUPTA: ... as if you didn't have enough. RAISON: Yes.

GUPTA: So, I think we have enough time for one more question. Rosemary in New York writes this, I've been -- and this is a very specific question, I think a good one for a lot of our viewers. "I've been working the graveyard shift for 23 years. I'm diabetic. I'm overweight. I sometimes only get a few hours of sleep a day. I'm so stressed out at work. What can I do to help myself?"

I mean, she has an impossible life, it sounds like.

RAISON: Yes, very rough. Yes.

GUPTA: How can she help herself?

RAISON: Well, you know, first thing she should do is look and see if she can change the circumstances of her life. It turns out working the graveyard shift, while some people can do it, is a risk factor for getting sick and is risk factor for getting depressed, and it really itself messes up your stress hormones.

The second thing she should do is to try to lose weight, of course. It's easier said than none. And the diabetes, you want that as well controlled as possible.

She's got a bad enough situation where I would recommend she'd see a physician. You know, she's somebody that might benefit from treatment, perhaps either therapy or medications, because she is in a tough spot. Sometimes, people can't change the tough spot.

GUPTA: Has your practice gotten a lot busier from the last time?

RAISON: There's been a lot more sort of activity, in general, at Emory, of people being very stressed out.

GUPTA: Well, thank you for being on the show.

RAISON: Sure.

GUPTA: You know, there's a lot of interest in Mind-Body as well, which is something you do a lot, the program.

RAISON: Yes, that's where I work.

GUPTA: I'd like to have you back to talk about that, this connection between the mind and body.

RAISON: Yes.

GUPTA: We'll focus on on HOUSE CALL. So, I appreciate you being here. Thanks.

RAISON: Yes, thank you, Sanjay.

GUPTA: Emotional eating can go hand-in-hand with stress. But that doesn't have to mean gaining weight. CNN medical correspondent Judy Fortin tells us today that replacing a couple of ingredients can make all the difference in the world.

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN MEDICAL CORRESPONDENT (voice-over): A batch of brownies doesn't have to be fattening, especially if you substitute healthier ingredients.

COLLEEN DOYLE, "THE GREAT AMERICAN EAT-RIGHT COOKBOOK: I'm going to cut the fat and the calories by just using egg whites.

FORTIN: Registered dietitian, Colleen Doyle, co-author of "The Great American Eat-Right Cookbook" says, you'll save more than 60 calories. And that's not all.

DOYLE: Instead of using the oil, which is all fat, it's 100 percent fat, I'm going to substitute an equal amount of apple sauce. That's going to save us, overall in this recipe, close to 900 calories and 100 grams of fat.

FORTIN: Apple sauce, baby food prunes and pumpkin pie mix add moisture and nutrition to baked goods. Doyle has tips on another family favorite.

DOYLE; These store bought chicken nuggets have on average 320 calories per serving and about 21 grams of fat. If you make the homemade instead of the store bought, you're going to save about 90 calories per serving and about 13 grams of fat.

FORTIN: She dips chicken in an egg and herb mixture and coats them with crushed Melba toast. But will the kids eat them?

DOYLE: They don't even know that it's healthier than the store bought chicken nuggets.

FORTIN: Judy Fortin, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: All right. Judy, thanks.

Now, during a heart attack, time, of course, is of the essence. But some patients who call 911 aren't getting to the hospital as quickly as they should. Stay tuned for details on that.

And if you think fitness and travel don't mix, think again. We've got some clever ways to stay in shape when you're out of town. All of it after the break.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL.

You know, most people know to seek help immediately if they have symptoms of a heart attack or a stroke. But an interesting new study says women's heart complaints may not be taken as seriously when they dial 911. So, how can you ensure that you're getting the care that you need?

Elizabeth Cohen joins us with some details on this. This sounds like a pretty fascinating and maybe scary study as well. What's it about?

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: It is. It is interesting. What they found is that women were 52 percent more likely to experience delays when they called 911 with heart problems. Now, Sanjay, the problem wasn't so much of getting the ambulances to their house -- that was just as quick as with men. It was once they got there, the delays started. And the delays continued until the time when they got them to the hospital.

GUPTA: They didn't believe them or they didn't think it was heart problems?

COHEN: It's not clear but a lot of people say that people don't take women with heart problems as seriously as they take men, because some people still have this feeling that heart attacks are more of a male problem. And also, Sanjay, as you know, women experience different symptoms.

GUPTA: Right.

COHEN: And not all emergency workers have sort of kept up with that. Women may not have the severe pain. Instead, they might, for example, feel nauseous.

GUPTA: Right. Or just tired, I've heard.

COHEN: Exactly.

GUPTA: So, what -- if you're a woman watching this right now and you're worried about this, what can you do?

COHEN: Well, a couple of things. One thing that you can do is, first of all, don't be a martyr. A lot of doctors I talk to say women can be martyrs, "Oh, I don't need to call 911, it's a just little indigestion." Call 911 if something is unusual.

Second, tell the emergency workers, for example, "I'm nauseous, I'm vomiting and this is extremely unusual for me. This is not normal. This doesn't happen to me." It's really important to make that point and be specific about your symptoms.

GUPTA: Women, obviously, the heart disease is not thought of as a woman's problem, nearly as much as it should be. But do these tips apply for men as well?

COHEN: Yes, some of these tips do. I was interested to hear what these emergency doctors and emergency nurses had to say.

If you're a man or even if you're a woman with problem other than heart disease, be specific when emergency workers come to your house. Don't just say, "Oh, I don't feel." Be specific about your symptoms, talk about when they started, talk about what you've do know to make yourself feel better. Be as specific as possible.

GUPTA: And that's why you're the empowered patient advocate.

COHEN: There you go.

GUPTA: I appreciate it as always. Thank you very much.

And be sure to catch the rest of Elizabeth's tips by visiting her Web site, CNN.com/empoweredpatient. Good stuff there.

Now, is frequent travel killing your workout routine? Maybe you need to change the way that you pack. Yes, it could be as simple as that -- details just ahead.

Plus, changes in the body during pregnancy can cause unusual aches and pains. Just ask my wife. But there are things you can do to feel more comfortable. We have some tips in our "Ask the Doctor" segment, my favorite segment and it's later on the show.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, frequent travel can kill your workout routine. Take it from me. But you don't have to abandon fitness when you hit the road. Simply knowing how to pack might make all the difference.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): As a busy sales manager in Silicon Valley, David Peck often found himself eating too much fast food and neglecting exercise.

DAVID PECK, BUSINESS TRAVELER: I get really stressed out, I'll go for the comfort food, fill the belly, feel good.

GUPTA: And things only got worse when he was on the road.

PECK: Juggling things, I'm probably not that good at it.

GUPTA: But Fit Nation trainer Robert Dothard says just because you're out of town doesn't mean the workouts have to stop.

ROBERT DOTHARD, FIT NATION TRAINER: Whatever city you're traveling, you can go online and find all sort of resources. Normally, they have running trails, jogging trails, just can run in place. Try to get a private room so nobody sees you do this, but it really is effective and it gets your heart rate up.

I can work a whole host of muscle groups just using simple ankle weights that don't take up any more room than maybe a couple pairs of socks.

GUPTA: And, of course, Robert says, take advantage of the free gyms and healthy food options in your hotel. And here's something else -- travel with rubber exercise tubing. ROTHARD: It's very light and it literally, it slices and dices. It has a thousand and one uses. I can literally work out full body with tubing.

GUPTA: As for David Peck, after getting a heart scare, he says he's eating better, even on the road.

(END VIDEOTAPE)

GUPTA: All right, David. Good luck to you.

Now, from leg cramps to medication affecting your exercise routine. I'm going to answer your questions next. Stay with us on HOUSE CALL.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. It's time for our segment Ask the Doctor. Let's get right to it.

Here's a question from Selene in Alaska, writes this, "I'm 36 weeks pregnant. I work at a pharmacy on my feet all day. I'm getting cramps in my legs. Can you tell me why? More importantly, what can I do about it?"

Well, Selene, leg cramps especially in the second and third trimester are very common. So, first things first -- don't be alarmed. They're usually caused by weight gain but also changes in your circulation. In addition, your growing baby adds some pressure on the nerves and blood vessels that go to your leg.

Now, since pressure and pinching that could be causing your leg cramps. It also sounds like from what you're describing that you're on your feet all day. So, something helpful could be wearing support hose.

Also, when you get the chance, try resting and elevating those legs as well. Stretch the areas that are cramping. Massage your muscles. Make somebody else it do it if you can. If the cramps continue and are severe, make sure to talk with your health care provider.

Also congratulations on your pregnancy, Selene. What you're describing, a lot of those things my wife is going through as well. I hope you get some relief, my wife as well.

Now, on to another email from Robert in Virginia who asks this, "How much does blood pressure medication affect heart rate when exercising? I'm 71-years-old, and I don't want to overexert."

Well, Robert, first off, you're wise to be cautious. Some blood pressure medications do lower your maximum heart rate and that's going to affect how you exercise. You should look for a target heart rate.

And the target for exercising for men your age is around 75 to 128 beats a minute. You can look on the Internet for that sort of information. The average maximum heart rate at about 150 beats a minute.

Now, because you're on medication, I would certainly ask your doctor whether you need to aim for a lower target heart rate while you're working out. You might want to discuss changing your medications as well if there is a problem. Good luck to you as well.

Unfortunately, that's all the time we have for today. If you missed any part of today's show, be sure to check out my podcast on CNN.com/podcast. Also, make sure to tune in next week as we continue to jump-start your health and bring you tips on how not to overindulge, especially with alcohol.

Send us your questions: HouseCall@CNN.com.

Remember, this is the place for the answers to all of your medical questions. Thanks for watching. I'm Doctor Sanjay Gupta. More news on CNN starts right now.