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"You don't have to go to
Gaza to treat posttraumatic stress disorder,"
my friend said. "Just come to New York."
It's not that the mental and
emotional state of the US population is indistinguishable
from that of Gaza's Palestinians -- many of
whom have lived with eight years of war and
civil strife -- thousands of lives lost and
homes destroyed, and unemployment reaching 40-50
-- some say 70-80-percent. Indeed, even those
of us hit hardest three weeks into the worst
of this unraveling financial crisis, are still
technically experiencing only an "acute
stress disorder." But there are signs that
each day, this growing financial crisis is traumatizing
us more and more. Add to that our costly, life-claiming
Middle East war, and we -- like the Palenstinians
in Gaza -- may also be on our way to significant
levels of population-wide traumatic stress.
Posttraumatic stress disorder,
which by definition lasts longer than several
weeks, is characterized by three sets of symptoms:
"Hyperarousal," an agitated state
in which the heart may race, concentration and
sleep are disturbed, startle responses are exaggerated
and anger easily triggered; "Re-experiencing"
the original trauma -- in nightmares, intense
and disturbing memories, and flashbacks; and
"Avoidance" of trauma-related thoughts
and feelings, coupled often with a sense of
detachment and estrangement, emotional numbness
and an apprehension about a bleak future.
All these are in abundant supply
in those closest to the crisis -- the ones who
have lost jobs and pensions, older people who
see their retirement savings melting away, and
people of all ages who cannot keep up payment
on their homes. Many who are, or were, working
on Wall Street are sleeping fitfully, jiggling
their knees uncontrollably in meetings, drinking
and eating too much, losing their appetites,
and popping antacids and tranquilizers. One
broker friend is awake far into the night, worrying
about her elderly clients' inability to live
on their diminished incomes and whether or not
she will be able to pay her own child's tuition.
Others, like one 30-year Lehman Brothers veteran
who is married to a colleague, have receded
into states of frozen denial; acting as if somehow
everything were still as it was. He dresses
as meticulously as he always did and sits for
hours at a computer which no longer registers
his trades.
And the symptoms are also present
with more or less intensity in many of the rest
of us who feel the financial foundations crumbling
under our feet. I have been hearing from retirees
who are waking up in the middle of the night,
panicked, to pore over diminished budgets, then
fall asleep worrying that their fixed incomes
will no longer permit them to live in the houses
they saved a lifetime to buy. A colleague out
West tells me her psychiatric inpatient service
is overflowing with people whose loss of homes
and jobs has undermined their precarious emotional,
as well as economic, security. Meanwhile, anxious
and depressed people, unable to afford gas for
the long trip to the outpatient clinic, call
in for more prescriptions for tranquilizers,
antidepressants, and sleeping pills. And children
may be just as deeply affected as their parents;
according to The Washington Post, a
recent national survey of 500 teenagers found
that already, "70% fear 'an immediate negative
impact' on the security of their families."
Former senator Phil Gramm's
infamously dismissive comment declaring the
US in the midst of a "mental recession"
is likely to turn out to be true in a way he
never intended. Financial irresponsibility and
lack of oversight are indeed creating the conditions
for "mental" disturbance. The associated
loss of confidence and hope further threatens
the trust upon which credit and the financial
markets depend.
Even when trauma is reliably
over, the feelings of being overwhelmed and
stuck persist. Five years after the war in Kosovo,
we found that 44% of all high school seniors
in the Suhareka region still had symptoms of
PTSD. And when stress is ongoing, its symptoms
and the accompanying depression are continually
reinforced. Some Americans will never recover
financially or emotionally from the loss of
jobs and homes and savings. Others will be long
unemployed, and their misfortune and lack of
income -- and the emotional distress both bring
-- will affect businesses in their communities
as well as in their own families and friends.
Meanwhile, vast numbers, perhaps our entire
population, will likely feel the uncertainty
and vulnerability that the ongoing and deepening
financial crisis is provoking -- feelings that
still bedevil so many who lived through the
Great Depression. One recent landmark study
on the influence of genetics and "life
stress" showed that of all possible causes,
financial setbacks were most likely to contribute
to depression.
In Gaza and Israel -- where
the consequences and threats of terrorist bombings
are ever-present -- and in Kosovo and New Orleans,
my colleagues and I have helped tens of thousands
of fearful and vulnerable people in the midst
of chaos. We teach them meditation, deep breathing
and movement techniques, mental images, and
exercise. Learning these techniques, they find
places of calm and control within themselves,
discover solutions to problems that had seemed
unsolvable, and raise their depleted physical
and emotional energy. Acting to help themselves,
they find antidotes to the helplessness and
hopelessness that are the hallmarks of depression
and traumatic stress. Learning together they
discover mutual support and a renewed sense
of community.
In Gaza, in the most vulnerable
parts of Israel, and in New Orleans, there is
another factor that makes people's stress and
depression -- and, yes, their anger as well
-- so much worse. This is the sense of being
dismissed and neglected by the larger world
on which they had once depended.
These feelings of neglect,
deception, and disrespect are only increasing
as the financial crisis deepens here and expands
overseas. They must be addressed. The various
bailouts are initial investments in confidence
as well as credit, the first signs of a public
assumption of responsibility. But they are only
a down payment on the far more comprehensive
measures that must follow, and should only be
the first step in the government's effort to
regain the trust that is necessary to real recovery.
As a country, we must honestly
admit to and address the causes of our crisis
-- greed, arrogance, and indifference. Then
we must begin to pay honest, ongoing attention
to the concerns of a population that feels betrayed,
vulnerable, and abandoned. These steps will
promote stress reduction as well as provide
fiscal reassurance. Meanwhile, we have to learn,
quite literally, to breathe deeply, to relax
in the midst of fear and uncertainty, to trust
that we, like the Israelis and Palestinians
and New Orleanians, can grow and change through
adversity. We cannot avoid the fear and the
stress in the world in these troubled times.
We can however, learn to live more peacefully
with them.
James S. Gordon, a Washington
DC-based psychiatrist, is the author of
Unstuck: Your Guide to the Seven-Stage Journey
Out of Depression.
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