Participants: Don Mckintosh (Host), Manjula Borge
Series Code: HFAL
Program Code: HFAL000170
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00:01 The following program presents
00:03 principles designed to promote good health 00:05 and is not intended to take the place 00:06 of personalized professional care. 00:09 The opinions and ideas expressed 00:11 are those of the speaker. 00:12 Viewers are encouraged to draw 00:14 their own conclusions about the information presented. 00:49 Hello, and welcome to "Health for a Lifetime." 00:51 I'm your host Don Mackintosh. 00:52 And today we're gonna talk about a serious, 00:54 but important subject, natural disasters 00:58 and their impact on us not just physically, 01:00 but our mental health and joining us in the sudid today 01:03 we talked about this is a psychiatrist, 01:06 who has been trained in both adult, 01:08 and now doing a fellowship in child 01:10 and adolescent psychiatry, Dr. Borge 01:15 and you're from Pittsburg, isn't that right? Yes. 01:17 And you got interested in psychiatry 01:20 and helping people in this way, how? 01:24 Well, you know, after recent natural disasters 01:27 going on with our country 01:28 and also overseas, I was wondering a what kind of 01:32 mental illnesses one can, you know, 01:35 expect and of course, so I was wondering 01:38 I would like to know more about this 01:40 and I was thinking of what I can do-- 01:43 To help. To help. 01:44 So I got interested. 01:46 So this is, I mean, this is a large group 01:48 you're working with today, 01:49 I mean, you're gonna impact what the Lord's help. 01:52 A lot of people and hopefully give them, 01:54 you know, some inside and what, what's normal, 01:57 what's not normal, and what can really help them. 02:00 Absolutely, I mean, the goal is here 02:02 to educate the people, you know, I feel very sorry 02:05 for what people and families have gone through 02:08 and are going through, and what I'd like to do is, 02:10 you know, see how I can help by educating them. 02:13 By telling them of information 02:15 that can be helpful to them, so that they can, 02:18 you know, have better lives and be able to deal 02:22 wit the stressors in a much better way. 02:24 Now you and I have talked 02:26 in another program which of people interest 02:28 in that they can get it from 3ABN. 02:31 On children and the impact of natural disasters, 02:34 but we want to talk about adults 02:35 in this particular segment, but first of all 02:39 we want to define what a traumatic 02:42 or natural disaster would be and then look at 02:45 some normal reactions, 02:46 and then look at some risk factors. 02:48 Before we then look more specifically at some specifics 02:52 so first of all, what is a definition 02:54 of the natural disaster or traumatic event? 02:57 Yeah, anybody who has gone our experienced event 03:01 or events after a natural disaster 03:05 is undergoes through what is called 03:08 a traumatic stress reaction. 03:11 And a traumatic stress reaction is the person 03:13 who has eye witnessed or experienced events 03:17 in which the physical and integrity of themselves 03:22 or others has been threatened 03:25 have experience what is called 03:27 a traumatic stress reaction, and-- 03:32 Lots of people who go through that, 03:33 I mean, like medical workers, 03:35 emergency workers, fire workers. 03:37 Absolutely, and those people who are involved 03:41 in those areas where the stress and mortality 03:44 is high have also experience 03:47 what is we called trauma. 03:49 According to the American Psychological Association 03:52 approximately 70% of US adults have experienced 03:57 at least one traumatic event in their lifetime 04:01 and one in five gone to develop symptoms 04:04 of what we called posttraumatic stress disorder. 04:07 Would you consider seeing like I watched 04:11 when the Twin Towers felt, September 11, 04:14 is that a traumatic event? 04:16 Suppose to be me, it was if, 04:18 I saw people physically jumping out of windows 04:21 was that a trauma for the whole country? 04:23 would that count as one event? 04:24 Yes, absolutely, you know, 04:26 if you have witnessed or traumatic event 04:29 to that magnitude is definitely traumatic 04:32 but I think it depends on the individuals. 04:34 Some people who have witness 04:36 different types of trauma in their lifetime before, 04:39 maybe more resistant to developing trauma 04:41 after witnessing something like that 04:43 or as others who have not and who felt like probably, 04:47 you know, it is very safe to be in America 04:49 and safe to be in that, probably, in that area 04:53 and that nothing like this 04:54 would happen to them, to them it might be 04:56 very, very traumatic compare to someone else. 04:59 So, but definitely witnessing a traumatic event 05:04 where the integrity and a danger was involved 05:08 to the person or others also is, 05:13 a person can also go through what is called 05:15 a traumatic stress reaction. 05:16 So, I mean, living in Florida would be kind of 05:19 traumatic at this time, living in different places, 05:21 these or seeing it on television 05:24 all these things kind of add up, absolutely. 05:26 So this is very important to talk about 05:27 what are some normal reactions 05:29 to these traumatic, traumatic stressors. 05:32 Yes, and I think that's very important 05:34 to keep in mind that these are normal reactions. 05:38 Because after experiencing trauma to this extend 05:42 that you are expected to undergo 05:45 certain normal reactions. 05:47 For example, we can talk about emotional reactions 05:51 where you can have shock denial, 05:54 anger, resentment, can feel abandoned 05:57 or a strange from people, you can feel betrayed, 06:01 you can get, you can feel depressed. Or patriotic. 06:05 Yes, absolutely you can, you can feel patriotic also, 06:10 you can feel lot of psychological distress 06:14 you can have flashbacks of the event, 06:16 you can have nightmares, you can feel, you know, 06:20 have all these stressing images or memories, 06:24 you can have memory loss of the event, 06:27 you can have physical reactions to the trauma, 06:32 you can have chest pain or discomfort, 06:34 you can have abdominal pain or distress, 06:38 you can have physical tension, fatigue, 06:41 you can feel paresthesia or numbness of the extremities 06:46 you can have headaches. 06:48 So these are some of the physical symptoms for trauma. 06:52 Interpersonal situations or reactions that are normal. 06:55 These are normal by the way 06:56 what you're talking about. 06:58 Absolutely, interpersonal you can, 07:01 people can get more have difficulty 07:04 with their relationships with their spouses, 07:06 with their families, with their children, 07:09 they can get more aggie, 07:10 more irritable with their relationships 07:13 they can feel, like I said, betrayed, 07:15 they can feel abandoned, sometimes they can feel 07:18 like the responsibility over them is overwhelming, 07:23 especially for male figure, 07:25 who is the head of the household by feel that, 07:28 okay, this is so much that they have to 07:30 take care of and deal with, so they might feel 07:34 more anxious and more stressed out. 07:38 Spiritually I imagine some people angry with God 07:40 and some people would say, I don't know, 07:42 I don't have anything to do with God anymore 07:44 and some people get closer to God. 07:45 Absolutely, some people can look at this as, 07:48 God, where were You, where were You 07:49 when I lost my child, when I lost my spouse, 07:52 where were You, I did You let this happen to me 07:54 and they can requisitioning God over and over, 07:57 they can get very resentful with God, 07:59 they can get very angry, 08:00 they can lose their faith in God. 08:02 Whereas some people can look at it as sign 08:06 from God saying that they need to change 08:09 their lifestyle that they were living 08:10 and they might become more closure to God. 08:13 So those are normal reactions, 08:15 but let's quickly go through some of the risk factors 08:18 in other words, those are normal reactions 08:20 and those as they play out 08:23 are actually a healthy thing, 08:24 they're coping mechanism, 08:25 maybe you caught there, but what about risk factors, 08:29 what are some of the things 08:30 that are very, well, risk factors? 08:33 Yeah, some of the risk factors are like, 08:35 if you lose communication with your family, 08:38 with your neighborhood, 08:39 with the community that is a risk factor, 08:42 if there is property loss that's really-- 08:45 That was really digging these hurricanes. 08:46 Absolutely, that's another risk factor, 08:49 if there is danger to yourself-- 08:51 Fear of safety. Absolutely. 08:53 And if you see lot of destruction 08:56 or death around you, that's another risk factor. 08:59 If there is a history of previous trauma, 09:03 that's another risk factor. 09:05 If someone has medical condition that can, 09:09 it can worsen, and so you can have worsening 09:12 of medical or psychological conditions 09:15 and giving you a risk factor to get illnesses 09:20 or you could-- Divorce, job loss. 09:23 Absolutely, you can divorce and job losses 09:26 another stressor for developing trauma. 09:29 So all these are risk factors and, I mean, 09:31 they're devastating in and of themselves, 09:33 they're all made your events to just huge, 09:35 and I'm sure you see a lot of people 09:37 that are just dealing with one of those things, 09:39 but these are compound in international disaster. 09:42 Yes, absolutely. 09:44 Okay, well we, you know, we talked 09:45 in the previous program about children, 09:47 but now, you know, 09:48 we want to focus in this program more on adults 09:50 and there are some of these things 09:52 that adults were experienced that you mentioned 09:56 post-traumatic stress disorder, 09:58 major depression, and generalized anxiety disorder, 10:02 and let's just work through those. 10:03 What are those mean and then hopefully 10:07 what can we do about them, 10:08 post-traumatic stress disorder for us? 10:10 Yes, post-traumatic stress disorder 10:12 or what we call as PTSD is also when someone 10:16 has eye witnessed or experienced situations 10:21 or events in which they were threatened, 10:24 their life was threatened or injured, 10:28 and their reaction to that involved 10:31 severe helplessness or horror 10:34 is one of the thing which constitutes PTSD. 10:39 So helplessness or horror, this is not you seen, 10:41 it's actually experiencing for sure 10:43 Yes, yes. Okay. 10:44 And the person re-experiences these events 10:49 in couple of different ways, 10:50 they can have flashbacks about it, 10:53 they can have distress in thoughts or images, 10:55 they can have nightmares about this, 10:58 they can actually experience it 11:02 as if it were happening again, 11:04 so which we called reliving the traumatic experience 11:08 or they could develop sleep disturbances 11:13 related to this trauma. 11:16 And so that's, that is not a natural reaction, 11:20 it's actually something that they're gonna need 11:21 to have help getting through. 11:23 Yes, actually, see sometimes 11:28 you can have natural reactions, you know, 11:29 you can have nightmares, you can have flashbacks, 11:32 you can have images of the trauma again 11:37 as if you're re-experiencing them, 11:40 but when it becomes to the point where 11:43 it is going on for a longtime 11:45 and it is interfering with your social 11:48 and occupational functioning that's when like 11:52 natural normal reactions are not normal anymore, 11:56 that's when they go beyond that state-- 11:59 For five years later they're still doing that or even. 12:01 Sure, some studies have shown PTSD 12:03 according like yours even up to 12:05 like 14 years after the event. 12:07 So what do they do for this? What would you do? 12:10 Someone comes in, how we help someone that's, 12:12 most people watch and they're going through them, 12:14 what do they do? 12:15 First of all, acknowledge that this is what's happening 12:18 just by what they've listen to now 12:20 and then what's the next step? 12:21 Absolutely, you know, I think very important 12:23 is to protect yourself, safety is first. 12:27 So, you know, get away from the situation 12:29 which you are in, which is unexpected 12:33 or you don't know what's going to happen next, 12:36 you need to get yourself or others 12:38 to a safe environment, that is very important. 12:41 Okay. Absolutely. 12:42 And then you need to protect yourself, 12:44 you need to protect yourself 12:45 from the natural, you know, the cold, 12:49 the weather that you're going through 12:52 get the proper nutrition, the food, 12:54 the clean water that you can have, 12:57 so you need to take care 12:59 of yourself in those aspects. 13:02 Basic ways and then what's next? 13:03 Absolutely, you need to get find out 13:06 what is going on in the community 13:07 with the resources around, 13:09 you need to find out where there is help, 13:11 you need to direct your families, 13:13 you need to tell, tell your families where, 13:15 you know, where you can meet or what, 13:17 what is the place that you can get together, 13:19 if something again happens, so you need to direct. 13:22 Put together plans. Absolutely, absolutely. 13:25 And so directing families and your loved ones 13:29 is important, so that one would know 13:31 where to come and where to meet up with, 13:33 in case, something happens again 13:35 or something is ongoing, 13:37 and then you'll need to, you need to connect 13:40 with the resources in the community 13:42 where they're giving the supplies 13:44 or where they're giving the food or the basic needs 13:46 or where there is information about, 13:48 where your loved one could be, 13:51 you know, you need to go and get involved with those 13:54 and inform the people, so that they can help you. 13:57 Instead they see someone like you? 14:01 Professional help is an important aspect. 14:05 After one experiences trauma, 14:07 if they're not feeling better after couple of weeks, 14:12 if they're not improving, 14:14 if their symptoms are not improving 14:15 or if they feel that they're not in control, 14:19 their things are getting out of control, 14:21 if they feel that it's important to speak 14:24 not necessarily a professional or a psychiatrist, 14:27 but you can start with maybe even your community, 14:30 you can start and speak with your friends 14:32 and express like what is going on 14:34 and see how others are feeling, 14:36 how they're reacting. 14:37 Sometimes it's helpful, especially mass disasters 14:40 when someone, when you speak to someone 14:43 and let them know how, what you're going through? 14:45 They're able to, you know, express 14:49 what they're going through tools, 14:50 so sometimes that might relieve your anxiety 14:53 or it might need to things better, 14:54 so that might not necessarily mean that 14:57 you and see a physiatrist. 14:59 So if you, if you talk with your family, 15:01 if you talk with the community, 15:03 sometimes if you think 15:04 you need a little bit more health, 15:06 if you talk to your clergy, 15:07 if you talk to some teachers, and you know, 15:09 I think social workers and people out there 15:11 are good at helping people and recognizing 15:15 when one needs more professional help. 15:18 So, for example, even talking to your primary care physician, 15:21 your physician can determine if you need 15:23 little bit more mental help 15:26 and then refer you to a psychiatrist. 15:29 When we comeback, we'll talk about 15:31 major depression, we'll talk about 15:32 these other things and how to relate to those. 15:35 Thank you for joining us. 15:36 We're talking about natural disasters 15:38 and their impact on mental health. 15:40 And join us when we comeback. 15:44 Have you found yourself wishing 15:45 that you can shed a few pounds? 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18:07 Well, in post traumatic stress disorder or PTSD, 18:11 a person can also have what is called avoidance, 18:14 where they avoid people, places, conversations 18:18 anything that reminds them of their trauma, 18:22 that is also one of the symptom, 18:24 so they're avoiding places, they, 18:27 probably they don't want to go to work, 18:29 maybe, sometimes they don't want to 18:31 be involved in the activities 18:33 that they used to be involved with or enjoy, 18:36 they try to avoid their relationships 18:39 or their family and this is the, this is the way 18:44 that they're, one of the symptoms that 18:46 they're going through with PTSD, okay. 18:50 Well, what one can do more than, 18:52 you know, connecting with family and resources 18:56 around them is once they get 18:58 to their mental health facility 18:59 and speak to a psychiatrist or a psychologist, 19:03 sometimes there are centers also, what is called, 19:05 centers for traumatic stress where they have treatment 19:11 for people who have been through trauma 19:13 that can be group therapy. 19:15 Sometimes it's important to, you know, 19:19 talk with people who have been through 19:20 the similar types of trauma, 19:22 I think that's very helpful for the person, 19:25 sometimes they can have individual therapy 19:27 with psychologist or psychiatrist 19:30 or some and depending on what their mental health 19:34 professional decides, sometimes they might need 19:36 also some medication to help you get through 19:40 these traumatic symptoms that you're going through, 19:44 these flashbacks, these reliving the experience, 19:47 this anxiety, this fear, this feeling of numbness. 19:50 So sometimes you might need some medications 19:54 also and that, that depends 19:55 on the mental health professional, 19:57 once they diagnose you. 19:59 But, you know, it's very important to go ahead 20:02 and get involved with 20:04 the different resources out there. 20:07 Now there is other things that you've said 20:09 can happen in a natural disasters, 20:11 you've said major depression is another thing 20:12 and a generalized anxiety disorder, panic disorders, 20:17 and specific phobias, let's go through 20:21 those rather rapidly because I want to then see 20:23 what you would do, I think there's probably common ways 20:26 to treat all of those. 20:28 So let's go through them very rapidly to define 20:31 what they are and then we have about seven minutes, 20:33 we want to use at least five of those 20:35 to talk about what to do. 20:36 So let's go quickly through the, 20:38 first of all, major depression. 20:39 Yeah, a person who has been through 20:41 or going through what is called major depression 20:43 is experiencing symptoms for a period of two weeks 20:47 or more where they experience depressed mood, 20:50 difficulty with sleeping, that is falling asleep 20:54 or staying asleep. 20:56 They have, they lose interest in things 21:00 that they used to do before, 21:01 they also have problems concentrating, 21:04 their energy is low, and they feel sluggish, 21:09 their appetite maybe decreased 21:12 or maybe sometimes increased. 21:14 Some people have increased appetite, 21:16 they feel guilty about what has happened 21:20 and what is going on or their reactions 21:22 to what has happened. 21:24 Sometimes there is psychomotor retardation 21:27 or agitation what we call is a person 21:30 is a little bit more irritable 21:31 when they're psychomotor agitated, 21:33 and retardation is where they're kind of more... 21:35 Sluggish. Exactly, sluggish. 21:37 And then sometimes they can have 21:40 suicidal thoughts. Okay. That's-- 21:43 So this would be of all those things are happening 21:45 like you think maybe this is a major depression. 21:48 What about generalized anxiety? 21:50 Generalized anxiety is when, you know, 21:53 there's typical what we talked about normal anxiety, 21:57 certain amount of anxiety after a natural disaster, 22:00 whereas generalized anxiety disorder is kind of 22:03 more in areas of not just necessarily in areas 22:09 that you know you get feel stressed out 22:12 or traumatized about, it is even in other areas 22:16 where probably you were doing functioning normally, 22:19 okay, that you have excessive anxiety 22:22 where it is, where the person recognizes that 22:25 this is excessive and this is, 22:28 this is unreasonable amount of anxiety. 22:32 They were never like this, sort of like the Bible says, 22:33 "Men's hearts failing them for fear." 22:34 Yes, and then they find it also difficult to control 22:38 this worry or anxiety that they're experiencing. 22:40 And they can go again through physical symptoms involved 22:44 with this generalized anxiety disorder 22:46 or psychological symptoms, you know, 22:49 a lot of symptoms and then this has to be 22:52 for a period of, you know, longer period of time. 22:55 Okay, panic disorders and specific phobias 22:59 and we're already to our five minutes, 23:01 so very briefly on this and then, 23:02 let's spend at least four minutes talking 23:05 about the treatment. 23:06 Sure, panic disorders is to discuss 23:11 what are panic disorders, we have to discuss 23:12 what panic attack is and very briefly panic attack 23:15 is a discreet amount of period of intense fear 23:20 or anxiety, in which symptoms are expressed 23:25 in a period of 10 minutes or less. 23:28 And some of the symptoms you can have 23:30 in panic and attack is where you feel like 23:33 you're getting chest pains or you know, 23:35 heart throbbing or feel of choking or feel 23:38 of the sensation of nausea, you get probably headaches 23:42 and like I said again, paresthesias 23:44 or a lot of physical complaints and panic attack. 23:49 So now panic disorder is 23:51 recurrent episodes of panic attacks. 23:54 Those 10 minute episodes. Yes. Okay. 23:56 And then this can, in panic disorder 23:59 you can also have excessive concern of getting 24:03 this panic attacks and you also worry 24:07 of the implications of this-- 24:08 You panic about being panicked, it's like really bad. 24:11 You worry of, you know, what's gonna happen, 24:13 related to your job or related to your relationship 24:17 because of this panic attacks. 24:19 And then the person also makes major lifestyle changes 24:23 because of this panic attacks. 24:26 And for example, a person who is going to, 24:29 you know, work, they might decided 24:30 that they can't work in that type of a job 24:32 anymore because they're gonna get come up 24:34 with the panic attack and might decide to change 24:37 their job and go for something else. 24:39 Okay, then we've got three minutes 24:42 and let's talk about, you have about five or six points 24:46 and what do you do about these? 24:47 What is the hope? What can we do to 24:49 manage the affects on us from natural disasters? 24:53 All the things we have mentioned. 24:54 Absolutely, very important, safety first, 24:57 protect yourself. Protect yourself, 24:59 protect the people around you, 25:01 protect your family direct. 25:04 Get, you know, explain to them where you want to meet, 25:07 how you want to in case someone gets lost 25:10 or communication is lost, how are you going to get 25:13 back together? Okay. 25:14 You know, and then connect, 25:15 connect with agencies different, 25:17 you know, Red Cross, FEMA, whatever different agencies 25:20 that are involved with helping your community, 25:23 you know, you connect with them. 25:24 And then important to get into your routine, 25:28 take care of yourself, you know, get plenty of rest, 25:32 get enough exercise, so that you form 25:35 some kind of a routine in your life. Okay. 25:38 Also helping others is very important. 25:41 It gives you a self control. 25:43 So if you can help others who are in the similar situations. 25:47 Absolutely, that will give you some sense of 25:49 control and support. 25:51 And you know, you can't forget prayer, 25:54 that is very, very important. 25:56 Pray that for the safety of yourself and others, 25:59 and pray for strength and courage to deal 26:02 with the issues that you're going through. 26:04 Okay, and then coming to that spiritual again, 26:08 what if you're just having problems 26:10 getting your mind around, 26:12 why God would allow us or what not. 26:14 Have you helped people through that? 26:16 Yes, well, you know, it's natural sometimes for us 26:20 to question God, when we are going through 26:23 difficult situations or when we have lost our loved one 26:27 or we see our loved one dead. 26:29 It is, it is natural sometimes to feel angry 26:33 and feel resentful and hateful. 26:35 Work through that. 26:36 Yes, but you also have to keep in mind 26:38 that our God is greater than any problem 26:42 that you can go through. Amen. 26:43 And He has the reasons, why things happen? 26:47 And when we go to heaven to meet Him, 26:50 we'll get an opportunity to ask Him, 26:51 why this has happen. 26:53 But while you're going through it, 26:55 you need to say that He is in controlled 26:58 and practiced that, also it's important to have faith. 27:02 That God is watching over you through 27:04 what you're going through and even though you've lost 27:08 your property or your loved one, 27:10 that He's in control and He will help you 27:13 and he-- you know, He is in charge, no matter what. 27:16 So keeping that in mind, 27:18 keeping in mind that these worldly things 27:21 and the possessions are not the focus of our mind, 27:25 we have to keep God as the focus 27:28 and then whatever happens, you know, He's in control. 27:31 Amen. And we do our best. 27:34 Thank you so much, Dr. Borge for joining us. 27:36 This has been very helpful and I hope as it, 27:40 it is aired again and again, it will help people 27:42 with the very thing as your heart's desire to help, 27:45 those that are experiencing natural disasters 27:47 knowing that God is there and having you know, 27:49 the specifics to help them. 27:51 Thank you for joining us on "Health for a Lifetime." 27:54 May God bless you today. |
Revised 2014-12-17