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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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