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SANJAY GUPTA MD

The Psychological Toll On Families Of Those Missing On Flight 370; Shedding Light On PTSD After Second Shooting At Fort Hood; How Do You Define Success?

Aired April 5, 2014 - 16:30   ET

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


DR. SANJAY GUPTA, CHIEF MEDICAL CORRESPONDENT FOR CNN: You know, for a full month now, the world has been watching and waiting and wondering trying to figure out what happened to Malaysia Airline flight 370.

You know, for most of us watching this on television, it's been an interesting mystery. But for the families of those onboard, it's been this agonizing period of uncertainty with the emotions fluctuating from tremendous hope to awful despair. It's a different sort of suffering, and few people know more about coping with this sort of grief than psychologist Charles Raison. Doctor, welcome back to the program. Thanks for being here.

Thank you, glad to be here, Sanjay, sure.

GUPTA: You know, you and I have had a chance to talk about all sorts of different things over the years. This sort of situation, Dr. Raison, where you have this period of hope, where the world seemingly is searching for your loved ones and they're on your side, in your corner, and then to go from that to despair. Is that worse than never having the hope in the first place?

DR. CHARLES RAISON, CNN HEALTH'S MENTAL HEALTH EXPERT AND ASSOCIATE PROFESSOR OF PSYCHIATRY AT THE UNIVERSITY OF ARIZONA IN TUCSON: Yes, probably. You know, there's some interesting scientific evidence to suggest that. They did a study a number of years ago where they looked at people's immune system by whether they were hopeful in the face of stressors or sort of negative, you know, the kind of people that would - that would expect the worst. And they found that hopeful people had better immune responses than people that were sort of more pessimistic.

RAISON: Except when the hopeful people's hope got dashed, and if their hope was shown to be unrealistic. They actually had this huge change where their immune system essentially collapsed. And so, we have some pretty good evidence that it is - that false hope - is probably worse than no hope at all. Yes.

GUPTA: It's fascinating. Again, it's under such tragic circumstances that we're even talking about this.

RAISON: Yes.

GUPTA: But this idea that there still isn't closure, Doctor. And, you know, --

RAISON: Yes.

GUPTA: -- I mean, if you listen to the various analysis, there may not be closure for a long time, if ever.

RAISON: Yes.

GUPTA: The hardcore evidence. What about that situation? If there's never closure, --

RAISON: Right.

GUPTA: -- there's always this lingering hope.

RAISON: Right. So you know there's three things that set people up to develop mental disturbances after trauma. One is that the trauma is unexpected, the other is if it's uncontrollable, and the final one is if it's unresolved. And you know, the most horrible thing about this Malaysian Airline thing of course is it hits all three of those -

GUPTA: Yes.

RAISON: -- you know - big time. And so, this unresolved nature of it, it just - you know - this is why people are so desperate to get prisoner of war bodies back and things like this. Closure, even if it's painful, helps people go on. And a lack of closure, you know, it just - it eats away at people. So, yes, this is - this is just an unbelievably cruel twist to this whole story, that these people are having to experience this up and this down and this sense that, you know, either there may be hope - you know - the question of false hope and also just the fact that nobody knows.

GUPTA: Right.

RAISON: It's so bizarre. And that in itself is so unusual. I mean, usually at least you can say we know in general what happened. This is the first one of these I think in my lifetime that's been so not closed.

GUPTA: But what about the physical impact? I mean, you know, you said that there's a higher concordance with mental disturbances after something like this, especially if you have those various ingredients. But what about just physically?

RAISON: Oh, yes. So, stress is a killer. It's a huge killer, right? And so there are literally hundreds and hundreds of studies showing that if you look at things like earthquakes or 9/11s or things like this, death rates spike. They spike acutely, people literally drop dead from heart attacks at a rate 6, 8, 10, 12 times higher than the regular rate. And then, if you look at that promise and look at their long-term sequela and, you know, years afterwards, they've done this in Oklahoma City for instance after the bombing. Health complaints skyrocket. So people get much physically sicker, and they die sooner.

GUPTA: You know, -- RAISON: And it's rough but that's the truth of the matter.

GUPTA: -- yes, and, again, some of this is jarring to hear but sort of we know this to be true - the connection between the mind -

RAISON: Yes.

GUPTA: -- and what's happening there and our body.

RAISON: Now, you know, in terms of what to do for these people, different people need different things. And, you know, I know you and I have talked about this in the past, but I think the general rule is the best way to help people that've gone through something like this is to try to understand each individual and how they've reacted to it and try to tailor one's treatment, one's help to that person's way of coping. You know, what you're looking for is you don't expect these people to be happy.

You expect them to be heartbroken, but you don't want to see them ceasing to function. You don't want to see them beginning to wish they were dead or becoming so fixated on their own pain that they really begin to unwind. And the treatment for people, although there are some general rules, it very much depends on supporting people and helping them build up the ways of coping that they themselves naturally have, and that varies from person to person.

GUPTA: Dr. Raison, thanks so much for being with us. You're the best in the business and we always appreciate having you on.

RAISON: Great, Sanjay. It was great to talk to you as always.

GUPTA: Thank you, sir. Up next, an all-too-familiar scene in Fort Hood, Texas. I'm going to talk to a Marine captain, Jason Hague, who himself suffered from post-traumatic stress. Going to share his insights along with the president of the American Psychiatric Association.

(COMMERCIAL BREAK)

GUPTA: Not even five years now after the worst shooting at an American military base, it happened again this week at Fort Hood in Texas. As you probably know by now, Ivan Lopez, a 34-year-old specialist, he had served four months in Iraq and was back now stateside undergoing treatment for mental health issues. On Wednesday, he opened fire on his fellow servicemen and women.

You know, when you think about something like this, can there ever be a satisfactory explanation as to why something like this happened? It doesn't need to happen, it shouldn't happen, we know that. Want to talk about it a little today.

Retired Captain James Hague of the U.S. Marine Corps is with us from Washington, and in New York is Dr. Jeffrey Lieberman, president of the American Psychiatric Association. Thanks both of you for joining us. Captain, let me start with you. You were deployed yourself three times. You say that you came back to your family a different man, that you had post-traumatic stress. When you hear the news of this week, what is your first thought?

JAMES HAGUE, RETIRED CAPTAIN, U.S. MARINE CORPS: My first thought is what could we have done to help him more? Why did the system fail? Why did he give up hope? Because we needed to do so much to help our veterans now. There's so many programs out there other than just the mental health system in the V.A. There were so many things that are still out there - other nonprofit organizations - other things that are out there that can be done to help these soldiers and these veterans.

GUPTA: You know, Captain, I think that is the most salient point. You know, did something fail him? How difficult is it to get the help that you need? You went through this yourself. I mean, it's something that you've talked about openly. What - you were able to get help. Why did it work for you when it doesn't seem to work for so many others?

HAGUE: It - I'll be completely honest with you - it took me almost 12 years to realize that I needed help. I went through three tours overseas before that I - I realized - that I needed help. It takes a very, very strong person to realize that they need help within themselves. It took my wife and my friends to tell me that I needed help. It took my wife's telling me that she was going to leave me before I needed to get help. So, obviously something failed in the system, because it took my wife to do that.

GUPTA: You know, what we know about him so far is that he seemed like a - somebody you wouldn't look at and say there is a problem looming here. He said hello, he was friendly to people, he had moved into a new place with his wife and his daughter. Captain, -- I'm sorry - Doctor, first you. Is there always some sign? Are there risk factors that people missed?

JEFFREY LIEBERMAN, PRESIDENT, AMERICAN PSYCHIATRIC ASSOCIATION: Very likely, yes. I mean, when we saw the incident with Aaron Alexis which is a very different case, that was not PTSD, that was clearly schizophrenia or psychosis. There were many, many early signs that were missed and not acted on. In this case, by the accounts that we've heard, it's not clear that this person had any signs of being very severely mentally ill or prone to violence.

But, as you point out, he had had some changes lately. From what I read in the news, he had the loss of a grandmother and a mother recently in Puerto Rico and he was grieving them. He had moved from where he previously was stationed after Fort Hood and was reestablishing a new location, plus the fact that he may have had the remnants of the PTSD that may've been induced initially during this tour of duty in Iraq.

GUPTA: I mean, some of these stats are just really - they're awful and they're unimaginable in that a veteran's worst wounds oftentimes are the ones we don't see at all. I mean, in 2012, we know that more men and women died (AUDIO GAP) than in combat. Military suicides are at the highest rate in a decade. Twenty percent of all suicides that are happening are veterans. Doctor, when you hear stats like that, is there something that we have failed to do? I know when you talk about mental health checkups, perhaps regular screening. Is there something else that we just said - look, this could make a huge difference and we have just not done it?

LIEBERMAN: Absolutely. I mean, first of all, our society, our country overall - not just in the military - has really failed to try and provide what would be evidence-based public health worthy mental health services for people. And we see the problem with the homeless, with the mentally ill who are in jails, and the periodic mass violence incidents occurring as a result. In the military, the problem is compounded and more concentrated and are producing these massive statistics of PTSD, of more combatant - more soldiers dying by suicide than enemy combatants. What's going on here?

So, mental healthcare needs to be moved to the front as something that is a urgent priority. If you're having an epidemic because of salmonella or e-coli, or there was some toxin in the air that people were succumbing to, you would be acting on it immediately. We're having this with mental illness-related complications and we should be doing that.

GUPTA: Just let me end on a little more of a positive note, something that I've been very interested in, and you - obviously has changed your life. You're on the board of directors of a group called Canines for Warriors -

HAGUE: Yes, sir.

GUPTA: -- tell me about the program, tell me about what it's done for you.

HAGUE: Canines for Warriors, like I was talking about, the 32 different medications when I was at my darkest point, I found Canines for Warriors and I got my service dog (Axel) who's sitting right here beside me, and I take him everywhere. If I didn't have him, I guarantee you that I wouldn't be sitting here today. I would be dead, I would've overdosed on one of those 32 different medications, drank myself to death, or ultimately would've become a statistic and committed suicide. We provide service dogs to wounded veterans with PTSD, traumatic brain injury or, you know, amputees. We've provided 117 now to veterans throughout the country. We've had no suicides, we've had no suicide attempts.

What he does for me is my Marines watched my back when I was overseas. When I came back home, like I said, you can't turn that switch off. And he is what is able for my brain to relax because he is technically watching my back. He can do all types of things. When I start to have a panic attack, when I start to have an anxiety attack, he senses that and he's able to lead me out of that situation. He also wakes me up from my night tremors, my night terrors. He can bring me my medicine. He can find my keys, he can find my wallet because of my traumatic brain injury. They can do, you know, anything that we need them to. We will tailor them to the specific needs of that veteran.

GUPTA: I'm glad - I'm glad you're doing well, I'm glad you found something that can help. There's a lot of people obviously as we're all saying that need to find that help as well. Captain, thank you so much for joining us, and Dr. Lieberman, thanks for coming back on the program.

Males: Sure. Thank you very much.

GUPTA: Now, there's supposed to be a safer alternative to smoking. In fact, some people say e-cigarettes have even helped them quit. But you know Poison Control issued a major warning about them this week. I'll tell you all about it, up next.

(COMMERCIAL BREAK)

GUPTA: The American Association of Poison Control Centers issued this stern warning on Tuesday. The group reports a surge in calls about exposures to e-cigarettes and also the liquid nicotine that they contain. We asked CNN Medical Correspondent Elizabeth Cohen to look into this.

(BEGIN VIDEOCLIP)

ELIZABETH COHEN, SENIOR MEDICAL CORRESPONDENT FOR CNN'S HEALTH, MEDICAL AND WELLNESS UNIT: Nicotine, it's a poison, and when it's liquefied, it's a highly-concentrated poison. Ren Galrup (ph) learned that the hard way when her four-year-old son got into liquid nicotine used to refill e-cigarettes.

REN GALRUP (ph), MOTHER: -- hear a little bit of a noise come in, and he has taken the lid off of all of them and has this liquid everywhere. He's got it all over him, he's been eating it.

COHEN: Her son vomited all day long and was rushed to the emergency room. Calls to poison centers involving e-cigarettes have surged - 215 in February alone. Just three and a half years ago, calls averaged only one per month. The Centers for Disease Control says the liquids in flavors like melon and strawberry look and smell like candy. So one mouthful of this for a child is like eating -

UNIDENTIFIED MALE: That's like eating four or five cigarettes. That could be lethal.

COHEN: And Poison Control experts say you don't even have to swallow liquid nicotine to get sick. So you've gotten calls from people while they're filling this thing up, it spills on their skin and they start to feel sick?

UNIDENTIFIED MALE: Yes, you could start feeling sick in as little as four to five minutes.

COHEN: A spokesman for e-cigarette makers says they want child-proof packaging and warning labels and they're working with regulators. But he put some of the safety burden on consumers too. "This is an adult product and should be treated as such," he wrote. "Responsible behavior should be promoted and enforced." The Centers for Disease Control called these liquids a threat. Poison experts say bottles can spill, cartridges can break, and little hands can get into this highly-concentrated poison. Elizabeth Cohen, CNN Atlanta.

(END VIDEOCLIP) GUPTA: How do you define success? Is it money? Is it power. Well, Arianna Huffington's going to stop by next with what she calls a third metric of success - how you can thrive.

(COMMERCIAL BREAK)

GUPTA: Seven years ago this weekend, my next guest found herself lying on the floor of her home office in a pool of her own blood. She had collapsed from exhaustion, and this served as a wake-up call for her. Arianna Huffington, and she's of course the woman behind the "The Huffington Post" as well as the author of a new book called "Thrive."

Let me ask you something that may seem like a bit of a non-intuitive question, and you are I are, you know, we both have an immigrant mentality I feel. But how important is happiness? Now, don't take that on face (AUDIO GAP), but is some degree of misery important for success?

ARIANNA HUFFINGTON, CHAIR, PRESIDENT, AND EDITOR-IN-CHIEF OF THE HUFFINGTON POST MEDIA GROUP, A NATIONALLY SYNDICATED COLUMNIST, AND AUTHOR: I don't believe that at all. I think that what obviously every life has challenges, obstacles even the most blessed one. And but what you call misery often comes from our own thoughts. It comes from our own negative fantasies about the future. It doesn't come necessarily from what is happening, but from what we think about may happen, or from the judgments that we have of our 'what did happen.' So that's why the book as well as talking about the third metric of success beyond money and power is very much about how do we connect with ourselves? How do we get to know ourselves and have some control of our own inner environment and our own reactions to what is happening in our lives.

GUPTA: People who are workaholics, when I talk to them, Arianna, they tell me oftentimes that, look, not only do I think that this is a good thing for me, I wouldn't be able to function well unless I was working as hard and as often as I do. They seem to derive legitimate, genuine joy from working that hard. What do you say to those people?

HUFFINGTON: Well, I totally get that. I'm a workaholic and I derive a lot of joy from my work. That is completely different from not giving ourselves and our bodies time to renew and regenerate. As you know as a doctor, the healing process is really this balance between the damage process that goes on throughout life and the restorative - the regeneration process. And if the damage process is really the one that dominates, disease follows. And right now, we have the evidence to prove it. You know, 75 percent of American healthcare costs are because of chronic, preventable stress-related diseases.

GUPTA: I want to - I want to ask you about this quote which I love this quote and as a dad, as a doctor, as a journalist, it's this quote, "How did it get late - how did it get so late so soon? It's night before it's afternoon. December is here before it is June, my goodness, how time has flewn." (LAUGHTER). How did it get late so soon? HUFFINGTON: Dr. Seuss of course. Dr. Seuss addressing what has become known as time famine. The time deficit that we all feel, and there are these surveys that show that people want time in their lives more than they want anything else. So, that's where it really comes down to what we value in our lives. And, you know, in my happy log I say we have 30,000 days to live the game of life, you know, if we're lucky. And how we live it depends on what we value. And our eulogies are not going to be our resumes.

So if we just value only money and power, we were going to end up feeling we never have enough and that we're always going to be breathlessly out of time. Because there's never enough time to just make our lives about those two metrics. But it will (ph) can include the other four elements I write about - between our wellbeing, our capacity for wisdom, for wonder and forgiving, then our lives are totally transformed.

GUPTA: Well, look, it's a pleasure, I'm a fan of yours. I hope that you can stay diligent to these really, really worthwhile goals, right? I mean, again, I think about these things a lot. I wish, frankly, I implemented them better, but I'm going to try more because of you and I appreciate that.

HUFFINGTON: Thank you so much, and I try them better because of you, so thank you. We need to support each other.

GUPTA: That's going to wrap things up for SGMD today. Time now to get you back in the CNN NEWSROOM with Brianna Keilar.